[Congressional Record Volume 155, Number 118 (Friday, July 31, 2009)]
[Extensions of Remarks]
[Pages E2162-E2164]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                  RECOGNIZING DAY OF THE AFRICAN CHILD

                                 ______
                                 

                               speech of

                          HON. BETTY McCOLLUM

                              of minnesota

                    in the house of representatives

                         Tuesday, July 28, 2009

  Ms. McCOLLUM. Madam Speaker, I rise in support of H. Res. 550, a 
resolution recognizing the Day of the African Child.
  Each year more than half a million women die in pregnancy and 9 
million children die of preventable causes, half of whom are in Africa. 
This resolution recognizes the need to reduce maternal, newborn, and 
child deaths in

[[Page E2163]]

Africa, and recognizes the Day of the African Child which is held 
yearly on June 16th, and the importance of the U.S. partnership with 
African Leaders.
  At this moment millions of boys and girls across the continent of 
Africa are struggling to survive. In Sub-Saharan Africa roughly 1 in 
every 7 children fail to reach their fifth birthday--the highest rate 
of under-five mortality in the world--and 9 out of 10 African mothers 
will lose a child during their lifetime.
  But the picture in Africa is not hopeless. Eritrea, Ethiopia, Malawi 
and Mozambique, for example, have made significant progress in child 
survival and have reduced their under-five mortality rates by 40 
percent or more since 1990. The African Union has made child survival a 
theme for their 15th Ordinary Session in 2010 and the G8 Summit leaders 
have also made a commitment to ensure all children have access to free 
basic healthcare by 2015.
  On June 16, 2009 I held a briefing with the Global Health Caucus and 
the Subcommittee on Africa and Global Health to commemorate the Day of 
the African Child to explore the challenges remaining and actions to 
improve the well being of Africa's children. I was pleased to co-host 
this event Congressman Payne, the African Union, and several other 
organizations.
  I urge my colleagues to support this resolution to make children and 
mothers in Africa and the developing world a priority.
  Madam Speaker, on July 14, 2009 I had the opportunity to speak at the 
Center for Strategic and International Studies (CSIS) to discuss the 
development of a comprehensive strategy for improving the health of 
newborns, children, and mothers in the developing world. I would like 
to enter my remarks from this event into the Congressional Record.

      Advancing Maternal and Child Health in the Developing World

       Good morning. I greatly appreciate the opportunity to be 
     asked by CSIS to speak about global health and specifically 
     the health needs of women and children in the world's poorest 
     countries.
       Let me start by thanking and congratulating CSIS and Steve 
     Morrison for the on-going commitment to elevate the 
     importance of global health. The work here is essential to 
     the examination of U.S. foreign policy and the health 
     investments our country is making around the world. CSIS's 
     global health effort is impressive and really important.
       Many of you are here today because you are working to 
     improve basic health care for women and children across the 
     developing world. Thank you for all that you do. Your work 
     may be to prevent needless deaths or to create opportunities 
     for tens of millions to achieve a basic quality of life in 
     which extreme poverty, hunger, disease, and suffering are 
     defeated. It is all important work and we need you to keep 
     fighting.
       Let me open my remarks with a single sentence from last 
     week's G8 Global Health Experts Report: ``Women and children 
     are among the most vulnerable groups and progress toward the 
     MDGs related to maternal, newborn and child health remains 
     too slow.''
       Let me repeat that last part again . . . ``progress toward 
     the MDGs related to maternal, newborn and child health 
     remains too slow.''
       Let me rephrase that in another way, 25,000 newborns and 
     children under-five died yesterday, are dying today, and will 
     die tomorrow--and everyday for the foreseeable future. One 
     thousand-five hundred mothers will die during pregnancy or 
     after delivery today, tomorrow, and everyday for the 
     foreseeable future.
       Is progress to end needless, preventable deaths progressing 
     too slowly?
       Of course it is. We don't need a G8 global health report to 
     tell us this.
       What the G8 should do is ask the mother and father of one 
     of the more than nine million children who died last year if 
     progress has been too slow. Or, they could ask the orphaned 
     children whose mother was one of the more than half million 
     women who die every year from a pregnancy related death.
       So what are we--the richest nation and the other donor 
     nations--doing to significantly reducing child and maternal 
     mortality while investing in building sustainable health 
     systems?
       Unfortunately, not enough in my opinion.
       Taking on the challenge of achieving MDG 4 to reduce 
     children mortality (by two-thirds) and MGD 5 to reduce 
     maternal mortality (by three-quarters) is a goal that could 
     be accomplished if the world community invests and acts.
       The goals are doable. But the fate of millions of women and 
     children cannot be just a talking point in a speech or a 
     summit declaration. We need to do more than just talk about 
     the MDGs.
       With regard to maternal and child health inspiring action 
     may be our biggest challenge. Ministries of Health in Sub-
     Saharan Africa and South Asia understand that women and 
     children are dying in massive numbers in their countries. The 
     development and global health community understand the 
     problem. Everyone in this room understands the situation.
       We don't need to wait for a miracle drug or a great 
     technological breakthrough to deliver an essential package of 
     interventions that can save the lives of millions of children 
     and hundred of thousands of women every year. We are 
     delivering those interventions today. And it is being done 
     all around the world right now, but it does need to be scaled 
     up and sustained.
       We know skilled birth attendants are needed at all births 
     and we know how to recruit and train them.
       We know expanding access to family planning and child 
     spacing improves the health of women and their children.
       We know exclusive breast feeding, immunizations for 
     measles, Vitamin A, and bed nets have combined to save 
     millions of lives over the past decade.
       We know the work of GAVI, the Global Fund, UNICEF and UNFPA 
     are saving lives.
       And, we know USAID has been making major contributions to 
     maternal and child health, as well as reproductive health, 
     for decades. Tens of millions of people are alive today 
     because of the child health programs implemented by USAID and 
     paid for by the American people over the past forty years. We 
     need to celebrate this tremendous success.
       All of you here today know every imaginable statistic and 
     fact about the lack of maternal and child health care, the 
     medical consequences, and the human cost. A lack of data is 
     not the problem.
       So let's look at maternal and child health from a different 
     perspective. What don't we know?
       This is a harder question.
       Something must be missing if we know how to solve such a 
     serious problem, save lives, and yet, children and moms are 
     still dying needlessly.
       Let me throw out a few questions for you to think about, 
     because I am looking for answers myself.
       Where is the urgency to save the lives of children and 
     mothers?
       Where is the political will to invest in the lives of 
     children and mothers?
       And does anybody know or care to know the names or the 
     faces of those babies and women who are dying needlessly at 
     this very moment?
       These are the questions we need to answer if we are going 
     to translate the endless reports, policy papers and strategic 
     plans into the advocacy, inspiration, investments, and action 
     needed to save lives.
       I am looking for answers and I am looking to you to help 
     find them.
       I am one voice and vote in the House of Representatives--
     there are 434 other voices and votes as well. Is child or 
     maternal survival a priority issue for Congress? We know it's 
     not but can it be much more of a priority?
       Imagine the possibility of a terrorist attack in which 5 
     million children were at risk, but we knew how to prevent the 
     attack and we knew it would cost $5 billion to save those 
     lives. Would Congress spend the money? Of course we would--
     even the Blue Dogs would vote for it.
       Unfortunately, the terror that strikes millions of parents 
     who watch their children die from malnutrition or malaria is 
     not the same terror that inspires Congress. The real sense of 
     urgency may need to start beyond Washington, in the very 
     countries in which women and children are dying at 
     unacceptable rates.
       For example, India and Pakistan have billions of dollars to 
     spend on advanced military hardware including nuclear 
     arsenals and yet tens of millions of their citizens live in 
     abject misery and die for no reason other than they are poor.
       Nigeria, a petroleum exporter, leads the African continent 
     in the number of mothers and children dying each year. This 
     should be a source of shame for such an African power.
       Where is the urgency in India, Pakistan, or Nigeria to 
     invest in their own citizens' lives? And, if they aren't 
     willing to make their own children's lives a priority, how do 
     I convince my constituents to make their kids a priority?
       Clearly the lack of urgency from the very countries where 
     women and children are dying translates directly into a lack 
     of political will.
       Since the whispers of dying moms and children are not heard 
     by politicians in Ethiopia, Zambia, Afghanistan, or the 
     United States, there should be no expectation that preventing 
     these deaths will be a political priority any time soon.
       For example, where is the urgency among nations of Sub-
     Saharan Africa to lobby Congress to save the lives of their 
     own citizens? If Africa's presidents are not prioritizing 
     maternal child health their ambassadors in Washington will 
     not be knocking on Congress's door asking for increased 
     appropriations.
       No urgency translates into a lack of political will which 
     in turn means limited resources and more needless deaths--a 
     self-perpetuating cycle.
       How will the NGO, think tank, and advocacy community help 
     to break this cycle? I want to hear your ideas.
       Here at home, is there the political will for the U.S. to 
     be the global champion for women and children?
       The Obama Administration has demonstrated the ability to 
     understand and articulate a global health vision. There have 
     been numerous positive statements regarding maternal child 
     health.
       The Administration's leadership would be essential for any 
     major increase in investments for maternal child health in 
     FY2011.

[[Page E2164]]

     But that requires the President to nominate someone to lead 
     our nation's international development efforts. It is 
     critical that a USAID administrator get in place as soon as 
     possible.
       How to inspire the political will--in the U.S. and around 
     the world--is something the child and maternal health 
     advocacy community needs to think long and hard about.
       This is an area where policy, politics, and pressure need 
     to come together to make real change.
       Unless a new model of grassroots advocacy, political 
     engagement, lobbying of Congress and the White House, and 
     real pressure from Americans all across this country takes 
     place--from school children to church groups to civic 
     organizations--I am afraid maternal and child health will 
     stagnate as an issue and we will not be successful at 
     appropriating the increased dollars needed to save lives.
       The reality we are facing is that the political and policy 
     success of the global HIV/AIDS community has put a real 
     squeeze on all other global health accounts.
       In the House FY2010 State and Foreign Operations 
     Appropriations bill we invested $7.8 billion for global 
     health with seven out of every ten dollars going to HIV 
     prevention, treatment or care. With regard to treatment, 
     PEPFAR has created a global health entitlement program that 
     means a person's lifetime treatment for HIV takes priority 
     over other health investments, like child and maternal 
     health. The cost is not only financial, but tradeoffs are 
     being made that can be counted in lives lost--too many lives.
       As Congress goes through our own domestic health care 
     reform all of my colleagues and I have heard first hand 
     stories from countless constituents about their challenges 
     accessing or affording quality health care. Those stories and 
     the people who tell them demonstrate the real need for health 
     care reform.
       Who are the mothers and fathers and children we are willing 
     to invest our tax dollars, our energy and our ideas for to 
     build healthier families and communities in far away places? 
     Unless we can make these lives real--less of a statistical 
     abstraction--tens of millions of children and millions of 
     mothers will continue to die.
       Last week Nicholas Kristof wrote in his New York Times 
     column that ``humanitarians are abjectly ineffective at 
     selling their causes.''
       He went on to say, ``I also wonder if our unremitting focus 
     on suffering and unmet needs stirs up a cloud of negative 
     feelings that incline people to avert their eyes and hurry 
     by. Maybe we should emphasize the many humanitarian 
     successes, such as falling child mortality rates since 1990--
     which mean that 400 children's lives are saved every hour, 
     around the clock.''
       If Mr. Kristof is correct in his assessment, then we should 
     be championing successes--every toddler who is now a teenager 
     because of access to basic healthcare, good nutrition and 
     clean water.
       It is absolutely remarkable to know that there are 
     circumstances in which for a few hundred dollars invested in 
     the right place, at the right time, with the right 
     intervention available--an illness can be prevented, an 
     infection can be treated, a mother can deliver a child 
     safely. Hundreds of thousands of American citizens are 
     contributing their own money to NGOs to make a difference in 
     the life of a family or person they don't even know. If those 
     Americans can be mobilized to make child and maternal health 
     a priority for President Obama and Congress then the power of 
     the American people and our tax dollars will save lives--
     millions of lives.
       As we all know there are many competing development 
     challenges that require resources and collectively contribute 
     to making poor communities healthier, more successful, and 
     better prepared to meet the opportunities of the future. 
     Whether it is basic education, agriculture development, clean 
     water, or maternal and child health, we need to make smart 
     investments that produce results and demonstrate to the 
     American people real improvements in real people's lives.
       Let me conclude by asking for your ideas and suggestions 
     about how to mobilize and inspire action from the American 
     people, Congress, the White House, as well as foreign leaders 
     to make maternal and child health a global priority. I would 
     like the opportunity for a dialogue on what NGOs, donors and 
     policy makers can do to energize, mobilize and communicate 
     more effectively on this issue.
       As all of you know, I am the author of H.R. 1410--The 
     Newborn, Child, and Mother Survival Act--which authorizes the 
     development of a U.S. strategy to reduce child and maternal 
     mortality and implementation of the strategy by USAID.
       It is a good bill, but it's not enough.
       We need a campaign--a movement--in support of the millions 
     of children and women's lives we can save if we only try.
       We need action in Congress and parliaments in donor and 
     developing countries.
       We need to organize parents and children as activists.
       We need to motivate and mobilize a political movement that 
     will create the support for the resources to allow 
     investments in interventions that will save lives, change 
     communities, and transform our future.
       I am committed to making pregnancy, child birth and a 
     newborn's start in the world safe, healthy and a joy for 
     every family--even the poorest of families in the poorest of 
     countries.
       We have a lot of work to do to make this vision a reality 
     and I look forward to hearing you ideas about how we can get 
     moving.

                          ____________________