ImprovIng the health of Women & ChIldren around the World by 2015 potx

2 MDG Health Alliance Pillars3 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 1

ImprovIng the health of Women & ChIldren

around the World by 2015

6 8

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

mdg health allIanCe pIllars

Improve ChIld health:

reduce the number of children under 5

dying from 8 million per year to 4 million

per year by the end of 2015

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 of women 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 of 2015

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, affordable and accessible care and products to women at highest risk of maternal mortality and support governments’ efforts 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 by the end of 2015

In collaboration with UNAIDS, PEPFAR, the

countries suffering the greatest burden

and other partners, virtually eliminate

the transmission of HIV from mother-to-

child by 2015 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 of the 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, by the 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

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 the health and

education Cluster of the

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 + Clifford sobel and barbara sobel Former US Ambassador to Brazil + diana taylor

Managing Director, Wolfensohn Fund Management + Jeffrey 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 of the 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:

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 affordable 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 of the 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 efforts 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 effect on child mortality, and donors who have an interest

in pursuing private sector approaches would be particularly well placed to offer initial support”

— Clinton Health Access Initiative

GLobAL CHALLenGe

Improve ChIld health

Reduce the number of children under 5 dying from 8 million per year to

4 million per year by 2015

mdG health alliance priorities Phase 1 of the Alliance’s child health agenda will focus on preventing child diarrheal deaths in the two regions of the 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 efforts 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 of children every year despite the existence of highly effective, 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

“

Led by Alan Batkin and Leith Greenslade, the Child 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 4 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 the health of women 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, affordable, 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 of the 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 of the target countries

2 Ensure an adequate supply of child-friendly ORS and zinc that meet quality standards at prices affordable

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 of the 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

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 efforts 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 of the goals furthest off 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.

affordable 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 health by 2015

mdG health alliance priorities Governments are increasing their reliance

on private health providers and local health businesses as an efficient way to extend services and provide essential medicines to hard-to-reach communities

In all regions of the world, utilization of private providers of health-related goods and services is growing — across all income levels

Phase 1 of the 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 efforts 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 efforts of the public health system to deliver high-quality,

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 the health of women and children

nmaternal@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% of the 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 the World 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 efforts to encourage

an enabling environment for health businesses to thrive

Key goals of the 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 affordable

+ Investigate innovative financing mechanisms to subsidize the cost of care for vulnerable populations and encourage them to seek care

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 efforts 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 by 2015 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 by 2015 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 of the gains achieved

mdG health alliance priorities

The first priority of the Malaria Pillar of the Health Alliance will be to support efforts to secure the necessary funding and get to near zero deaths by 2015

This strategy requires $6.7 billion between 2012 and 2015 for commodity procurement and distribution across sub-Saharan Africa $3.5 billion of