After months of speculation and debate over the priorities, the 2010 G8 Summit in Muskoka, Canada concluded by affirming a sustainable commitment to maternal, newborn and child health through a total contribution of US$ 5 billion over the next 5 years. But overall the G8 commitment to health and development fell far short of what many wanted and what is needed.
The Muskoka Initiative includes broad support from G8 Heads of State and Governments, as well as an additional contribution of US$ 2.3 billion from other governments and foundations – Netherlands, Norway, New Zealand, Spain, Switzerland, South Korea, UN Foundation and Bill and Melinda Gates Foundation. As host of the G8, Canada pledged US$ 2.75 billion over 5 years, and will also emphasize accountability for results to ensure a sustainable reduction in maternal and child mortality.
The 2010 G8 Summit pledged a commitment to accelerated progress in achieving MDG4 and MDG5 ahead of the UN High Level Plenary Meeting on the Millennium Development Goals (MDGs) in September, where the UN Secretary General is expected to announce a Joint Action Plan for Women’s and Children’s Health. UK Prime Minister David Cameron called for a renewed focus on gender equality and women’s empowerment, pledging US$ 600 million over 2 years. The United States committed US$ 1.35 billion over two years, and noted President Obama’s US$ 63 billion Global Health Initiative that emphasizes maternal and child health. Germany and Japan pledged to each contribute US$ 500 million over the next five years to the Initiative.
The International Planned Parenthood Federation (IPPF) welcomes the efforts by the leaders of the G8 to improve the health of the world’s most vulnerable women and children. The first 10 years of the MDGs have delivered too little for women and children. The commitment of the G8 and partners to make key contributions to the Joint Action Plan for Women’s and Children’s Health is essential if we are to make the progress required in the final five years of the MDGs. But it needs to be properly funded. In the lead up to the MDG Summit in September, IPPF urges governments to renew commitments, and invest in family planning and maternal and newborn health services. Investing in MDG5b is the quickest way to achieving all the MDGs.
IPPF Director-General Gill Greer said “This is a significant step forward in saving the lives of world’s most vulnerable women and children. Ideological motivations meant that life saving family planning was purposefully omitted from the Millennium Development Goals, and therefore many funding decisions, until 2008. In those eight years, the consequence of sidelining access to modern methods of family planning was the death of 5.1 million women and 1.2 million children. A further 4.8 million children were orphaned. The political leadership, and the funds that must surely follow, of the G8 and other countries will help prevent this human tragedy from ever occurring again.”
There are currently 215 million women worldwide with an unmet need for family planning. The UN estimates that meeting unmet needs for contraception alone would reduce up to a third of maternal deaths globally. Having fewer pregnancies and spacing births increases the survival rate of both women and their children. Women must have the right to choose both when and whether they want to become a mother. Providing access to both family planning and maternal and newborn care to all women in developing countries who need them would cost $24 billion per year by 2015, double today’s investment and just $4.50 per capita. This investment would avert approximately 70 per cent of all maternal deaths and 44 per cent of all newborn deaths.[1] The US$ 5 billion pledged by the G8 is but a fraction of the investment needed to meet the unmet for contraception.
The Muskoka Initiative outlines a broad commitment to strengthen health systems for women and children in countries facing high mortality and unmet need for family planning. This goes beyond the global consensus on maternal, newborn and child health to include spending on water, health education and nutrition. The Initiative pledges to work within a sustained global effort for greater effectiveness and accountability, in line with commonly agreed global targets for MDG4 and MDG5. There is an urgent need for predictable long term funding if the Muskoka Initiative is to succeed for poor and marginalized women and their children in low income countries.
Only last year all G8 leaders signed the Consensus for Maternal, Newborn and Child Health, which stipulates that “comprehensive family planning advice, services and supplies” are critical to improving maternal, newborn and child health. IPPF is concerned that past G8 commitments have not been included the Muskoka Initiative, and calls on the G8 to fulfil its commitments to maternal and newborn health by ensuring family planning is central to proposed new funding.
Two weeks prior to the G8, the 6th Annual Parliamentarians’ Summit on "Balancing the Scales of Women’s Lives in the Countdown to 2015” in Ottawa was attended by over 40 parliamentarians from around the world. Their final outcome document noted the parliamentarians’ concern for the lack of progress on MDG5, and called for greater resources and coherence under an international funding mechanism specifically for MDG5, “which will provide targeted assistance for sexual and reproductive health and rights, family planning and access to safe abortion when and where it is legal and therapeutic abortion".
Every year, more than 500,000 women and girls die from child birth or pregnancy-related causes, amounting to one death every minute of every day. Between 15 and 20 million women suffer from maternal morbidity every year. Ninety-nine per cent of all maternal deaths occur in developing countries, primarily in sub-Saharan Africa and South Asia.
As MDG5 includes the target of ‘universal access to reproductive health,’ and indicators to address unmet need and contraceptive prevalence rates, there is a strong need to emphasize family planning and the sexual and reproductive health of young people as a critical component in maternal health.
Decades of evidence clearly shows that family planning is a key component to reducing maternal mortality. There is a global consensus that the ability to plan one’s family and space births is one of the four pillars of maternal health and a critical component in newborn and child health. No country has made significant inroads to improving maternal health without also having widespread access to family planning in place.
Towards a sustainable reduction in maternal and child mortality, civil society has a critical role in ensuring progress towards sexual and reproductive health in particular, and the MDGs in general. Women’s health issues are rarely high on political agendas without it. Civil society is in a position to deliver specialized sexual and reproductive health services, especially to poor and marginalized people who are beyond the reach of government assistance. Civil society must be included in order to hold national governments to account for commitments they have already signed, and ensure that sexual and reproductive health is prioritized on the development agenda.
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IPPF is the world’s leading organization in sexual and reproductive health, working with the poor, marginalized, socially excluded and or underserved. In 2008, IPPF delivered 66.8 million services to 31 million clients in 170 countries; many of whom have only IPPF to rely on for live-saving health services. IPPF provided 20 million sexual and reproductive health services to young people, which constituted a third of all IPPF’s services in 2008. IPPF is a unique network of reproductive health organizations with an unrivalled global reach and a strong voice advocating for commitment to achieving reproductive health for all internationally, regionally, nationally and at the community level.
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[1] Guttmacher Institute and UNFPA, Adding It Up: The Costs and Benefits of Investing in Family Planning and Maternal and Newborn Health, Guttmacher Institute, New York, December 2009.