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World Health Organization director-general Margaret Chan is recognized by MPs in the House of Commons on Nov. 21, 2011. (CHRIS WATTIE/REUTERS)
World Health Organization director-general Margaret Chan is recognized by MPs in the House of Commons on Nov. 21, 2011. (CHRIS WATTIE/REUTERS)

Q & A

Harper's maternal health pledge hinges on measuring progress Add to ...

Margaret Chan knows that things get done when progress is being measured.

Ms. Chan, the director-general of the World Heath Organization, was in Ottawa on Monday to open a meeting of international experts who have been tasked with ensuring that the promises of the last year’s G8 Muskoka Initiative on Maternal, Newborn and Child Health are kept.

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She sat down with The Globe and Mail to talk about the Canadian initiative and its potential benefits for women and children around the world.

What is your feeling about the impact of the initiative to date?

The millennium development goals (MDGs), especially [those related to child mortality, maternal health, and stopping the spread of HIV, malaria and other diseases]were agreed upon by world leaders in the year 2000. Over the past decade, much work has been done. But it’s very clear to us when we look at the progress in the health-related MDGs, the ones that are falling behind are the maternal mortality and the child health.

The G8 leadership took, to me, two very important positions: to refocus the global community’s attention on [child mortality and maternal health]but this time they added another very important element, and that is accountability and transparency. Why is it so important? If you don’t measure, you don’t know if you are making progress. Who are we measuring? We are measuring governments who gave commitments.

It’s been a very difficult year economically but governments did make those commitments. Have they been keeping their promises?

Some countries have been doing better than others and Canada is one of the countries who honours their commitments.

Now the U.S. has committed to invest more in the global health initiative. So we are now beginning to see whether they are walking their talk, as [Canada’s International Development]Minister [Bev]Oda puts it.

We have been dealing with [HIV]for decades and now we are beginning to see for the first time new infections are coming down, so that’s good news. New infections in children over the last decade have decreased by 30 per cent. And in 21 countries that people have been following, for the first time they see less new infections. So why do we see that? It’s because, now, 50 per cent of the people in the world who need the medicine get covered. And with treatment it can actually prevent the spread of the disease from the person who is getting treated.

Now, 50 per cent of pregnant women in the world get tested. And when they are positive, they are put on ARV [antiretroviral therapy] When they are put on ARV, the chances of passing the disease to their newborn is much, much, much reduced. So the aspiration of seeing zero infection in our newborns in the next generation is on the horizon, which was unthinkable.

Is that part of the function of the maternal and child health initiative?

Absolutely, because we promote integration of services. Notwithstanding the fact that sometimes in the way we do business, we organize our thinking in terms of disease – this is malaria, this is HIV, this is tuberculosis, and this is antenatal care for women, and this is immunization for children – but when it comes to the clinic level, the facility level, the women want an integrated service.

For us technicians we need to listen to the voices of the women and, of course, to children. The mothers will speak on behalf of the children. What do they need? How can we do it in a cost-effective manner? Efficiency and effectiveness. And this is part of also proving to great countries who kept their promise, we are using your money in a smart way.

Are Canadians using their money in a smart way?

I think the Canadian government’s investment in overseas development is smart, investing in the areas with the greatest return on investment. Why do I say that? Women are an important population. Children are the future of every country. If you really want to help the developing countries, this is the best area to help them. Not only are you making their people healthy, but you are also investing in the future of their children. So this is what I call value-added smart investment.

How will we know if countries are living up to their commitments on maternal and child health?

This is exactly what we are doing here at this meeting in Ottawa. We are bringing together people from 21 countries and other development partners and also the UN agencies, civil society, academics and many scientific institutions from Canada to say, ‘OK, how are we going to implement the 10 recommendations [of a spring report on the G8 commitment]’ One of the recommendations is to measure countries to see if they are keeping promises. If the recommendations are implemented in full, this is another game-changing initiative from the Canadian government.

This interview has been edited and condensed.

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