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Sarah Brown

Sarah Brown

Posted April 21, 2009 | 11:40 PM (EST)

Build for Mothers and You Build for Everyone


The following is the keynote address I delivered to the African First Ladies Health Summit today in Los Angeles, organized by USDFA and African Synergy.

Firstly I would like to thank the First Lady of California Maria Shriver -- who i know spoke to you at lunch yesterday -- for inviting me here to Los Angeles. She is a woman who achieves so much for other women, and continues to strive to understand the great and positive impact that women are making with their contribution in this rapidly changing world.

I also thank US Doctors for Africa and African Synergy for convening this summit. When I mentioned to people back in the United Kingdom that I was coming all the way to California for an African First Ladies Health Summit, they expressed surprise. Not at the event -- the tremendous work done by so many first ladies is well acknowledged and the value of gathering together self-evident.

No, the surprise came at the choice of location.

But I am delighted that this choice of location celebrates US Doctors for Africa's work, as we will at the gala event tonight. And also that the high profile nature of this event here in the USA means that word will spread of the issues we are here to discuss an that we have a forum to discuss issues that can transform Africa and know that an international media will listen.

Standing here with you today, I speak with certainty when I say I know we all share a common goal.

For it goes without saying that we all want to see rising of standards of health and education across the globe. And of course we all want to ensure the good health and well-being of women and children in all our countries. Good healthcare, access to education, an end to children living in poverty without access to many of the basic provisions of life.

In this room we have champions in the fight against HIV/AIDS, against malaria, against poor sanitation and for clean water, for better nutrition, for education, for girls, for newborns, for infants -- and for communities, economies, the environment. In short, we want to achieve the targets set by the millennium development goals.

I admire enormously the work that you all do and your commitment to the causes you have taken on -- stepping up to the challenges faced in each of your home countries and working tirelessly to create the momentum for change and your dedicated work to create a reality where people in your country not only survive but prosper.

I understand that there are many causes that exist side by side and each of us are right to argue for the causes we know to be important: action on HIV/AIDS, on malaria, on nutrition, on infant deaths, action on schools and on building health care systems.

All of them great causes.

Causes so big that we can devote our lives to them.

But as I have learned more and more about these great challenges, I have kept asking myself whether there is one goal that could unlock all these goals? One goal that without action on which we cannot realize any of our objectives. One millennium target which if pursued aggressively could help us reach all our targets.

And I have become convinced a mother's survival is the key, for it is the key to her baby's welfare and often that baby's life. A mother's survival can help prevent her family being hit by malaria. A mother's survival can ensure that all her children, including her girls, go to school. A mother's survival can ensure that her children receive the right nutrition, ensure they receive their immunizations that will ensure their health during their first tender years.

So much that is important, happens in the very early years of a child's life when a mother is so central to every part of their days and nights.

I don't believe that we will make the progress on HIV/AIDS without addressing maternal mortality. We will not make the progress we want on malaria without addressing maternal mortality. We will not make progress on getting more children to school without reducing maternal mortality.

But we will make progress on all these things and on nutrition, on empowerment and education, on health care, on immunization, even -- I believe -- on the environment, if we make progress to reduce the number of mothers dying needlessly in childbirth.

When one mother survives, a lot survives with her.

It has been said a mother's place is in the home. I say a mother's place is everywhere and always has been. And so I have come here as a mother -- a mother who knows that without help and assistance, childbirth can be painful and dangerous, a mother who understands that lacking even the most basic healthcare can put your life at risk, a mother who knows that for far too many mothers, giving birth is a death sentence.

What should be the happiest time in your life turning into the saddest time.

We have the technology, the medicine, the science. The costs are not great. The solutions simple. We have yet though to really find the moral commitment and the political will.

There has been, over the past year or so, a growing momentum. An understanding that we must all work together. No longer in silos on vertical solutions, but to integrate our efforts.

Indeed with the current global economic climate that we now face, never has there been such an important time to integrate our efforts, and integrate the resources we have to maximize their reach.

You know that if a health system is strong enough to cope with mothers in pregnancy and childbirth, then it will be able to cope with so much else. A health system that works for mother, works also for early infant care, for vaccinations, for infection control, for blood transfusions, for emergency surgery for every member of the community. Build for mothers and you build for everyone.

Over a year ago now the maternal mortality campaign was convened. A campaign that brought together governments, the grassroots membership of the White Ribbon Alliance and many of the larger NGOs and campaigning charities, other international organizations and academic institutions, the private sector, and individuals. And I'm delighted to announce two new members -- US Doctors for Africa and African Synergy.

The maternal mortality campaign has started to raise awareness for an issue that had remained cloaked in silence, with terrible figures unchanged for 20 years. For every minute a mother dies in childbirth, for every death 30 more are left permanently injured, her baby 10 times more likely to die than if she had lived, her elder children 4 times more likely.

The last year has been incredible with this issue taking pace and gathering momentum at every level. I have heard too often of international meetings with an agenda to discuss all the millennium development goals where little or nothing would be said about #5 -- the goal to reduce maternal mortality by 75% by 2015.

Now this issue is discussed every time. At every meeting on every table. And we're going to keep it there.

The success of the campaign is in part because it is built around a few key objectives, objectives that all organizations can sign up to, and build into the work they do.

The messages are simple and clear:

  • To put girls and women at the center of funding for health system strengthening -- including the G8 taskforce's report on new innovative international financing for health systems this July.
  • To identify and work with countries to get financed health plans up and running that meet the targets.
  • To urge the UN secretary general to make reducing maternal mortality a top priority -- the gateway to the success of all the millennium development goals.


The maternal mortality campaign also seeks:

  • To appoint national champions like yourselves to mobilize action at country level with all the help that our growing and powerful network can provide. And to continue to work together more effectively to work out exactly what makes a health plan succeed -- the best clinical interventions, the best educational support, the best care of mothers and newborns. Doing better on human rights and working with the experts in HIV/AIDS, malaria, nutrition and early years development to integrate our efforts to achieve together what we all want -- better lives for people in Africa.
  • and -- finally, but very significantly -- we must find a way to get maternal mortality recognized as a key indicator of a functioning health system. Our campaigners believe that all health budgets and funds should measure their success on how well they do for mothers -- no more pregnant mothers dying from malaria, risking MTCT from HIV/AIDS, dying of malnutrition or worse still of ignorance.


The international campaign is growing all the time, every day, and there will be key influential points this year: at the African health minister meeting at the African Union next month, at the meeting of the G8 nations, in Italy this July, at the United Nations General Assembly in New York in September, and I know the White Ribbon Alliance is organizing a gathering this November in Tanzania.

Bience Gawanas, the social affairs commissioner at the African Union has agreed to be the co-chair with me on the maternal health leadership group. Every step of the way it is important that African Leaders -- including yourselves -- are steering this.

While we need our campaign to keep up the pressure on the global stage, what is vital to the long overdue success for reducing maternal mortality will be the work that is done at the national level, where the grassroots at the bottom and the global activity at the top meet to turn policy in to a living reality for families and communities.

You as First Ladies are powerful champions for the causes you support. Powerful role models, motivators and catalysts for action. Your work is formidable. If we can also harness the efforts of civil society and clinicians to support you, you will be unstoppable.

If we succeed in combining all our efforts -- the results are potentially phenomenal. Building for women will mean building a lasting future for our world.

What I ask of you today is that whatever your personal cause may be -- be it education, nutrition, malaria, HIV/AIDS -- that you also take on maternal health and place it at the heart of all your good work.

When people die we say of life "it has to go on, life must go on." But when a mother dies it doesn't just go on for her children, nor for her community, the local economy and the environment too.

Please let us work together to make sure maternal mortality is a problem of the past and not our children's future.

Thank you.