Gates Foundation pledges $1.5B for maternal, child health

Calling on world health leaders to do more to prevent deaths of mothers and their newborn babies, Melinda Gates said Monday the Gates Foundation is pledging $1.5 billion over five years for family planning, maternal and child health and nutrition in developing countries.

The donation is the second largest in the foundation's history, after a $10 billion, 10-year pledge in January for vaccine development and delivery. The foundation Monday announced initial grants of $94 million in India and $60 million in Ethiopia.

Among the grants for India, Seattle-based PATH received $24 million to demonstrate a model for health services that will save lives of newborns and reduce illness and death of mothers.

Melinda Gates challenged the idea that "large numbers of maternal and child deaths are inevitable, or even acceptable, in poor countries."

"It is not that the world doesn't know how to save the 350,000 mothers and 3 million newborns who die every year," she said at a women's health conference in Washington, D.C. "It is that we haven't tried hard enough.

"Policymakers in both rich and poor countries have treated women and children, quite frankly, as if they matter less than men."

Gates said she would make the health of women and children her personal priority as co-chair of the world's largest charitable foundation. She noted that the foundation will alter its model from one focused on specialized diseases to a more integrated approach.

"The goal is to design our work around the needs and wants of women and children, not around our own areas of expertise," she said.

The overall picture has been improving over the past 30 years, Gates said, citing recent studies from the University of Washington's Institute for Health Metrics and Evaluation and collaborators in Australia that found the number of women dying from pregnancy-related causes has dropped by more than 35 percent — from more than 500,000 annually in 1980 to about 343,000 in 2008.

She called the next several months "a critical window of opportunity to secure new global action," as Canada will urge donor countries to endorse a major maternal and child-health initiative when it hosts the G-8 Summit in Ontario this month.

U.N. Secretary-General Ban Ki-moon, also speaking at the conference, said women's health "must be front and center in the push to meet the Millennium Development Goals" and are among the most cost-effective investments for future generations.

According to the UW study of maternal mortality in 181 countries, developing nations have made substantial progress, particularly Egypt, China, Ecuador and Bolivia.

Nearly 80 percent of all maternal deaths are concentrated in 21 countries, and six countries account for more than half of them. Maternal death rates are highest in India, Nigeria, Pakistan, Afghanistan, Ethiopia and Congo.

Death rates also rose in a few high-income countries, including the United States, although changes in reporting practices may have contributed to the increase. Looking at maternal-mortality rates globally, the United States now ranks No. 39, between Macedonia and Lithuania.

While reports indicate mortality may be declining, Steve Gloyd, executive director of Seattle-based nonprofit Health Alliance International, said, "We haven't made as much progress as we should have, especially since so many solutions are simple and just need to be available to all women and children."

Gloyd, also a professor and associate chairman in UW's Department of Global Health, said the funding should help strengthen the ability of governments to provide "much-needed basic health services."

Gates said family planning could reduce deaths of mothers by 30 percent and newborns by 20 percent, but that more than 200 million women have no access to contraception.

The largest of Gates' initial grants — $38.7 million — is going to North Carolina-based Family Health International to develop cost-effective ways to increase access to voluntary contraception in poor urban areas of India.

"As a woman," Gates said, "I can't imagine being denied access to the tools I need to plan. It is my basic right to be able to choose when to have children."

Kristi Heim: 206-464-2718 or kheim@seattletimes.com