Genocide by Inaction

“The latest global maternal death statistics indicate that of the 536,000 women that died in 2005 of childbirth related complications, about half or 261,000 were African women. These figures also indicate that Africa is the only region where maternal deaths have increased since 1990 up from 205,000.

Africa Public Health Rights Alliance Issues Maternal Death Scorecard At Start of Women Deliver International Conference on Investing in Women’s Health.

Relentless Increase in African Maternal Death Could Be Equated To Genocide By Inaction – Says Africa Public Health Rights Alliance “15% Now” Campaign.

* Health financing Scorecard indicates that average annual per capita health expenditure of $13.5 in bottom 10 countries is equal to a night’s cinema expenses in the top 10 countries.
* Health worker scorecard indicates that more developed countries that steal health workers from less developed countries instead of training theirs are culpable for maternal deaths.

In a statement ahead of it’s scorecard to be launched on the second day of the Women Deliver International Conference on Investing in Women’s Health holding in London from 18 to 20 October, Rotimi Sankore Coordinator of the Africa Public Health Rights Alliance “15% Now!” Campaign stated that:

“The latest global maternal death statistics indicate that of the 536,000 women that died in 2005 of childbirth related complications, about half or 261,000 were African women. These figures also indicate that Africa is the only region where maternal deaths have increased since 1990 up from 205,000. Maternal deaths dropped in every other continent over the same period. In Europe from 4,800 to 2,900, and in the America’s from 21,000 to 16,000. We are very concerned that the prevalent maternal death risk also reflects a much bleaker picture of overall reproductive health in Africa.” “The scorecard based on the 2005 figures and latest comparable global health financing and health systems data[1] shows that in the bottom 10 countries globally - all of which are African except Afghanistan, maternal death risk is between 1 in 7 (Niger) and 1 in 15 (Mali). In the top 10 the risk is between 1 in 47,600 (Ireland) and 1 in 13,800 (Switzerland). Possibly every family in the bottom 10 countries will suffer 1 maternal death. Overall 1 in 23 African women have a lifetime risk of maternal death compared with 1 in 2,300 in Europe. This is not acceptable and African governments have to act without delay to end this waste of African women’s lives.” Abiola Akiyode-Afolabi, Director of Women Advocates Research and Documentation Centre (WARDC) and APHRA 15% Campaign partner underlined that: “The scale of maternal death anywhere is tied to two key factors: overall levels of sustainable health financing, and the ratio of health workers to the population especially midwives, nurses and doctors. The scorecard shows graphically how lack of both combine to undermine the lives of African women. In the top 10 countries, government health expenditure far surpasses private expenditure, while in the bottom 10 citizens are mostly left to fend for themselves. If deliberate state action to exterminate a social group is interpreted as genocide, its difficult not to infer that persistent inaction could mean the same. The practice of government without responsibility in Africa must stop” “International human rights law calls for health systems that are available, accessible, acceptable, and of good quality. Governments must make it an urgent priority to build and support public health systems that integrate primary and reproductive health care with guarantees of sexual, reproductive, and all other rights of women. This is the only way we will turn the tide on maternal deaths,” emphasised Frank Donaghue, Chief Executive Officer, of Physicians for Human Rights and APHRA 15% Campaign partner.

“It is also crucial to highlight that women’s health is not only about Maternal Deaths” added Felicita Hikuam Global Programs Manager of the Worlds Aids Campaign and APHRA 15% Campaign Partner. “There is a direct link between lack of sexual and reproductive health and rights and a wide range of issues including HIV and AIDS which is now one of the leading killers of women. Women are still not able to universally uphold their rights to: choose their partner, decide to be sexually active or have consensual sexual relations, have consensual marriage or decide whether or not to have children. Lack of education, economic dependence, poverty and lack of legislation to protect women in many parts of the world means that women, especially young women, are still very vulnerable to sexual abuse, and subsequently, HIV infection. These issues must be addressed alongside issues of maternal deaths and as part of reproductive health and rights.” Key Notes for Editors:

One of the key MDGs is the reduction of maternal death by 75% between 1990 and 2015. The APHRA 15% Campaign scorecard not only shows how bleak the present situation is, it also indicates what needs to be done if the lives and dignity of African women are to be protected and the MDG target for reducing MM is to be met.

The Scorecard underlines that to reduce their disease burden and improve overall public health including reproductive health, African countries must drastically raise investment in health to :

* Meet the 2001 Abuja pledge to allocate 15% or more of annual budgets to health (excluding external resources)

* Increase annual per capita expenditure on health to a minimum of $1000 over 5 years in the first instance.

* Increase and maintain percentage government expenditure on health (as against private expenditure) at between 50% and 90% (excluding external resources) in order to approach similar levels in top 10 countries.

* Ensure that a minimum of 10% of GDP excluding external resources is spent on health.

On Health Systems / Workers - Invest in infrastructure, training and retention of personnel towards ensuring: ü A minimum density of 3 doctors per 1000 between now and 2015.

* A minimum density of 10 nurses per 1000 between now and 2015.

* A minimum density of 1 midwives per 1000 between now and 2015.

* A minimum density of 1 pharmacist per 1000 between now and 2015.

* Appropriate levels of dentists, public health, community health, scientific and technological staff.

The most developed countries must show sincerity in their offers of development aid and:

* Stop subsidising their health systems with African health workers and professionals and immediately end official policies recruiting health workers from where they are most needed.

* Raise their own domestic expenditure on health, education and training to meet domestic needs.

* Ensure that dependency is ended sooner by asking African governments to match aid by meeting the Abuja 15% pledge to ensure sustainable health financing.

* Ensure that health development aid is holistically targeted at the intertwined problems of reproductive health, child mortality, HIV and AIDS, TB and malaria.

ENDS Support the Africa Public Health Rights Alliance 15% Now campaign for sustainable financing for health in Africa -

For Further Information Please Contact the Following: Internationally / At the Conference in London: Africa Public Health Rights Alliance “15% Now! Campaign Int. office: +44 207 424 5744; Or Africa Office +234 1 4925568, email: 15percent[at]africapublichealth.org.

In the United States: Physicians for Human Rights Barbara Ayotte, Director of Communications w) [617] 695-0041, ext. 210 , email: bayote[at]phrusa.org In South Africa: World Aids Campaign Tel: + 27 21 466 7827, (Or Netherlands International Office Tel: +31 20 616 9045), email: waccapetown[at]worldaidscampaign.org

In Nigeria: Women Advocates Research & Documentation Centre (WARDC):
Tel: +234 1 8197344 , womenadvocate[at]yahoo.com or wardc[at]womenadvocates.org

The Africa Public Health Rights Alliance [and the “15% Now!” campaign] launched on December 10 2006 - International Human Rights Day - is the first to articulate Public Health for Africa as a Rights and Development issue across Africa and beyond. It brings together actors from various key sectors of civil society.

The Campaign is based on the premise that “we all have to be alive and well to exercise any other rights in any meaningful way” and therefore that Right to Health and to Healthcare is arguably the most crucial right of all as articulated by both the constitution of the World Health Organisation and Article 12 of the International Covenant on Economic, Social and Cultural Rights.

Current social development and health indicators from international and African institutions show that over 8 million African lives are lost annually to preventable, treatable and manageable health conditions and diseases. Child Mortality, HIV/AIDS, Malaria, Maternal Mortality, and TB mainly account for these.

Any loss of life to disease is bad enough. The annual loss of populations equivalent to entire African countries - and over a few years greater than the losses from all modern day global wars and conflicts combined is both unacceptable and unsustainable, and brings Africa closer to the slippery slope to collapse of society and extinction.

The key objective of the Alliance is to engage the African Union, sub-Regional Economic Communities such as the East African Community (EAC), Economic Community of West African States (ECOWAS) and Southern Africa Development Community (SADC) etc, their institutions / member countries, and the African public towards: 1) Promoting greater awareness and understanding of African Health Issues and; 2) Adopting Comprehensive Health Policies based on a Public Health Rights and Development philosophy - and mobilising and committing resources for sustainable implementation.

The Alliance will also engage global stakeholders and actors including donors, the UN, EU and their institutions, World Bank, IMF, and international Non-governmental Institutions and organisations especially those concerned with health, social and economic development.

[1] Health Finance, Health Systems and Maternal Death Data from WHO, UNFPA, UNICEF and World Bank. Latest comparable figures are for 2004 and 2005 respectively. Figures have been computed by sources to ensure comparability and are therefore not necessarily official statistics of individual countries, which may use alternative methods.

* The Africa Public Health Rights Alliance (APHRA)

* Please send comments to [email protected] or comment online at www.pambazuka.org