Statement by Michelle Bachelet at the Harvard Ministerial Health Leaders’ Forum
07 June 2012
Statement by Michelle Bachelet Executive Director of UN Women at the Inaugural dinner of the Harvard Ministerial Health Leaders' Forum. Harvard University, Boston, Massachusetts. 3 June 2012.
[Check against delivery]
Good evening. I am so pleased to join you tonight for the Inaugural Dinner of the Harvard Ministerial Health Leaders' Forum. I commend the faculty and Harvard for this wonderful initiative to promote transformational leadership in health. I thank Dean Julio Frenk for inviting me to this Forum, and for being such a distinguished expert and dedicated champion of global health.
Although Dr. Frenk has published much more than I have, we share much in common. We are both medical doctors and have been Ministers of Health. And we have both stood up, and encountered opposition for sexual and reproductive health and public distribution of the morning after pill to prevent unwanted pregnancy. We survived…and we are always ready to stir controversy again to defend the right to health.
I am delighted to be here in this prestigious institution of Harvard University. I welcome all of the Ministers of Public Health from Africa, Asia, and Latin America.
I pay tribute to each one of you for having been recognized as leaders for your contributions in the health sector. And I congratulate all of you for having been selected by Harvard University as the 2012 Health Leaders.
Transformational leadership is not a personality type, or an individual attribute or a catalogue of qualities. Leadership is a dynamic process of listening, fostering consensus and engaging with people to further principles and to achieve goals that you believe in.
I suspect that this spirit of collaboration is found in those of you who were chosen to be here. I congratulate each and all of you! I join you in the belief in public service and in a sense of mission that compels me to believe in the possible.
During my life, I have had the privilege to live in service of shared goals for democracy, equality and justice, first for my country of Chile, and now for the women of our world through UN Women.
I know that there is no limit to what a woman can accomplish. I am pleased to see four women health ministers among the 17 represented here tonight. Wherever I go, I call for more women leaders—as Heads of State, as Ministers, as members of Parliament, and as CEOs and on the boards of companies.
We still have a long way to go to reach equality. But we are getting there.
And we will get there faster if all of you take steps, and leaps and bounds, for women's empowerment and gender equality. This is transformational leadership in health in action.
Just as a healthy society is underpinned by the principles of equality and justice, good leadership is based on the pursuit of human rights and human dignity for all, with government deriving its just powers from the consent of the governed.
During my life, I have learned that listening is a very powerful form of communication and absolutely essential to problem solving and good decision-making. Transformational leadership is just and inclusive.
In Chile, we succeeded in reducing the waiting times in primary care facilities by 82 percent. We reduced the number of Chilean people living in poverty, expanded free access to health care, built daycare centers and preschools that are free of charge for Chile's poorest families, and extended the provision of pensions for older persons.
We achieved these and other goals by prioritising social welfare and social protection and by going out into the field and talking to all the different stakeholders, by listening to people and taking responsive action.
In 2009 in Chile, we embarked on a project called “Let's Build Better Health for Everyone. This process of community participation aimed at choosing health priorities with a goal to reduce inequities.
The process involved four stages. First, listening to different opinions and collecting information through 57 forums held throughout the country with some 50,000 people. Second, classifying and analyzing the information by a group of experts. Third, returning the proposals to communities for validation. And, finally, incorporating the proposals into the health objectives for the decade of 2011-2020, and into the 2010 regional health planning.
I can tell you that the consultation process produced extremely valuable information for designing and carrying out effective social policies. The majority of the proposals made by the community and the health care workers were sensible, feasible, and well thought-out, and they were also innovative, efficient and oriented towards social justice.
Transformational leadership in health begins with a commitment to defend the right to health, for everyone, especially those who are vulnerable and disadvantaged.
But as you and I know, this brings challenges because as Health Ministers, we face particular demands that are not always matched by financial and human resources. After the priorities and agenda were set with community participation for our health agenda in Chile, tension occurred when the implementation began. We had to respond to needs and this meant modifying technical criteria, changing administrative procedures and adapting services to meet public demand.
These are real challenges that demand transformational leadership that respects the human being, takes care of business now, and also looks to the future.
Today we see emerging trends that demand a health response across sectors. I am talking about population dynamics, climate change, the rise of middle-income countries and the growing burden of non-communicable diseases.
You are I are one of 7 billion people on Earth. While people are living longer and healthier lives, huge inequities persist. The current pace of growth is adding about 78 million more people every year-and almost all growth is occurring in urban areas in less developed countries, some of which already struggle to meet their people's needs. At the same time, many rich and middle-income countries are concerned about low fertility, declining populations and ageing.
As the global population grows from the current 7 billion to almost 9 billion by 2040, and the number of middle-class consumers increases by 3 billion over the next 20 years, the demand for resources will rise exponentially.
By 2030, the world will need at least 50 per cent more food, 45 per cent more energy and 30 per cent more water — all at a time when environmental boundaries are throwing up new limits to supply.
Whether we can live together on a healthy planet will depend on transformational leadership that addresses inequality, disparities and discrimination in society—conditions that deprive individuals of their right to health and are not sustainable.
We see this so clearly when we examine the health of women and children. Studies show that women's health status is an indicator of women's status in society overall.
Of all health indicators, maternal mortality represents the greatest inequality between rich and poor. Every day 800 women die from complications of pregnancy and childbirth, two women every minute. Every year such complications leave more than 10 million women with physical and mental disabilities.
We know that globally, maternal mortality is due to a lack of access to quality health services. The high rate of maternal mortality, with the vast majority of deaths occurring in sub-Saharan Africa and South Asia, also has root causes in poverty and gender inequality—in low access to education, especially for girls, in early marriage, adolescent pregnancy, and low access to sexual and reproductive health information and services, including for adolescents.
We know that the more that women's rights are respected, including the right to sexual and reproductive health, the lower the rates of mothers dying during pregnancy and childbirth, the lower the rates of teenage girls getting pregnant, and the lower the rates of abortion.
And we also know that non-communicable diseases—cancers, cardio-vascular disease and diabetes are taking a rising toll and are responsible for more than 60 percent of all deaths globally. Nearly 80 percent of these deaths occur in low and middle-income countries and this can push households into poverty and adversely affect national economies.
Therefore urgent efforts are needed to deliver integrated health services and to promote healthy lifestyles that focus on a nutritious diet and physical activity and reduced use of alcohol.
My friends, today and every day, individuals like you and institutions like the Harvard School of Public Health are coming together to advance the rights of women and children, and to advance public health. And these efforts are paying off.
Thanks to an alliance of governments and leaders like you, UN agencies, the private sector, NGOs, universities, and philanthropic groups such as the Gates Foundation, we are moving to eliminate deaths from malaria.
Polio is close to eradication, like smallpox before it. HIV/AIDS is coming under control, slowly but steadily. The health of women and children is improving. In every country men, women, and young people are mobilizing to end violence and discrimination against girls and women.
It is a pleasure to head the newest United Nations agency UN Women. There is rising awareness that women and girls contribute so much to the health of families and communities, propel economic growth and improve prospects for the next generations.
These advances testify to the growing power of global partnership.
And this is where I appeal to you. I appeal to you make the health of women and children a priority.
I say this because investing in the health and well-being of women and girls is not only the right thing to do from a moral and human rights perspective. It is also smart, strategic and cost-effective.
Studies and experience show that prioritising women's and child health improves service delivery. This means focusing on delivering cross-sectoral interventions where they are needed to meet the real needs of people. In addition, if health resources are limited, women's and child health will give the highest return on investment.
When mothers are educated and healthy, chances are their children will be too. When women are healthy and educated, and can participate in the economy, poverty, poor health and malnutrition decline, and living standards and economic growth rise higher.
Women put 90 percent of their income back into their families and the well-being of their children. A child born to a mother who can read is 50 percent more likely to survive past the age of five. Girls who finish secondary education are between four and seven times more likely to use condoms compared with girls who do not finish, and are less likely to become HIV-positive.
Just last month UN Women joined other UN agencies and organizations in a global partnership to advance the health of Every Woman and Every Child.
Since 2010, over 200 partners have made policy, service delivery and financial commitments to advance the Global Strategy for Women's and Children's Health, through Every Woman Every Child, totaling over $40 billion dollars. Among them are 69 countries, of which 53 are low- and middle-income countries.
Of the 17 Ministers of Health attending the conference, 12 are from countries that have made commitments to advance the Global Strategy for Women's and Children's Health through Every Woman Every Child.
I know that the countries represented here that have not made commitments to Every Woman Every Child have made commitments to improve women's and children's health in their own nations.
These commitments are paying off.
Child mortality is declining. The MDG target to reduce child mortality can be reached, with substantial and accelerated action to eliminate the leading killers of children. Special efforts to fight pneumonia, diarrhea and malaria, while bolstering nutrition, could save the lives of millions of children.
Maternal health is improving. Thanks to efforts from people like you, the number of women dying of pregnancy and childbirth related complications in the last 20 years has been reduced by nearly half.
Progress is being made in all regions. Yet accelerated action is needed, especially in sub-Saharan Africa, where less than one in four women have access to contraceptives and more than half of women give birth without a skilled birth attendant.
Access to family planning could cut maternal deaths by an estimated 20 to 35 percent. Yet today some 215 million women, who would like to plan and space their births, still lack access to effective contraception.
Global partners are poised to expand access to family planning and I applaud and support this effort.
Efforts to provide family planning, midwifery services and emergency obstetric care will save and improve the lives of millions of women and their families.
This is especially important for young women. Today pregnancy and maternal conditions are the number one killers of 15-19 year old adolescent girls worldwide. These girls are twice as likely as women are in their 20s to die during pregnancy or childbirth. For those under 15, the risks are 5 times higher.
Despite these risks, one in seven girls in the developing world marries before the age of 15. Moreover, progress has stalled in all regions in reducing the numbers of adolescent pregnancies.
Today I urge all of you to place a special focus on adolescent girls. By doing so, you will demonstrate leadership that transforms their lives and boosts the well-being of your nations.
Every Woman Every Child aims to save the lives of 16 million women and children, prevent 33 million unwanted pregnancies, end stunting in 88 million children, and protect 120 million children from pneumonia by 2015.
It is not just about reducing child and maternal mortality or a specific disease. It is also about girls' and women's empowerment. For these reasons, as part of Every Woman Every Child, you can find commitments to ensure access to education and tackle child marriage, and to expand integrated services for maternal and child health, HIV and AIDS prevention and care, and non-communicable diseases.
There are also commitments to support country-led health plans; to share research and innovation; to enhance financing, health worker training and policy, and to improve service delivery to reach people where they live.
Yes, this mission to save 16 million women and children by 2015 is challenging. This is an enormous and unprecedented undertaking. But it is achievable with our collective strengths.
As health ministers, I encourage you to continue to reach out across sectors and work with your other ministers and global partners. A vaccine or AIDS treatment works so much better if a person has food, safe water and sanitation. Contraception works so much better if a woman can take her own decisions about her body and her life. Public health improves when efforts are also take to fight poverty, violence and discrimination.
As transformational leaders in health, you have the technical, political and leadership skills to create an environment where every person can claim their right to health.
Through your good work to tackle AIDS, malaria and tuberculosis, to improve the health of women and children, you are making our world a better place. And you are contributing to the achievement of the global Millennium Development Goals.
There is so much good work that all of you are doing, for which I thank you, and so much good work that remains to be done!
This summer is going to be an important one for global health. In June, leaders will meet for the Rio+20 Conference on sustainable development, the G20 Summit, and the meeting on A promise to Keep to end the preventable deaths of children. In July, we have the Family Planning Summit and the 19th International AIDS Conference. Many of your countries will be represented at these events.
I want to encourage you to keep pushing ahead, keep doing what you believe in. As our collective capacity is growing, we must use it to its full potential to accelerate action on women's and children's health.
This is so important as we engage with all concerned to define the post-2015 agenda. The health and rights of women and girls are vital to sustainable development.
By placing the health of women and children at the centre of the global development agenda, we can deliver the results by 2015 that we have promised to them.
I thank you.