Isobel Coleman

NEW YORK (WOMENSENEWS)–The day after money manager Warren Buffett announced he was giving $31 billion of his personal fortune to the Bill and Melinda Gates Foundation, about 60 people happened to be gathered for a forum on maternal mortality at the Council on Foreign Relations in New York.

The June 27 meeting had been scheduled well in advance but the philanthropy news helped spotlight discussions of how to solve the world’s maternal mortality problem.

The maternal health field needs about $9 billion more a year to mount a realistic attack on the problems of maternal deaths and disabilities, panelist and Columbia University professor of clinical population and family health Lynn Freedman told the audience, relying on the estimate from the World Health Organization.

That attack, Freedman said, could go a long way toward alleviating the specter of 500,000 women dying each year during pregnancy or shortly after childbirth.

The $9 billion that Freedman and other maternal health advocates identify as crucial falls short of what’s actually being spent, but it’s one-third of the Seattle-based Gates Foundation’s current $29.1 billion endowment, which is now expected to double over the next two decades from the proceeds of the Buffett donation.

Speculating About a Windfall

Conference participants could only speculate about what the foundation might do if it decides to earmark some of its windfall for alleviating maternal mortality.

What, for instance, could be done for the 1 in 6 women who die in childbirth in Afghanistan and Sierra Leone?

“So how would you direct these countries?” Isobel Coleman, the panel’s moderator and a senior policy fellow at the council, asked Freedman and Geeta Rao Gupta, president of the International Center for Research on Women based in Washington, D.C.

“If we were queen for a day?” Gupta responded.

Coleman laughed: “Queen for a day. No, if you were Melinda for a day.”

The forum participants agreed that they would direct funding to shore up inadequate health care systems and improve transportation networks to speed women’s access to health services. They said they would spend money to train more health care providers and increase family planning services.

Without these kinds of concurrent investments, Coleman said the bad health of women worldwide will continue to undermine broader reforms focused on children and infrastructure.

“There’s so much attention on AIDS, infants, children, education,” Coleman told Women’s eNews after the forum. “Yet the linchpin to all of this is women. Women as mothers continue to be neglected.”

$9 Billion Maternal Health Bill

The $522 million the Gates Foundation has dedicated to reproductive and maternal health programs between 1995 and 2005 is more than triple the $164 million it gave to child health programs and half what it devoted to stopping HIV-AIDS during the same 10-year period. Yet the sum is only a small fraction of what is needed to reduce maternal mortalities and boost health-care access for an estimated 9 million women each year who suffer serious pregnancy-related disabilities, according to a 2000 report issued by the World Health Organization.

Laurie Garrett, a senior fellow for global health at the Council on Foreign Relations, said the spending decisions of the Gates Foundation could dictate where the world focuses its energies, potentially making it difficult for smaller health organizations to survive.

“The foundation is already massive, it’s hard to imagine how priorities can be set by any other institutions,” Garrett said. “If for some reason women’s health isn’t prioritized then things can be dicey on women’s funding.”

Dr. Helene Gayle is the former director of the Gates Foundation’s HIV, tuberculosis and reproductive health program. Interviewed by telephone after the gift was made public, she said the foundation is likely to expand women-oriented programs in its global health initiatives.

“If people are guided by where the impact can be the greatest, then women’s health will continue to be an important issue,” said Gayle, now president and CEO of CARE-USA, a global poverty eradication organization based in Atlanta.

Since the Gates Foundation was formed 12 years ago, increasing literacy, bridging the digital divide and immunizing the world against preventable diseases have been cornerstones of its mission. The foundation has targeted an ambitious effort to eradicate malaria, tuberculosis and polio.

Women’s Health at Center Stage

About seven years ago, the foundation attacked the HIV epidemic. Today, women’s health programs are now at center stage of Gates health policy, which includes major funding of cervical cancer research and the development of a working microbicide–or vaginal gel–to block the transmission of HIV.

Melinda Gates has spoken at length about creating a microbicide gel that once applied topically will prevent the sexual transmission of HIV. The microbicides are intended to help women protect themselves when they can’t negotiate safe sex. Overall, the Gates Foundation has given $123 million to different organizations that are now testing gels on women in southern and western Africa and India.

The Gates have made little public mention of their support of Planned Parenthood organizations. Over the years, the Gates Foundation has given a combined $33 million to the New York-based Planned Parenthood Federation of America, the International Federation of Planned Parenthood, and to different branches of Planned Parenthood in the United States and Canada. But Bill and Melinda Gates try to sidestep the direct references to abortion and take an apolitical funding stance.

“They stay out of anything related to abortion, and stay out of culture wars,” says Dr. Nils Daulaire, president of the Global Health Council in White River Junction, Vt.

This distinguishes the Gates Foundation from the Susan Thompson Buffett Foundation, based in Omaha, Neb., and the namesake organization of Buffett’s wife that received a gift of $3 billion in June. The foundation publicly supports abortion services and gave more than $4 million to the Planned Parenthood Federation of America and different Planned Parenthood branches around the country in 2003.

In the meantime, maternal health advocates will be watching closely for funding cues from the Gates Foundation.

“It’ll be interesting to see what they do for women in the global health area,” said Freedman. “It’s not their comfort level; obviously Buffett is more comfortable . . . But the foundation has changed over the years.”

Malena Amusa is a Women’s eNews intern from St. Louis, Mo.

Women’s eNews welcomes your comments. E-mail us at [email protected].

For more information:

Council on Foreign Relations
Maternal Health and Foreign Policy Symposium:

The International Center for Research on Women:

“Maternal Mortality in 2000: Estimates developed by WHO, UNICEF, UNFPA”