Statement

26 October 2009

Now is the Time: Executive Director Addresses High-Level Meeting on Maternal Health

Statement by Thoraya Ahmed Obaid at the High-Level Meeting on Maternal Health: Millennium Development Goal 5, in Addis Ababa

My friend and champion of women’s health, Minister Tedros, thank you for your leadership in your country and at the regional and global levels. Minister Koenders, thank you for your compelling statement and commitment to sexual and reproductive health. We, at UNFPA, appreciate the Netherlands’ leadership on sexual and reproductive health and its focus on Millennium Development Goals (MDGs) 5 and its focus on that. And we thank you for being UNFPA’s consistent supporter.

This meeting would not have been possible without the support of the Netherlands, the hospitality of the Government of Ethiopia and the support of our United Nations colleagues in Addis Ababa.

Excellencies,

Ladies and Gentlemen,

We are here for one reason and one reason only: to accelerate action to improve maternal health and end the needless death and suffering of women.

Women are dying because for too many years, women’s lives, dreams and rights have not been given the priority attention they deserve.

We are here in Addis because we believe that maternal death and disability is one of the greatest moral, human rights and development challenges of our time.

We are here in Addis to say that no woman should die giving life and no woman should die from unsafe abortion.

I am optimistic because, compared to just a few years ago, women’s health has gained increased attention and there is growing momentum.

Today, campaigns and initiatives throughout the world champion maternal health and the rights of women. I refer to Women Deliver, the Maternal Mortality Campaign, the White Ribbon Alliance, the Partnership for Maternal, Newborn and Child Health, the Campaign to Accelerate the Reduction of Maternal and Child Mortality in Africa, and the upcoming African Union Summit on Maternal and Child Health in July 2010 and also the Maputo Plan of Action. The United Nations Secretary-General is also a strong champion, and he has launched the UNITE campaign to end violence against women. All these have one main message: going back to the basics and focusing on communities, where real life and death happen, and where critical decisions are made every single day.

There is rising awareness and commitment.

I believe that we have reached a unique point in time. If we commit ourselves to concrete action, focusing on empowering communities to demand their rights, there is a great probability that we will finally see the curve of maternal mortality steadily decline.

Because no woman should die giving life, UNFPA is intensifying action with partners to achieve MDG 5 and universal access to reproductive health by 2015.

We are proud of our collaboration in the informal group we call the H4, with UNICEF, the World Health Organization and the World Bank, to accelerate progress in countries to save the lives of women and newborns, and to promote transfer of knowledge from one country to another. One of these countries is a Delivering as One UN pilot, Rwanda.

Over the past five years in Rwanda, the use of modern contraception has nearly tripled, skilled birth attendance has increased from less than 40 per cent to more than 50 per cent, and deliveries in health facilities have jumped from less than a third to nearly half of all deliveries. This is impressive progress towards ensuring that every pregnancy is wanted and every birth is safe.

Here in Ethiopia, we’ve already heard from His Excellency Dr. Tedros Ghebreysus, about the deployment of more than 30,000 health extension workers, a near doubling of the Ethiopian health workforce in only three years. This is an initiative from which we all can learn.

To build on this, UNFPA has joined with partners to support adolescent girls in the State of Ahmara. The girls are empowered with education and livelihood skills to prevent child marriage, improving their prospects for a brighter future.

In Bolivia, home to the highest maternal death rate in Latin America, a new midwife training programme, supported by UNFPA, improves care to indigenous women while respecting their culture identity.

In Bangladesh, a documented decline in maternal mortality is attributed in large part to community engagement and mobilization.

In Djibouti, women have organized themselves to establish a community health fund. The fund supports health care visits during pregnancy, and life-saving care during childbirth, including transportation, to ensure a safe delivery.

In Mozambique, Tanzania and here in Ethiopia, mid-level health workers are being trained to carry out higher level functions, task-shifting that is saving lives.

In Cambodia, Yemen, Zambia and other nations, midwives are being deployed to make childbirth safer.

In Ghana, pregnant women, children under 18 and the elderly will soon be exempt from payment in the national health insurance scheme. This will make it easier for those who most deserve support to get the health services they need.

In Nepal, the Government will scale up free maternity services. This will enable a million and a half women to have a safer delivery over the next five years.

There is no shortage of good practices. Even in the most resource-constrained countries, governments are taking bold initiatives.

In every region, exciting things are happening and we will learn more today from several countries presenting their national experiences.

But we are here in Addis because, despite the progress being made, it is not enough. Of all MDGs, MDG5 is the goal lagging the furthest behind.

Today, maternal mortality is the world’s largest health inequity. Women who are poor, including young girls who are often married, have the least access to needed services.

Yes, there is growing awareness, commitment and momentum, but to tip the scale towards maternal health, I have three main messages.

The first is that life and death is a political decision.

The second is that leadership and resources will determine whether we fail or succeed.

And the third is that solidarity and partnership are the only way forward.

I say life and death is a political decision because we know what works and needs to be done. And with just five years remaining in the countdown to 2015, we need urgent action.

To improve maternal health, we need to scale up and deliver a comprehensive package of sexual and reproductive health information, supplies and services.

This includes services for safe delivery, such as skilled attendance at birth and emergency obstetric care, and for HIV prevention and for one of the most cost-effective interventions in development—family planning. We know that the return on family planning is much more than the costs of its provision. It is an empowering intervention for women, which needs to find its priority place again, among not only the life-saving interventions, but also among the rights of women to have choices in their lives, especially the right to determine the number and spacing of their children.

When women are healthy and empowered, they deliver for their families, communities and nations. Their newborns are more likely to survive, children to thrive, and these benefits carry through to the next generation.

When women enjoy equal rights and opportunity, they contribute to peace and security, creating a better life for all.

Women are the weavers of the fabric of society, and targeted investments in reproductive health in general and family planning in particular have a dramatic and lasting impact on the economic and social health of nations.

On the other hand, if we fail to meet our targets on maternal health, we will never overcome poverty and illiteracy, reduce child mortality, achieve universal education and gender equality, and meet other development challenges.

Now to my second point, leadership and resources will mean the difference between success and failure.

We know what it would cost to meet our goals and, sadly, we know the cost of too little action.

It would cost the world $23 billion per year to stop women from having unintended pregnancies and dying in childbirth, and to save millions of newborns. This amounts to less than 10 days of global military spending. Instead, the world loses $15 billion in productivity each year by allowing mothers and newborns to die.

In war or peace, in natural or man-made disasters, in a prosperous economy or during a financial crisis, women continue to get pregnant and what happens after that depends on whether they are rich or poor: they give birth, or they sometimes seek abortion, safely and legally or unsafely outside national laws; they sometimes miscarry and, too often, they die while giving birth from preventable causes. We cannot change or postpone these facts of life until a war ends, or until communities have recovered from a disaster or until the economy is strong again. Saving women’s lives cannot wait—it’s now—every minute—another woman dies, it is now.

During this decade, funding for population and reproductive health has remained at the same level while funding for other areas of health has increased substantially. Today, I call on governments, organizations and financial institutions, in the North and in the South to recommit and invest in sexual and reproductive health, including family planning, as an urgent priority.

To move ahead, we must match growing momentum with rising resources. And we must place maternal health and MDG 5 at the centre of global health initiatives, health system strengthening and funding mechanisms.

A health system that can deliver for women when women are ready to deliver is a health system that will benefit all.

And this brings me to my third point – solidarity and partnerships are the only way forward.

Solidarity and partnership brought governments and partners together 15 years ago at the International Conference on Population and Development, and they agreed for the first time that everyone has the right to sexual and reproductive health. And only through broad-based coalitions and mutually supportive action can we achieve universal access to reproductive health by 2015.

Solidarity and partnership brought progress during the past 15 years.

Today, more girls are going to school, more births are attended by skilled health personnel, more women and couples are choosing to plan their families, there is rising action to end violence against women and girls, and more communities are taking a stand against female genital mutilation and cutting. There are reported prevalence declines in Egypt, here in Ethiopia, Cote d’Ivoire, Mali and Nigeria.

Today, stronger action is being taken to link policies and programmes for HIV and AIDS and sexual and reproductive health to save more lives. And gender and reproductive health are now addressed more than ever before in humanitarian response benefiting displaced persons and refugees.

But as we all know, we have an unfinished agenda. We still have a long way to go and we need to go faster. And solidarity and partnership, maximizing our common ground and minimizing our differences, will propel us further ahead.

South-South and triangular South-North-South partnerships are rich partnerships that we all must support and these can be deepened.

All of us can make a unique and valuable contribution. In this room are ministers, parliamentarians, representatives of governments, civil society and the private sector, young people and United Nations colleagues.

Yes, we agree that maternal death and disability is one of today’s greatest challenges.

But even the greatest challenge can be overcome when people are united by a common cause. Now is the time.

Thank you.