A $1.5-Billion Pledge for Women and Children

By Caroline Preston

The Bill & Melinda Gates Foundation will spend $1.5-billion over the next five years to improve maternal and child health, family planning, and nutrition programs in poor countries, Ms. Gates announced at a conference in Washington on Monday.

Challenging the notion that high maternal and child death tolls are unavoidable, she urged leaders of governments and oother institutions around the world to make women’s and children’s health a higher priority.

“The death toll is so huge and has persisted for so long, it’s easy to think we’re powerless to do much about it,” said Ms. Gates. “The truth is, we can prevent most of these deaths—and at a stunningly low cost—if we take action now.”

She emphasized the importance of fashioning health programs for women and children that tackle multiple needs, including family planning, prenatal care, safe childbirth, and nutrition.

“The Gates Foundation is joining many others in the global health community in working toward a more integrated approach to women’s and children’s health,” said Ms. Gates. “Women and children have a continuum of needs, and we must design health programs accordingly.”

To oversee its more-integrated approach, the Seattle fund recently formed a family-health division, bringing together employees who work on mother’s and children’s health with those who work on family planning and nutrition.

Gary L. Darmstadt, who directs the division, said the new pledge will complement the foundation’s investments in developing and delivering vaccines.

“The foundation’s approach has traditionally been more disease oriented,” he said. “We’re looking at women’s and children’s issues in a more holistic way and trying to really look at it from the ground up.”

Also new will be the program’s intensive focus on a few countries, he said.

Much of the money will support programs in India, Ethiopia, and other nations that have relatively high maternal and child mortality rates as well as lawmakers and community leaders committed to reducing them, he said.

An initial $94-million will go to efforts in India and $60-million to Ethiopia. Additional grants will be announced over the next year.

The new investments will support efforts to train health workers to provide multiple services, identify effective methods for expanding access to family-planning services, and develop treatments such as simplified antibiotics for infections in newborns.

Child and maternal health programs that already receive Gates money include Save the Children’s Saving Newborn Lives effort and an initiative at Columbia University called Averting Maternal Death and Disability.

Charles Lyons, a former Gates official who now leads the Elizabeth Glaser Pediatric Aids Foundation, called integrating child and maternal health services “the smart thing to do.”

“The international community, the health community, and the rest of the world just increasingly understands what we have to accomplish and the need to focus on strengthening health systems,” he said. “The Bill and Melinda Gates Foundation is a very important leader and voice in relation to global health and this is a further example of their commitment to drive toward impact.”