Status of Women Committee on May 5th, 2010

[The Chair, Liberal, Hedy Fry]

I'd like to call the meeting to order, please.

I'd like to welcome the witnesses who came all the way here to share their insights with us and answer questions.

As you know, pursuant to Standing Order 108(2), this committee is doing a study on maternal and child health. On April 12, 2010, the Standing Committee on the Status of Women unanimously adopted the following motion to study maternal and child health. The motion states:

That the Committee study maternal and child health following the government's announcement to make maternal and child health a priority at the G8 in June that Canada will be hosting, as long as this is done before the end of May.

So we have a very narrow timeline for this committee to meet and listen to witnesses.

Now I want to welcome everyone here, and I will list the witnesses: Action Canada for Population and Development, Katherine McDonald, executive director; the Guttmacher Institute, Sharon Camp, president and chief executive officer; Oxfam Canada, Robert Fox, executive director; and of course the White Ribbon Alliance for Safe Motherhood, Maureen McTeer, Canadian representative.

Because you're each four separate and distinct groups, I'm going to ask you to take 10 minutes to present to us. You could take less if you wish, but 10 minutes.... I'll give you a two-minute signal so that you will know that you only have two minutes, and then we will move to a question and answer session.

We will begin with the Guttmacher Institute, Sharon Camp, president and chief executive officer.

[Dr. Sharon Camp, President and Chief Executive Officer, Guttmacher Institute]

Thank you very much for the invitation to appear today. Let me dive right in.

If we could convince the world community, developing as well as donor country governments, to double current investments in both family planning and maternal newborn health, we could reduce maternal mortality by 70%, cut nearly in half newborn deaths, and generate a range of other development benefits.

The Guttmacher Institute, with financial and technical support from the United Nations Population Fund, estimated the cost and benefits of three alternative investment strategies for reducing maternal deaths.

In the first scenario, we calculated the cost-effectiveness of increasing investments in family planning alone to a level sufficient to address 100% of the unmet need for modern contraception. We estimate that about 215 million women worldwide have an unmet need; that is, they don't want to become pregnant any time soon but are not using any effective method of contraception.

In the second scenario, we calculated the cost-effectiveness of making new investments only in maternal newborn health to a level sufficient to provide the WHO-recommended package of basic maternal newborn care to all those women and newborns needing it.

In the third scenario, we calculated the cost-effectiveness of combining both the additional investments in family planning and those in maternal newborn care. Here are the results.

If you'll turn your attention to the sets of graphs I'm holding in English and French, you'll see that the stacked bar to the left shows current expenditures of $11.8 billion U.S. for contraceptive services—those are in red—and maternal newborn care, split between intended pregnancies in green and unintended pregnancies in grey.

The two taller bars compare the cost-effectiveness of making additional investments in maternal newborn health alone and the cost-effectiveness of making additional investments in both family planning and maternal newborn care simultaneously. By investing an additional $3.6 billion U.S. in family planning, we reduce the annual cost for caring for unintended pregnancies—those that women may not have wanted and certainly didn't plan for—from $6.9 billion a year to $1.8 billion, a savings of over $5 billion U.S. This in turn reduces the overall cost of providing universal access to comprehensive family planning and maternal newborn care by roughly $1.5 billion U.S. a year.

Now let's look at the impact on maternal health.

I'd like to thank my two volunteers. The easels didn't show up, so I have human easels.

On this chart, the first bar represents the current situation. Based on 2005 United Nations figures, we started with an estimate of 550,000 largely preventable maternal deaths in 2008, a major share of those resulting from pregnancies that the women did not want or plan, and many of them ending in unsafe abortion. Addressing the unmet need for family planning alone would save lives, as you can see from the next bar. So, of course, would the much larger investment required to provide universal access to a basic package of maternal newborn care.

But look at the impact of making both investments together: a whopping 70% reduction in maternal deaths, from 550,000 to 160,00 in a single year. In the Guttmacher model, that would save the lives of 390,000 women, with most of them in the prime of their lives and most of them already mothers of young children. And we know that the death of a mother puts the lives of her young children in serious jeopardy.

Next week, at the World Health Assembly, WHO, the World Bank, the UN Population Fund, and UNICEF--known as the H-4--will release new UN estimates of maternal deaths for 2008. We now expect that they will be lower than the estimates used in these Guttmacher calculations. But the basic results of the cost-benefit analysis do not change, even if we start with lower numbers of maternal deaths.

Doubling investments in both family planning and maternal/newborn health from the current level of under $12 billion U.S. a year to roughly $24.6 billion would cut maternal deaths by at least 70% and newborn deaths by 44%. The combined investment strategy would save more lives. It is also $1.5 billion a year less expensive than investing in maternal and newborn health alone.

It's also the approach that provides the greatest development benefits outside the health field, including higher education levels, especially for women; higher labour force productivity, including greater female labour force participation; increases in household wealth resulting in reductions in poverty; and slower rates of population growth, resulting in less pressure on renewable natural resources. If you know your MDGs, that's seven out of the eight, I believe.

This, I submit, is smart government at its best.

Thank you very much for your time.

[The Chair, Liberal, Hedy Fry]

Thank you very much.

We will now go to Robert Fox from Oxfam Canada for 10 minutes.

[Robert Fox, Executive Director, Oxfam Canada]

Thank you to the committee for your leadership and your work on this issue, and for the invitation to appear before you today.

Among the four of us, I know we're going to be covering off a lot of statistics, and there are some very powerful ones. Circulated in your package is a brief from Oxfam that provides, from our perspective, some very compelling reasons that we, as Canada, should be exhibiting our leadership and demonstrating our leadership globally in addressing this issue, and how critical and important this is for women around the world and for the women who are most poor around the world.

I don't want to start with the statistics. I want to bring us back to who we are talking about when we're talking about these initiatives globally. I have the opportunity and the privilege to meet with many of these women and young girls as I travel around the world. As I say, I think it's important, when we're looking at what we can do with billions to benefit hundreds of millions, that we do have in our minds who it is we are talking about.

Young girls who are supporting their families are working in the maquilas in Managua. They are 16 years old and they have two children. They're working in difficult conditions, earning poor wages, and often facing significant occupational health and safety hazards, and yet they are absolutely determined to raise their family and contribute to their community, contribute to their economy, and contribute to a better future. But they recognize that in order for them to do that, they need some support. They need access to comprehensive community health services to ensure that their sexual and reproductive rights are respected and that their ability to access the services they need are supported.

We're dealing with women in southern Africa, in communities in Namibia, where the rates of HIV infection are among the highest in the world. These are women who are living in hovels made of paper or plastic, who have a number of children, who themselves have had very few opportunities to get an education. These women have few opportunities to get any access to information, but more importantly to the power they need in order to exercise control over their lives and to create an environment in which their children have the prospects to live a better life than they do.

I've spent time in Darfur, meeting with literally thousands of women and girls, themselves terrorized and traumatized by the violence in that country. Hundreds of thousands of them have been victimized by rape as a strategy of war. They are dealing with the caustic and corrosive impact, on themselves and their family and their community and their future, of large numbers of children born of violence.

So when you're dealing with these different circumstances and you see how rending this is for people, you can't but recognize the urgency and the enormity and the absolutely compelling reason that we need to do much more in this area.

We need to understand that in taking on this issue, there's no quick fix. It's not a little thing here; it's not a little thing there. It is a comprehensive, integrated response that is required to deal with the full range of health and human services to ensure that people can secure their sexual and reproductive rights, but that also situates that in the broader context. We recognize that the thing that will have the largest impact on how many children a woman has is how much education she has received. The thing at the end that will have the biggest impact on her ability to access health services is that there's a coherent national health care system that has publicly available services with no fees and no barriers to access.

We need to then be addressing these issues at the level of individuals, in terms of behaviours and attitudes, and at the community level, in terms of cultural norms and societal values. We also need to be looking at these issues systemically, in terms of the services that are available within nations, and recognize that it is in the bed, in the household, in the markets, in the parliaments, in the courts, and in the streets that the future of those women and their prospects for living a healthy life, being able to raise children who cannot just survive but can thrive—all of that—is what is at stake here.

We're very clear about what we need to do. What we've been lacking in this case is the political will and the commitment to do it.

The week before last, I was invited to address the United Nations General Assembly on the millennium development goals. And there I raised the issue of the amount of money that has been committed by the world for bailing out the banks and refloating the economies of the global north.

The American ambassador to the United Nations took some umbrage at what I said, because he interpreted it as a critique of how much money had been allocated to reviving and restoring and revitalizing our economies.

While I might have had a certain quibble--I might have suggested that a deeper gender analysis might have been brought to bear on how that money was spent, or that there might have been more environmental sensitivity to how that money was spent--at the end of the day I said I had no concern at all about how much money the world had committed to refloating the economies of the north. But it's really important that we understand that the bar has now been set, against which our performance globally will be measured in terms of our response to the more than one billion people on this planet who are deeply poor.

When we look at this initiative with respect to maternal health and supporting the capacity of children to survive, we have to be absolutely clear about the amount of money we're talking about. It is a pittance compared to the trillions that have been mobilized. And anything less than the full amount of money that is required in order to ensure that women can secure their sexual and reproductive rights, that there are full and comprehensive health services available to citizens of this planet, that we have the educational support, and the support to clean water and sanitation, and all of the other building blocks that are essential not only for prosperity but for equality on this planet, indicates that we are negating our responsibility as citizens and as human beings.

You're in a privileged position, as leaders and as respected people within this country, to bring a very clear message to the government to support this initiative; to indicate that we need serious bucks behind it; and to indicate that the expectations of Canadians in terms of our obligations to our values, our traditions, and our understanding of our role within Canada with respect to this issue demand that we raise the bar, raise our level of ambition, and commit seriously our resources and our energies to this objective.

Thank you.

[The Chair, Liberal, Hedy Fry]

Thank you very much.

The next presenter will be Ms. McTeer from the White Ribbon Alliance for Safe Motherhood.

[Maureen McTeer, Canadian Representative, White Ribbon Alliance for Safe Motherhood]

Thank you, Madam Chair.

And thank you, members, who have taken the time to be here and to actually discuss and to also think seriously about some of the issues, as Robert has put them in context.

I have been in a privileged position; we're all in a privileged position, but my privileged position included the opportunity to go to some of the countries of the world with my spouse when he was foreign minister. One of the things I always did--because my view of life was that the last thing I needed was another lunch--was to go see CIDA projects. I would go to clinics, to maternity clinics, and hospitals, and I would speak with ministers responsible for the status of women and ministers responsible for women and children and get a feel for the kinds of needs they had. That was some time ago. And if anything, those needs are much more serious, and much more urgent now than they were even in the late 1980s and early 1990s. That's what we're talking about here.

All of us were very excited and very pleased when the Prime Minister said he would follow up on the work that was done in Italy at the G-8 to in fact make maternal health and women's sexual and reproductive health, which is an essential component of maternal health, a key at the G-8; and that he would be a champion for us, if you will.

I hope that it's in that context that this discussion can be held, and that it will be an important reminder to all, both in government and in Parliament at large, that these are issues of saving women's lives. It is absolutely essential that we deal with them and look at them in that context if we're going to move forward.

I've given some information, which you should all have, with respect to the White Ribbon Alliance. There is a website that gives you much more information. It's www.whiteribbonalliance.org/.

Many of us are either...well, in Canada you're the “third lady”, but it's too hard to explain how you got to be the third lady so everyone is referred to as “first lady”, and many of us are in that category. There are queens and movie stars and models and everything from fish to nuts...poor people who have no income whatsoever, but who are interested in these issues. We have a very broad cross-section of people in over 148 countries, including Canada, and we are very excited about the work that's being done.

But I'm glad that we have this opportunity to come here and discuss how, in fact, we can contribute to helping save women's lives.

The White Ribbon Alliance supports grassroots organizations across the globe to demand that all governments provide necessary medical care for women along the continuum of care for childbirth, including vital reproductive and sexual care.

We are probably going to repeat something that you have heard several times this week already, but we know that investments in health care produce results. Eighty per cent of maternal deaths are preventable with the provision of basic care. Yet the current absence of these services in the developing world costs the global economy $15 billion a year in loss of productivity, beyond any health issue, and family and community disruption.

At the heart of the WRA's mission is the principle of partnership. We have built strong coalitions across hundreds of groups to ensure capacity for care is increased and resources harnessed to reduce maternal, newborn and child mortality and morbidity.

At the heart of the White Ribbon Alliance's mission is the principle of partnership. We have built strong coalitions across many countries to ensure that there is a capacity for care, that the capacity is increased, and that resources are harnessed to reduce maternal, newborn, and child mortality and morbidity.

To achieve these goals, we advocate several things.

First, we advocate increased and targeted funding to ensure and strengthen health care systems, especially in low-resource countries and regions. This was something I was delighted to see mentioned by the development minister in her remarks recently.

We advocate for the provision of family planning services in all of their manifestations.

We advocate for the provision of medical care to women in need, including abortion in countries where this procedure is legal.

We advocate for the training of skilled birthing attendants, especially those who are going to provide care to women in their own communities.

We advocate for the provision of obstetric emergency services and postpartum care for women. I'm sure you've all heard loud and clear the message that Dr. André Lalonde of the Society of Obstetricians and Gynaecologists gave yesterday. In one of my other volunteer hats, I'm a public member of the SOGC, and I've learned a great deal about medicine and about how little I know about medicine, even though I claim to teach it at law school.

The sixth area where we advocate is in the provision of education and materials to prepare women in the long run to be their own advocates for maternal care, for positive health policies, and for real and timely access to reproductive and sexual services. It is this role as advocates for action on maternal health, on sexual and reproductive options, and on access to those that is the key focus of our efforts leading up to the G-8 meeting here in June, to the UN Secretary-General's meeting in New York in late September, and to the Seoul G-20 meeting in early November.

You have probably heard a great deal during these committee hearings about how we must, and can, save women's lives and those of their children. The social, economic, medical and human rights challenges are complex and significant. But the good news is that there is very little disagreement on the nature of the problems in maternal and child health, and even less on the solutions to a tragedy that kills over 340,000 women every year and leaves a million more disabled or chronically ill.

The actions that we expect of governments, like our own, who have committed to international human rights conventions are clear, and form part of our mission.

You'll see what I recommend that your committee do, and how I hope you'll play that role, but I'd like to end on a personal note, in part because I sometimes find this has a larger impact.

Part of what we did last year at the White Ribbon Alliance was fund a shipment from a wonderful group in Saskatoon called Save the Hungry. They were providing a million dollars worth of equipment and supplies, but they had to have payment for the container to take it over to Ghana. We paid, the shipment was taken, and we re-equipped a maternity section of a major hospital where the three ORs were not working prior to the arrival of this equipment. Then, as a thank you, the doctor who received it said to us, in a very matter-of-fact tone, which was as surprising to me as the story, that he was so pleased to have this and to have the ORs up and working again because it meant that in the morning he would not have go down to the emergency section and make the decision as to which of the women needing a C-section would live and which would die.

I think when we hear those stories, it reminds us, as Robert's stories did, that these issues have a human face. We are affluent. We are influential. You are more influential. You have an opportunity now to make a difference, and I'm really looking forward to seeing that happen.

[The Chair, Liberal, Hedy Fry]

Thank you very much, Ms. McTeer. Very well said.

Now, finally--last but not least--we go to Katherine McDonald from Action Canada for Population and Development.

[Katherine McDonald, Executive Director, Action Canada for Population and Development]

Thank you, Chair, and thank you for the opportunity to present before this committee.

Around the world this past year there has been unprecedented global attention on the issue of maternal mortality as both a health issue and a human rights issue. While a woman in Canada has a one in 11,000 chance of dying from complications of pregnancy and childbirth, in Niger, pregnancy-related causes will kill one in seven women. This injustice and inequity underscore the seriousness of these human rights violations. It is the underlying reason why industrialized nations such as our own must do more.

So let's begin by talking about what those industrialized nations have already agreed to do. The 2000 millennium development goals, or MDGs, included a global promise to reduce maternal mortality by three-quarters by 2015 and to achieve universal access to reproductive health by the same year. Unfortunately, as noted by UN Secretary-General Ban Ki-Moon, this is the goal to which the least progress has been made by governments, so it is unlikely to be met. In September, as we've heard, world leaders will gather to review progress on the achievement of the MDGs. Overall levels of maternal mortality have barely changed over the past 20 years, although it is anticipated with new data recently released and the new UN estimates that we will see some signs of progress, which indeed will be encouraging.

But the MDGs were nothing new. In 1994, at the International Conference on Population and Development held in Cairo, 179 governments, including Canada, committed to provide by 2015 universal access to reproductive health, to a full range of safe and reliable family planning methods, and to related reproductive health services that are not against the law. These commitments have been further fleshed out by international human rights experts. In recent years, the right to survive pregnancy and childbirth has increasingly been recognized as a basic human right. According to human rights experts, avoidable maternal mortality violates women's rights to life, health, equality, and non-discrimination.

Several UN treaty monitoring bodies have found violations of key human rights treaties where states have failed to take measures to prevent maternal mortality. In 2006, African leaders without exception adopted the Maputo plan of action on sexual and reproductive health and rights, which, among other strategies, mandates the health system to provide safe abortion services to the fullest extent of the law. While it may not be common knowledge, it is true that all African states permit abortion under some circumstances. Indeed on April 19 to 21 of this year, the African Union convened a continental conference to celebrate progress on maternal and child health.

Canada has also committed to deliver its foreign aid in accordance with the ODA Accountability Act. It requires all aspects of Canadian aid to focus on poverty reduction and requires that the perspectives and concerns of the poor be taken into account in the delivery of that aid. Canadian aid and all the decision-making related to it must be consistent with six principles; these are, Canadian values, foreign policy, sustainable development, aid effectiveness, the promotion of democracy, and the promotion of international human rights standards.

What are the international human rights standards related to maternal mortality and morbidity? The human rights experts who sit on these treaty monitoring committees have interpreted their respective international treaties as requiring states to provide a whole host of obligations. These include affordable and comprehensive reproductive health care services, including family planning services; programs geared to increasing knowledge about and access to contraceptives, as well as safe abortion services in accordance with local laws; dissemination of reproductive health and family planning information; guaranteed access to emergency obstetric care, and ensuring that births are attended by trained personnel and that quality emergency care is available for complications from unsafe abortions. These human rights experts have linked maternal deaths and ill health to a failure to provide these services. In other words, the states in question, if they're not providing the services, are actually violating human rights.

In June 2009 the Human Rights Council of the UN adopted a landmark resolution recognizing maternal mortality and morbidity as a pressing human rights concern. With this resolution, which Canada co-sponsored, member states acknowledge that the issue of maternal health must be recognized as a human rights challenge and that efforts to curb the unacceptably high global rates of preventable maternal mortality and morbidity must be urgently intensified and broadened. It is the first intergovernmental acknowledgement of maternal mortality as a human rights issue.

Not even one month later, in July 2009, at the meeting of the G-8 in Italy, the G-8 heads of government agreed that maternal and child health was one of the world's most pressing global health problems. They committed to “accelerate progress on...maternal health, including through sexual and reproductive health care and services and voluntary family planning”. They also announced, and I quote, support for “building a global consensus on maternal, newborn and child health as a way to accelerate progress on the Millennium Development Goals for both maternal and child health”.

It is encouraging that after years of neglect, governments are increasingly speaking out against this tragedy, but the question remains: how do we turn these words into actions? Of course, in June, the leaders of the G-8 countries will gather in Huntsville for their 36th annual summit. As well, of course, a G-8 and G-20 summit, which is co-hosted with South Korea, will take place at the same time.

The Muskoka summit comes at a critical time. The world's most powerful heads of state will need to address international development as we enter the final period for delivering on the MDGs. The summit will follow unprecedented global attention to maternal, newborn, and child health. Momentum has never been greater to accelerate progress in this crucial area.

So let's look at what we might want from our government and other heads of state from this G-8. One, we want governments to live up to and build on past commitments. The past commitments include last year's G-8; efforts to ramp up to achieve the MDGs; we want governments to meet the commitments they made in Cairo in 1994 and at subsequent UN reviews; we want to make sure that the maternal and child health initiative lives up to the promises made in the ODA Accountability Act and is based on evidence of what works and what is effective; we want to make sure there is enough money to do all of this; and I think we should call on our government to make a plan to reach 0.7% of gross national income relative to ODA.

Thank you.

[The Chair, Liberal, Hedy Fry]

Thank you very much, Ms. McDonald.

Now we will go to the question and answer portion.

We will begin with a round that lasts seven minutes. The seven-minute round for each person will mean seven minutes for both questions and answers. I am asking everyone to please stick to a short question and a pithy answer so that we can get as many questions and answers done as we possibly can.

We will begin, therefore, with Ms. Neville for the Liberals.

[Anita Neville, Liberal, Winnipeg South Centre, MB]

Thank you very much. I'll try to keep it short.

We are indeed privileged to have the four of you here today. Your presentations were all quite splendid.

I'll put my questions out, and then leave it open and let Ms. Fry manage the time.

My first question is to you, Ms. Camp. I would like to know from you what the impact of the previous U.S. President's policies were on maternal health worldwide and the impact they did or did not have. That's President Bush's policies.

My second question, which I would put to all of you, is given that Canada signed on in Italy at the G-8 to maternal health policy, from each of your perspectives—and you've all addressed it some way or other—what would you each see as the optimum outcome of the G-8 meetings coming up? From Canada's perspective, what would you like to see there, and the leadership for Canada to provide?

Ms. Camp.

[Dr. Sharon Camp]

Thank you.

Although we can't put a number on the impact of former President Bush's policies in this area, we do know that international funding for family planning services stagnated during that period, even though the need for family planning grew. As a result, there were almost certainly more unintended pregnancies, probably half of which ended in unsafe abortions. And the result of both unsafe abortions and unintended pregnancies would have been substantial in terms of the impact on maternal mortality.

As you all know, unsafe abortion is a very important component of maternal mortality worldwide. In those countries that have in fact addressed other contributors to maternal mortality, deaths related to unsafe abortion actually become an even larger share of maternal deaths.

So all of this was unfortunate. We lost a good deal of momentum in the effort to make reproductive health care universally available. I hope that we can now, with the change of government in the United States, make up for that lost time by making substantial new investments in family planning services around the world.

[Anita Neville, Liberal, Winnipeg South Centre, MB]

In terms of the outcome of the upcoming meeting, what would you each like to see in terms of Canada's role? What would be optimal?

[The Chair, Liberal, Hedy Fry]

We'll begin with Ms. McTeer.

[Maureen McTeer]

I would like to see several things.

First of all, I think there has to be funding. Robert has mentioned it. I think we've all mentioned it. That was part of what this G-8 was supposed to be about. It was not supposed to be a question of what maternal health is but rather a question of how we fund it.

I think it also has to be integrated. It's really important that we not all go off on different tangents. For instance, on micronutrients and nutrition, Canada is known as a world leader. It makes sense for us to play a leadership role. But that is an add-on. That is something in addition to.

We're talking, in a sense, about two different kinds of things. We're talking about maternal health, which is basically medical care. We are talking about training people, which again, the development minister has mentioned is something that will be a priority. That has to be there. We have to have systems within which all of this can happen.

We have to have access to family planning in all its manifestations. We have to recognize, I believe, and respect, the whole history and the historical places that brought us to where we are with respect to sexual and reproductive health. And as Secretary Clinton has made quite clear, you can't talk about women's sexual and reproductive lives without also being conscious that there will be times when abortion is necessary.

We know that it kills women. We know that it's controversial. We know that there are many religious groups who really object to it. But if I were putting this together, that is what I hope would be included.

[The Chair, Liberal, Hedy Fry]

Thank you.

We'll go to Mr. Fox.

[Robert Fox]

I would say that what we're looking for from this meeting is to move forward. We need a serious commitment of funding, and we need it to be very clear that it's a multi-year commitment of significant funding.

The reality is that in order to deal with this issue from a systemic perspective, we have to build health care systems. That's a long-term investment to train professionals and health care workers and to support them in their work.

One year of funding, those sorts of conferences where people come together, pledge something, cut a cheque, and then the next year move on to the next issue, would be fatal. It would be irresponsible, and it would be unacceptable. Right? So we need a long-term commitment of significant funding to address this problem in a systemic and sustained way.

We clearly need an integrated approach. We need to deal with the reality of people's lives. Abortions are going to happen, but that isn't the question. The question is whether they are going to happen in hospitals or with medical attention for women who are not wealthy. We need to ensure that the system understands that this is one integral element of a broader approach and that to the extent that we deal with it properly, we will, in fact, minimize how often it happens and when it happens. And we will ensure that when it happens, it happens with the best possible outcome for everyone involved.

As I say, there are a number of elements of the package, but what I would stress is the magnitude, the long-term duration, and the integrated nature of that initiative.

[The Chair, Liberal, Hedy Fry]

Thank you, Mr. Fox.

I'll go to Ms. McDonald because we only have a minute left. You speak and then I'll have Ms. Camp if she wishes to add something to this.

[Katherine McDonald]

I would absolutely support everything my colleagues said and repeat it. I would also emphasize the fact that a piecemeal approach to this G-8 maternal and child health initiative is ineffective. It will reduce the impact of the financial investment that is made. It needs to be a comprehensive, integrated, across-the-board approach with no strings attached.

[The Chair, Liberal, Hedy Fry]

Thank you.

Ms. Camp.

[Dr. Sharon Camp]

I'll be very quick.

I would love to see the Canadian government double its current level of investment in both family planning and maternal and newborn health. We're not talking about a lot of money, as Robert said.

But more than that, I'd really like to see the Canadian government join with governments like Norway, Great Britain, and others that have been involved in the leadership of this new movement to mobilize the entire world community.

This is a wonderful opportunity that you all have as hosts of the G-8 meeting to bring along the rest of the world's governments in a commitment to reach the MDG 5 goal by 2015. It's not impossible to do, it's not a lot of money, and I hope you'll provide some of the leadership to do it.

[The Chair, Liberal, Hedy Fry]

Thank you very much.

Now I will move to Madame Deschamps for the Bloc.

[Johanne Deschamps, Bloc, Laurentides—Labelle, QC]

Thank you, Madam Chair.

Thank you very much for testifying before us today and for sharing your experience. It is very important. You are in the field, you know the conditions that African women live in. They are grappling with serious problems and left to their own devices.

You have all said that donor countries must double their financial aid. You also say that it is imperative that we have a global vision in order to attain realistic, tangible, concrete objectives. If we put all of the necessary effort into this we could attain the objectives you have set out, in particular that of reducing the rate of maternal mortality by close to 70%.

You know that a broad debate is going on because some wish to eliminate abortion from this picture. Unless I am mistaken, you are telling us today that if we do not include it, we are going to miss the target completely. The money will be wasted because we will not reach the objectives and we will not sufficiently reduce maternal mortality.

At the end of last week's meeting in Halifax, a press release stated that the countries that had met had arrived at a consensus. The Minister of International Cooperation stated that everyone was going to work on their priorities. In short, there is no consensus for people to work together. One does not get the impression that efforts will be coordinated. We are practically seeing failure even before the G8 meeting next June.

I don't really have a question. These events leave me speechless. The living conditions of these women are being turned into a monetary issue. This has become a political football. We are forgetting that at the heart of the problem, we want to save lives and that to do so, we have to have everything in these initiatives, including abortion.

I don't understand how a country like Canada, where this is a right that women have, is excluding abortion from the measures that we want to offer other women on the planet who are dealing with very serious problems.

How can Canada show leadership—correct me if I am wrong—when it is not meeting its own commitments?

[The Chair, Liberal, Hedy Fry]

Thank you. I'll start with Mr. Fox, and then I'll go to Ms. Camp, Ms. McDonald, and Ms. McTeer.

[Robert Fox]

My French is awful and so I am going to speak to you in English.

It is a concern, given that Canada, through the Paris Declaration, the Accra Agenda for Action, and all the other initiatives we've taken with respect to our approach to international cooperation, where we are acknowledging the importance of southern ownership and the fact that our responsibility as a donor is to support nations in the south, to have them identify their priorities, to have them identify how they believe systems should be, how the needs and the rights of their citizens should be met and respected, is actually now proposing something whereby we would be forcing governments to the south to keep track of the Canadian money, distinct from the money that's coming from Britain, France, Germany, Japan, and all the other G-8 countries, and all the other countries of the world. It's actually going to create a huge burden on health care systems in the global south, because all of a sudden, they're going to have to start to ensure that they're tracking the Canadian money this way and other people's money that way.

From a perspective of aid effectiveness and value for money and accountability, it isn't a good precedent and it isn't a good signal to send.

[The Chair, Liberal, Hedy Fry]

Thank you, Mr. Fox.

Ms. Camp.