Health: Maternal Health

Earl of Sandwich Excerpts

Wednesday 12th January 2011 Lords Chamber

[The Earl of Sandwich]

My Lords, I am grateful to my noble friend for following up the short debate of the noble Lord, Lord Crisp, which I missed. The 2015 deadline for the health MDGs is looming nearer. I have seen the recommendations of the UN taskforce implementing a $40 billion global strategy for women and children’s health. They are formidable but I was struck by one passage:

“The chasm between what we know and what we do, between our ability to end poverty, despair, and destruction and our timid, often contradictory efforts to do so lies at the heart of the problem … the challenge posed by the MDGs is deeply and fundamentally political. It is about access to and distribution of power and resources”.

It is important that health practitioners, when coming into contact with global health, take note of these words because they take us to the heart of the community involved.

In southern Sudan, for example, on the eve of its independence, a lot of money has been earmarked for health through the Government and the multi-donor trust fund but little has been spent effectively. There have been delays in implementation, logjams in drug procurement, problems in paying health workers and transferring funds into services—every kind of obstacle you expect in a poor country, only worse. The most experienced NGOs there are frustrated. No one is giving up. It will just take a long time and many mothers and children will die waiting. This is the hard lesson that we have to pass on to dedicated teams who are rightly desperate to help these countries meet their millennium goals.

The latest UN development report reminds us that global healthcare need not be expensive but it will thrive in a more democratic and politically friendly environment. It is sometimes assumed that the ill health of the poor stems from their own ignorance and that we have to fill an acute knowledge gap that exists between rich and poor. However, my experience is that the very poor, given half a chance, are the best architects of their own development, whereas outsiders are not.