First Day at the Women Deliver Conference - from Islean Kinghorn
Women Deliver issue of The Lancet—all content is free!
It’s all go today. Now over to Islean Kinghorn to fill us about what went on at the first day of the Women Deliver Conference—Rhona 
Twenty years ago, the Safe Motherhood Initiative, a global campaign to cut global maternal deaths by half, was launched was launched at a conference in Nairobi, Kenya. Although there have been improvements in middle-income countries, some countries, such as those in Sub Saharan Africa have made little to no improvement.
Meanwhile, the deadline for the millennium development goals (MDG’s), 2015, is looming. MDG 5—reducing maternal mortality by 75%—is way off track. It is currently estimated that one woman dies each minute in childbirth, resulting in a loss of 10 million women in each generation. There are also massive disparities between the rich and poor. While 1 in 6 women in Afghanistan die during pregnancy, this figure is 1 in 25,000 in the US and 1 in 30,000 in Sweden.
The Women Deliver Conference, which I have been lucky enough to attend today on behalf of TheLancetStudent.com, was organised by Family Care International and a number of UN agencies and international NGOs. Its aim is to galvanise the political will to effectively tackle this issue. One message that has been clear today is that the knowledge and technology to save these lives is here, what is required, is funding and implementation. As Gordon Brown (UK Prime Minister) said in his televised address and welcome, “We know how to save lives, now we must show the world we have the political will.”
I am usually sceptical of such political statements, as I have heard the PM make remarks such as this before, and fail to follow through. So when Douglas Alexander (Secretary of State for International Development) took to the stage to announce that the UK were donating £100 million over the next five years to the UN Population Fund (UNFPA) I was nicely surprised. It was not till the commentator group began, and Thoraya Obaid (UNFPA Executive director) thanked him for the donation, that I thought again. She remarked that while they were very grateful for the contribution, they were still 80 million short of their target of 150 per year. This figure was put into context further by a presentation from Geeta Gupta (President, International Centre for Research on Women). The presentation was that of a large body of research on maternal health worldwide. It estimated that while funding needed to increase by 11 times, this amount would be only 0.016% of global GNP and 2% of global aid.
I’ll try and be brief, but here are a few of the main points from the other sessions. You should also know that there were loads I didn’t get to see because you simply can’t be in two places at once.
Morning Plenary
- Julio Frenk, former Secretary of Health of Mexico
- P. Kamalan, Malaysia, International Trade Union Confederation
- Thoraya Obaid, Executive Director, UNFPA
- Peter Poit, Executive Director of UNAIDS
- Mary Robinson, President of Realising Rights
- Geeta Rao Gupta, President, International Centre of Research for Women
Key points
- Maternal health needs to become a political priority, we have the technology, national budgets must invest in maternal health
- Feminization of HIV with women now constituting 2/3 of those infected in some parts of Africa
- There must be meaningful partnerships between AIDS workers and those involved in women’s health
- Recognition that although vertical programmes are important, they cannot be done without functioning health systems. We need to use specific focus to drive overall improvement
- The need to tackle the issue of abortion
Geeta Rao Gupta “…this is a moment of opportunity… we should build on this momentum to create the tipping point of action.”
The session was closed by Francisco Songane (Director of the Partnership for Maternal, Newborn and Child Health) who spoke very passionately and movingly; my favourite quote was “…abortion kills, we have to tackle it without taboos.” He also told us we needed to be courageous and passionate. I really felt inspired by the energy of his voice and I headed off to the rest of the day elated.
Investing in Women’s Access to Safe Abortion: What Are We Waiting For?
- Nozer Sheriar, Federation of Obstetrics and Gynaecology Societes of India
- Nancy Northup, Centre for Reproductive Rights, USA
Key points
- 66000 women die each year due to unsafe abortion with 100 million risking their lives to obtain an abortion where there is no legal, safe access.
- The prevalence of abortion remains the same around the world despite huge variance in legality. Criminalisation is not an effective deterrent.
- Medical procedures, as opposed to surgical, can be very affective in areas of low skill and absence of facilities, at reducing mortality and morbidity
- How human rights can be applied and how treaties can be interpreted to implicitly imply the right to safe abortion
- Although there are religious and cultural factors it should be up to the individual woman to take such factors into account when exercising her right to autonomy
Afternoon Plenary
I’ll let Rafi tell you about that (Note from Rhona—Rafi is also attending the conference on behalf of TheLancetStudent.com)
Meeting the Needs of Young Women and Girls: HIV prevention and its links to wider action
- Lynn Collins, UNFP
- Naana Otoo-Oyortey, IPPF (Internationl Planned Parenthood Association)
- Tim Shand, IPPF
- Kevin Osborne IPPF
Key Points
- Rationale for linking HIV with Sexual and Reproductive Health (SRH)—80% of HIV is sexually transmitted, mother to child transmission—Root causes: poverty, inequality, gender-based violence, marginalisation of venerable populations, stigma and discrimination.
- Potential benefits (don’t yet have evidence)—increased access and uptake of services, decreased stigma and dual protection
- Linkages need to be bi-directional, both parties have to be fully committed
- Collaboration needs to occur at a country not just a global level
- Child marriage is common in many countries, especially developing ones, even in place of prohibitive laws
- The prevalence of HIV in married girls of 15-19 years is higher than that of their peers
- There are still misconceptions that marriage will protect girls from promiscuity and disease when in fact the reverse can be true
- Positive Prevention—providing prevention to those who are HIV positive, they are the people who are able to transmit the disease but it is often assumed they will not be practicing sexually
- The ABC approach needs to be re-dressed not simply tweaked to meet the needs of those for which this approach is not feasible
- The issue of criminalisation. In the UK if you are positive and have sex with another person, using a condom and even if that person does not get infected, if you fail to inform them of your status you can be prosecuted.
- Young girls often know their status before men, does this put an unfair onus on them when they are likely to be in a disempowered position already
All in all it was an amazing day and, although very tired, it’s now coming on 11pm and I’ll need to get up at 6am, I feel very privileged to have had this opportunity. I can’t wait to learn even more tomorrow and hopefully meet and speak with some influential people. More of that tomorrow. Islean Kinghorn