Newborn breakfast: Challenge for action

25 SEPTEMBER 2013 | NEW YORK

Newborn health was at the top of the agenda during a breakfast meeting held on the side of the UN General Assembly. More than 100 participants, including representatives of donor agencies and foundations, the UN, health care professional associations, private business and civil society, attended the provocatively titled session, “Where should the money go for newborn survival – prevention or care?”. The session was organized by Johnson & Johnson, March of Dimes, Save the Children, and the MDG Health Alliance.

Moderator Richard Horton, editor of The Lancet and co-chair of the independent Expert Group, led panelists through a lively 90-minute discussion that made the case for investment in prevention (led by Dr Chris Howson, Vice-President for Global Programs at the March of Dimes) as well as the for prioritizing care (led by Dr Winnie Mwebesa, Senior Director of Family Planning/Reproductive Health, of Save the Children).

Prevention, argued Dr Howson, is harder to promote, yet it is central to our ambition to reach our MDG targets. Key countries, including middle-income countries, are not yet receiving adequate attention in this effort. “Prevention is not dramatic – you can’t simply put up a photo and say, ‘This child survived because its mother had 400g of folic acid.”

Investment in proven packages of care, argued Dr Mwebesa, is demonstrated to have strong returns in community health and economic development, and is in urgent need of attention.

Dr Horton underlined the importance of both approaches, and noting that the debate is really one of the overall need for greater attention to newborn survival. “In the continuum of care, if we are really honest, we have missing the newborn piece out”.

A second set of panelists, including Dr Mickey Chopra, Chief of Health of UNICEF, and Dr Liz Mason, Director of Maternal, Child and Adolescent Health at the WHO, provided concrete examples of countries where progress is being made – 77 countries, for instance, in the past 10 years have reduced their newborn mortality rate by 25%. In particular, countries like Malawi, with its focused attention to scaling up Kangaroo Mother Care (skin to skin care) demonstrate how simple measures can promote preterm survival – preterm itself being the largest cause of newborn mortality.

Panelist Leith Greenslade of the MDG Health Alliance remarked on the importance of bringing the private sector to the tables as a major partner in the joint effort for newborn survival, especially given the need for greater innovation and financing. Horton noted UK Development Minister Justine Greening’s announcement during the UN General Assembly week about a new £1 billion grant for the Global Fund to Fight AIDS, Tuberculosis and Malaria: “Wouldn’t it be wonderful if Justine Greening could announce £1 billion for newborn health?”

Dr Bill Keenan, Executive Director of the International Pediatric Association, rounded off the panel, remarking on the important role of the health care professional associations in guiding advocacy for patient care given the enormous networks that his organization and other professional networks like FIGO, ICM and COINN represent.

Dr Carole Presern, Executive Director of The Partnership for Maternal, Newborn & Child Health provided closing remarks and a challenge for the future, reminding that it is not a simple case of prevention or care when commitments, in general, are still scare for newborn survival. This can be seen, she said, by the fact that only 25% of all commitments to the Global Strategy mention “newborns” – far less than one would expect given that newborn mortality now contributes to 44% of all deaths of children under age 5.

“We have a major opportunity here to make a difference,” said Dr Presern, applauding the ambitions of the Every Newborn movement, whose action plan is due to launch in May 2014. “It’s been surprisingly, frankly, that we have not had an Every Newborn movement before now. But the time has come, and it’s our turn to make a difference.”

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