Global anti-poverty and public health advocates are pressing Congress to approve an urgently needed bill that would save millions of lives by ensuring that U.S. dollars allocated to child and maternal health around the world are effectively spent. Despite considerable progress, goals in reducing child mortality, established by the United States and its United Nations partners, aren’t being met, putting tens of millions of children at risk.
Last year, a so-called blue-ribbon panel of business and development leaders cited management problems in the U.S. Agency for International Development (USAID). These included inadequate data collection to measure progress, and a lack of coordination and accountability.
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Reforms mandated by Congress — including a coordinated U.S. strategy and targeting of resources, as well as ongoing congressional oversight — are required to ensure that USAID continues to make the progress needed to save millions of impoverished children and mothers.
“We’re moving in the right direction, but without these reforms, we’re going to deal with these preventable and treatable health emergencies for decades,” Ken Patterson of RESULTS, a nonprofit anti-poverty advocacy group, told The Blade’s editorial page. “We want to make sure the United States stays focused on its goals for saving children and mothers. Putting these reforms into legislation will do that.”
Every year, more than 6 million children — 17,000 a day — less than 5 years old die of mainly preventable and treatable causes. Malnutrition causes nearly half of these deaths. Other causes include pneumonia, diarrhea, and malaria.
Even those horrific statistics represent progress, thanks partly to U.S. efforts to support vaccines, better nutrition and medical care, training for community health workers, and other life-saving initiatives. Over the past 25 years, such efforts have helped cut in half the number of children under age 5 who die of preventable and treatable causes.
But Congress must ensure that U.S. dollars are doing all they can. Roughly 800 women a day, mostly in the poorest places in the world, die from preventable causes related to pregnancy and childbirth, leaving their newborn children at far higher risk of death and disease.
If nothing changes, the goal established in 2000 of reducing child mortality by two-thirds in 2015 won’t be met until 2028, the U.N. Children’s Fund reports. That means tens of millions of additional child deaths.
In Congress, U.S. efforts to fund global child and maternal health programs, as part of an overall investment in international development assistance, are promoted by a bipartisan group of lawmakers. Funding global health represents, arguably, the most effective investment made by the U.S. government.
Far less than 1 percent of the U.S. budget — perhaps $20 billion a year — goes to global antipoverty and public health initiatives. Still, a lack of resources is not the biggest problem. USAID must become more effective.
The global development agency must set clear, measurable, and transparent goals. It must create new funding sources, focus on the poorest and most vulnerable populations, use evidence-based interventions easily adopted by host countries, and coordinate all resources linked to maternal and child survival. Such reforms have proved effective in controlling the global AIDS epidemic and in USAID’s work on alleviating malaria.
Dozens of global anti-poverty and public health advocacy groups are working with representatives in the U.S. House and Senate to introduce bipartisan legislation that would, without requesting additional funding, require USAID to reform its decentralized strategy on infant and maternal health.
Ohio’s congressional delegation, Republicans and Democrats, should get behind this legislation. It would mean even better returns on U.S. investments in global health — returns measured by millions of lives saved, and healthier and more stable communities and nations.
First Published June 1, 2015, 4:00 a.m.
