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ImprovIngthehealthof
Women & ChIldren
around theWorldby 2015
6 8
10 12 14
4
2 MDG Health Alliance Pillars
3 Who We Are | Leadership
4 Improve Child Health
6 Improve Maternal Health
8 Near-Zero Malaria Deaths
10 Near-Zero Transmission of HIV from Mother-to-Child
12 Save One Million Lives from Tuberculosis
14 One Million Community Health Workers
2 | www.mdghealthalliance.org
mdg health allIanCe pIllars
IMPROVE CHILD HEALTH:
Reduce the number ofchildren under 5
dying from 8 million per year to 4 million
per year bythe end of2015
In collaboration with UNICEF and other
partners, in countries with the largest
concentrations of child mortality, increase
access to medicines that prevent and
treat the leading causes of under 5
deaths, including oral rehydration with
zinc, pediatric antibiotics, bed nets and
malaria medicines, and interventions that
prevent the leading causes of neonatal
deaths; with a particular emphasis on
increasing private sector contributions to
achieving MDG 4.
IMPROVE MATERNAL HEALTH:
Reduce the number ofwomen dying
in childbirth from 350,000 per year to
less than 180,000 per year and achieve
universal access to reproductive health
by the end of2015
In collaboration with the H5 agencies
(UNFPA, UNAIDS, UNICEF, WHO and
the World Bank) the United Nations
Foundation and the United Nations
Commission on Life-Saving Commodities
for Women and Children, tap into the
vast potential of private health providers
and health businesses to deliver high
quality, aordable and accessible care
and products to women at highest
risk of maternal mortality and support
governments’ eorts to achieve MDG 5.
NEAR-ZERO MALARIA DEATHS:
Reduce the number of deaths caused
by malaria from 655,000 to near-zero
by the end of 2015
In collaboration with the Roll Back
Malaria Partnership, the African Leaders
Malaria Alliance, the Global Fund, the
World Bank, WHO, the United States and
the United Kingdom, UNICEF, and other
key partners, in countries with the largest
concentrations of malaria deaths, ensure
continued universal coverage of bednets
as well as aggressive deployment of
diagnostics and treatment integrated with
community case management in both
the public and private sectors.
NEAR-ZERO TRANSMISSION OF HIV
FROM MOTHER-TO-CHILD: Virtually
eliminate the transmission of HIV from
mother-to-child bythe end of2015
In collaboration with UNAIDS, PEPFAR, the
countries suering the greatest burden
and other partners, virtually eliminate
the transmission of HIV from mother-to-
child by2015 worldwide. The Business
Leadership Council for a Generation Born
HIV Free, consisting of globally recognized
private sector leaders, has been formed to
bring to bear the collective resources and
acumen ofthe private sector to achieve
the 2015 deadline. The BLC will identify
concrete, actionable roles for businesses
to maximize their impact on vertical
transmission rates in high-burden countries.
SAVE ONE MILLION LIVES FROM
TUBERCULOSIS: Reduce the trajectory
of the number of HIV+ patients who
will die of TB, currently estimated at
1.3 million people, bythe end of 2015
In collaboration with Stop TB and other
partners, increase the TB cure rate by
providing screening programs to test
for infections every three years, provide
treatment to TB-positive individuals,
provide preventive TB treatment to
all women living with HIV at risk of TB
exposure, examine all pregnant women
for signs and symptoms of TB, assess
whole-family risk, and develop new child-
friendly diagnostics.
ONE MILLION COMMUNITY HEALTH
WORKERS: Recruit, train and equip
1 million community health workers
to advance maternal and child health
by the end of 2015
In collaboration with WHO and UN
Agencies, leading telecommunications
and high-tech firms, academic institutions,
and leading NGOs and foundations,
accelerate the provision of community
health workers with training and
equipment to diagnose, prevent and
treat the leading causes of maternal
mortality and child mortality in the
highest burden countries.
www.mdghealthalliance.org | 3
Who We are
The MDG Health Alliance is convened
by MDG Advocate Ray Chambers.
The Alliance is comprised of eminent
leaders from the private, public,
and nonprofit sectors working in
conjunction with theHealth and
Education Cluster ofthe Secretary-
General’s MDG Advocates. Together,
we seek to fulfill the vision articulated
in the UN Secretary-General’s Every
Woman Every Child movement by
mobilizing public-private partnerships.
Private Sector Leaders
+
Alan Batkin
Vice-Chairman, Eton Park Capital Management
+
Kathy Calvin
CEO, UN Foundation
+
Peter Chernin
Former President and CEO of News Corporation,
Chairman of Chernin Entertainment
+
Jack Dorsey
Founder and Executive Chairman of Twitter and
CEO of Square
+
Leith Greenslade
Private Social Investor and Partner, Acumen Fund
+
Austin Hearst
CEO and Chairman, Chestnut Holdings LLC
+
Gabriel Jamarillo
General Manager, The Global Fund for HIV/AIDS, TB,
and Malaria
+
Ellen Lambert
Merck Foundation
+
Charlie MacCormack
Formerly President and CEO, Save the Children
+
John Megrue
CEO, Apax Partners US
+
Brad Palmer
Managing Partner, Palm Ventures LLC
+
Naveen Rao, M.D.
Lead, Merck for Mothers
+
Cliord Sobel and Barbara Sobel
Former US Ambassador to Brazil
+
Diana Taylor
Managing Director, Wolfensohn Fund Management
+
Jerey C. Walker
Former Chairman of CCMP Capital Advisers, LLC
Improve Child Health
Leadership: Alan Batkin and Leith Greenslade
Improve Maternal Health
Leadership: Naveen Rao, M.D.
Near-Zero Malaria Deaths
Leadership: Suprotik Basu
Near-Zero Transmission of HIV from
Mother-to-Child
Leadership: John Megrue
Save One Million Lives from Tuberculosis
One Million Community Health Workers
Leadership: Jeff Walker
MDG Health Alliance Pillars
Six Pillars underpin the work ofthe Alliance, each led by a respective Chair or
Co-Chair, who is responsible for ensuring forward progress and coordination across
agendas, convening networks of new and traditional partners, raising visibility,
awareness, and resources, advocating in favor of increased public sector financing,
and assisting with logistics and in-kind resources:
4 | www.mdghealthalliance.org
Accordingly, since 2004 the public health
community has recommended ORS and
zinc for child diarrhea, however, not one
of the countries with the highest burden
of child diarrhea mortality has achieved
significant coverage of either product, as
the table below shows.
Private Sector Opportunity
An opportunity exists for the commercial
distribution of quality ORS and zinc
at aordable prices and in a variety
of formulations (tablets, syrups, food
supplements, soil fortification etc)
throughout the developing world. There
are 560 million children under 5 living
in the developing world and they each
average 3 episodes of diarrhea every
year. In addition, there are 140 million
underweight children who are at greater
risk of death from infection who would
benefit from zinc supplementation.
In most ofthe high child mortality
countries, consumers have already
demonstrated a willingness to pay for
diarrhea treatments, typically buying
products from local, private pharmacies
or kiosks and incurring costs up to
US$5.00 for medicines that do not treat
dehydration or strengthen a child’s
Millennium Development Goal 4 calls for
a reduction in early childhood deaths to
4 million per year in 2015. This goal will
not be met without new global eorts to
prevent and treat the leading causes of
child mortality (pneumonia, diarrhea,
preterm birth, birth asphyxia, malaria and
neonatal infection) in the countries where
deaths are concentrated, particularly
India, Nigeria, DRC, Pakistan, China and
Ethiopia. As undernutrition is the leading
risk factor for death among children in the
developing world, all strategies need to
incorporate a strong nutrition component.
ORS and zinc treat-
ment for diarrhea
should appeal to any
donor seeking a high
return on investment
and the ability to have
a rapid eect on child
mortality, and donors
who have an interest
in pursuing private
sector approaches
would be particularly
well placed to oer
initial support”.
— Clinton Health Access Initiative
GLOBAL CHALLENGE
IMPROVE CHILD HEALTH
Reduce the number ofchildren under 5 dying from 8 million per year to
4 million per year by 2015
MDG Health Alliance Priorities
Phase 1 ofthe Alliance’s child health
agenda will focus on preventing child
diarrheal deaths in the two regions ofthe
world where they are most concentrated
— the northern states of India and Nigeria.
In Phase 2 this approach will be extended
to the other high child mortality countries
along with eorts to reduce child
pneumonia deaths and neonatal deaths.
Phase 1: Reducing Child Diarrhea Deaths
Diarrhea is the second leading cause
of death for children under 5, claiming
1.3 million every year with India and
Nigeria accounting for one third of
all deaths. Diarrhea continues to kill
millions ofchildren every year despite
the existence of highly eective, low cost
treatment options — oral rehydration
solutions (ORS) and zinc. ORS prevents
dehydration — the leading cause of child
diarrhea deaths — and zinc boosts the
immune system, reducing the duration
and severity of a diarrheal episode and
preventing new infections for two to
three months. If used routinely ORS and
zinc could prevent 90% of child diarrhea
deaths, saving more than 1 million
children every year.
Country
Annual Number Under 5
Deaths from Diarrhea
ORS Treatment Coverage Zinc Treatment Coverage
India 237,000 26% 0.3%
Nigeria 200,000 26% 1%
DRC 100,000 31% 0%
Pakistan 74,000 41% 0%
Ethiopia 73,000 26% 0%
WHO, 2008 and UNICEF, 2009
“
www.mdghealthalliance.org | 5
Led by Alan Batkin and Leith Greenslade, the Child
Health Pillar ofthe MDG Health Alliance works in
partnership with UN Agencies, the private sector,
nonprofit organizations, academic institutions and
others to support country efforts to accelerate
progress toward achieving Millennium Development
Goal 4. The Pillar operates in support of
Every Woman
Every Child,
an unprecedented global movement
spearheaded bythe United Nations Secretary-General
to mobilize and intensify global action to improve the
health ofwomen and children.
n child@mdghealthalliance.org
immune system. There are also large
groups of consumers who either treat
diarrhea with home remedies or not at
all, making it one of most undertreated
illnesses in the developing world. Shifting
existing consumer and health provider
demand towards quality, aordable, child-
friendly ORS and zinc and generating new
demand from those who are currently not
seeking treatment outside the home
represents a significant opportunity for
manufacturers of ORS and zinc.
New Public-Private Partnerships
The Alliance is working in partnership with
UNICEF, the United Nations Foundation,
the Clinton Health Access Initiative, PATH
and the Bill and Melinda Gates Foundation
to mobilize new private-public
partnerships to increase the supply of,
demand for, and distribution of ORS and
zinc in countries where child diarrheal
deaths are concentrated, beginning with
India and Nigeria. Further, to build
momentum and support for new
partnerships, MDG Health Alliance
Business Councils will be established in
India and Nigeria to advocate and
mobilize resources for the diarrhea
challenge and other Alliance priorities.
Key goals ofthe Public-Private
Partnerships to End Child Diarrheal
Deaths in the target countries include:
1 Increase household and health
provider demand for ORS and zinc
through:
+ commercial advertising campaigns
using traditional media (particularly
radio, television and print) and mobile
communications (particularly text
messaging)
+ incentives for consumers to use ORS
and zinc and for health providers
to stock and promote their use,
particularly amongst the extensive
informal private pharmacy networks
that exist in most ofthe target countries
2 Ensure an adequate supply of child-
friendly ORS and zinc that meet
quality standards at prices aordable
to the poorest households by:
+ matching product design and
packaging to consumer preferences
+ supporting the regulatory changes
necessary to increase access to ORS
and zinc (e.g. achieving “over-the-
counter” status for zinc in all target
countries)
+ working with local pharmaceutical
manufacturers to stimulate local
supply, including co-packaged and/or
co-dispensed ORS and zinc products
+ training and incenting local pharmacy
networks and health workers to sell
the products
3 Mobilize local distribution networks
to maximize access to ORS and zinc
focusing on those regions within
countries where diarrheal deaths are
concentrated, by:
+ leveraging the knowledge, expertise
and assets ofthe leading private
sector distribution channels in target
countries so as to broaden the outlets
that will sell ORS and zinc to include
local kiosks and pharmacies
In the countdown to 2015, country-
led demand for new private sector
partnerships to increase the use of
ORS and zinc is strong creating an
opportunity for collective impact that
could save the lives of one million
children under 5.
6 | www.mdghealthalliance.org
Every day, approximately 1000 women
die due to complications of pregnancy
and childbirth — nearly all of these
deaths are preventable. Millennium
Development Goal 5 will not be met
without significant global eorts to
prevent and treat the two leading causes
of maternal mortality worldwide — post-
partum hemorrhage and hypertensive
disorders during pregnancy, such as
preeclampsia. Access to family planning
is also known to play an important role in
reducing maternal mortality.
MGD 5 is one ofthe
goals furthest o
track and we need to
accelerate progress
on maternal health.
Together, through
strategic public-
private partnerships
we can make the
tragedy of a woman
who dies while giving
life a memory, rather
than a crisis.
aordable and accessible care and
products to those at greatest risk of
maternal mortality.
Initially, the Alliance will work in India
and Nigeria, which together account for
one third of maternal deaths worldwide,
and Uganda where an estimated 6,000
women die each year. In Phase 2, the
Alliance will explore opportunities to
work in additional countries with a high
burden of maternal mortality.
Phase 1: Identify Sustainable and
Innovative Business Solutions
The governments of these target
countries are committed to
strengthening their health systems and
improving maternal health. And many
communities in these countries have a
strong business sector which facilitates
opportunities for innovation in public-
private partnerships at the local level.
GLOBAL CHALLENGE
IMPROVE MATERNAL HEALTH
Reduce the maternal mortality ratio by 75 percent and achieve universal access
to reproductive healthby 2015
MDG Health Alliance Priorities
Governments are increasing their reliance
on private health providers and local
health businesses as an ecient way to
extend services and provide essential
medicines to hard-to-reach communities.
In all regions ofthe world, utilization of
private providers of health-related goods
and services is growing — across all
income levels.
Phase 1 ofthe Alliance’s Maternal
Health agenda will focus on helping
governments reach MDG 5 through
innovative ways of engaging private
health providers and businesses to
expand their maternal health eorts and
reach women in rural and underserved
urban communities. The Maternal Health
Pillar will tap into the vast potential
of these providers and businesses to
supplement the eorts ofthe public
health system to deliver high-quality,
www.mdghealthalliance.org | 7
Led by Naveen Rao, M.D., the Maternal Health Pillar
of the MDG Health Alliance works in partnership
with UN Agencies, the private sector, nonprofit
organizations, academic institutions and others to
support country efforts to accelerate progress toward
achieving Millennium Development Goal 5. The Pillar
operates in support of Every Woman Every Child, an
unprecedented global movement spearheaded by
the United Nations Secretary-General to mobilize
and intensify global action to improve thehealthof
women and children.
n maternal@mdghealthalliance.org
The business community has expertise
that could be valuable in developing and
supporting innovative business solutions
and bringing them to the public sector
in developing countries to accelerate
progress in reaching MDG 5.
Private Sector Opportunity
Approximately 80% ofthe population
in India and 50% in some parts of Africa
receive their health care from private
providers — and these percentages
are growing. Women in low and
middle income countries are using a
range of private clinics, fee-for-service
providers (including traditional birth
attendants and midwives), pharmacies
and health shops for their care. These
private providers and entrepreneurs
have tremendous reach into high-
need communities. They are based
in the communities they serve, have
many touch points with families and,
as businesses, have learned how to
establish trust and build customer loyalty.
They are also often owned by women.
New Public-Private Partnerships
The Alliance is working in partnership
with the H5 agencies (UNFPA, UNAIDS,
UNICEF, WHO, and theWorld Bank),
and the United Nations Foundation
to increase the supply of and demand
for midwifery services. The Alliance
will also work with the United Nations
Commission on Life-Saving Commodities
for Women and Children to mobilize new
partnerships to increase the supply of
and demand for life-saving medicines
to combat post-partum hemorrhage
and preeclampsia (specifically, oxytocin,
misoprostol and magnesium sulfate), and
facilitate access to key family planning
products. Further, to build momentum
and support for new partnerships, MDG
Health Alliance Business Councils will be
established to advocate for and mobilize
resources to strengthen maternal health
and other Alliance priorities, including
policy and financing eorts to encourage
an enabling environment for health
businesses to thrive.
Key goals ofthe Maternal Health agenda
in the target countries include:
1 Improving quality of private health
services
+ Identify and support innovative
solutions and partnerships to help
upgrade the quality of private care
2 Expanding access to goods,
services, education and referral
+ Explore opportunities to equip local
health shops and providers with
essential maternal health information
and supplies, and help them link
women to quality health services
3 Making goods and services more
aordable
+ Investigate innovative financing
mechanisms to subsidize the cost of
care for vulnerable populations and
encourage them to seek care
8 | www.mdghealthalliance.org
this overall need for commodities has
already been committed — a testament
to the increased partnership between
endemic countries and the international
community — leaving a cumulative gap
of $3.2 billion over four years. Should
this gap not be filled, we are at risk of
reversing the gains we have made.
The principal funders remain overwhelm-
ingly The Global Fund to Fight AIDS,
TB and Malaria (approximately 70% of
all external funding for malaria), The
World Bank’s International Development
Association, the United States’ President’s
Malaria Initiative, and the United Kingdom’s
DFID. While the Malaria Pillar will look to
support eorts to continue and increase
contributions from these vital partners, a
more diversified financing strategy will
provide more sustainable support for
progress towards our 2015 goal, including
domestic support from sub-Saharan
African countries given their improving
economic growth and access to conces-
sional loans. On World Malaria Day 2012,
Millennium Development Goal 6 calls
for the halting and reversal of malaria
trends by2015. In April 2008, United
Nations Secretary-General Ban Ki-moon
issued an even bolder call: to protect all
those at risk of malaria with treatment
and prevention interventions with the
ultimate goal of reaching near zero
deaths by2015. An estimated 655,000
persons died of malaria in 2010. 86%
of the victims were children under 5
years of age, and 91% of malaria deaths
occurred in the WHO African Region.
Rapid increases in
access to prevention
and treatment inter-
ventions have saved
over one million lives
— 85% over the past
five years alone.
GLOBAL CHALLENGE
NEAR-ZERO MALARIA DEATHS
Reduce the number of deaths caused by malaria from 665,000 to
near-zero by 2015
International funding to combat the
disease surged from US$200 million a
decade ago to US$1.8 billion in 2010, with
over US$3 billion mobilized since the
Secretary General’s call to action in 2008.
Since 2000, malaria deaths have declined
by one third. However, the current global
funding crisis threatens the achievement
of the Millennium Development Goals,
including those specifically related
to malaria. There is a risk of reduced
resources for malaria control, which
could lead to significant increases in
malaria cases, and deaths, and a serious
reversal ofthe gains achieved.
MDG Health Alliance Priorities
The first priority ofthe Malaria Pillar of
the Health Alliance will be to support
eorts to secure the necessary funding
and get to near zero deaths by2015.
This strategy requires $6.7 billion
between 2012 and 2015 for commodity
procurement and distribution across
sub-Saharan Africa. $3.5 billion of
[...]... new infections in children were reduced by 30% between 2002 and 2010 Eliminating Motherto-Child-Transmission of HIV is within our grasp, but the time is now to harness the momentum and push for 2015 as a deadline to achieve this goal 10 | www.mdghealthalliance.org The Global Plan towards the Elimination of New HIV infections Among Childrenby2015 and Keeping Their Mothers Alive: 2011 -2015 This Global... HIV by2015 G lo bal Challe n g e Millennium Development Goal 6 calls for the halting and reversal of TB bythe end of2015 For the 33.3 million people living with HIV worldwide, antiretroviral therapy (ART) has given patients the promise of a full and fulfilling life Now people living with HIV can raise their families, work and pursue their dreams And yet, too many patients are falling prey to another... 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 n Global Fund www.mdghealthalliance.org | 9 Near-Zero transmission of HIV from mother-to-child Virtually eliminate the transmission of HIV from mother-to-child by2015 G lo bal Challe n ge Millennium Development Goal 6 calls for the halting and reversal of the spread of HIV by2015 34 million people are living with HIV globally and 1.8... living with HIV in need of services Intensified efforts are also needed to support countries with low HIV prevalence and concentrated epidemics to reach out to all women and children at risk of HIV with the services that they need The Global Plan supports and reinforces the development of costed country-driven national plans MDG Health Alliance Priorities The first priority ofthe MDG Health Alliance is... Led by Suprotik Basu, Managing Director of the office ofthe UN Secretary-General’s Special Envoy for Malaria, the Malaria Pillar ofthe MDG Health Alliance works in partnership with UN Agencies, the private sector, nonprofit organizations, academic institutions and the African Leaders Malaria Alliance, to support country efforts to accelerate progress toward achieving Millennium Development Goal 6 The. .. smartphones, mHealth, and multimedia will seek to increase the effectiveness and quality of CHW service delivery through the use of technology Led by Pillar Chairman Jeff Walker and Vice-Chairs Austin Hearst and Brad Palmer, the Community Health Worker Pillar of the MDG Health Alliance works in partnership with UN Agencies, the private sector, nonprofit organizations, academic institutions and others to... mothers to childrenby2015 BLC members are a select group of leaders who represent media, finance, telecommunications, health, technology and retail The BLC is committed to treating 2015 as a deadline, not a goal and bringing business acumen and resources to the challenge The BLC is chaired by John F Megrue, Jr., CEO of APAX Partners US The BLC Advisory Board is comprised of Dominic Barton (Worldwide Managing... and they and their families may face financial catastrophe Children may have to leave school and go to work or stay at home to care for an ailing parent Parents who die of TB leave behind millions of orphans (according to theWorldHealth Organization, there were 9.7 million children who were living as orphans due to parental death in 2009) Health workers, one of our most precious resources in the. .. isoniazid, HIV testing and TB screening across the population every three years and TB care MDG Health Alliance leadership will complement the work of partners to: + ake health services more widely M available In 2010 less than a third of people living with HIV sought care for TB at a clinic That needs to double by2015 + mprove the quality of TB care By I 2015, the cure rate for TB among people living... recognized for their notable success in reducing morbidity and averting mortality in mothers, newborns MDG Health Alliance Priorities and children CHWs have been crucial The first priority ofthe CHW Pillar of the MDG Health Alliance is to identify concrete, actionable roles for businesses to maximize their support and investment in Community Health Workers in high-burden countries The focus will be . ImprovIng the health of
Women & ChIldren
around the World by 2015
6 8
10 12 14
4
2 MDG Health Alliance Pillars
3 Who. eliminate the transmission of HIV from mother-to-child by 2015
The Global Plan towards the Elimination
of New HIV infections Among Children
by 2015 and