Redefining "Impossible" When It Comes To Maternal Mortality

The same elements that wiped out smallpox -- national commitment, coordinated, focused efforts and sufficient funding -- can make maternal mortality a thing of the past.
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Someone recently told me that saving mothers' lives in the developing world is impossible. They argued that the maternal mortality problem is too complex, too challenging, too expensive.

But, that is exactly the wrong attitude.

We've overcome health challenges today that once seemed impossible. We've eradicated disease, created cures and discovered innovative new methods to save lives that would have been unimaginable only a few decades ago. We've done it before and we can do it again.

Just look at smallpox. Sixty years ago, more than 50 million cases of smallpox emerged annually and a quarter of the victims died. To get a sense for the magnitude of 50 million people per year, consider that today there are five million new cases of HIV/AIDS each year. There were ten times more people with smallpox, plus the global population was smaller.

In 1967, the world health community launched a global effort to eradicate smallpox. It took a coordinated, worldwide effort, required the commitment of every government and cost $130 million dollars. By 1977, smallpox had disappeared. The smallpox eradication saved $17 billion dollars and millions of lives. In just 10 years, we had done the impossible -- turned one of the world's deadliest diseases from a terror into a memory.

And smallpox is not the only global health success story. Polio has been reduced by 99 percent since 1988. Twenty-six countries reduced their malaria cases by more than 50 percent between 2000 and 2006. Creative new health strategies like micro-insurance for poor people or Kangaroo care for pre-term babies are transforming health outcomes in even the most low-resource settings. Dedication and innovation are transforming health care worldwide.

One hundred years ago, dying in childbirth was an accepted norm in the United States and Europe -- tragic but inevitable. Today it's almost unheard of. Some might think that the overall increase in wealth is what saved mothers' lives and that, without it, real progress is impossible. But they are wrong. For proof, we need only look to Sri Lanka.

Sri Lanka isn't a wealthy nation. A third of its population lives in poverty and it has been devastated by natural disaster and civil conflict. However, the tiny island nation has done something remarkable -- it reduced its maternal mortality rate by almost 50 percent every decade since independence. In 1960, 340 Sri Lankan women died for every 100,000 live births. Today, the rate is only 13 deaths for every 100,000 births, a rate nearly comparable to developed nations.

Sri Lanka achieved this dramatic drop in maternal deaths by investing in health infrastructure. It built a network of health centers which provide free health care to the population. It invested in training skilled midwives and providing all women with access to family planning while educating communities and empowering them to secure their own health care. Sri Lanka proves that being a developing nation doesn't mean a country is condemned to a high maternal death rate. For example, Sri Lanka has a lower GDP than the Ivory Coast, but the Ivory Coast has more than ten times the maternal death rate.

There is reason to hope, even in most affected countries. In August, I traveled to my home country of Ethiopia with a team from the Bill and Melinda Gates Foundation to shed light on the state of maternal health. Ethiopia continues to have one of the highest maternal mortality rates in the world and much of what we saw was heartbreaking and frustrating. However, we also saw progress. The Ethiopian government has trained 30,000 young women to serve as health extension workers and provide essential health care like immunizations and antenatal check-ups to rural communities. We met women who survived difficult pregnancies because of the new hospitals and clinics the government is building and I met the dedicated health workers working around the clock to save lives.

The same elements that wiped out smallpox -- national commitment, coordinated, focused efforts and sufficient funding -- can save mothers' lives in the developing world. I'm asking all nations to take up this challenge: commit to ending maternal mortality now. Make maternal health a national priority. Recognize that mothers' health is at the heart of achieving development, not a by-product or an afterthought. Dare to create a world where giving birth doesn't mean gambling with your life.

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