The theme of this year’s World Health Day is “Urbanization and Health.” Maternal mortality and morbidity, and neglected tropical diseases have a hugely debilitating impact on urban slum populations—who often lack access to health services. I would like to take this day to celebrate the increased attention to the connected issues of neglected tropical diseases and maternal health and to highlight the importance of a comprehensive, integrated approach to maternal health. This sort of approach not only includes universal access to reproductive health services but also addresses neglected tropical diseases—and their impact on maternal morbidity and mortality.
Maternal health and neglected tropical diseases have a number of things in common, ranging from a shared history plagued with little political will to the death tolls associated with each issue—according to the World Health Organization, 536,000 women die from pregnancy complications a year, and neglected tropical diseases kill an estimated 534,000 people a year. More recently, these two global health issues share something else: a boost in funding, international attention and overall momentum.
The issue of maternal health is attracting more attention than ever before. Organizations like Women Deliver and the Maternal Health Task Force are reaching out to new partners and new sectors, holding global conferences, and advancing the dialogue around MDG5, the maternal health Millennium Development Goal. New sectors are also getting involved, funding projects, and producing innovative technologies in each of these fields. The Pulitzer Center on Crisis Reporting, which funds international reporting projects, named maternal mortality a priority issue for 2010—and will be funding journalists to investigate the crisis of maternal mortality. Several efforts are underway to investigate the use of cell phone technologies to improve access to maternal health information—and also to track neglected tropical diseases. The Global Network for Neglected Tropical Diseases is building support and raising the profile for the control and eradication of a variety of neglected tropical diseases. Several public-private partnerships are helping to expand the coverage of treatment and prevention of neglected tropical diseases. Finally, President Barack Obama has set an example by naming neglected tropical diseases and maternal and child mortality as two of the four pillars of the Global Health Initiative.
It is encouraging that these two issues have gained so much attention at the same time – not only because they share a history of neglect, but because of the impact they have on one another. In a recent paper, Dr. Peter J. Hotez, outlined how certain neglected tropical diseases, such as hookworm, contribute to anemia in pregnant women and explained that deworming during pregnancy has a significant impact on reducing maternal and perinatal morbidity and mortality. Deworming is also an extremely cost-effective way to improve school attendance—and female education is an important predictor of a woman’s risk of surviving pregnancy and childbirth.
The reverse is also true: women’s health during and after pregnancy impacts the incidence and impact of neglected tropical diseases on whole communities. Around the world, women are the primary caregivers for children, the sick and the elderly. They boil water, make sure their children wear shoes, and put their children to sleep under bednets—all of which reduce transmission of disease. If women’s health is not protected, their children suffer: a child who loses his or her mother is far more likely to die before their fifth birthday than a child whose mother survives.
The momentum around these two issues is building. The time is now for the maternal health community to focus on a comprehensive approach to maternal health – that not only includes universal access to reproductive health services, but also considers maternal health in a broader context, including the relationship between maternal health and neglected tropical diseases. This kind of comprehensive approach, will dramatically improve the lives of the world’s most economically, socially and geographically marginalized populations—specifically those living in remote rural villages and crowded urban slums.