Remarks At USAID’s Saving Lives at Birth Development Exchange Awards Ceremony
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Oh, Raj, thank you so much. Well, I want to begin by, of course, thanking Raj for his leadership, his imagination, innovation, his extraordinary commitment to the work that USAID does and the really driving force behind translating into reality what we have hoped to see happen. And I am delighted to be with you again to lend my voice and support for the goal of protecting the health and lives of mothers and children at birth.
I would echo what Raj said in thanking all of our partners. This is a great opportunity for us to internationalize our innovative efforts to bring to the table those who have such a track record in accomplishing positive changes, but also share our vision about what is possible.
I also want to express my sympathy and solidarity with the government and people of Norway. I just came from the Norwegian ambassador’s home, signing the condolence book, and it is just a commonplace statement to make, which is that Norwegian people and successive governments have been so generous and supportive in ending conflicts, in bringing people together, in pioneering development, and we’re very grateful, First Secretary, that you are here representing the people and Government of Norway.
We have a tremendous opportunity to take advantage of all of the changes that are occurring in the world today and put them to work on behalf of development. We know that it’s moving so quickly, there is no way to keep up with the fast-paced global innovation contest that is happening on products and goods and services, but we can do our part to make sure that we harness all of that scientific and technological capacity on behalf of the poor and the needy. And we want to do development more effectively, that has been our goal. We want to teach people to fish, not just keep providing fish to them. We want to change systems; we want to find ways to leverage the assistance we provide to change the way governments care for their own people. We want to deliver the highest possible impact for each and every taxpayer dollar that we spend, and one of the ways we’re doing that is seeking out good ideas and putting them to work.
So in reaching out to the global community, NGOs, international partners, and working with likeminded governments and foundations and other institutions, we have established this program of Grand Challenges. And few challenges are as persistent or heartbreaking as the health of mothers and children, because we are well aware that the single most critical window for maternal and child health occurs from the onset of labor to 48 hours after childbirth. And for too many people in too many places, what should be a moment of great joy ends in tragedy.
You know the statistics: a woman still today in 2011 dies in childbirth every two minutes. In 2009, according to the WHO, 2.6 million children were stillborn, one million newborns die every year in the two days after birth, and we just cannot watch that happening without saying, “How can we prevent these deaths?” And we know this can be impacted on when pregnant women have access to adequate nutrition and prenatal care, lifesaving medicines, skilled health workers when they do give birth. And we’ve seen progress. From 1990 to 2008, the global maternal mortality rate dropped by 34 percent; in some places like Bangladesh, even more – it went down 40 percent. In Nepal, it has now dropped 50 percent, and I have to say, very proudly, in large measure due to USAID programs and interventions.
And yet over her lifetime, a woman in Sub-Saharan Africa today remains 136 times more likely to die in childbirth than one in a developed country. So how do we find affordable, scalable, sustainable ways to change the equation? How do we reach women and children in faraway places? How do we make it our priority to put this on the agenda of governments that have not always paid enough attention? Well, we wanted to mobilize a global community of innovators, and so many of you are representing that global community.
We identified three major barriers to saving lives at birth. First, a lack of medical technologies appropriate for the community or clinic setting. Second, a shortage of trained, equipped caregivers in positions to help. And third, a lack of demand – too many mothers still don’t know about the care they need and where and how they can find it.
So in March we issued this challenge, and we said, “Bring us your best ideas.” And as Raj said, we’ve been overwhelmed by the response. From Nairobi to Islamabad to Palo Alto, people have answered the call. Now, I don’t yet know who the winners are; I’m going to leave that to the judges. But I want to tell you that so many of your submissions, which were reviewed to me, are so exciting that, whoever the winners are, you’re all winners, and you all need to continue to pursue the innovation that was selected to bring you here.
For example, if you are dealing with the very common problem of bleeding during childbirth or a postpartum hemorrhage, the most common treatment, a drug called Oxytocin, is delivered by injection. And you know injections are complicated; you require sterile equipment, trained medical personnel, the drug degrades if it isn’t kept cold, which is very difficult to do in a lot of the settings we’re concerned about. And so we know that new mothers in many communities bleed to death without access to the right medicines. There was a very disturbing article on the front page of I think The New York Times in the last week about what is happening in Uganda, a country that has had more attention and has developed more facilities, but even there has not kept up with the demand that is required.
So converting that medical intervention into an aerosol spray that can be inhaled through a simple disposable device immediately after childbirth – no needles, no cold storage, no bloodborne diseases – has the potential to save many lives. Or working continuously to prevent mother-to-child transmission of HIV/AIDS – ideally, women receive treatment during their pregnancies that will prevent transmission, and if they don’t, those who are in the process of delivery, they have a 24 hour window after birth to get their children to a clinic to receive medication to prevent their child from contracting HIV. But think about it: Within 24 hours of birth, you’re exhausted, you may be recovering; how are you going to get your child to where the child goes? Because we still don’t have enough clinics and other settings where all these services are available in one place.
It’s been a particular cause of mine, and it’s part of the driving motivation behind our Global Health Initiative is don’t make these women travel hours to get their HIV/AIDS treatment and then travel in a different direction to get maternal care and then travel in a different place in order to get the kind of high, tertiary care treatment for delivery. So now researchers are developing a pouch that can last for months and, apparently, looks like something that you get at a fast food restaurant, like one of those little ketchup containers. And then a mother can have it on hand and will be able to care for her child immediately.
So we have lots of great ideas that are here, and to the 600 entrants all over the world and to the 77 finalists and the eventual winners my message is the same: Please keep going with these ideas. There were so many great ideas. And figure out ways, and we will try to help you figure out ways to make them scalable, sustainable, deliverable interventions. And this is the kind of creative approach toward enhancing development that I think is in the best interests of the people whom we are hoping to serve, but it’s also necessary in these times of great budgetary strains on all governments, not just my own, so that we can deliver higher impact in way that will keep our publics continuing to support this very important work.
So I thank Raj and his team for hosting us today, and I really commend all of you for participating. I wish everybody the very best and to the finalists, when you are announced, congratulations. But to every one of us, please – these grand challenges shouldn’t stop with the announcement of winners. We have to keep making our best efforts in order to overcome the challenges that we are aiming at. So I’m grateful to you and I want to do everything I can to support you, and we will work through USAID with all of our partners to deliver better development results for the entire world.
Thank you all very much. (Applause.)