Significant progress towards reducing child and maternal mortality is being made but to meet the Millennium Development Goals 4,5,6, strategies aimed at reaching the world's most inaccessible, marginalized and vulnerable populations will be required, health leaders said today.
Ethiopia's Minister of Health and the heads of four leading global health organisations, the GAVI Alliance, UNAIDS, the Global Fund to Fight AIDS, TB and Malaria, and UNICEF said that immunisation coverage, large-scale campaigns to prevent malaria and access to AIDS and malaria treatments have improved in developing countries thanks to more resources, new partnerships and technologies, stable, long-term donor support and improved coordination among health actors.
Ethiopia's Minister Tedros Adhanom Ghebreyesus expressed his country's strong commitment to achieving the MDGs and stated that "Ethiopia is on track to meet MDG 4" but must rely on strong donor support for its national health plan to continue its progress.
Increasing immunisation rates are recognised as essential to achieving MDG 4, a two-thirds reduction in childhood mortality by 2015, the experts said. Polio teeters on the edge of eradication; measles, a major killer of children in the poorest countries, has been dramatically reduced; malaria deaths have been cut by half in parts of Africa due to a concerted effort and expanded access and use of insecticide-treated bed nets; and the deadly Hib disease, a leading cause of meningitis, has been virtually eliminated in some parts of Africa. Last year, nearly one million more people were receiving antiretroviral therapy than in 2006, and today some three million people living with HIV are now on treatment globally – two million in sub-Saharan Africa.
Over the past eight years, global investments to fight malaria have increased ten-fold and AIDS investment eight-fold. The Global Fund alone has financed programmes worth US$11.4 billion since its creation in 2002. This unprecedented increase in resources is already showing encouraging results in reducing mortality and morbidity.
GAVI, a public-private alliance of major global health players has achieved success in delivering essential childhood vaccines in the developing world. Since its creation in 2000, GAVI's support has prevented 2.9 million future deaths and protected 36.8 million additional children with basic vaccines. Immunisation rates have increased to more than 70% in many countries.
"Many more people are living longer and healthier lives today thanks to increased access to HIV treatment. This could not have happened without substantial financial investments and improved health systems," said Dr Peter Piot, Executive Director, UNAIDS. "The challenge now is to sustain these gains and to ensure more equitable access for people who have been marginalized."
"Recent statistics show that under-five mortality continued to decline in 2007," said Ann M. Veneman, Executive Director UNICEF. "Continued success in measles and tetanus immunization rates, distribution of insecticide-treated nets (ITN), and prevention of mother to child transmission of HIV should maintain this positive trend."
Even with these improvements, the experts agreed that to reach the MDGs and achieve equitable distribution of public health across social, gender, ethnic and geographic levels will be more complex and costly.
"However successful we have been so far, we still face major challenges in ensuring vaccines reach the most vulnerable children. It's getting harder; the distances are getting greater and, in the areas we need to reach, the health systems are weakest. We must determine the best strategies with which to reach those girls and boys who are still missing out on immunisation," said the GAVI Alliance's Executive Secretary, Dr. Julian Lob-Levyt.
"The progress in fighting malaria alone can reduce child mortality enough to reach the MDG 4 target," Dr. Michel Kazatchkine, the Executive Director of the Global Fund said. "However, the great progress we have seen recently must be consolidated into lasting, sustainable progress in mother and child healthcare."
Pointing to the lessons learned through the AIDS response, Dr. Piot said: "Involving civil society and ensuring a rights-based approach can help strengthen health systems and deliver results to the people."
The experts also argued that development should be led by national priorities and a country's long-term plans.
"Altering business-as-usual and embracing a country-driven approach should be a core principle for development agencies, donor organisations and civil society organisations worldwide," said Lob-Levyt.
The GAVI Alliance (formerly the Global Alliance for Vaccines and Immunisation) is a public-private partnership of major stakeholders in immunisation. It includes developing country and donor governments, the World Health Organization, UNICEF, the World Bank, the vaccine industry in both industrialised and developing countries, research and technical agencies, civil society, the Bill & Melinda Gates Foundation and other philanthropists.
UNAIDS is an innovative joint venture of the United Nations, bringing together the efforts and resources of the UNAIDS Secretariat and ten UN system organizations in the AIDS response. The Secretariat headquarters is in Geneva, Switzerland—with staff on the ground in more than 80 countries. Coherent action on AIDS by the UN system is coordinated in countries through UN theme groups, and joint programmes on AIDS. UNAIDS' Cosponsors include UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, ILO, UNESCO, WHO and the World Bank. Visit the UNAIDS Web site at www.unaids.org
The Global Fund to Fight AIDS, TB and Malaria is a unique global public/private partnership dedicated to attracting and disbursing additional resources to prevent and treat HIV/AIDS, tuberculosis and malaria. This partnership between governments, civil society, the private sector and affected communities represents a new approach to international health financing. The Global Fund works in close collaboration with other bilateral and multilateral organizations to supplement existing efforts dealing with the three diseases.
To date, the Global Fund has committed US$ 11.4 billion to more than 550 programs in 136 countries to support aggressive interventions against AIDS, tuberculosis and malaria. Programs supported by the Global Fund have provided AIDS treatment for 1.75 million people, TB treatment for 3.9 million people, and by distributing 59 million insecticide-treated bed nets for the prevention of malaria worldwide. The Global Fund provides a quarter of all international financing for AIDS globally and two-thirds of funding for TB and malaria.
UNICEF is on the ground in over 150 countries and territories to help children survive and thrive, from early childhood through adolescence. The world's largest provider of vaccines for developing countries, UNICEF supports child health and nutrition, good water and sanitation, quality basic education for all boys and girls, and the protection of children from violence, exploitation, and AIDS. UNICEF is funded entirely by the voluntary contributions of individuals, businesses, foundations and governments.
For more information, contact:
Jeffrey Rowland, GAVI Alliance
+41 79 240 4559
Vera Mehta, UNAIDS
+1 917 399 6713
Jon Lidén, The Global Fund to Fight AIDS, Tuberculosis and Malaria
+41 22 791 1723