Remarks by Administrator Rajiv Shah at the Acting On The Call Conference

Wednesday, June 25, 2014
Administrator Shah speaking at the Acting On The Call conference

[As Delivered]

Good Morning, and welcome. Thank you all for being here today, and welcome to Acting on the Call. I am and our team is especially grateful to the Government of Ethiopia, Minister Kesete Admasu, the Government of India, Minister Harsh Vardhanm for co-hosting our event today, and our partner and colleague for years past and years forward, UNICEF, led by its able executive director, Tony Lake.

I also want to thank colleagues from so many organizations including the Bill & Melinda Gates Foundation—President Mark Suzman is here—who have collaborated with us. Thank you as well to UN Secretary General Ban Ki-Moon and Special Envoy Ray Chambers, and our partners from business, civil society, and other governments that are here.

Later today you will hear from President Jim Kim of the World Bank, Christian Paradis, the Minister of International Development from Canada, so many wonderful leaders from across the United States - Ambassador Debbie Birx, our capable PEPFAR leader, Carrie Hessler-Radelet and Heather Higginbottom, representing the Peace Corps and State Department, respectively.

We are here today because for the first time in our history, we stand within reach of a world that was simply unimaginable for so long: a world without child and maternal death.

We know how to reach every woman and every child with simple, low-cost medicines and interventions that will help all of them survive and thrive. Child survival and maternal mortality have been a focus in the United States in our foreign policy for decades. Every year we commit and spend nearly $1.5 billion on this moral mission. And today, we know that how we deploy those precious dollars has the potential to transform hundreds of thousands of communities that suffer from the senseless tragedy of losing children to preventable death.

In the past two decades, we have seen global rates of child mortality, chronic hunger, and extreme poverty cut in half. Each day this year, 17,000 more children will live and 700 more women will survive childbirth compared to 20 years ago because of the efforts of the organizations, partners, and leaders represented in this room today.

And if we accelerate this rate of reduction, our core performance through 2030 as we are going to do by working faster, cheaper, and better, we can realize a world where every child everywhere survives to celebrate their 5th birthday.

But this is about more than numbers.

Sometimes, as we work on these challenges every day, we have to remind ourselves of what this work really means. I’ve seen what it means in the slums of India, where children are lost to simple, preventable diseases because they don’t have access to clean water and healthcare.

In the refugee camps of Jordan, where children who until recently were in middle class communities and going to school, will have their lives, futures held back, because of the environment in which they now live.

And on the dusty plains of Afghanistan, where the children cry out as they too often continue to suffer from chronic hunger and hidden malnutrition.

What binds us together in this room is our moral determination to bring dignity and opportunity to every human being. But we also know that achieving this goal serves our national security and foreign policy as well. We know that countries grow faster when they save children’s lives; therefore, families have fewer kids, the demography of country changes, and economies grow one to two percent faster for ten to fifteen years, experiencing a demographic dividend.

Right now in South Sudan, nearly four million people are at risk for famine. Nigeria is reeling not only from the abduction of 300 school girls by Boko Haram, but by a senseless series of bombings throughout the north that have disrupted the supply of basic services to some of the world’s most vulnerable communities. Across the globe this year there will be more refugees than any other time since World War II. And that’s why our mission is so important right now.

Empowering the world’s most vulnerable children to survive and thrive is the underpinning of global stability and the requirement for building resilient, democratic societies. As President Obama has said, “This is our first task—caring for our children. It’s our first job. If we don’t get that right, we don’t get anything right. That’s how, as a society, we will be judged.”

The reality is that we note today, that it is unacceptable and heartbreaking that 6.6 million children and nearly 300,000 women will die from diseases or childbirth in situations where we can save their lives. That’s why since the beginning of the Obama administration, the United States has invested more than $13 billion in child and maternal health; a commitment that represents a strong bipartisan legacy of American leadership in global health.

Yet the question remains: do we have a global partnership capable of delivering on the results we seek?

That’s why two years ago, together with UNICEF, Ethiopia, and India, we hosted a Call to Action—helping us all learn about what is now possible and how we can help each other best achieve the rapid end of child death. It was a powerful moment, and it has led to more than 177 countries and 450 civil society groups and faith based organizations stepping forward to sign a pledge, to report on progress, to make resource commitments, and to redouble their efforts to be part of leading the charge to end child death.  

Since then, nearly a dozen countries have launched their own local calls to action, set national targets, and created evidence-based report cards and business plans to focus on vulnerable regions within their countries and their societies. Today we have with us representatives of the 24 partner countries, health ministers, heads of state, and I would just like to ask the ministers and heads of delegation to stand up so we can recognize your presence and your leadership. Thank you. We wouldn’t be here today if it were not for the leadership you demonstrated over the past years.

In India, you’ve already bent the curve of progress. You had a call to action, you targeted 184 districts where child death rates were far higher than the rest of the country, increased funding by 30% in those districts. You brought in business leaders like Hindustan Zinc, a multi-billion dollar mining company, to help transform communities through public/private partnerships, and I look forward to Minister Vardhan speaking later today about how you have achieved a 6.5% annual reduction in the rate of child death in just the last two years.

In Ethiopia, once one of the most dangerous places for a child to be born, today an army of 38,000 front-line health extension workers are targeting the causes of child death, and Minister Kasete will speak later today about the extraordinary progress in reducing newborn deaths by 30% in just two years across the population of six million Ethiopians.

We just had a breakfast with our country leaders where we heard country after country share the innovations and the stories and the leadership that is in fact accelerating our progress towards achieving our goal. This is a global movement, led by countries themselves, in concert with private sector leaders, faith and civil society leaders, and traditional donors.

Yet the next question for our Agency was how can we do our part—as donors, as partners, as allies—to help countries that are now committed to this business-like, results oriented approach? So we took a hard look in the mirror. We reviewed more than 160 grants and contracts and awards worth more than $4 billion, and discovered that while we made strides we could make some changes that would save lives faster and more efficiently.

The review was conducted under the auspices of a Blue Ribbon Panel composed of an extraordinary group of leaders from science, business, government - people who know how to deliver transformational results - led by Ray Chambers, the UN Special Envoy for Child and Maternal Survival. The panel included distinguished private sector leaders including John Megrue and Jeff Walker, former members of Congress such as Senators Bill Frist and Harris Wofford, and health and development experts such as Paul Farmer and Helene Gayle. At the same time, we sent out teams of USAID experts led by Katie Taylor and Ariel Pablos-Mendez to a diverse array of countries like Nigeria, DRC, and Bangladesh to learn about how we could better support your efforts.

With new action plans as our guides, we are proud to announce that we are now able to realign $2.9 billion of planned investment in child survival in an effort that, between now and the end of 2015, will save the lives of 500,000 additional children.

This represents more than dollars. It represents decisive action that will help us accelerate progress as we all work to achieve the Millennium Development Goals on time. Because if we’re going to make these big investments and spend our money, we need to do it in a way that delivers the biggest impact and the most profound results. Our plan is codified in this report, which I hope you will have a chance to look at, review, comment on, and offer feedback.

What I’m most proud of in this effort is the data driven, evidence-based approach that will reposition resources and deliver better results. We’ve actually cut global health programs in 26 countries to focus on the 24 where we can save the most lives working in partnership. We are making transparent every project, grant, and contract, it’s all published in the report and available online so that we can align our investments with your report cards and deliver results more effectively.

We’re shifting resources from parts of countries where sometimes we’re not going to get as much of a result to really focus on the poorest in urban slums and rural communities to make sure that we save as many lives as possible with our efforts. And we’ll do the things that we’ve been doing in business and other parts of society for a long time: streamlining and integrating supply chains, ensuring that if we reach a pregnant woman with one intervention, we’re also carrying with us the six or seven other simple, low-cost strategies that will help that woman survive childbirth and help that child get off to a healthy start.

These might seem simple but taken together, they save lives.

And here is what this looks like. This chart illustrates the targets we’re setting between now and 2020 for reducing child lives. And you can see the inflection point at which we, together, following the leadership you’ve already demonstrated believe it’s possible to literally bend the curve of progress and accelerate the results we seek.

In any particular country, and I think this is an example of Zambia, you can quantify where you would expect the additional child lives and maternal lives to come from. What are the diseases and what does the evidence tell us we should focus on in order to most effectively achieve results. I’m particularly thrilled that this slide represents Zambia because next week, together with Dr. Jill Biden, I will have the chance to join her as she visits Zambia to learn about some of the progress you’ve already made in saving mothers and children’s lives and to further elevate America’s commitment to this task.

And this is what it looks like in total. We see the red line representing the historic trend, which is good. It’s coming down. We’re saving more lives all the time. The green line represents the A Promise Renewed goal that we set in 2012. And the yellow line represents a further acceleration if we can implement the findings of the report.

To accelerate our progress and deliver on these opportunities, we’re announcing today an additional $600 million in new partnerships with 26 partners, spanning the world’s most innovative businesses, universities, and NGOs. Alongside the Coca-Cola Company, we will support an initiative called Project Last Mile, to ensure that we can reach children in the most remote parts of the world. If a child has access to Coca-Cola, they should also have access to amoxicillin, oral rehydration solutions, basic vaccines, and a simple insecticide treated bed net to protect themselves from diseases that can kill them and thankfully the leadership at Coca-Cola is willing to lead this fight.

Alongside Laerdal Global Health and Johnson & Johnson, the government in Norway and the Bill &       Melinda Gates Foundation, we will support the Helping 100,000 Babies Survive & Thrive Initiative—a new effort to tackle birth asphyxia because every newborn should be born in a setting where someone has a cheap 7 to 10 dollar bag mask next to them and can suction that baby if they cannot breathe. That simple, active, getting this neonate doll and trained health workers out to the settings where women are having children outside of an assisted facility, will save 100,000 newborn lives every year. And alongside Johns Hopkins University and several NGO partners, we will announce a new flagship child survival and maternal health partnership that will allow us to tackle the leading causes of maternal and child mortality in our 24 focused country partners, by focusing on scaling up high impact interventions and measuring results.

You know, earlier this year, I had the chance to deliver an address at the National Prayer Breakfast. It’s a setting that brings together three or four thousand political leaders from the United States and around the world, and faith leaders also on a global scale. And in that moment, I had a moment to describe that it was now possible to end extreme poverty and its corollary consequences of preventable child and maternal death, and large-scale chronic child hunger. And I expected people in the room to respond favorably to the idea that we can achieve this grand goal by working together. And I spoke of meeting families in refugee camps in Dadaab, Kenya and in rural communities in Afghanistan and Yemen, all of whom would benefit from this new approach.

But what surprised me was that in a room of 3,000 people who don’t often think about these challenges, one of the greatest applause lines we got was when we talked about how our efforts collectively have helped 440 million children get immunized or improved nutrition for 12 million kids through agricultural support. The data points that show, that we as a community have a partnership strong enough to sustain this effort and deliver this result, inspires the rest of the world to support us. Because even as many people think that our political system here in the United States, or elsewhere around the world, is too often divided and focused on fighting each other instead of doing good in our world, we know that this area of work is the striking exception to that reality.

Thirty years ago, a Democrat, David Obey, joined Republicans Sonny Callahan and Chris Smith in creating the first ever child survival fund. Twenty years ago, Democrats like Nancy Pelosi and our own secretary, then Senator John Kerry, joined Republicans like Bill Frist, Henry Hyde, and Jesse Helms to push for and win the first funding for HIV/AIDS which then led to the launch of the PEPFAR program. Ten years ago, Democrats like Pat Leahy and Republicans like Tom Coburn joined together to drive large funding increases for an effort to address malaria, under President Bush’s leadership, the President’s Malaria Initiative. And tonight, members of Congress from both sides of the aisle will come together to honor and support your work, because our politics and our political system recognizes that by doing this work and showing the world the best of American values, we in fact enhance all of our lives.

At a time when people wonder if we can still come together to accomplish big things, we can, and we are, showing the world that this is possible. So to all of you gathered here today, whether you serve as advocates in the offices of businesses and corporate boardrooms or the halls of Congress, thank you for your partnership, your advocacy, your action on behalf of the world’s poorest people. To members of my team who have kind of killed themselves over the last few months and years to make today possible - Ariel, Katie, Kelly Saldana, Elizabeth Fox, Kate Bunting, Justine Lewis, Clay Doherty, Tiffany Drake - the list is too long to go through each individual, thank you. Thank you very much.

Washington, DC

Last updated: July 18, 2014

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