The Bush Institute's Summit to Save Lives

This morning I got up before my kids were awake for school to travel down to Washington, DC to participate in The Bush Institute's, Summit to Save Lives. For all the varying opinions and political beliefs people may have with regard to President Bush, no one can argue that his putting global health issues on the map is anything short of commendable. Through PEPFAR (the President’s Emergency Plan for AIDS Relief) and PMI (the President's Malaria Initiative), he prioritized the scaling up of life saving efforts in some of the poorest and most affected countries in the world.

The institute  has now focused on expanding that work and moving it forward with the stewardship of my friend, Mark Dybul, with whom I traveled to Ethiopia a year ago. Before I arrived at the Summit, the Institute had already announced one way in which it will be working to expand their mission, by unveiling the Pink Ribbon Red Ribbon Initiative. In partnership with PEPFAR, Susan G. Komen for the Cure and UNAIDS, the Institute committed to a new initiative that will expand the availability of vital cervical and breast cancer screening and treatment for women at risk in developing nations in sub-Saharan Africa and Latin America. This new initiative seeks to leverage the platform built through PEPFAR, which was really the topic I traveled to DC to discuss. More specifically, how do we use the successes already achieved to do more and to expand those service delivery systems to address some other challenges that are linked but not yet fully integrated.

My role this morning was that of a moderator for a panel called, "Improving Health Outcomes for Women and Children Through Integrated Care." Needless to say, I was in the company of a very impressive group of accomplished individuals including:

•Mrs Jeannette Kagame, the First Lady of Rwanda and a tireless advocate for women's and children's health
• Dean Julio Frenk, M.D., the Dean of the Harvard School of Public Health and the former Minister of Health for Mexico
• Dr Luis Gomes Sambo, M.D., the Regional Director for Africa at the World Health Organization
• Lois Quam, the Executive Director of the Global Health Initiative at the State Department

We began by discussing a bit about the challenges of MDGs 4 and 5, respectively. Dr. Sambo spoke about all the normal constraints to a health challenge such as costs and human resources but noted that with women's health issues, we really needed an integrated approach that strengthened the system so that women could access the services they needed when they needed them. Doing so will of course not be easy and Julio Frenk urged us to, 'move out of the silos' in order to truly integrate the solutions without losing focus.

Another challenge that could not be ignored - beyond the physical and medical challenges - are real social and value-based challenges to addressing women's health. The panel vocalized one of the bigger factors we sometimes fear to discuss out loud but rings very true. The lag in women's health could perhaps be attributed to the fact that women are not valued as much as their male counterparts. The speakers all noted that this is a fight for dignity and respect. Mrs. Kagame stated that until we truly see women as partners, we will fail. And indeed, several speakers noted that women may be the topic of this discussion but they are also the key solution as they also represent the majority of the health workforce.

Also interesting was to think about how these investments need not be pitted as different or contrary to the successes of the past. While it’s true the investments in AIDS and malaria which have been so successful were "vertical" interventions (so named because they focus on one particular disease or health issue), as Lois Quam noted, "We treat people, not diseases." What we are poised to do here is to take the platforms that were built to support those investments and expand on them to address women's health more effectively. It's an amazing opportunity but not if we take our foot off the gas. Mrs. Kagame urged us all to not let up pressure. Budgets may be tight but we must continue these programs that are working so well in saving lives. Now is the time to build on them, not to step back. 

In my final effort to take advantage of the moderator's microphone, I asked one last question to the panel (for which I was very delighted). I queried about the role of civil society and groups like Every Mother Counts in being a part of the solution. One of Dean Frenk's best lines was that, "health is too important to be left to doctors alone." All of the panelists noted how the current face of women and children's health is truly changing and will require all of us - including civil society groups like EMC, universities, faith based groups and non profit organizations.

This might have been my briefest visit to our nation’s Capital to date but one of the more stimulating dialogues in which I have been able to participate. I was even able to catch an early flight home so that I could surprise my son on his first full day of Kindergarten..!