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Today poor sexual and
reproductive health is a leading cause of death and disability in the
developing world.
It limits life expectancy, hinders educational attainment,
diminishes personal capability and productivity, adds to the costs of health
care at the tertiary level and thus impacts directly on economic growth and
poverty reduction.
Every year, about half a million
women die during childbirth, over 95 percent in Africa and Asia.
A mother’s
death lowers family income and productivity, affecting the entire community.
It is estimated that pregnancy-related death among women and newborns results
in a combined $15 billion loss in productivity each year in the developing
world.
While devastating, these global
statistics do not fully convey the tragedy that a family encounters when a
mother dies during childbirth.
This tragedy can be easily averted. We know how
to prevent these needless deaths. Effective interventions exist. And this is
what makes these deaths doubly tragic.
The vast majority of maternal
deaths could be averted if every woman had access to reproductive health
services, especially family planning, skilled attendance at birth and
emergency obstetric care.
One in four women who want to
avoid or space a pregnancy are not using an effective method of contraception.
This means that 215 million women have an unmet need for family planning. And
we know that effectively addressing this current unmet need would prevent
150,000 maternal deaths and 640,000 newborn deaths each year.
The final
speaker, Sharon Camp, will tell you more findings like this from our new joint
report, Adding it Up.
The point is that this lack of
essential health services keeps women trapped in a vicious cycle of poverty
that runs from one generation to the next.
It is this poverty trap that
must be broken if we are to achieve the Millennium Development Goals.
Investing in sexual and reproductive health can play a significant role in
making this happen and that is why the second target under MDG5 is universal
access to reproductive health.
Benefits of Investing in
Reproductive Health and Rights
Good reproductive health enables
couples and individuals to lead healthier, more productive lives, and in turn
to make greater contributions to their household incomes and to national
savings.
The health benefits of these
investments are well known, well documented and substantial.
They include the prevention of
deaths due to pregnancy and childbirth, the prevention of HIV, the prevention
or reduction of conditions such as obstetric fistula and other sexual and/or
reproductive illnesses and disabilities; better nutritional status and
decreased risk of anemia for women; and increased survival rates and better
health of infants.
It is estimated that ensuring
access to voluntary family planning could reduce maternal deaths by up to 40
per cent, and child deaths by as much as 20 per cent.
The World Bank estimates
that ensuring skilled care in delivery and particularly access to emergency
obstetric care would reduce maternal deaths by about 74 per cent.
These are significant benefits.
But as striking as these numbers are, the personal, social, environmental and
economic benefits of reproductive health services may be even more important.
These benefits are extremely
important for human welfare and economic development.
They include
improvements in women’s status and greater equality between women and men,
slower population growth, as well as benefits at the individual, household and
societal levels.
These investments in
reproductive health in general, and particularly in family planning, bring
government savings.
That is why we say that family planning is not an item of
expenditure; it is an investment that brings high returns.
A study in Mexico found that for
every peso the Mexican social security system spent on family planning
services between 1972 and 1984, it saved nine pesos in expenses for treating
complications of unsafe abortion and providing maternal and infant care.
In Thailand, every dollar
invested in the family planning programme saved the government more than $16.
Even more dramatic is the
analysis in Egypt, which found that every dollar invested in family planning
saved the government $31.
This included savings on government expenditures on
education, food, health, housing and water and sewage services.
Studies also show that the
benefits go beyond government savings.
Where mortality is high, parents are
likely to have more children but to invest less in each child’s health and
education, impeding their economic prospects and their health.
Guaranteeing universal access to
reproductive health services reduces adolescent birth rates which, in turn,
positively affect educational achievement among adolescents in general and
girls in particular.
It is also true that
reproductive health investments, particularly in family planning, can produce
what is called a "demographic bonus".
This is a one-time window of
opportunity that opens for economic growth that is spurred by lower rates of
fertility and mortality, and a large healthier working population with
relatively fewer dependents to support.
If jobs are generated for the working
population, this bonus results in higher productivity, savings and economic
growth.
In East Asia, where poverty has
dropped dramatically, the demographic bonus is estimated to account for about
one-third of the region’s unprecedented economic growth during 1965 to 1990.
There is also no doubt that
investing in sexual and reproductive health is strategic for curbing the
HIV/AIDS epidemic. This is important for improving maternal health because
AIDS-related maternal deaths are rising in highly affected areas such as
sub-Saharan Africa.
This is why UNFPA is working
with UNAIDS, the Global Fund and PEPFAR to more fully integrate policies and
programmes for HIV and AIDS with sexual and reproductive health.
Stronger
linkages will result in more relevant and cost-effective programmes with
greater impact.
These are just a few examples of
the benefits of investing in reproductive health and rights.
As I said when I
began, we know what needs to be done. We know what works.
Increased Financing needed to
Strengthen Health Systems
We also know that we need to
strengthen health systems. If a health system can deliver for women, it is a
strong health system that benefits all.
The health-related MDGs, 4, 5
and 6 to reduce child mortality, improve maternal health and combat HIV and
AIDS are interdependent. And they are best addressed through a health systems
approach that includes community participation.
Of course, building a solid
health system with skilled health workers, drugs and supplies and health
information systems requires adequate governance, stewardship and financing.
Yet when it comes to financing,
in many countries it is a challenge to raise adequate funds for universal
health coverage.
Even though funding for global health rose considerably
during the past decade, funding for reproductive health remained stagnant and
actually declined for family planning. We need to remedy this funding gap
urgently.
To achieve MDG5 and improve
women’s health, we need to move from speech lines to budget lines.
Strengthening health systems requires sustained investment over time.
The High Level Task Force on
Innovative Financing for Health Systems calculates that strengthening health
systems to ensure rapid progress towards the health MDGs in 48 low income
countries would require a gradual increase of investment up to $36-$45 billion
by 2015, on top of the $31 billion that is spent today.
So we need to increase financing
to improve health and human capital and remove the health barriers to economic
growth. The relationship between health and economic growth is mutually
reinforcing.
The report of the Commission on Macroeconomics and Health found
that spending on health brings a sixfold return on investment. Improved health
is not just a consequence of economic growth but also a crucial weapon against
poverty.
I am encouraged by new global
health partnerships and national efforts to get more money for health and more
health for the money.
This includes the plan that emerged from last week’s
retreat of UN Secretary-General Ban Ki-moon to improve the health of women and
children.
There is also the initiative of Canada as the G8 host this year to
make maternal and child health a development priority. And there is the
upcoming Women Deliver Conference here in Washington, D.C. in June, and the
African Union Summit on Maternal and Child Health in July in Kampala.
Momentum is building rapidly and
exponentially.
Call to Action
To answer the Addis Urgent Call
to Action for Maternal Health, there are three things that you can do as
Finance Ministers.
First, make reproductive
health, including family planning, a priority in national budgets and efforts
to strengthen health systems.
Second, use your
leadership and stature to promote the health and rights of women and girls as
a vital investment to improve economic growth, equity and stability. Investing
in women is smart economics.
And third, increase
investments in the education, health and livelihoods of adolescents. This will
improve human capital and productivity now and for generations to come.
What we need now for success is
the political will and action to make universal access to reproductive health
a reality so that no woman dies giving life.
Thank you."
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