Gender activists want more philanthropic funding for maternal health

DAR ES SALAAM, Tanzania — Gender health activists want philanthropists to step up and start filling the gaps in maternal and child health funding. According to Donor Tracker, total official development assistance to maternal, newborn, and child health stagnated between 2017 and 2021 at around $10 billion annually, with 53% of funding coming from bilateral donors in 2021. Underfunding has mainly affected primary health care but there are also serious shortfalls in research and development, said Katelen Kellogg, communications officer at the Bill & Melinda Gates Foundation philanthropic partnerships team. Kellogg said addressing the women’s health funding gap would boost the global economy by $1 trillion, which would lead to a 1.7% increase in per capita gross domestic product annually by 2040 when health costs are reduced and more professionals are working in the health space. But currently, only 4% of all biopharma research and development spending goes toward female-specific conditions, she said. “Philanthropy can help create conditions that enable people and communities to thrive by speeding innovations and filling gaps that governments and businesses can’t or won’t address. And that includes boosting survival rates and the overall health of mothers and babies,” Kellogg said. According to Kellogg, only a small fraction of philanthropy is dedicated to advancing Sustainable Development Goals, gender equality, or racial equity. The fallout from the COVID-19 pandemic; global geopolitical tensions that have sparked conflict in Europe and the Middle East; and response to climate change emergencies, are also pivoting funding away from mothers and children. But there are some bright spots in this space. Philanthropists in partnership with governments committed $445 million to urgently fund primary health care during last year’s Global Financing Facility for Women, Children and Adolescents. But this is not enough, according to gender activists at the recent WomenLift Health conference in Tanzania, who argued that there is a general feeling within the health space that philanthropists have paid more attention to other critical areas such as HIV, TB, and malaria, denying maternal and child health much-needed funding flows. “Globally this has been a challenge in terms of realizing progress on maternal health,” said Dr. Ellen Mkondya-Senkoro, the chief executive at the Benjamin W. Mkapa Foundation. We do not have a special funding geared towards maternal health.” In 2022 donors pledged $15.7 billion to the Global Fund to Fight AIDS, Tuberculosis and Malaria’s seventh replenishment. The Goalkeepers report by the Gates Foundation found that SDG 3 targets around reducing maternal mortality and ending all preventable deaths under 5 years of age are worryingly off track. “Globally, maternal mortality rates have remained stubbornly static over the past eight years, and in some countries, from the United States to Venezuela, they have risen,” the report stated. “Unless we specifically focus on [SDG3] things are going to get worse,” said Dr. Anita Zaidi, the president of the gender equality division at the Gates Foundation. One way to achieve this is by elevating more women in global health leadership positions. Presently, women make up 75% of the health workforce around the world but only hold 25% of senior leadership positions, a situation that is limiting the ability to tackle the world’s most pressing health challenges, according to Amie Batson, president of WomenLift Health. “When more women lead, they bring new ideas and creative solutions that enable communities, organizations and entire countries to prosper. There is also rich evidence that shows women leaders are more likely to prioritize the health needs of children, women and communities, from reproductive and maternity care, to clean water and sanitation, to stronger health systems,” Batson said. In Tanzania, maternal health deaths have declined from 500 per 100,000 live births to almost 100 per 100,000 live births since President Samia Suluhu became the country’s leader, according to Senkoro of the Mkapa Foundation. She said political leadership commitment toward maternal and child health has seen the country invest its development funds toward improving health infrastructure, like building more health facilities and rehabilitating existing ones. The Gates report also estimates that by making innovations for maternal health accessible to those who need them most, 2 million additional lives could be saved by 2030, and 6.4 million lives by 2040. On this front, the Gates Foundation is supporting innovations that prevent postpartum hemorrhaging such as the IV iron infusion, those that prevent infections during pregnancy like making the antibiotic azithromycin available to mothers, and an AI-enabled ultrasound. And this is where collaborative philanthropy can come into play. Collaborative Funds of between $2 billion to $3 billion annually have been raised and distributed to nonprofits and communities to accelerate progress on complex societal issues, according to Kellogg. “Collaborative funds are one of the fastest growing and highest impact drivers of philanthropy. Research shows that collaboratives are significantly more likely than traditional foundations to prioritize racial or gender equity or to be led by women or people of color, attributes that are especially relevant for improving maternal health outcomes,” Kellogg said. Update, May 10, 2024: This article has been updated to clarify sourcing for comments made by Katelen Kellogg.