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USAID @ UNGA: International Alliance Launched to Support Country-Led Advances in Reproductive, Maternal and Newborn Health

For the past ten years, the UN Millennium Development Goals have provided a blueprint to build stronger nations by setting aggressive goals from halving extreme poverty to significantly reducing maternal and child mortality to promoting gender equality.  The ambitious agenda and relatively short time period galvanized unprecedented collaboration among governments, international organizations and private partners to achieve results by the year 2015.

With five years remaining until the target date, new alliances are being formed to ensure real progress is made.  Today the U.S. Secretary of State Hillary Clinton, U.K. Deputy Prime Minister Nicholas Clegg, Australia Foreign Minister Kevin Rudd, and Melinda Gates, co-chair of the Bill & Melinda Gates Foundation announced a five-year public/private global alliance to contribute to the goal of reducing the unmet need for family planning by 100 million women, expand skilled birth attendance and facility-based deliveries, and increase the numbers of women and newborns receiving quality post-natal care by 2015.

The Alliance will specifically address aspects of Millennium Development Goals (MDGs) 4, Reduce Child Mortality,and 5, Improve Maternal Health,where progress has been especially slow. Currently, it is estimated that more than 200 million women want to use contraceptives but don’t have access. In addition, only half of the 123 million women who give birth each year receive the antenatal, delivery and newborn care they need; and progress in reducing deaths has been slower for newborn deaths than for deaths among children ages one month to five years.

The Alliance includes the U.S. Agency for International Development (USAID), the UK Department for International Development (DFID), The Australian Agency for International Development (AusAID), and the Bill & Melinda Gates Foundation.

Watch Karin Slowing Umaña, Secretary of Planning and Programming, Republic of Guatemala, and Hon. Prof. David Mphande PhD, Minister of Health, Malawi, talk about maternal and child mortality in their respective countries and how the Global Health Initiative is a key partner towards meeting MDGs 4 & 5.

USAID @ UNGA: Addressing the Global Water and Sanitation Challenge

Submitted by Chris Holmes

This morning at an event at the UN Summit titled, “Addressing the Global Water and Sanitation Challenge: The Key to the MDGs,”  USAID Administrator Dr. Rajiv Shah discussed the United States’ efforts and renewed attention to ensure water security world-wide. Perhaps no single issue is as important to achieving all of the MDGs as water and sanitation.

Today, one and a half million children die each year from preventable water and sanitation–related diseases. Water scarcity is becoming a growing impediment to food security and economic growth; Floods and droughts continue to kill thousands and displace millions; and there are increasing signs that water is becoming a greater factor in violent conflicts throughout the world.

At this year’s summit, USAID will rededicate itself to building a water-secure future – a future where people have the water they need, where they need it, when they need it. A future where no child dies from a water related disease, where food security and economic growth are not limited by the availability of water resources, and where no one has to fight to secure the water they need for their families.

1,000 Days: Partnering to Reduce Child Undernutrition

Child undernutrition has historically been – and continues to be – one of the most serious health and development issues we face today. The good news: This problem is preventable.

This morning, I joined leaders of governments, international organizations, civil society groups, and private sector companies in creating a collective global commitment to improve child nutrition during the 1,000 Days: Change a Life, Change the Future event in New York City.

The 1,000-day window, beginning from a woman’s pregnancy until her child is two years old, is critical to a child’s ability to thrive for a lifetime. We know that healthy children are more likely to get an education and to contribute to their communities when they become adults. The Scaling Up Nutrition (SUN) Framework, which I helped launch in April this year, points to strong evidence that interventions during this critical time can save lives. The Framework seeks to accelerate the international community’s efforts to combat undernutrition through strengthening partnerships.  Today’s event was an opportunity to highlight the SUN Framework and outline a way forward through the SUN Roadmap, which United Nations Secretary-General Ban-Ki moon launched this morning.

U.S. Secretary of State Hillary Rodham Clinton co-hosted today’s event with Ireland’s Minister for Foreign Affairs Micheál Martin. They voiced their strong support for the SUN Roadmap and called on leaders across the globe to act on specific targets toward improving nutrition — and thus the health, education, and economic opportunities — for people most in need.

Stressing action and accountability, Secretary Clinton said, “The Scaling Up Nutrition roadmap, the so-called SUN roadmap, that is unveiled today will be a critical tool for coordinating our efforts, and it will be up to us to follow that roadmap to our destination.”

Nutrition is key to the success of the Millennium Development Goals.  It is also a major objective of both Feed the Future and the Global Health Initiative.  Nutrition is integral to USAID’s development programs across sectors.  We create and support agriculture programs that not only improve access to food, but also aim to improve the quality of food produced.  We are implementing humanitarian assistance programs for the most vulnerable that aim to prevent undernutrition—rather than treat it when it might be too late.  And through our health programs, we deliver a package of nutrition interventions—and maximize the benefits to women and young children by coupling these packages with clean water, sanitation, and hygiene programs, infectious disease interventions, and efforts to strengthen health systems.

To be successful, global efforts require engagement from all levels – from donor governments to the private sector, from civil society to international organizations. Today’s event was evidence of the enormous momentum across the international community to break the cycle of hunger and undernutrition. Our collective challenge is to harness this momentum and translate it into concrete actions and support countries at the implementation level. We know this challenge is large, but we also know that global action and strong partnerships produce tremendous results: We have seen the incidence of polio drop by over 99 percent since 1988; we are making significant strides against HIV/AIDS; and we have celebrated remarkable gains in maternal mortality reduction.

It is our responsibility to seize this moment to help children—at a time before they can help themselves—to realize their potential.

USAID @ UNGA: Thank you for Saving the Lives of Millions of Children

Submitted by Amie Batson
Deputy Assistant Administrator, Global Health

Today as the United Nations General Assembly begins its review of progress on fighting poverty and disease, I took part in a meeting about something great you did: You helped save the lives of more than 5.4 million children all over the world in the past 10 years.

Here’s how: you stopped accepting that parents in African and other developing countries must wait up to 15 years to protect their children with vaccines – if they ever got them.  Because of that stand, a new partnership, the Global Alliance for Vaccines and Immunization (GAVI), was formed to take action.

GAVI has made a successful, life-saving difference, paid for by you — whether you’re in the U.S., fourteen other countries, or the European Union.  The Bill & Melinda Gates Foundation is also a generous supporter. And the U.S. Agency for International Development is a major partner in the field.

In its first 10 years, GAVI and its global partners, including the U.S., provided support to countries which delivered vaccines against life-threatening childhood diseases to more than 250 million children, saving the lives of more than 5 million, and shielding millions more from the long-term effects of illness on growth and development.

This success makes for a safer world for all of us. As a public health professional who has worked in immunization for much of my career, this is an exciting development. And as a mother, I think it’s the right thing to do.

As the U.S. expands our commitment to global health through the $63 billion, six-year Global Health Initiative announced last year by President Obama, our support for immunization will continue and increase.

Immunization is critically important in the world’s effort to achieve Millennium Development Goal 4: reducing child mortality.  When children escape disease, they have a fighting chance to thrive and attend school. As they grow into healthy adults, they can then contribute to the development of more vibrant and productive societies.

Since the 1970s, USAID has worked with partners across the globe to confront the challenge of vaccine-preventable diseases and help immunize children in remote parts of the world.

At today’s meeting hosted by GAVI and UNICEF, global health leaders took stock of current efforts to save the lives of children.

My message to the group was simple – we know a lot, but achieving the Millennium Development Goals  will require creative new approaches to reaching the millions of children who aren’t immunized – or receiving any real care, to accelerate the access to life saving vaccines, and to ensure sustainable systems are established to serve children today and in 5 years.

These innovations come from the countries – doctors, nurses, health workers –who have found innovative ways to reach into communities and provide services and from scientific and technological innovations in development where we need to ensure these breakthroughs in the science translate into lives saved.

Research, development, and the use of vaccines and immunization are top priorities for USAID. As USAID Administrator Dr. Raj Shah has said, “Humanity demands an AIDS and malaria vaccine to prevent these scourges, and low-cost pneumonia and Rotavirus vaccines that will eliminate hundreds of thousands of child deaths every year.”

Despite the success of immunization programs, vaccine-preventable diseases are still estimated to cause more than 2 million deaths every year.  Together with the GAVI partners, we can prevent more of them.

USAID @ UNGA: Championing Effective Solutions to End Malnutrition in Women and Children

Submitted by Bruce Cogill Ph.D.
Chief, USAID’s Nutrition Division

Administrator Raj Shah joined a historic gathering of the First Ladies of Africa, who convened to declare nutrition as a critical priority for eliminating poverty.

Nutrition is a top priority of both Feed the Future (FTF) and the Global Health Initiative (GHI). To reduce the growing burden of malnutrition, Dr. Shah announced $1 million to expand USAID and Global Alliance to Improve Nutrition (GAIN) efforts to improve heath and nutrition.

“These investments will help vulnerable families improve the health of their children by giving them access to diversified, quality diets and empowering them to make better informed decisions in areas like water, sanitation, and hygiene,” said Dr. Shah.  “All these combined efforts are focused on the critical 1,000 day window of opportunity from pregnancy to the first 2 years of life.”

This partnership was developed because nutrition is the catalyst for improving the lives of millions of people living in extreme poverty, and that failure to meet the nutritional needs of developing children has permanent, irreversible effects.  As the connections between health, economic development and food security become increasingly clear; nutrition is emerging as a central priority.

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USAID @ UNGA: Polio Eradication Efforts Spotlighted During Summit on Reaching the Millennium Development Goals

Submitted by Ellyn Ogden
USAID Worldwide Polio Eradication Coordinator

Today, representatives from partner countries, donors, non-governmental organizations and the private sector met on polio eradication. I represented USAID.

USAID is working closely with the United Nations (U.N) and partner countries to address this outbreak. The global polio eradication effort is at a critical point in time.  Since the launch of the Global Polio Eradication Initiative (GPEI) in 1988, the global number of polio cases has reduced by over 99 percent.  Now, polio is endemic in only four countries (India, Pakistan, Nigeria and Afghanistan) compared to 145 countries before the GPEI began.  Furthermore, GPEI’s efforts have mobilized 20 million volunteers around the world, staged mass immunization campaigns, and vaccinated about 2.5 billion children worldwide.  Cases in India and Nigeria are at their lowest ever – an indication that we can not let up on our efforts now.

Still, significant challenges remain. I just returned from an immunization effort in 34 districts of Tajikistan – a country in the midst of its first importation of wild poliovirus in 12 years and the first case in the WHO European Region since it was certified as polio free in 2002. As of September 15, 2010, there are 456 confirmed cases of polio, in Tajikistan – out of 648 total polio cases confirmed worldwide (compared to 1008 for the same time period in 2009). For each confirmed case, there are hundreds of silent infections.

While the outbreak in Tajikistan appears to have peaked, it is important to note that the outbreak is not over and continued immunization campaign and improved routine immunization are urgently necessary. Outbreak response in Tajikistan is continuing, and to minimize the risk and consequences of further international spread, National Immunization Days (NIDs) are being held in neighboring countries, including Uzbekistan, Turkmenistan, Kazakhstan and Kyrgyzstan. This week four additional cases of polio have been confirmed in the Russian Federation, bringing the total number of confirmed polio cases in Russia to 12.  The last four cases were confirmed in two regions of the North Caucasus, Chechnya (3 cases) and Dagestan (one case).  In response, the Ministry of Health and Social Development announced that they plan to launch two rounds of polio immunization campaigns in all regions of the Southern Federal District (which includes the North Caucasus) among children aged 1-5 years old in September, to be followed by nationwide polio immunization campaigns in October – April 2011. The open sharing of information about cases allows for a comprehensive and rapid response with the support of the international community and reduces the chance of further outbreaks.

To eradicate polio, we must eliminate the persistent reservoirs of this disease including insecurity, inconsistent management and ownership by local governments, sub-optimal communication and community mobilization, and reaching newborns, minority and mobile populations. Because of the need to frequently repeat campaigns, there is often a certain fatigue about seeing yet another vaccination team knocking at the door. Yet these proactive house-to-house campaigns are the only proven way to eliminate polio from a country. And with the world being so close to wiping out polio forever, we can’t afford to give up or to settle for “almost.”

The U.S. is the largest bilateral donor to the GPEI, contributing over $1.4 billion to date. Polio eradication is also a key part of the Administration’s Global Health Initiative (GHI). In 2009, President Obama announced a U.S. commitment to work with the Organization of the Islamic Conference (OIC) on polio eradication during his speech in Cairo in which he called for a new beginning between the United States and Muslims around the world. Read about USAID’s (PDF)approach to polio eradication. The new 2010-2012 GPEI Strategic Plan, recently endorsed by the World Health Assembly, requires a $2.6 billion budget through 2012, with a $1.3 billion funding gap.

COUNTDOWN TO THE MDGS: WHO Cuts Global Annual Estimate of Maternal Deaths

Submitted by Susan K. Brems Ph.D. Senior Deputy Assistant Administrator, Bureau for Global Health

The World Health Organization said Wednesday that fewer women are now dying each year from complications during pregnancy and childbirth.  A new report found that 358,000 women died during pregnancy or childbirth in 2008, mostly in poor countries of sub-Saharan Africa and South Asia. This represents a 34 percent decline from previous international estimates of greater than 500,000 maternal deaths annually.

USAID welcomed the publication of the WHO,  the United Nations Children’s Fund (UNICEF), the United Nations Population Fund (UNFPA) and the World Bank.   USAID has been one of the largest donors with sustained investments and programming in both maternal health and family planning.

The Inter-agency methodology estimates 358,000 maternal deaths each year worldwide, close to the 343,000 deaths estimated by the Hogan et al. Institute for Health Metrics (IHME) published in the Lancet in April 2010.  Inter-agency methodology uses nationally representative data and was developed and refined by worldwide experts from UN agencies and major universities in North America and Europe.

The Inter-Agency and IHME estimates of worldwide decline in maternal mortality support USAID’s earlier analyses of DHS data that have shown declines in many countries where governments and donors, including USAID, have had continuous, focused programming on improving health systems that affect maternal care, as well as delivery of high-impact interventions, including family planning and safe delivery care, to prevent and treat the major causes of maternal mortality.

Maternal mortality is still unacceptably high. All partners need to seize the momentum and enhance family planning and maternal health programs to quickly reduce the still unacceptably high toll of preventable maternal deaths. Secretary Clinton challenged USAID to build on existing global health programs and create lasting change. We have made great strides with previous investments, but as Secretary Clinton noted, in many places a woman might be treated for HIV but die in childbirth.

With just five years left to achieve the Millennium Development Goals (MDGs), recent progress presents us with a historic opportunity to achieve lasting reductions in maternal and under-five deaths.

COUNTDOWN TO THE MDG SUMMIT: USAID’s Rajiv Shah: “We Need Results”

As featured in Ministerial Leadership Initiative’s blog

Part two of the 8-part series In the Driver’s Seat: A Series on Country Ownership of Health Programs. Dr. Rajiv Shah was sworn in as the 16th Administrator of the United States Agency for International Development (USAID) on December 31, 2009. He spoke with John Donnelly earlier this month.


Q: What does country ownership mean?

A: I think it primarily means the country owning and defining the set of priorities in terms of what they want to accomplish in the health sector. It will vary country by country and vary based on disease, and it will vary on different country governments and their prioritization of health problems. It’s fundamentally about saying in the last decade that there’s been this huge growth in global health, with a lot of the work being done by NGOs, contract partners, and foundations that sometimes operate outside the dialogue and engagement with the host country. If we are going to achieve progress at a higher level, and ensure that countries sustain these achievements, then we need to make this whole system of donor-supported global health activities fit within a country’s own set of aspirations for global health. We’ve now seen a lot of different models for countries to express their priorities. The ones I prefer are inclusive of civil society and other groups within those countries.

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COUNTDOWN TO THE MDG SUMMIT: Global Investment in Malaria Prevention Could Save 3 Million Lives Over Next Five Years

By Rear Adm. Tim Ziemer, U.S. Global Malaria Coordinator

This morning at the National Press Club, I joined the Roll Back Malaria Partnership (RBM) to launch the third report from the Progress & Impact Series “Saving Lives with Malaria Control: Counting Down to the Millennium Development Goals”.  The report states that the lives of almost three quarters of a million children in 34 African countries are estimated to have been saved in the past 10 years through the use of insecticide treated mosquito nets, indoor residual spraying, and preventive treatment of malaria during pregnancy.  The Lives Saved Tool (or LiST model) provides the first assessment of lives saved based on the level of coverage achieved with currently available malaria prevention tools. The report estimates that an additional 3 million lives could be saved by 2015 if the world continues to increase investment in tackling the disease.

Admiral Ziemer hands out a bednet at a distribution site. Photo Credit: USAID/Global Health

The results in global malaria prevention and control are encouraging, but, as we have seen before, this progress is fragile and can be easily reversed.  As we expand and consolidate these gains, it is vitally important to ensure that our efforts not only maintain momentum, but also continue to adapt to emerging challenges such as drug and insecticide resistance. That’s why a key imperative in the United States’ Strategy for meeting the MDGs is to leverage innovation as a powerful catalyst for development.

The U.S. Government’s commitment to fight malaria is a key component of our nation’s foreign assistance strategy and the Administration’s Global Health Initiative to expand the promise of good health that is the foundation of stronger and more stable families, communities, and societies.  On behalf of the American people, the U.S. Government has taken extraordinary steps to curb the spread of this preventable and curable disease.  Working with national governments and other donors, the President’s Malaria Initiative (PMI), led by USAID and implemented together with the Centers for Disease Control and Prevention, reached more than 50 million people in the past year with highly effective malaria prevention or treatment measures in 15 focus countries in Africa.

Education + Health = Opportunity

Submitted by Wendy Coursen

This is Education Week at USAID. We work across the globe from Dhaka to Dakar; and Kabul to Kinshasa to promote development and save lives by helping people and societies recover from disaster, escape poverty, and improve health and education.  All efforts are conducted on behalf of the American people – reflecting the care and generosity of our nation that people across the globe admire and respect.

Throughout our nearly 50-year history, USAID has developed robust education programs that have increased literacy, built local capacity to deliver basic education services, encouraged workforce development, and developed generations of leaders through scholarships and access to higher education. On a fundamental level, education empowers societies: It leads to opportunities for economic growth, promotes civic engagement and good governance, and supports (PDF)sustainable democracy.  In the development community, we often say the same about the benefits of ; in fact, education and health not only complement, but depend on each other for maximum impact.

Community Health Worker

A community health worker in Nemba, Rwanda, teaches a health education class to women. USAID, with partner Jhpiego, has trained 800 community health workers in Rwanda. Credit: Jhpeigo

For disease prevention and treatment, the communities we serve often need access to commodities like bed nets , antiretroviral drugs, and safe water.  They also need the tools and access to information about critical health concerns and what to do about them. Women who participate in literacy programs have better knowledge of health and family planning and are more likely to adopt preventive health measures or seek medical help for themselves and their children. Family planning also enables women to stay in school longer, which contributes to improved maternal and child survival and increased ability for parents to raise healthy, well-nourished children.  Healthy children, we know, are more likely to learn, more likely to thrive throughout their lives and contribute to their communities as adults.  Early and sustained investments in health and education – for men, women, and children — are truly investments for life.

In the late 1990s, USAID was instrumental in bringing the educational children’s series Sesame Street to South Africa. The country has been significantly impacted by the HIV/AIDS epidemic, and in 2002, the show introduced Kami, the world’s first HIV-positive Muppet. Through Kami, age-appropriate HIV/AIDS messages reach millions of children, parents, caregivers, and educators. Her message is also helping to reduce the fear of stigma that prevents many from seeking treatment.

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