As world leaders gather for the G8 Summit, I want today to argue that, over the course of the next five years, we have the means and the opportunity to put to an end some of the most egregious problems facing the world today. But that the only way we will do so is by putting women front and centre of all our efforts. Most importantly, I will argue that this is a perfect moment when, with political will and with leadership, we can change the course of history.
Our generations are the first that can make a real difference to the discrepancy of wealth and opportunity which exists around the world today. We know so much more about what works and we know what needs to be done. We understand, for example, that it is conflict ultimately which mires people in poverty. If I think about those dreadful refugee camps that I’ve seen around the world, in Darfur and on the Burma/Thai border, if you are languishing in one of those camps, it doesn’t matter how much access to aid and to trade and to money which you have, until the conflict is over you are going to remain poor and miserable and fightened and dispossessed. And in just the same way we know that it is conflict which mires people in poverty and condemns them to stay there, so we now have learnt and generally accept that it is free trade and the private sector and wealth creation and enterprise and jobs which lift people out of poverty. And I must emphasize the importance, which should never be forgotten, on bringing the Doha round to a successful conclusion. A successful conclusion to the Doha round, and on any basis at all, would mean an increase in world trade of about $300 billion and the total amount of aid flows across the world is something like $150 billion. So the importance of the Doha trade round should never be forgotten. And lastly that money, aid spent well, works miracles, not least when we are talking about maternal health. This is the context within which I want to set my comments today.
Ladies and Gentlemen, this is my first overseas speech since becoming Secretary of State for International Development and I can think of no better place to deliver it than here, in the home of philanthropy: the Carnegie Endowment; and in that great hothouse of free thought that is Washington DC. And I’d like to congratulate Carnegie as they celebrate their Centennial this year. We have a great dialogue with Carnegie and regard Tom [Carothers] as a member of the Department for International Development family in Britain.
So, let me begin by paying tribute to President Obama and Secretary Clinton for their commitment to global development. I salute too, the tireless battle pursued against HIV/AIDS by President Bush. And I applaud the pioneering efforts of the Clinton Foundation; the campaign against River Blindness spearheaded by President Carter; and the inspirational work of Bill and Melinda Gates. You are true leaders, one and all.
Approach to development under new, coalition Government
I want to begin with a few words about our new coalition government, a government that is motivated by a shared determination to erode these vast inequalities of opportunity that I described and we see around the world today.
Ours is a new agenda, one of value for money; accountability; transparency and empowerment. We have promised to enshrine in law Britain’s commitment to spend 0.7% of GNI on overseas aid from 2013. And crucially, we will keep aid untied from commercial interests - in this I urge the US to follow our lead.
Millennium Development Goals
This new agenda will underpin our approach to the Millennium Development Goals. These goals, agreed by the UN ten years ago, were the concrete embodiment of our generations’ collective commitment to tackle the terrible poverty and suffering that afflict so many. As well as being in our own national interest that is also our shared moral obligation.
And yes, the commitment has led to some real results:
- We are on track to halve extreme poverty;
- We’ve made strong progress on universal primary education, where some thirteen African countries look set to achieve that MDG
- Measles-related deaths fell by 78% between 2000 and 2008
However, in other areas - and indeed, even within those goals where we are doing quite well - progress is patchy. Most regions are off-track on tackling child mortality; while progress on maternal health is especially disappointing. It’s significant, too, that across all the goals, sub-Saharan Africa lags far behind.
And, however hard we try, new challenges constantly threaten our ability to meet the MDGs and jeopardise our gains. The world of 2010 is not the world of 2000. We’ve had food price hikes. A global recession. A massive increase in the cost of fuel.
Some argue that against this backdrop we should focus our attention on domestic priorities. I disagree. This is a time to reaffirm our promises to the world’s poor, not abandon them. We should never balance the books on the backs of the world’s poorest people. It is true that charity begins at home, but it doesn’t end there.
Promoting global prosperity is also very much in our own interests. Development is good for our economy, our safety, our health, our future. It is, quite simply, the best return on investment you’ll find: a cause that commands consensus across the political spectrum both in Britain and hopefully, here in America.
So, our response is not to abandon the MDGs but to encourage all parties to work towards a clear action plan that can be agreed at this September’s UN Summit. For our part, Britain will also be aligning development more effectively with other policies, whether with trade, investment and enterprise, climate change or economic growth.
In the UK, we have brought together the three policy pillars of development, defence and diplomacy through our new National Security Council. This synergy will allow us to reduce poverty in fragile states, while also building capacity and guaranteeing security and stability.
I know that balancing and integrating all of the elements of power is a major objective for you here in the States.
There are areas, however, where our approaches to development differ. In Britain, the Department for International Development is a separate Government Department in its own right. As its Secretary of State, I have a seat in Cabinet and on the National Security Council. A vibrant DFID, at the table, agitating, campaigning and helping to deliver progressive change for communities worldwide.
And in our Government, an equally vibrant coalition whose leaders share a vision of a world where everyone has the opportunity to fulfil their true potential. Abroad as well as at home, we believe in decentralising power and responsibility, empowering citizens, making governments more transparent and accountable.
Here in the States, President Obama has spoken out for greater transparency and accountability across his administration. Back in Britain, our Prime Minister, David Cameron and Deputy Prime Minister, Nick Clegg, have applied these same principles to our new coalition government.
That’s why one of the first things I did on taking office was to launch our new UK Aid Transparency Guarantee, a guarantee that will help to make aid transparent to citizens in the UK - and also to those in recipient countries too. This chimes with Raj Shah’s promise to embrace “extreme transparency” throughout USAID. I look forward to working with Raj and to discussing this with him when we meet again this afternoon.
We’re also fundamentally redesigning our aid programmes so that they build in rigorous evaluation processes from day one. The focus will be on outputs and outcomes rather than inputs. In these difficult, economic times donors have a double duty, a responsibility to achieve maximum value for money: not just results but results at the lowest possible cost.
With this in mind, we want to test the concept of cash on delivery aid that’s been mooted by the Centre for Global Development. CGD has been the leader of so much great thinking on development, and Nancy Birdsall told me this morning that she learnt her trade here at Carnegie.
We’re also taking a fundamentally new approach to our bilateral and multilateral aid: reviewing what we do - and where - so that we can maintain a ruthless focus on results. At the same time, I’m setting up a new independent body that will gather evidence about the effectiveness of our programmes. Again, our two nations are on the same page: I know Raj Shah envisages a stronger focus on impact evaluation in USAID’s work.
Let me now, Tom, turn to the most off-track of the MDGs: maternal health.
When a jumbo jet crashes anywhere in the world it makes the headlines. If it were to crash week in week out in the same place there’s not a person alive who wouldn’t be talking about it. The international community would set up an enquiry and no money would be spared in making sure it never happened again. Yet, in Nigeria, the equivalent number of women die each and every week from pregnancy-related causes - and the world stands silent.
In Britain, we want to make a serious contribution to tackling this tragedy. Today, at the G8, our Prime Minister, David Cameron, is working with PM Harper and other G8 leaders to ensure the world delivers on its commitments to cut the number of women and children dying during pregnancy and childbirth in some of the world’s poorest countries.
The Prime Minister will argue today that it is indefensible in this, the twenty first century that for so many women, pregnancy and childbirth should represent a death sentence or at least, a morbid lottery. Or that the risk to a woman of dying in the UK due to a pregnancy-related cause at some point during her lifetime is 1 in 8,200 while in Niger, it is 1 in 7.
Every year, at least a third of a million women, and probably more, die due to complications in pregnancy or child birth. The vast majority of those deaths occur in low and middle income countries.
And research by my department tells us that if a mother dies in childbirth, there is a high chance her child will die within a few months too.
But we all know - it doesn’t have to be like this. As Melinda Gates said earlier this month, it’s not that we don’t know what to do or that we can’t do it. It’s that we haven’t tried hard enough. We have within our grasp a golden opportunity, a perfect moment when we have the technology and the political will - if not to eradicate maternal mortality - then to reduce it significantly.
The great blot on public health
History is on our side. The last time that the UK had a Conservative/Liberal coalition government was back in 1935. That coalition didn’t pull its punches when it referred to Britain’s maternal mortality rate as the “great blot on public health”. Determined to reverse the trend and with political will behind him, the British Prime Minister, Stanley Baldwin established a national midwifery service. This move, coupled with the necessary policies and resources, saw maternal deaths fall by 80% in just 15 years. The resonance with where we are today is uncanny and only serves to sharpen our government’s resolve to seek an equally radical result abroad.
We will not be afraid to try new approaches: maternal health is an area where there’s room for innovation.
Look at the example of Madhya Pradesh where pregnant women are offered free transport to hospital and paid 1400 Rupees (about $30) to compensate them for the work their partners lose in having to stay at home to supervise the other children. Phone numbers for the service are widely displayed, while community workers spread the message about safe deliveries and timely check-ups. These workers receive 350 Rupees (about $8 dollars) for every expectant mother that they bring to the hospital.
Innovation isn’t confined to overseas activities. Closer to home, I was excited to hear of Oxford University’s creative plan to use crowd-sourcing as a means of undertaking research into maternal health. 10,000 healthcare professionals across the developing world will be asked to complete an online survey and to identify where they see the gaps in maternal healthcare in their respective countries.
We are being equally innovative in my department. Two weeks ago I launched a fund that will allow our health professionals to share their skills with birth attendants, doctors, nurses and midwives across the developing world. We want to encourage partnerships that can pilot new techniques, such as live internet link-ups or the use of mobile phones for emergency referrals or operations.
Family planning and safe abortion
I want to turn now, Tom, to a subject that I recognise to be sensitive but which is nevertheless close to my heart. I understand the cultural difficulties implicit in any discussion about contraception and abortion; I merely lay these facts before you: every year 20 million women seek unsafe abortions and 70,000 of them, many still girls, die as a result. And 215 million women around the world who want to use modern contraception don’t have access to it.
President Obama has described a woman’s right to make a decision about how many children she wants to have, and when, as one of the most fundamental of human freedoms.
Let me say this to you today: I could not agree with him more.
Empowering women to take decisions about their own future is the right thing to do for so many, many reasons. Not least, as your President pointed out -the fact that it is a basic human right.
The UNFPA estimates that satisfying the unmet need for modern family planning would reduce unintended pregnancies by 53 million every year, the greatest reduction being in low income countries.
We recognise that these are difficult areas and will proceed carefully - while never forgetting that our ultimate goal is always to empower women in their own lives. That goal is simply non-negotiable and I promise you here and now, that Britain will be placing women at the heart of the whole of our agenda for international development. In the immediate term, we will be doing everything in our power to urge all countries to sign up to a strong set of commitments on maternal health at September’s MDG Summit.
Women at the heart of development
Just as maternal health covers a whole continuum of care, so too, does gender cover a continuum of opportunity - of which a key stage is education. Focussing our efforts exclusively on women rather than on women and girls is to miss the opportunity to reverse a vicious cycle that can be the lot of girls in poor countries. The cycle starts with limited access to education but soon leads to poor employment, ill-health, early marriage and, all too frequently, to violence and exploitation.
By making sure that more girls have the chance to attend school we can replace that vicious cycle with a virtuous one that ultimately puts females at the heart of their families and their communities. Bringing in money, supporting local enterprise, making sure their own children are educated. And typically, putting an average of 90% of their earnings back into the family compared to the 30 or 40% that males contribute.
There are many reasons why education is particularly hard for girls. These can be linked to issues of comparative low status: girls will often be expected to do the household chores or to make the long journey to fetch water, instead of attending school. When I visited Pakistan earlier this month, I saw how insecurity can add to the difficulties girls face. The new work that I was able to announce while I was there will see some 300,000 girls in the province of Khyber Pakhtunkhwa encouraged to attend school in return for a monthly allowance. There is a good story to tell in Afghanistan, too, where 3 million girls are now attending school.
Making sure that girls are able to have access to education - and are able to complete that education - will remain a key priority for the UK’s Department for International Development.
Cash-transfers as part of the solution
Cash incentives can also work for education - and for health too, as we saw with the Madhya Pradesh project - but they can also have a wider application, enabling women to meet basic household expenses and ultimately, to re-invest their savings in the family unit.
I give you the example of Nihoza Angelique from Rwanda, a country my party knows well. She has less than a quarter of a hectare of farmland on which to support her family of three. However, thanks to development support, she has now been in employment for six months, earning 1,000 Rwandan francs per day (less than $2), out of which she is saving some 400 francs (just under 70 cents) in her newly-opened savings account. With her first salary she bought school uniforms for her children. With her second and third salaries, she bought a goat. She now plans to use her savings to build a house for herself and her children.
Gender and voice
We’ve seen, ladies and gentlemen, that when women are empowered economically they are more likely to have a voice in the community and to be advocates for other women.
In Nepal, the percentage of female Members of Parliament rose from 6% to 33% in 2008, while Ghana has seen a women elected Speaker of the national Parliament for the first time in its post-independence history. In the UK - although we’ve had a woman Speaker, indeed, a female Prime Minister - only 22% of our MPs are women. In your Congress, female representation is just 17%. It’s salutary to be reminded that the developed world isn’t always the shining beacon we might wish it to be.
On the theme of governance let me say a few words about the new UN Gender Entity. This is an historic opportunity to create an efficient, powerful and well-resourced body that has the chance to make a positive impact on the lives of millions of women and girls across the world. It is vital that a competent and visible leader is appointed as soon as possible, a leader who is mandated to make progress in this crucial area.
Ladies and gentlemen, as we sit here in Washington - across the world, millions of people are suffering. Millions of people are denied the dignity and the opportunity they deserve. We can change that.
The playwright, George Bernard Shaw once said that the essence of inhumanity wasn’t hate, it was indifference. He was right: indifference kills. September’s MDG Summit represents a golden opportunity for us to demonstrate that we are not indifferent, that we will recommit to the promises that we made ten years ago to the world’s poor.
We must call on the world’s political leaders to come to the Summit ready to make and deliver ambitious pledges. We must urge them to fulfil their aid commitments and to sign up to the Secretary-General’s Action Plan on women and children’s health. We must grasp this single moment that history offers us, a moment when, together, we can make a stand. If we are prepared to do that then we truly can leave this world a better place for generations to come.