Saving Mothers' Lives

• Author: Melinda Gates
• Position: co-chair and trustee of the Bill and Melinda Gates Foundation.

ONE of the best pieces of news I’ve heard this year is that the bleak maternal health statistics we’ve been puzzling over for so many years appear to have been wrong.

Until the Institute for Health Metrics and Evaluation (IHME) released a new report on maternal mortality in April, we thought the world had made roughly no progress on saving mothers’ lives. Now we know that, according to the best and most complete data available, maternal mortality has been going down steadily for 30 years. In 1990, the global maternal mortality ratio (the number of maternal deaths for every 100,000 live births) was 320. In 2008, it was 251.

Obviously, those numbers don’t put us on pace to reach the Millennium Development Goal (MDG) target of a 75 percent reduction in the ratio, but they’re a good reason to be optimistic. Add to them the Group of Eight (G-8) industrial countries’ new $7.3 billion, five-year initiative on maternal and newborn health and the ongoing effort by the United Nations (UN) to develop a comprehensive Joint Action Plan for Women’s and Children’s Health, and we might finally be on the cusp of having a new story to tell about maternal health.

Some of the country-level findings in the IHME report are even more exciting than the overall picture. A handful of very different countries, from Bangladesh to Bolivia to China to Egypt to Romania, have made major strides in maternal health in the past 20 or 30 years. These success stories demand further study, because they point the way to broader progress. As we determine how China decreased its maternal mortality ratio from 165 in 1980 to 40 in 2008, or why Egypt’s ratio has gone down 8.5 percent annually since 1990, we will build up a bank of best practices for other countries to adapt and adopt.

The fact that some countries are doing significantly better than the average also suggests that the explanation for slow progress is not a lack of expertise or effective tools, but rather a lack of political will to apply that expertise and those tools. Enough countries are saving mothers in large enough numbers to prove that we know how to achieve our goals. Unfortunately, most countries have failed to make it a priority.

But by sharing success stories, we can build the necessary political will that will lead to much more aggressive maternal health policies. That is exactly what is happening in Malawi right now. I traveled there in January, and the walls at the hospitals were covered with a poster that...