Evidence of meeting #15 for Foreign Affairs and International Development in the 40th Parliament, 3rd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was countries.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

Margaret Biggs  President, Canadian International Development Agency
Diane Jacovella  Vice-President, Multilateral and Global Programs Branch, Canadian International Development Agency
Ron Garson  Director, Summit Policy Division (G8/G20) , Department of Foreign Affairs and International Trade
Francis Deng  Special Adviser to the Secretary-General on the Prevention of Genocide, Department of Political Affairs, United Nations

11:05 a.m.

Conservative

The Chair Conservative Dean Allison

Order. Pursuant to Standing Order 108(2), our study on the Group of Eight, or G8, summit, with a focus on the maternal and child health initiative, will commence.

I want to welcome our witnesses today.

From CIDA, we have Margaret Biggs, the president, and Diane Jacovella, vice-president of the multilateral and global programs branch.

We also have, from DFAIT, Ron Garson, director of the summit policy division.

I believe, Ms. Biggs, you have an opening statement, after which we will go around the room for questions. We're here until 12 o'clock.

Ms. Biggs, thank you very much for being here. I'll turn the floor over to you for your opening statement.

11:05 a.m.

Margaret Biggs President, Canadian International Development Agency

Thank you very much, Mr. Chair.

Thank you for inviting me to speak about the Canadian International Development Agency's work on maternal and child health.

Aid effectiveness is a priority of the Government of Canada, and CIDA's work on maternal and child health delivers on the government's commitment to ensure that Canada's development assistance is focused, effective and accountable.

Improving the health of mothers and children is a foundational development issue. Healthy children, able to thrive and ready to learn, are fundamental to the long-term growth and prosperity of all countries and societies, and ensuring the health of children begins with their mothers. That is why improving maternal and child health and reducing maternal and child mortality and morbidity are both an essential part of the international framework of the millennium development goals.

It is also the reason why the government has chosen to champion this cause at the G8.

The medical journal The Lancet recently reported that maternal deaths have dropped by approximately 35% between 1980 and 2008. This is according to a new study by researchers from the University of Washington and the University of Queensland in Australia.

Now, while I must caution that this is only one study, and it is based on estimates, early reports of new data from the World Health Organization seem to indicate a similar trend. And if true, this provides evidence that investing in maternal and child health can work and can save the lives of millions of women.

But even with these encouraging results, progress has been slower than it should be.

Allow me to start with Millennium Development Goal 5, improving maternal health.

Of all the millennium development goals put forward a decade ago, maternal health is the one that lags the farthest behind. Complications from pregnancy and childbirth are the leading cause of death for young mothers, young girls aged 15 to 19. Every year more than 500,000 mothers die worldwide from pregnancy and childbirth, particularly in sub-Saharan African and Asia, and 20 million mothers suffer lifelong illnesses or other harmful effects from their pregnancies.

For Millennium Development Goal 4, reducing child mortality, the situation is equally concerning.

Although death in children under five has declined steadily worldwide, we have not yet achieved the results we need to at this point if we are to meet the millennium development goals for 2015.

Every year, as you know, three million babies die within the first week of life, and almost nine million children in the developing world die before their fifth birthday because of causes that are largely preventable, such as pneumonia, diarrhea, malaria, severe acute malnutrition, measles, and HIV.

As we approach the G8 summit in June and the United Nations millennium development goals summit in September, we are reminded that much work remains to be done.

With proper planning and resource mobilization, it is within the reach of many developing countries to prevent the deaths of mothers and children by strengthening their health systems, training health workers, and providing simple proven interventions such as immunizations, insecticide-treated bed nets, and better nutrition.

The G8 can make a tangible difference in terms of maternal and child health. G8 countries have a strong record of accomplishment in health. In recent summits they committed to eradicate polio and they agreed to scale up support to the fight against HIV/AIDS, tuberculosis, and malaria, and these have seen results.

They have also repeatedly stressed the importance of strengthening health systems, particularly in Africa, so that people, particularly women and children, have access to quality local health services.

During the G8 development ministers meeting in Halifax last week, the G8 ministers agreed that the most effective approach to improving maternal and under-five child health and reducing mortality and morbidity is through a focus on strengthening developing-country health systems to provide high-impact, integrated interventions on the ground, including skilled birth attendants and immunizations.

Central to these discussions was the view of G8 ministers, who were joined by Mali's health minister, that if you could provide these integrated and comprehensive services at the local level it could make a significant difference in terms of the lives and mortality of children and mothers. These include access to primary care; equipped and resourced facilities; trained front line health workers, particularly skilled attendants for births; and robust health information systems to monitor performance and progress. Ministers also committed to support countries' efforts to improve access at the local level through properly equipped and resourced health systems, including a skilled health workforce.

The G8 ministers also recognized the fundamental importance of improving nutrition. Nutrition is essential to early childhood development and to building a healthy population in the long run, and today, malnourishment leads to serious illness, blindness, mental disorders, and death among the world's most vulnerable. According to the World Health Organization, malnutrition contributes to over one-third of all childhood deaths, and the nutrition of mothers, as you know, is critical for the health of their newborns and their children's future development. So by underscoring nutrition and putting forward its importance as a crossover issue between maternal and child health, I think the G8 can make a fundamental difference here.

I think we gave the chair a copy of the chair's summary coming from the G8 ministers meeting last week in Halifax, if you'd like to circulate it.

Canada's proposed contribution to the G8 maternal and child health thrust could involve various interventions, including responding to the importance of strengthening health systems, in particular human resources for health, at the country and local level through the training, deploying, and retaining of skilled health workers, and family planning, which includes the use of modern contraceptive methods.

It is also important to note that through the government's consultations with the United Nations and other partners, this G8 initiative will complement and make a key contribution to the United Nations Secretary-General's millennium development goals summit in September.

As you know, CIDA is the main means by which the Government of Canada can address maternal and child health, and I'd just like to take a few minutes to give you an outline of some of the things we're already doing.

As you may know, one our main priorities is around children and youth. We're already working in many countries to strengthen health systems, improve access for women to maternal and reproductive health care, reduce sickness and death in newborns, increase immunization, and promote nutrition. Maternal and child health is one of the three components of our priority around securing a better future for children and youth, and it starts with the mothers.

We recognize that effective family planning is one part of improving maternal and child health, and it is an important element of an effective health system. One of the things we know about family planning is that this kind of programming reduces unwanted pregnancies.

Family planning includes the woman's ability to space and limit her pregnancies, which has a direct impact on her health and her well-being, and on the outcome of each pregnancy. So in response to the needs of developing-country partners, family planning is integrated with activities in a number of CIDA's maternal health and safe motherhood projects, in line with our international commitments.

For example, in western Mali, CIDA support has helped to ensure that skilled health workers attend almost half of all deliveries. In Guatemala, CIDA's support to the Society of Obstetricians and Gynaecologists of Canada and its local partner associations has helped to train over 730 health professionals so they may better provide for mothers and newborns during childbirth.

The other component of CIDA's maternal and child health strategy is to promote a healthy start for infants and young children, so they may thrive, attend school, and become active members in their communities.

CIDA has been a leader in promoting proper nutrition and medical services like immunization. We know that undernourishment increases children's susceptibility to infectious diseases, mental impairment, blindness, and permanent physical stunting. That is why CIDA is helping to provide vitamin A, iodine, and other micronutrients, which play a crucial role in the health of young children and mothers. As a founding partner and principal donor of the micronutrient initiative, Canada has become known for its leadership on vitamin A and iodine. Indeed, UNICEF has said that Canada's support for iodized salt programs has saved six million children from mental impairment.

Canada is also helping children through the Catalytic Initiative to Save a Million Lives. In fact, CIDA was the first to support UNICEF in training and equipping front-line health workers to deliver modern malaria treatments, bed nets, antibiotics for infections, and other health services to children and vulnerable groups.

The need to improve maternal and child health is instrumental to fulfilling CIDA's mandate of reducing poverty in the poorest countries around the world.

At the recent UN roundtable meeting in New York, Minister Oda stated that the government is prepared to invest a significant level of new funding in this initiative, and we expect that it will be successful in inspiring other donor countries to follow suit.

Thank you very much, ladies and gentlemen. I welcome your questions.

11:15 a.m.

Conservative

The Chair Conservative Dean Allison

Thank you, Ms. Biggs.

We're going to start with Mr. Rae of the Liberal Party, for seven minutes.

11:15 a.m.

Liberal

Bob Rae Liberal Toronto Centre, ON

Thank you so much for joining us today.

I don't want to put you on the spot, but I'm afraid I'm going to have to. When Secretary of State Clinton and Foreign Secretary Miliband were here to discuss the G8 summit, they both were very clear that in their view, reproductive and sexual health, including access to safe abortion services in those countries in which it's legal, is a critical part of a comprehensive initiative.

You're the leader of CIDA: what is CIDA's position with respect to the comments of two of our most valued and experienced allies in this field?

11:15 a.m.

President, Canadian International Development Agency

Margaret Biggs

Thank you.

I won't comment on their views specifically. As I think you'll see in the statement that the chair issued after the G8 development ministers meeting yesterday, in the continuum of care from pre-pregnancy through to the age of five, there are a variety of measures that could be contemplated that would include family planning and that would include reproductive health. Within the context of that, countries can be free to choose to focus on the things where they feel they can make the greatest difference.

So I don't think there's a contradiction there in terms of the scope that might be required in terms of a maternal and child health framework, which would go, again, in a continuum of care, from pre-pregnancy through to the age of five.

11:15 a.m.

Liberal

Bob Rae Liberal Toronto Centre, ON

I'm trying to understand what this means for Canada, though, in terms of what we have done in the past and what we will do in the future.

My understanding is that there would be several examples of agencies that would have been funded, or that have been funded, by CIDA, that include abortion referral as part of their service--a comprehensive service that includes family planning and includes other things.

Are we now to understand that it's the new position of the Canadian government that we will not provide support for those agencies because their work includes abortion referral?

11:20 a.m.

President, Canadian International Development Agency

Margaret Biggs

Well, CIDA in the past has never funded abortion services directly--

11:20 a.m.

Liberal

Bob Rae Liberal Toronto Centre, ON

Not directly; I'm talking about funding agencies that provide abortion referrals. That's why I chose my words so carefully.

11:20 a.m.

President, Canadian International Development Agency

Margaret Biggs

--yes--and we won't in the future fund abortion services directly.

We do provide support to countries who in their health systems...and through that there may be, where it's legally available and voluntarily accepted, abortion services. We will continue to fund health systems, and we will continue to fund organizations. We fund the United Nations Population Fund, and they have a broad approach to reproductive health. We continue to fund them. But we have not in the past, and we won't in the future, directly fund abortion services.

11:20 a.m.

Liberal

Bob Rae Liberal Toronto Centre, ON

No, but we've never.... The point is we've never done it.

So what you're telling me is that in effect there's going to be no change?

11:20 a.m.

President, Canadian International Development Agency

Margaret Biggs

That's right. There's no change in the policy.

11:20 a.m.

Liberal

Bob Rae Liberal Toronto Centre, ON

In the policy.

11:20 a.m.

President, Canadian International Development Agency

Margaret Biggs

There's no change in the policy.

11:20 a.m.

Liberal

Bob Rae Liberal Toronto Centre, ON

As a result of all the announcements and statements that have been made, actually there'll be no change in the current position of the Canadian government, which is that we fund governments that include abortion as an integral part of their health care system and we will continue to fund agencies in those countries that could include abortion referrals as part of their service.

Is that correct?

11:20 a.m.

President, Canadian International Development Agency

Margaret Biggs

That's correct. There's no change in CIDA's programming and there's no change in how we will approach these issues. However, the government has made clear that as part of their G8 contribution, they will focus on other areas, a range of areas to be determined. It could include family planning, but it will not support directly abortion services.

11:20 a.m.

Liberal

Bob Rae Liberal Toronto Centre, ON

I don't want to get you engaged in this, but in effect what you're telling us is that for all the... What the statement that's been made really means, in effect, is that there's no change in Canadian government policy. The Government of Canada...and in fact no foreign government goes into a country and says we're going to fund abortions directly. We fund health care systems. We provide direct support for national treasuries. We provide support for health care reform in countries. We provide support for NGOs and for agencies that provide referrals, and what you're telling us is that this is not going to change.

11:20 a.m.

President, Canadian International Development Agency

Margaret Biggs

Correct. CIDA's programming will remain the same as what we're doing now.

11:20 a.m.

Liberal

Bob Rae Liberal Toronto Centre, ON

Okay.

There are two other areas in which I see contradictions or problems. The second one is this question of advocacy for women. One of the concerns I've had, and I've heard it from several NGOs, is the very real concern that in a number of countries, Canada is no longer funding advocacy groups for women--in Pakistan, for example, a very significant reduction in advocacy for women--in a number of situations where advocacy for women is critical.

We've heard about Match, we've heard about KAIROS and the other organizations; still no funding, I understand, for the International Planned Parenthood in the Canadian-based organization that is working overseas.

Can you explain why that would...if maternal health is significant? We all recognize that one of the reasons why we have not achieved the goals yet that we've set out--I would argue quite strongly--is that women are not empowered in enough societies to get the services they need and to insist on a different standard.

The record will show very clearly that one of the reasons industrialized countries have made such a dramatic change in the condition of women is because women have become politically empowered and socially empowered. That's why, in the past, Canadian governments have said we believe in equality for women and we believe that in empowering women and women's organizations and women's advocacy, we'll be able to improve their health.

So has that policy changed?

11:20 a.m.

President, Canadian International Development Agency

Margaret Biggs

No, the policy has not changed. I think the Prime Minister's focus on maternal and child health for the G8 summit speaks to the points you just made, about the importance of focusing on women and children. In fact, I think many would argue that maternal mortality is a litmus test of how well functioning health systems and health services are in any country, so I don't think anything has changed.

CIDA continues to integrate gender equality, equality between women and men, in everything we do. In fact, CIDA's been a leader in that area for many years. CIDA has done a fair amount in Afghanistan, for example, in terms of direct programming but also in terms of encouraging women's participation in civil society, in the democratic process, and has gone out of its way to do that.

So I think the track record is still very strong in terms of encouraging the role of women, particularly with respect to children and families, but in every aspect of development; it's integrated in everything we do.

11:25 a.m.

Conservative

The Chair Conservative Dean Allison

Thank you very much.

That's all the time you have.

11:25 a.m.

Liberal

Bob Rae Liberal Toronto Centre, ON

Really? It went so fast. I was having such a good time.

11:25 a.m.

Conservative

The Chair Conservative Dean Allison

It does go quickly. We'll try to get back for another round.

I'm going to move to the Bloc now.

Madame Deschamps.

May 4th, 2010 / 11:25 a.m.

Bloc

Johanne Deschamps Bloc Laurentides—Labelle, QC

Thank you, Mr. Chair.

Good morning, Ms. Biggs. Welcome to the committee.

You know that one of the Millennium Goals, Goal No 5 concerning maternal health is the one that we are lagging most behind. You said at the end of your statement that the government was prepared to give significant additional funding for that goal.

Where is the government intending to take that additional funding from? Will it take it from the current envelope that exists for International Aid or are we going to have to cut in other programs in order to get this additional funding?

11:25 a.m.

President, Canadian International Development Agency

Margaret Biggs

Thank you very much for the question.

The government has indicated it will provide new funding toward maternal and child health that would be over and beyond what we are currently spending in the area. We would hope that others as well would put incremental resources toward this effort to really make a difference.

As you will recall, in budget 2010 of a few months ago the government indicated it would have a further 8% increase in its international assistance resources, an extra $354 million in 2010-11. A portion of that would go, I would expect, toward this new initiative, what we can do extra, new, for maternal and child health.

These would be new dollars. They would not be cutting other programs to put toward maternal and child health.

11:25 a.m.

Bloc

Johanne Deschamps Bloc Laurentides—Labelle, QC

I may not be an expert in numbers but as the minister has announced that from 2011, there will be a freeze over the next five years, how can we honour our commitments taken by Canada at the G8 summit? We know that the envelope being frozen, there will certainly be some problems arising. In fact, we might be backtracking. Where will the money be coming from? If there is a freeze how shall we be able to meet these goals? Is it realistic to think that we can reach the goals that we set for 2015?