Sarah Kidangasi shares her battle with fistula.

(WOMENSENEWS)–Governments and advocacy groups are rallying to lobby leaders of industrialized countries, known as the Group of Eight, this week for billions of dollars to help prevent maternal deaths, the leading killer of women of childbearing age in developing nations.

The G-8 economic summit of Canada, France, Germany, Italy, Japan, Russia, the United Kingdom and the United States will convene for three days beginning July 7 in Hokkaido Toyako, Japan.

Japanese Prime Minister Yasuo Fukuda has pledged to make the problem prominent on the agenda of the summit. More than 500,000 women die each year as the result of pregnancy–the vast majority in the developing world–and virtually no progress has been made to reduce maternal mortality over the past 40 years, according to the United Nations Foundation.

At the summit, the Partnership for Maternal, Newborn and Child Health–an international coalition of U.N. agencies, donors, governments and civil society groups–will call on world leaders to commit an additional $10.2 billion a year to maternal and child health.

The coalition projects that this level of funding–which includes $1 billion a year for family planning and $3.9 billion for maternal and newborn health–would address 70 percent of the global need by 2015.

In May survivors of obstetric fistula–a childbirth injury causing incontinence which affects 50,000 to 100,000 women in developing countries annually–met with congressional leaders in a visit sponsored by the U.N. Foundation and U.N. Population Fund. On May 21, the House of Representatives unanimously passed a resolution sponsored by Rep. Lois Capps, D-Calif., to reduce maternal mortality domestically and globally.

U.S. Not on the Front Lines

Ann Starrs, president of the New York-based maternal health group Family Care International, said the United States is conspicuously absent on the front lines of the fight.

"There’s this sense in Europe and in civil society . . . that the U.S. has been such a non-productive, non-contributing player in this field," said Starrs, whose group was the organizing partner of the Women Deliver Conference in London in October 2007. The conference galvanized support for maternal health initiatives by bringing together 2,000 representatives from the development sector representing 115 nations.

Last year, when 181 countries–including every nation in sub-Saharan Africa–donated to the U.N. Population Fund, which supports family planning and maternal health programs, U.S. President George Bush withheld $34 million in congressionally allocated funding, contending that the resources the U.N. agency provides to the Chinese government support coercive abortion, a claim that independent analysts have refuted.

However, some private U.S. money is kicking in. This fall, the Seattle-based Bill and Melinda Gates Foundation gave a two-year grant of nearly $1 million to the White Ribbon Alliance for Safe Motherhood, an international coalition of U.N. agencies, donors, governments and civil society organizations led by developing countries.

In April, a study funded by the Partnership for Maternal, Newborn and Child Health, published by the British medical journal The Lancet, found that less than a quarter of 68 priority countries are on track to meet the fourth millennium development goal of reducing maternal mortality by 75 percent by 2015. The millennium development goals are eight benchmarks to reduce poverty and improve health the U.N. pledged in 2000 to try to achieve by 2015.

Lack of Health Care and Prevention

On Tuesday, the New York-based Center for Reproductive Rights and Nigeria-based Women Advocates Research and Documentation Centre issued a report blaming the leaders of oil-rich Nigeria, which has the world’s second-highest rate of maternal mortality, for failing to fund and regulate the country’s health system, to curtail corruption, to provide access to family planning and to put political will behind reducing maternal deaths.

Another major contributor to maternal mortality is the prevalence of HIV in some developing nations. In Nigeria, for instance, the adult prevalence rate is 3.9 percent and about 3 million people are infected with HIV, according to U.N. statistics. Starrs said HIV–the virus that causes AIDS–may as much as double the risk of maternal death.

According to a U.N. report published last month, 33 percent of the 1.5 million HIV-positive pregnant women in 2007 received drugs to prevent HIV transmission to their children.

When such treatments are administered, programs generally do not include ongoing HIV treatment for mothers, according to an April report by Cynthia Eyakuze, Debra Jones, Ann Starrs and Naomi Sorkin published in the research journal Developing World Bioethics.

The call for funding from nations attending the global summit is part of a recent groundswell of advocacy and pledges to combat maternal mortality, but last week a draft communique was leaked to the Financial Times that indicated leaders may push back the 2010 target date for funding universal HIV treatments and development aid to Africa committed at a 2005 summit.

One new advocate for maternal health is Sarah Brown, wife of the British prime minister. In February, Brown became the patron of the White Ribbon Alliance for Safe Motherhood, which is campaigning for an additional $10 billion in annual funding.

Since then, she has hosted and addressed dinners to raise awareness of maternal mortality among politicians, celebrities and businesswomen in London, Washington and Davos, Switzerland. Last month, she addressed the International Confederation of Midwives Congress in Glasgow, Scotland, where over 2,000 people signed a letter urging global leaders to reduce maternal deaths.

Funding a Maternal Health War Chest

At a September U.N. General Assembly meeting and at October’s Women Deliver Conference, donors promised more than $1 billion to fight maternal mortality.

In May, more than 40 African leaders–including Nigerian Vice President Goodluck Jonathan–attended the Fourth Tokyo International Conference on African Development in Yokohama, Japan, where they created an action plan to increase assisted births in Africa from 50 to 75 percent in five years.

Politicians and ministers from around the world–including 61 of the 68 nations with the highest rates of maternal and child mortality–pledged to improve maternal health at the Countdown to 2015: Maternal, Newborn and Child Survival conference held in Cape Town, South Africa, in April.

In addition, a fund launched by the U.N. Population Fund in February to focus exclusively on maternal health has garnered $22 million in commitments from donors including the governments of Austria, Finland, Ireland and Spain. The U.N. agency hopes to begin work in 25 countries by the end of 2009, with a goal of raising $465 million and working in 60 developing countries by 2011.

"There is compelling evidence that we can have high-impact interventions at relatively low cost," said Yves Bergevin, coordinator of the U.N. Population Fund’s new maternal health fund. In the 1970s and 1980s, for example, Honduras, Thailand and Nicaragua reduced maternal deaths by half in four to six years by ensuring high access to family planning, attended deliveries and emergency obstetric care.

The commitments for the new fund come on top of record levels of core support for the U.N. Population Fund; contributions from member nations rose to $419 million in 2007, from $360 million in 2006.

"If countries put their political will behind it, we can achieve significant results by 2015," Bergevin said.

Kara Alaimo is a New York-based writer.

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

For more information:

Women Deliver

Partnership for Maternal, Newborn and Child Health

The Lancet’s "Countdown to Millennium Development Goals 4 and 5"

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