Stephen Harper heads to Geneva this week to help ensure that the billions of dollars the world pledged to improve the health of mothers and children in poor countries produce results. But it's not simple. Just figuring out what each country actually pledged after the caveats and fine print are examined is tough enough. Then there's setting standards and making complex calculations about how much went into the maternal- or child-health kitty, as opposed other health issues. And measuring results requires common yardsticks. In 2000, the UN set eight Millennium Development Goals for improving life in poor countries by 2015, but progress on reducing deaths of mothers and young children has been slow. Last year, Mr. Harper championed the cause at the Muskoka G8 summit. Now, he and Tanzanian President Jakaya Kikwete will co-chair a UN commission tasked with tracking the path from pledges to goals.
THE PLEDGES - $40-BILLION
Countries said at a UN conference last September that they would spend a total $40-billion on meeting the maternal- and child-health goals - not just donations from wealthy countries like Canada, but money that developing nations will add into their health-care systems. It's not always clear from patchwork promises how much additional money is really being pledged, and in the past, it was often unclear what was delivered. At the June G8 summit, leaders promised $5-billion, but each country's pledge applied to different programs and time periods.
THE REALITY - HOW MUCH IS SPENT?
Tracking spending isn't as easy as it seems. Even simple contributions like a county's donation to the Global Fund on HIV, Malaria, and TB are subject to the calculations: 45 per cent counts as a contribution to maternal and child health. How much of a developing country's health budget counts toward child and maternal health? And countries' reporting on their spending is often far from transparent or easily understood.
THE PLANS - WHERE DOES THE MONEY GO?
Simply spending money doesn't save lives; what matters is that it goes into effective programs. Aid organizations say some relatively simple items like vaccines for major killers or nutritional supplements would have a major impact, while providing more attendants for childbirth would dramatically reduce deaths. But following how the money is streamed into programs in dozens of countries requires a major effort.
THE NUMBERS - MEASURING RESULTS
The crucial question of whether the money saves lives depends on measuring the results, and the commission Mr. Harper co-chairs will set some of the yardsticks. The commission will weed through various national standards , such as vaccination rates, to set up common ones that will be used to judge progress. It will also suggest ways to help developing countries measure results by collecting statistics with better systems for things like registering births and deaths.
THE GOALS - REDUCE BOTH CHILD AND MATERNAL MORTALITY BY TWO-THIRDS
The Millennium Development Goals seek to slash the death rates of children under 5 and mothers in pregnancy and childbirth - with the aim that by 2015 the number will be one-third what it was in 1990. Progress has been slower than with other goals, even though some of the "fixes" are relatively straightforward. Mr. Harper's G8 Muskoka initiative was aimed at saving the lives of 1.3 million children and 64,000 mothers each year. Meeting the Millennium goals overall would save the lives of millions of children and hundreds of thousands of mothers.