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The White Ribbon Alliance in China

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The following is a speech delivered at the Women's Health Conference in Bejing, Tuesday 13 December 2011

I am delighted to be here in Beijing to address this important group on the issue of women's health.

I have enjoyed many visits to China over a number of years both officially with the British government and on a personal basis with my young family for the Beijing Olympics in 2008.

And I seem to have brought the sunshine with me for this visit - but then you have just sent us two lovely pandas to Edinburgh, one of whom has a Chinese name that means sunshine.

Everyone in Scotland, in fact across all of Britain, is enchanted with our new Chinese visitors - and it symbolises for us just how strong the relationship is between our two countries. We have 80,000 Chinese students in Britain now, and this relationship can only grow stronger as they go forward with their lives to fulfil their promise.

And I am delighted to be here to talk today to talk about healthcare, and particularly maternal and new-born health.

No country has done more than China to improve health care so quickly.

No country has such ambitious plans for the future of its health care system.

And in no country will we see the growth of health care faster than here in China.

Today China spends 4.6% of its national income on health.

That will almost double to 8% as part of the current five-year plan and its successors.

That is why increasingly all the major health companies, health research institutes, NGOs and other organisations are locating in China.

With a population of around 1.39 billion, this has been the greatest of challenges, and there is much on which to congratulate China on improvements in recent years. Life expectancy is growing, and new born survival improving dramatically, and maternal mortality also reducing.

With that comes new challenges - from how best to engage, and effectively look after, a larger ageing population to how to reach further into the poorest rural communities to improve health care provision and outcomes there too.

I am the global patron of the White Ribbon Alliance for Safe Motherhood.

The White Ribbon Alliance is an international coalition that pushes for change to make pregnancy and childbirth safe for women and newborns around the world.

In some cultures, white symbolises mourning and in others it symbolises hope and life. In the Chinese theory of the five elements white has an energy that is contracting; it is associated with metal, and so with brightness and purity and fulfilment, but is also the colour of mourning.

As such, the white ribbon is dedicated to the memory of all women who have died needlessly in pregnancy and childbirth.

Since its launch in 1999, the White Ribbon Alliance - now a rapidly growing global movement with members in 153 countries - has been amplifying the voices of women and their communities, and is now a leader holding those accountable for the tragedy of maternal mortality and urging action.

It is a grassroots movement that builds alliances, strengthens capacity, influences policies, harnesses resources and inspires action to save the lives of women and newborns around the world, and has been welcomed by political leaders everywhere in recent years at the international meetings.

No one fails to understand these days just how central a mother is to the health and wellbeing of herself, of her children and of her community.

When a mother survives she raises her child providing food, taking her child to school arranging vaccinations and health checks and is an important provider. When we lose a mother, it is so much harder to raise the child - and in the poorest countries, often impossible.

I first become involved with the campaign to reduce maternal mortality when I discovered that the issue of mothers dying in pregnancy and childbirth was not discussed at the G8 international meeting as recently as 2007.

Since then, I have served as global patron of the White Ribbon Alliance for Safe Motherhood, spoken at many forums, including the world economic forum in Davos, the United Nations, the World Health Assembly, and the African First Ladies Summit. Many articles, letters, meetings and advertising campaigns later, I am proud that we have seen progress. But of course, there is still much more to do.

Until last year the number of mothers dying annually in pregnancy and childbirth from mostly avoidable causes was 500,000. That figure had not changed for over 20 years, despite the expertise and concern of health professionals around the world. Last year, the figure was reassessed and lowered to around 350,000 deaths per year. That's a great improvement, but the number of maternal deaths is still unacceptably high.

The biggest challenge today is saving the lives of girls and women in pregnancy and childbirth. As Education for All has pointed out, the 67 million children who lack schooling around the world are the ones who suffer the most. Too many maternal deaths each year involve teenage girls who are uneducated, who marry too young, who give birth before they are grown, and who miss out on good nutrition, health education and the chance for a long and productive life.

I know that in China the improvements in maternal and infant mortality have been significant and achieved through dedicated hard work and investment. The most remote and poorest rural communities remain a challenge, but I understand that the commitment exists to improve there too.

It is timely also to look at the connections between grassroots activities everywhere and to share best practice with each other. So the White Ribbon Alliance stands ready to do this with its sister organisations in countries like Nigeria, Tanzania, Kenya and Rwanda.

The White Ribbon Alliance has great strengths in these countries and many more where it is at the heart of ministerial health care policy making.

At the last G8 summit in Canada maternal health was placed at the heart of all millennium development goal discussions. It has since been taken up by a growing number of health ministers across Africa. A successful African Union campaign has increased awareness and promotion of the issues.

I should tell you that the investment in new roads by China in Africa has helped our cause - those roads have improved transportation and access for many people but especially for pregnant mothers to access health facilities. I have also seen the Chinese three-wheeler ambulances designed to be just wide enough to fit on single-track roads in Nigeria. These narrow ambulances serve remote communities on hard to reach roads and save lives every day.

The White Ribbon Alliance has great strengths in these countries and many more where it is at the heart of ministerial health care policy making.

So, of course, we recognise that investment in healthcare is important, and growing. But so too is the value of joining up the different healthcare issues to create better-integrated services. I have been speaking recently to the Susan G Komen for The Cure, an organisation dedicated to breast cancer and cervical cancer who have achieved so much in research, advocacy and health education for early diagnosis (you know in the USA and the UK if you are diagnosed early with stage one breast cancer you have a better than 95% survival rate - quite a leap forward in recent years). So Komen are expanding their excellent work to help women worldwide and have talked to the white ribbon alliance about its huge 153 country grassroots network.

We have been sharing our different skills and expertise, understanding that the Pink Ribbon of breast cancer can benefit from the White Ribbon of maternal health and vice versa.

I was interested to hear Dr Babatunde Osetimehin, who is the executive director of the United Nation's Population Fund say just this week, that the "efforts to deal with the HIV/Aids epidemic might have been much more effective if they had been more tightly integrated with those to improve sexual, reproductive and maternal health". This means that efforts to improve the health of women and their children, including eliminating mother-to-child transmission of HIV, requires a joint commitment and integrated efforts.

Another example of how we need to join things up;

Healthcare systems must meet people where they are and offer all services they require. So it is reassuring to see this international recognition of the strengthening of the integration of services. By doing so, we can improve quality and accessibility of health services, which also means more people will use them.

I believe that in addition to understanding how we can gain extra healthcare benefits from integrated systems, we also can make great strides by encouraging a multi-stakeholder approach.

We know that here in China, every major global health care company is establishing a presence. There is so much to achieve in China alone with the rapid expansion of healthcare investment and drive to improve services everywhere.

I will let Professor Lord Darzi speak more about this area as the medical expert from the Institute of Global Health Innovation at Imperial College, but what is evident is that there is much to gain from bringing together different partners to forge innovative and lower cost healthcare solutions.

The challenge of a large population also provides an opportunity as costs can be driven down for pharmaceuticals and specialist equipment. Investment in innovation and improvements in healthcare and health training can also be achieved. Now is a great time to focus on achieving some previously impossible dreams to tackle widespread diseases and conditions.

The political will exists, and the know-how, both people and technology, is out there. This could be an exciting time for new breakthroughs and radical ways to bring new services to many people. I know that China will want to lead the way in this.

And what is clear for us all - globally - is that there is much to learn from grass roots activity; a great benefit to reap from pursuing integrated health systems: and everything to gain from a multi-stakeholder approach to both innovation and lower cost health care solutions.

At the heart of this is the health and wellbeing of the mother as she can act to do so much more, and reach widely across her family and whole community for everyone's wellbeing. I know that China has recognised this in the new health plan to focus on women's health.

A mother will always fight for the best for her child; we must fight for the mother so she can do this. And by working together we can achieve this.

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