I sincerely hope David Cameron watched the BBC programme Four Born Every Second last night. The documentary featuring four pregnant women in four very different countries highlighted the vastly different experiences of childbirth, depending on the country a woman happens to live in. With 800 women still dying in pregnancy or childbirth every day and 99.5% of these deaths taking place in low and middle-income countries the differences between the four featured countries - Sierra Leone, Cambodia, the UK and the United States - could not be starker.
The documentary, which was aired as part of a cross-media inquiry Why Poverty? aiming to reach more than 500 million people worldwide, certainly lives up to the series' self-set challenge of busting some myths around poverty. The welcome questions it raised with regard to the causes and consequences of maternal health and child survival are the reason that I hope the prime minister watched closely.
In Sierra Leone we were introduced to 25 year old Hawa, about to give birth to her fifth child. The doctor treating Hawa touched on the issue of a redistribution of wealth in connection to Sierra Leone's health problems such as difficult access to emergency obstetric care. The vital issue, so obvious yet often ignored, is that health is not only a medical challenge but is fundamentally determined by poverty and inequality, and to improve health all the factors which impact on it need to be addressed. This includes building viable health systems, as was demonstrated in the film, but it also goes a lot further.
David Cameron is currently one of the world's most influential men when it comes to improving the world's health, as along with Liberian president Ellen Johnson Sirleaf and President Susilo Bambang Yudhoyono of Indonesia he will be producing a report for the United Nations on the new framework for ending poverty after the expiration of the Millennium Development Goals in 2015. This report will have an impact on the lives of millions, if not billions, of people around the world for many generations to come.
What became clear in Four Born Every Second was that countries need to find their own solutions to maternal and child health and that aid will not be enough to sustainably eradicate poverty and ill health. For health to be improved it needs to be treated as a cross-cutting issue, taking into account issues such as nutrition, access to clean water or availability and affordability of medicines. Stringent goals need to be set around the very economic systems and legal rules that keep a vast proportion of the world's population in poverty. It is essential that the new framework for ending poverty is based on the understanding that poor health, poverty and inequality go hand in hand, because health is not only a consequence of poverty, it is also a prerequisite of development and of enabling people to move out of poverty.
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