A matter of life and death

As Harper draws in high-profile help to invest in maternal and child health, a complex story emerges from the developing world

AFP

AFP

Why would Stephen Harper want to revisit the 2010 G8 Summit?

That’s the one where he welcomed fellow world leaders in Muskoka, in Ontario’s cottage country. What a headache. Before the summit, millions of taxpayer dollars were shovelled into the region with lax oversight. “Rules were broken,” the interim auditor general, John Wiersema, said later. The Muskoka summit preceded a Toronto G20 summit that was marred by riots and police strong-arm tactics. The week’s main announcement, a global Muskoka Initiative aimed at reducing mother and infant mortality in the world’s poorest countries, carried a $7.3-billion price tag but received little coverage in Canada except as an example of Harper’s refusal to include funding for abortions in developing countries.

Yet Harper is returning in a big way to the global-poverty issues he addressed at Muskoka. From May 28 to May 30, the federal government will host a high-level summit on maternal, newborn and child health in Toronto. Under the title “Saving every woman, every child: within arm’s reach,” it will attract specialists and public figures, including United Nations Secretary-General Ban Ki-moon; Margaret Chan, director-general of the World Health Organization; and Melinda Gates, co-chair of the Bill and Melinda Gates Foundation.

Life in Ottawa instills certain reflexes. I admit that when I learned about the Toronto summit—via a tweet from Laureen Harper—my reactions, in more or less this order, were: (1) scandal-plagued PM needs a distraction; (2) cheap PR stunt; (3) here’s another play to the PM’s social-conservative base.

I was not alone in these assumptions. I emailed a university prof who does work on Canada’s role in the developing world; she wrote back, “I suspect this looks good for Harper as part of his campaigning strategy (motherhood and apple pie). I heard someone make an astute point the other day about how the Christian-right NGOs were behind the promotion of the maternal health program that Harper introduced at Muskoka. Would be interesting to learn more about who in Canada was encouraging Harper to take this program on, and how the [maternal] health program has been shaped to appeal to the Christian right.”

But I was left with a nagging question: Why would Ban Ki-moon and Melinda Gates lift a finger to help Harper’s campaigning strategy (motherhood and apple pie)? Harper has had strained relationships with the UN, where he was unable to land Canada a seat on the Security Council. I’ve got a crazy hunch Melinda Gates votes Democrat. Yet they’ll be in Toronto. So I started asking people who actually work in maternal and child health, and they told me a more complex story than any I’d brought to you before now.

First, the scale of the challenge. In 2012, 6.6 million children died under the age of five years. Almost half, or 2.9 million, died within 28 days of birth. One million died before the end of the day they were born. The risk is not only to babies: Because of infection or hemorrhage, for many millions of women around the world, the most dangerous day of their lives is the day they give birth. These trends are improving: In 1990, the figure was 12 million child deaths worldwide. But it’s a staggering toll in suffering and lost human potential, so, in 2000, the United Nations committed to reducing child mortality and improving maternal health among eight “millennium development goals,” with specific targets for major global improvement by 2015.

By 2010, progress toward the maternal-health and child mortality goals was slower than for other goals such as the fight against extreme poverty or AIDS. Harper decided to give them a push at the Muskoka G8. The result was the so-called Muskoka Initiative. The Harper government allocated $1.1 billion in new funding over the five years ending in 2015, and agreed to maintain existing funding at $1.75 billion over the same period. Four-fifths of that money has since been disbursed and, of that amount, four-fifths has gone to countries in sub-Saharan Africa.

“But for us, that’s not the only important part of Canada’s contribution. It’s also the voice, and drawing attention to maternal, newborn and child health,” Mariam Claeson of the Gates Foundation told me. “Keeping that momentum going is, for us, a crucial part.”

“On this policy issue, they have been so consistent,” Rosemary McCarney, the president of Plan Canada, said. The “they” in that sentence referred to the Harper government. “Just incredibly consistent. At some visceral level, they really care about this issue.” In the past year alone, Plan Canada was provided pre- and postnatal care, tetanus vaccinations and skilled birth attendants for 248,000 women in half a dozen developing countries.

Now, the thing about the Millennium Development Goals is that they set targets for 2015 for myriad human ills that will not be solved by then. So, in its ungainly fashion, the world is trying to figure out what goals to set for beyond 2015. In the domain of maternal and child health, that effort has been led by UNICEF and the World Health Organization. There’s been a steady drumbeat of meetings around the world this spring to refine a draft action plan on newborn health. It will be the basis for new, post-2015 goals in this area. “The Toronto summit is a critical event in this road map to the Every Newborn action plan,” the Gates Foundation’s Claeson said.

“This is the time to push the global reset button on immunization, which is kind of the base of the pyramid of child survival,” Seth Berkley, the CEO of the GAVI Alliance, said. GAVI is dedicated to immunizing a quarter of a billion children and saving up to four million lives over the five years ending in 2015. About 83 per cent of children worldwide are immunized against diphtheria, whooping cough and tetanus. But if you ask a slightly tougher question—who’s immunized against the 11 diseases the WHO recommends children be protected against?—the number falls to five per cent worldwide.

Canada is a major funder of GAVI, and Berkley, who spoke to me from Geneva, singled out Canada’s ambassador to the United Nations in Geneva, Elissa Golberg, as “an amazing advocate on a range of issues—a kind of super-ambassador.”

Yes, but what about abortion? “Contraception and safe abortion services must go hand in hand,” Jolanta Scott-Parker, then the executive director of the Canadian Federation for Sexual Health, told a parliamentary committee in 2010. In that year, I wrote that “in effect, the Harper Conservatives have outsourced their pro-life politics to the developing world.”

But it’s not as though Canada’s government is some sort of weird outlier on this. “It’s hard for us to judge the Canadian position [on funding abortion in maternal-health projects] when it’s, in some ways, very similar to the position we have,” Claeson said.

And indeed, in a TED talk she gave in 2012, Melinda Gates was specific. “If we’re going to make progress on this issue, we have to be really clear about what our agenda is. We’re not talking about abortion. We’re not talking about population control. What I’m talking about is giving women the power to save their lives, to save their children’s lives, and to give their families the best possible future.” The WHO/UNICEF draft action plan makes no mention of abortion.

It’s fair to debate every aspect of making the world healthier for the millions for whom childbirth is a life-threatening experience, and the millions who don’t survive to their first birthday. But it’d be handy if the debate were informed by what this government is actually doing, and people who work hard every day to save lives tell me the Harper government has done good work on this file.




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A matter of life and death

  1. I have no doubt these organizations take help where they can get it and don’t criticize government policy lest the $ start drying up.

    It is nice we are putting funding into these important initiatives, but also sad we are letting the Harper gov’t do to women in the third world what they are too afraid to do to women in Canada.

    • The problems of the developing world are big enough that Harper and Canada can do good, and make a difference for women’s health and children’s health, while staying out of the abortion quagmire.

      Canada’s commitment’s frees up resources from other groups to spend on the more controversial activities, and still make an overall positive contribution.

      The problem is a big problem. One doesn’t have to involve oneself in every aspect of the problem. One can choose a niche where one can make a positive contribution and indirectly support the entire project, Like Chretien, the Liberal government, and the Iraq War. Canada provided far more support to the American war effort than most of the actual vocal supporters of the war.

      The people who want to play politics because some contributors might not agree with all aspects of the entire project are endangering the entire project.

      There is enough to do on this problem that where people and groups and countries might disagree is stupid to worry about. Work on the parts of the problem. The problem is big enough to do this.

      • But if everybody felt this way the “controversial” stuff would never get done.

        There’s a strong argument to be made that Liberals can increase their vote share among those who want to protect women’s rights AND ensure our money is spent more efficiently by not being afraid to get involved in projects that don’t shy away from abortion. And if they do enough work on the topic, maybe someday it won’t have to be controversial at all.

        • I am sure Harper will not be troubled by the Liberals and the NDP making an issue about how he is contributing in a positive way with the UN and the Gates Foundation in addressing the health issues of mothers near and after birth in the developing world.

          It would make Trudeau and Mulcair look like ideologues. They will annoy the UN and the Gates Foundation from the necessary publicity they want for the entire project. Bash people and countries who are willing to help in important niches of the project. Demonstrate your ingratitude. Have that ingratitude associated with the UN and the Gates Foundation.

          Do it. I dare you to. Play domestic politics, and damage support for a critical international project.

          Pursue perfection and destroy the very good.

          Would that demonstrate that you are ready to govern?

          • Nonsense. Most Canadians will realize its the first step towards a better overall policy.

        • There are plenty of programs that need money. Belinda Stronach is supporting one program…Mosquito nets to fight malaria. That is another Bill and Melinda Gates Foundation initiative. The money goes to the foundation and then they decide, along with the donor, what the best fit for the funding is. This foundation has a great reputation because they are constantly evaluating the success of their initiatives and making changes so they are getting the best bang for their buck. If the foundation is happy with where Canada is earmarking its money, then the program is a good thing. Diluting the spending by spreading it to other programs would likely not be wise.

    • I’m sorry, I don’t quite understand what part of saving lives you find “sad”. I guess being a Harper-hater is more important to you than saving lives and actually making the world a better place?

      • Here’s a novel idea – try reading the entire sentence. You may be amazed to find that it clearly answers your begged question.

  2. This provides great context for why the government is taking action and providing leadership in this area but it is still not clear to me what exactly the government is doing. I don’t suppose the Minister Paradis or any of the staff who work in his department were available to provide comment on this…

    • Playing a shell game.

    • The Canadian govt. is doing the same thing that several billionaires are doing. They are giving money to experts in the area of maternal/child health and letting them spend it as they see fit to promote the well being of live born children and their mothers. Those experts, Unicef and The Bill and Melinda Gates Foundation actually track how money is spent and whether the resulting health outcomes are positive, justifying how they have earmarked the dollars. If the outcomes to not justify the monies spent, they look at new strategies. Right now, vaccine programs for developing countries is a very good way to promote health for young children because many communicable illnesses that we in the west vaccinate for, are endemic there and they cannot afford to vaccinate.

  3. Harper is ether so embroiled in his narcisitic ego or morally corrupted.

    We have real disabled in subsistence poverty in Canada that have no hope, yet he is so ready to gove away our tax dollars….to regions where the money will make no difference in the end. The problems in these areas are driving by over population, corrupt politicians and religious/cultural stupidity.

    When I mean real disabled, I mean people dying of cancer and incomes forcing poverty on familes, I mean blind people of which 90% can’t find a job and get less than 1/2 the pverty line to live on. I mean families needing help for disabled children and can no longer care for them and can’t find help.

    But hey, Harper must have a serious narcissistic ego trip if he thinks he is serving Canadians….if tossing money to lost causes takes priority over taking care of our own. This is a former long term conservative, and I now will be voting Justin.

    • Dave….The plan is to vaccinate the developing world. You yourself should want everyone vaccinated because in this day and age, people get on planes and come to YOU in Canada. They bring their illnesses to YOU. The money isn’t going to any “corrupt government”. It is going to Bill Gates and his foundation. The same foundation that Warren Buffet and the Thompson family gave their money to. Maybe you should do a little research about this foundation and how it does business.

  4. Feed and breed today for a bigger problem tomorrow simply doesn’t work. And censoring it like CBC, or denying it like UN does, isn’t going to change reality.

    Without addressing political corrupt, cultural stupidity and religious ignorances…this money will be wasted and generate a larger problem tomorrow.

    Better we spend it on our own people and Harper should manage Canada and not be a ego driven “international” party goer on other peoples money.

    • We go a long way towards addressing the problem of ignorance if you’d get a library card.

    • Dave gave away:
      “Without addressing political corrupt, cultural stupidity and religious ignorances…this money will be wasted and generate a larger problem tomorrow.”

      Clearly, in Dave’s mind……more african’s surviving to adulthood is a problem.

  5. Regardless of your political stance or how you feel about Harper, every Canadian should be proud of the good work and investment our country has made in the lives of children in the developing world. It’s easy to gloss over numbers, but these are REAL CHILDREN with mothers and families who want so desperately for them to survive those first few critical years.

    We are so lucky to live in a first world country like Canada. Yes, we have our issues, but we have food, shelter, running water, toilets. I met a girl from India recently who shared how difficult it was for her growing up to use the bathroom, because her village only had a field to defacate in, and she and the other women would have to wait for the privacy of nightfall to go #2. Think about that for a minute. Having to hold your poop in all day long because it is inappropriate and dangerous for you to go in the daylight surrounded by men. There are women who endure this RIGHT NOW in many parts of the world.

    Canada, and admittedly, Harper, have improved the lives of children, millions of them, around the world. And now we are bringing together some of the best and brightest to figure out how to move this forward even more. I have to say, it makes me incredibly proud to be a Canadian.

  6. Imagine, a “university prof who does work on Canada’s role in the developing world” not being aware of the complexities of the issue, or more likely, not really caring as long as it gives her an opportunity to show off her Harper Derangement Syndrome.

    • There likely aren’t many as schooled in the complexities of dealing with issues related to funding and implementing programs as Bill and Melinda Gates. They have spent years funding research to try to eradicate AIDS in developing countries and now they are trying to vaccinate the whole third world. In addition, they have taken on Malaria and the inequality in education for people of colour in the US. Through it all, they have had to deal with all kinds of political partisans, lobbyists, cultural barriers and plain ignorance. I don’t know who in the Harper govt. decided to give our aid money to the Bill and Melinda Gates Foundation but whoever it was, was brilliant. No matter what the restrictions are regarding abortion, the money will be wisely spent on saving children and mother’s lives because Bill and Melinda Gates only spend money where it shows a positive return.

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