Thank you.
Results is a national grassroots advocacy organization. We are committed to creating the political will to end poverty and needless suffering. We champion cost-effective, proven, tangible, and impactful solutions that will benefit the world's poorest and, we believe, by extension, the world as a whole. Our volunteers across the country are parents who think that no other parent's child should die for lack of immunizations that cost pennies. They're neighbours who think that nobody around the block or around the world should die for lack of drugs or access to drugs that cost dimes or dollars. They're everyday citizens, and they're your constituents.
So I'm honoured to be here today to represent their views, but also I'm honoured to present some recommendations outlined in the brief that was developed by a coalition that includes results in partnership with some of Canada's largest and most respected development organizations, including Unicef Canada, World Vision Canada, Care Canada, Plan Canada, and Save the Children, whom you'll hear from as well.
About a year ago, our organizations came together to push for child, newborn, and maternal health to be the signature development theme at the G8 initiative. We certainly weren't alone in that effort. Many partners in the room are part of that and very focused on that. So we were all very glad in January when that came to fruition.
In terms of the numbers, in the world's poorest regions, close to nine million women watch their children succumb to painful yet mostly preventable disease and illness, illnesses that, as I said, cost dimes—not dollars—to treat, illnesses like diarrheal disease, malaria, pneumonia, measles, and malnutrition. At the same time, at least 350,000 mothers die annually in childbirth due to complications during delivery.
I'm not going to run through all the statistics at this point, because I think you're very well versed in those at this point, after hearing from a number of very informed witnesses. Perhaps just to paint a picture, I'll tell this very brief story.
Last year I had the opportunity to go to Bangladesh to lead a parliamentary delegation there. We were looking at the challenges associated with global poverty but also very much focused on the hope and solutions. One day we went to a hospital called the ICDDR,B hospital in Dhaka. We were there in March, and it was just before rainy season. At that point, waters are stagnant, and babies get sick primarily of diarrheal disease and other diseases as well.
We went to that hospital that receives about 700 to 800 patients a day, children with diarrheal disease, moms and babies coming in for treatment. It's such a busy time of year that they don't have enough wards or beds, so they construct giant white tents outside, next to the hospital. I think there were two or three of them, and row upon row of kids getting oral rehydration therapies and intravenous therapies. While they're there being treated for other leading causes of death, kids who are malnourished are getting therapeutic feeding and other access to treatments that are again very inexpensive.
That scenario was poignant for a mom like me, but it's played out throughout the world. Diarrheal disease alone kills about 1.5 million children every single year. Most of those children who made it to that hospital will survive, actually, and that was the story of hope, because they had access to health services. However, many more in the most impoverished pockets of the world unfortunately will not, because they do not have access to dependable health care close to home.
This brings me to our brief. What we've focused on in our brief—I think you have it in your packages—is very much not about the global initiative as a whole, although we have some thoughts on that, but very much about where Canada's value-added contribution can be. So we've been focusing on where Canada's contribution to the G8 initiative should go.
What we're calling on is for Canadian investments in a cadre of front line health workers who have the support and training necessary to deliver an integrated bundle of high-impact interventions targeted at the poorest people, where they live, and all of that with the commitment to monitor results and measure impact.
I'm going to go over those four core elements very quickly here.
Number one, as I said: ramp up the number of front line health workers who are supported, trained, equipped, and motivated to deliver essential services to mothers and children at the community level close to home. As I'm sure you've heard, skilled and motivated health workers in the right place at the right time with the necessary infrastructure, drugs, and equipment are an essential part of the solution. That's from the Partnership for Maternal, Newborn and Child Health. There's a consensus around that. It's important because evidence shows that up to 80% of deaths of children under five years of age around the world may occur at home with little or no contact with health providers and that one in four women experience childbirth without skilled assistance.
Two, provide those front line workers with the capacity to deliver an integrated package or a bundle of interventions to get at the leading causes of death. Kids don't just die of one thing. They're susceptible to a whole gamut of illness and disease.
Among children, just four diseases--pneumonia, diarrhea, malaria, and measles--account for close to half of all under-five deaths in the developing world. The majority of these lives, experts say, could be saved by increasing the use of low-cost, effective prevention and treatment measures.
This is a UNICEF pack of oral rehydration salts, which many of you who have travelled have seen. This is what could save the life one of those children who ended up at ICDDR,B hospital. It costs, we've determined, something like 20¢ to 40¢ a package.
For mothers, there is clear evidence to show that the availability of skilled attendants at birth and immediately after, with the capacity for timely referral to access to other care facilities, is the critical factor in addressing the major causes of maternal mortality such as hemorrhage, infections, and hypertensive disorders. But also, these front line health workers have a very important role to play in addressing maternal health, which is also absolutely integral to healthy pregnancies and deliveries.
Number three, focus on the poorest people, again where they live, close to home, in rural areas or urban slums. The poorest people actually live, get sick, and die alone, far away from the nearest hospital. So focusing on the poorest people in terms of what kills them or what makes them sick will help us go a long way.
Number four, commit to accountability and tracking results, which allows for appropriate mid-course correction and measurable results on mortality impact, coverage of services, etc. In other words, any effective aid program should have a commitment to ensuring that we're getting it right and then having the capacity to improve practice along the way.
Those are the four legs of the table, as I call them, that we have been advocating for. You can read more in the brief.
Again, just to tell the story of how that plays out on the ground, this year I had the opportunity to lead another parliamentary delegation, this time to Ethiopia. We did a real focus on child and maternal health.
In Ethiopia, with the commitment of the ministry of health there and with partners like CIDA, UNICEF and NGOs, and the Global Fund, they've created a system that's very focused on community care front line workers. They've trained 30,000 young women who have about a grade 10 education. They have given them a year of training in the leading causes of death and illness and intervention—training on malaria diagnostic tests or how to deliver ACTs, which costs about a buck. A baby or a child who gets malaria can die within 24 hours. If you're far away from a hospital setting, you need to have people close by who can diagnose and treat that quickly, or that child is gone. There are 30,000 of them. They made a conscious decision that they would all be women, too. Talk about empowering women within communities; it was very powerful.
They've also created 15,000 health posts in rural areas in Ethiopia, health posts about the size of your living room, that have the equipment to address all these leading causes of death. They call them the “16 packages”. They get at malaria, therapeutic feeding, ORTs for diarrheal disease, but also immunizations. We saw babies getting measles vaccinations and polio vaccines.
So with 15,000 health posts and 30,000 health workers, that is about health system strengthening and transformative change in that country. That is the model we're talking about that could be a solution for the challenges that we face globally.
I want to talk about the money thing before we get through the two minutes.
The G8 acknowledges that the international financing gap to save 10 million women's and children's lives, between now and 2015, is estimated at approximately $30 billion globally. We feel that Canada's fair share contribution should be $1.4 billion in new—and I'll repeat, “new”, not reassigned, not repackaged, not reallocated—money. Over the next five years, that could have tremendous impact.
Thank you for this. I think it's time to focus on hope and opportunity, and we welcome the fact that you're studying this issue and helping us do that.