15 years since Cairo

On Monday, “Secretary of State Hillary Rodham Clinton will deliver a speech commemorating the 15th anniversary of the International Conference on Population and Development (ICPD),” held at Cairo. “At this event, Secretary Clinton will declare the U.S. Government’s renewed support for and dedication to reaching the ICPD and other related UN agreements, including the Millennium Development Goals, by 2015,” which include reducing both maternal mortality and malaria.

In a publication marking 15 years since the Cairo Conference, UNFPA has published an update entitled, “Healthy Expectations: Celebrating Achievements of the Cairo Consensus and Highlighting the Urgency for Action.” The document explains that …

In 2005, the lifetime risk of death from maternal causes was 1 in 22 for women in sub-Saharan Africa, compared with less than 1 in 6,000 for women in more developed countries. For each woman who dies, 20 additional women suffer pregnancy-related disabilities … Most maternal deaths occur to women who live in sub-Saharan Africa and South Asia. The number of maternal deaths in sub-Saharan Africa has increased as the number of women in the childbearing ages has grown.

maternal-mortality-lifetime-risk2.jpgThe attached map from UNFPA shows heightened maternal mortality in just the same regions of the world where malaria is most prevalent.

When Secretary Clinton speaks she will remind us that, “Millions of lives have been improved and saved through effective and affordable reproductive health programs, which have proven to prevent the deaths of women and children, reduce the spread of HIV/AIDS, grow economies, and preserve natural resources.” These programs should include malaria in pregnancy control as an integral part of antenatal care.

It is useful in this context to think of the ICPD guiding principles. Principle 4 addresses “Advancing gender equality and equity and the empowerment of women.” For malaria control this means ensuring malaria in pregnancy control programs are fully funded and operational since pregnant women suffer more from malaria than other adults in endemic areas.

Principle 8 recognizes the right of people to space their children. This process can be frustrated due to fetal loss during malaria in pregnancy or from peri-natal and infant mortality when children are born with low birth weight and are less likely to survive.

Neither our reproductive health nor our malaria programs are complete until we plan to meet the needs of pregnant women who are risk from this deadly parasitic disease. Integrated planning and service delivery is required.

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