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Strengthening maternal, newborn and child health:
the next steps

Julio Frenk, chair, The Partnership for Maternal, Newborn and Child Health; dean, Harvard School of Public Health

How G8 leaders can strengthen global commitment to worldwide health goals and improve the chances of those most vulnerable to preventable disease

From "The G8 Camp David Summit 2012: The Road to Recovery," edited by John Kirton and Madeline Koch,
published by Newsdesk Media Group and the G8 Research Group, 2012
To order a printed copy of the full publication, please click here. • To download a low-resolution pdf, click here.

When the G8 leaders gather at the US presidential retreat of Camp David in May, it will mark their third summit since the 2010 Canadian Summit, where the historic $5 billion Muskoka Initiative on Maternal, Newborn and Child Health (MNCH) was launched. Last year, during the G8 Deauville Summit in France, I referred to Muskoka as a game-changer in terms of donor commitments' to save the lives and improve the health of pregnant women, newborns and children under five – the three groups most vulnerable to preventable disease.

The Deauville Summit focused on the accountability of these commitments, which is critically important to ensure that the necessary momentum and progress are maintained. It took place at the same time as the Commission on Information and Accountability for Women's and Children's Health was completing its work. The 10 clear recommendations and 11 related indicators that came out of the commission will allow progress to be tracked year by year, alongside the G8's accountability process.

How can the G8 leaders at Camp David continue to play a leadership role on the three health-related Millennium Development Goals (MDGs)? There are several opportunities that could help maintain the high bar set by the leaders in Muskoka for achieving the MDGs, as well as other global health goals.

First, there is a need to strengthen the growing global movement for women's and children's health catalysed by the Muskoka Initiative and by the Global Strategy for Women's and Children's Health, which was launched by United Nations secretary-general Ban Ki-moon. Global health is about recognising the interlinked nature of health challenges across the globe. Those who fall outside current systems must be able to share the benefits of available resources, including knowledge. The Every Woman, Every Child initiative, a campaign accompanying the Global Strategy, continues to galvanise new commitments and, importantly, to focus on concrete action in this area.

Second, health priorities and strategies must be integrated to maximise efficiency and impact. The global community tends to fragment the health and development agendas as if they are unconnected, competing priorities. On the contrary: they are deeply connected, especially from the perspective of the women and their families who are affected by them every day. For instance:

This integration is required not only within the health sector, but also across other development sectors, through improving access to women's education, clean water and sanitation, through promoting food security and sustainable development and through ensuring participation in labour markets.

barrier to sustainable economic growth and development must be recognised. Malnutrition leads to losses in gross domestic product by poor countries of as much as three per cent each year. Adults affected by malnutrition earn almost 20 per cent less than their non-affected counterparts. It is estimated that the direct global cost of child malnutrition is between $20 billion and $40 billion each year.

Health means wealth

Everyone recognises that the health of populations contributes to the wealth of nations. But there must be a commitment to strategies that acknowledge that fact.

Finally, there is a need for greater accountability. When the MDGs were adopted in 2000, it marked the first time in UN history that every country in the world accepted accountability on a set of mutually agreed goals, targets and measures. In 2010, the Muskoka Initiative set clear goals for MNCH with an accountability framework. Moreover, accountability is one of the pillars of the Global Strategy for Women's and Children's Health. This will help produce lessons for other areas of global health and development.

In March, The Partnership for Maternal, Newborn and Child Health joined with three other leading global health partnerships

Third, the case must be made that women's and children's health is not merely an expense. It is an investment that contributes to future economic growth and sustainable development. Examples include:

The importance of addressing malnutrition as a determinant of health, a marker of social inequities and an underlying – the GAVI Alliance, the Global Fund to Fight AIDS, Tuberculosis and Malaria and the Global Polio Eradication Initiative – to send an open letter to G8 leaders asking for the inclusion of a specific statement of commitment for global health in the 2012 G8 Camp David Declaration and Accountability Report. The request was worded as follows:

We acknowledge the need for continuing efforts to improve the health of women and children, especially in least-developed countries. Through the continued implementation of our Muskoka Initiative, we stand behind our commitment to Millennium Development Goals 4 and 5, and urge greater accountability and action through the full implementation of recommendations by the Commission on Information and Accountability for Women's and Children's Health in support of the Global Strategy for Women's and Children's Health, launched by the UN secretary-general in 2010. This includes addressing key needs, such as more support for family planning, as well as greater food security and better nutrition for pregnant women and children.'

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