By Eleanor Heavey, Sickkids Centre for Global Child Health
As the 2015 target deadline for the Millennium Development Goals (MDGs) quickly approaches, two important platforms have taken place over recent weeks that seek to galvanize the international community into action. In particular, these platforms intended on accelerating international progress in the achievement of MDGs #4 and 5 – specifically, the reduction of both maternal mortality and the under-five mortality rate by two thirds between 1990 and 2015. Two high-level meetings in Toronto and Johannesburg were further accompanied by the launches of a major study series and two reports on Maternal, Newborn and Child Health (MNCH). Between them, they sup- port the tracking of continued MDG progress and provide a framework to further improve outcomes for newborns, women, and children in resource-poor environments across the world.
Toronto was in the global spotlight May 28-30 as international leaders and experts convened to develop strategies for advancing MNCH at the Saving Every Woman, Every Child: Within Arm’s Reach global Summit. There, Prime Minister Stephen Harper announced that Canada will contribute $3.5 billion in MNCH funding from 2015 to 2020. With support of global leaders including Ban Ki-moon, United Nations Secretary-General, President Jakaya Kikwete of the Republic of Tanzania, Her Majesty Queen Rania Al Abdullah of Jordan, Dr. Margaret Chan, Director-General of World Health Organization (WHO), and Melinda Gates, Canada called upon global partners to end preventable maternal, newborn and child deaths.
Much of the focus surrounding the Summit has been on Canada’s leadership in bringing together experts and heads of state from across the world. Notably, the Summit also showcased Toronto as an active hub of expertise at the forefront of the international public health and development community.
Several SickKids physicians and researchers attended and presented at the Summit. Dr. Diego Bassani, an epidemiologist at SickKids and assistant professor of the Dalla Lana School of public health, demonstrated his Grand Challenges Canada-supported innovation – a low-cost fetal heart monitor, powered by human energy – to Ban Ki-moon and Dr. Chan.
Dr. Zulfiqar Bhutta, co-director of the SickKids Centre for Global Child Health and professor at U of T’s Department of Nutritional Sciences, joined the Summit’s expert panel on nutrition. Dr. Bhutta is one of the foremost MNCH leaders in the world and one of the seven members of the UN Secretary-General’s Independent Expert Review Group for monitoring global progress on MDGs 4 and 5.
Dr. Bhutta is a lead author and advocate, integral to the development of the first comprehensive analysis of the evidence for interventions to prevent newborn deaths in nearly a decade. The Lancet Every Newborn Series, launched in advance of the Saving Every Woman, Every Child Summit in May 2014, presents the clearest picture to date of a newborn’s chance of survival and the steps that must be taken to end preventable deaths. The series examines the latest evidence for health interventions, estimates their potential for saving lives, and evaluates the investment required to scale up the most effective interventions to nearly universal coverage. The analysis suggests that the lives of nearly three million mothers and babies could be saved every year if available methods to improve newborn health-care were scaled up to at least 90 percent coverage in all countries.
Following The Lancet series, a global launch was held on June 30th to release the Every Newborn Action Plan (ENAP) at the Partnership for Maternal Newborn and Child Health (PMNCH) Partners’ Forum 2014 in Johannesburg, South Africa. ENAP provides the global health and development community with a roadmap and joint-action framework aimed at reducing preventable newborn mortality by 2035. ENAP works to advance the goals of the UN’s Global Strategy for Women’s and Children’s Health and was endorsed at the 67th World Health Assembly. The plan provides guidance on how to strengthen newborn health components in existing health sector strategies. The launch of the action plan is accompanied by a set of concrete, measurable commitments from stakeholders, including SickKids, in support of the UN Global Strategy.
The PMNCH Partner’s Forum 2014 also provided a platform for the launch of the Countdown to 2015 Report for 2014. Countdown to 2015 is a multi-disciplinary, multi-institutional collaboration which tracks progress in the 75 countries where 95 percent of all maternal and child deaths occur. Countdown to 2015 supports the continued tracking of progress toward MDGs 4 and 5, identifying knowledge gaps, proposing action strategies, and promoting accountability from governments and development partners. The Countdown to 2015 Report for 2014: Fulfilling the Health Agenda for Women and Children highlights important progress in many countries and on many pressing health challenges. At the global level, over the 25- year span of the MDGs, maternal and child deaths will have been almost halved. The report highlights the compelling power of high-level commitment, consistent funding, and a focus on evidence-based programming to effect dramatic, life-saving change.
The end of 2015 will inaugurate a new era in global health. However, the global health community will enter that era with “unfinished business” that can and must be addressed. The Countdown to 2015 report notes that efforts must be focused where progress has been slowest when moving forward in setting new goals and accountability structures. This includes improving maternal and newborn survival by investing in care on the day of birth when the risk of mortality is highest, addressing infectious diseases and confronting the huge burden of under-nutrition that affects many children.
Canada continues to play a key international leadership role in building on the momentum toward ending the preventable deaths of mothers, newborns and children in resource-poor environments. Advancing MNCH remains Canada’s top international development priority, and SickKids is proud to be a part of Canada’s contribution to improving MNCH outcomes around the world.
We can, and should, celebrate the progress made so far. But in order to end preventable maternal, newborn and child deaths within a generation, we must ensure that MNCH continues to remain front and centre of the international development and global health agenda going forward.