More than 50 countries in the world are paying more in debt service than on health care, the Bill & Melinda Gates Foundation CEO
Mark Suzman
said during a discussion at its annual “Goalkeepers” conference in New York on Wednesday that was largely focused on improving the maternal and newborn health in low-income countries. 

“You can’t save those 800 preventable maternal child deaths a day, you can’t save thousands of preventable childhood deaths, if you aren’t allocating into those core investments in human development, health, and education,” Suzman said. 

His comments were in response to a frequent call made earlier at the conference by Kenyan President
William Ruto
to extend debt relief to 10 countries already identified by the International Monetary Fund as in “debt distress.” 

Relieving their debt burden will give these countries—including Ghana, Lao, and Malawi—a chance to leverage their resources for economic development, climate action, and to address the United Nations’ sustainable development goals. Ruto also reiterated that the world needs to reform international financial systems that are no longer working. 

“It is defeatist for us to assume that there is nothing we can do about the current financial crisis that is facing our world,” Ruto said. 

On the same panel,
Melinda French Gates,
co-chair of the foundation, said presidents and prime ministers such as Ruto in Kenya understand the value of women in their society, and “they know that if women are well and healthy, then the family is wealthier and the kids get educated.” 

French Gates agreed restructuring debt for countries in distress is needed so that they “can rebuild their health systems while they deal with climate shocks.” 

If “we refinance these countries, they’re going to thrive and grow. And guess what? That’s good for the global economy.”

The discussions were part of a day-long conference that followed an evening of awards and celebration for the foundation’s “goalkeepers”—individuals who are working across the world to address the sustainable development goals.

The event was filled with stories of individuals and organizations and their on-the-ground successes, from Yetunde Ayo Oyalowo, a doctor in Lagos, Nigeria who founded a program that sets up mobile clinics in markets and hard-to-reach communities to, Eva Nangalo, a midwife in Uganda. 

In her talk, Oyalowo described learning that “money saves lives,” a phrase Suzman reiterated later to emphasize that money spent in low-income countries across Africa, Asia, and Latin America on simple tools and interventions such as vitamins and portable ultrasounds, “help save mothers and children’s lives who otherwise would die of completely preventable causes.”

The current international financial architecture should not be the complex, inexplicable structure that exists today, but instead should be as simple as the world “putting money where it matters most,” Suzman said. “And where it matters most is saving human lives.” 

Yet, “particularly because of the Covid crisis, but through a lot of other challenges, we are not, as a world, putting our money where our mouth is,” and tackling the 17 goals agreed on by all U.N. member states in 2015, he said. 

“Our mouth has said, ‘the SDGs are a core set of commitments by every global leader to every single citizen on the planet,’ and we’re not paying up, and we need the financial system and the financial architecture, which is the big banks, the big agencies, to step up,” Suzman said. 

Low-income countries need more resources because they “need to be in the driver’s seat, accountable to their own citizens for these SDG implementations,” he said. 

Wednesday’s conference was centered on maternal and newborn health, the subject of the foundation’s annual Goalkeeper’s report. The document details how progress in addressing maternal and newborn health has stalled, contributing to the loss of 4.6 million childhood deaths every year. It offers seven practical, low-cost interventions for improving the health of mothers and babies that can lead to better outcomes for both, such as multiple micronutrient supplements, a portable ultrasound powered by artificial intelligence, and intravenous iron. 

As a foundation, Gates provides at least US$370 million in annual funding for maternal and childhood health, money that has facilitated research and development and allowed scientists and practitioners to test these interventions for statistically significant outcomes. 

Earlier this week, the foundation announced a separate US$200 million commitment to help countries “achieve universal access to family planning products and information, faster delivery of lifesaving health solutions, and a reduction in maternal and child mortality.”

The foundation also works actively with the World Health Organization and other health providers to have the innovations outlined in the report introduced as best practices in care. But for the interventions to be rolled out widely, that requires the approvals of global, regional, and national health authorities, Suzman said in a news conference after the event. 

“We’re in active discussions across all these interventions, but we can’t provide the resources to make all these changes,” he said. 

This story was updated to include news of the additional funding commitment announced by the Gates Foundation on Wednesday.

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