Monday, 23 November 2009
Private Members’ Business
Maternal, Newborn and Child Health
Debate resumed, on motion byMs Rea:
That the House:
- applauds the Government’s increase of total health funding in the foreign aid budget and an increase in spending to maternal, newborn and child health, which is much needed when in our region, including South Asia, 200,000 mothers and 3.2 million children are dying every year from preventable causes;
- notes that:
- Australia still requires an increase in total health funding in the foreign aid budget to progress toward the Millennium Development Goals (MDGs) 4 and 5 by 2015;
- Millennium Development Goal 4 to reduce child mortality by two-thirds and MDG 5 to reduce maternal mortality by three-quarters have made the slowest progress of all MDGs and are off-track to being achieved by 2015;
- Millennium Development Goal 5 has made virtually no progress globally and has reversed in most of sub-Saharan Africa in the last 20 years—it is the only MDG not making progress of any significance;
- the health MDGs are achievable but require increased effort and greater cooperation from all developing and developed countries; and
- evidence indicates that successful proven, cost effective strategies exist that can reduce child deaths by at least 60 per cent and maternal deaths by 75 per cent, which would save the lives of 240,000 children and 26,000 mothers in our immediate region each year;
- acknowledges the importance of the Australian Government increasing its support for health systems in the Asia Pacific region and in Africa (though coordinated mechanisms including the International Health Partnership) to ensure that adequate, coordinated, long term and predictable donor resources are available to support effective basic and reproductive health plans and systems in each developing country in our region; and
- recognises that:
- greater focus must be placed on training health professionals and midwives to ensure significant reductions in newborn, child and maternal mortality;
- system strengthening must also be ensured to provide incentives for staff to be retained in countries and areas of need; and
- an increase in Australian support for maternal and child health related spending is required to support the provision of basic health services and strengthened health systems; and that this will demonstrate Australia’s leadership and commitment to ending the preventable deaths of children and mothers globally.
It is almost unbelievable that in our modern world today, a place so often called the global village, there is even a necessity to move a motion such as those in the parliament. Sadly it is a fact that women are dying in childbirth at a rate of one per minute even as I am speaking and that roughly 24,000 children will die today of preventable diseases—things as common as diarrhoea and malaria. It is a reality that we as a global society are far from doing the right thing when it comes to preventing such horrific events from occurring.
It is also a reality that in any community, no matter how progressive or civilised we call ourselves, if we cannot care for our small children and for the women who bear those children and support them through pregnancy, childbirth and the rearing of those children then we are failing as a community. It is very important that all members of the House, regardless of the issues that they may have been battling over today, take some time to read and acknowledge the frightening statistics that glare out at you when you read this motion.
I was privileged to have a meeting in my electorate office on 1 April this year and it was far from a practical joke that a number of constituents in my electorate came to talk to me about this very serious issue. We had students and staff from Iona College, including teacher John Carroll. We had Erika Meerwald from St Peter’s Catholic Church in Rochedale, Jennifer Byrne from Caritas, Paul Mercer who is a Wyndham doctor and also involved with TIA, Mitchell Evans, Mick Doyle, Michael Lucas and Sam Hutsig, all students from Iona College which is a very large private boys school in Bonner. Accompanying them was Gillian Marshall who is the Queensland chair of the Make Poverty History Coalition and a tireless worker on this issue. As a result of the discussion with them I agreed that I would move a private members motion on this issue because we are falling way behind in our achievement of the Millennium Development Goals, particularly MDGs 4 and 5.
I would like to acknowledge Nell Kennon, the government relations coordinator for World Vision, who had a key role in the drafting of this motion. Indeed, it was her efforts, her work and her research that pulled this motion together. It is also important that we acknowledge the importance of this motion today, because it is part of World Vision’s Child Health Now campaign, which has been launched in New York and Nairobi and will be launched in Australia on Wednesday. So it is timely that this motion is going through the parliament.
What I want to acknowledge, though, is not just the horrendous statistics which tell us all that we must each individually and as a community be striving harder to introduce policies and provide development assistance aid for people in those countries where child and maternal mortality is extremely high. It is also important to acknowledge that the Australian government is well aware of this problem, that we have made commitments to targets around funding in development assistance for these particular goals. Indeed, as a result of this year’s budget we have increased funding by $200 million over four years for the United Nations partnership for the MDGs, which includes $42½ million for the UN’s Population Fund—a lead agency on millennium development goal 5.
It is important that this government has not only increased spending for achieving the Millennium Development Goals but also refocused a lot of that spending specifically to the issue of health, acknowledging the need to support more programs to assist children. When you consider that children die of diarrhoea and that with such simple medication as we take for granted they would be able to stay alive, it is so important that our funding is directed to this area. (Time expired)
I rise to support this motion and I commend the member for Bonner for an excellent motion. I support every word of it. One of the things I am most pleased about is that, as we have moved through what has been a very difficult economic time, the one thing we have not debated in this place is the cutting of overseas aid. I think it is a tribute to the government and a tribute to the opposition that this has not become a political football in the course of the broader debate. So I commend the member on the motion and on her own genuine commitment to the outcomes sought by the motion.
Australia’s aid effort is significant. We are delivering $3.8 billion in overseas development assistance, or 0.33 per cent of our gross national income, with a commitment to raising this to 0.5 per cent by the middle of the next decade. There are very important objectives in the Millennium Development Goals that we seek to support by these commitments of foreign aid. Australia’s foreign aid payments are working in a global effort to help eradicate extreme hunger and poverty and achieve universal primary education, along with reducing child mortality, improving maternal health and delivering a sustainable environment. Other goals are to promote gender equality, combat HIV-AIDS and malaria and build global partnerships for development. It is a topic that I have spoken about on many occasions. In fact, in my maiden speech I commended the government for their commitments in this area, and I hope that together all members can acknowledge our ongoing obligation to those who share one thing with all of us, and that is our common humanity.
It is important, though, that we deliver foreign aid in a way that builds up our neighbours across the world, creating stronger and better societies and delivering new hope to individuals. I believe this is the intent of the motion before us this evening. Our aid should promote stability and growth among our neighbours, address serious health challenges, tackle the hard issues of debt relief and be responsive and flexible when disasters strike, as Australian governments of all persuasions have always demonstrated when these disasters have struck in the past. None of us will forget the response of the Australian government to the tsunami tragedy, which was so swift and overwhelming and which was responded to in kind by the Australian people in such an incredible fashion.
The coalition government also gave priority to these matters and was a keen supporter of overseas aid. Minister Downer made it clear when he said:
Australia’s overseas aid program plays a central role in Australia’s approach to addressing challenges to regional security and prosperity. Through the aid program, Australia is helping our neighbours realise the benefits of broad-based economic growth, respond effectively to the challenges posed by fragile states, and cope with humanitarian crises.
There is one thing I am concerned about, and particularly in the context of the motion that is put forward tonight. We need to focus on the health needs of women and children, and that is why I am personally very disturbed and concerned at the decision of this government to reverse a 13-year position that had stood in this place in overturning the ban on foreign aid used to pay for abortions. The ban was in place for a very good reason. A similar ban had been introduced by the Reagan administration in 1984. It was then overturned by the Clinton administration before being reinstated by President Bush in 2001. In this country, it was introduced by John Howard following a lot of work put together by Senator Brian Harradine from Tasmania. The government has recently overturned this decision, and it was completely within the Prime Minister’s ambit to ensure that that did not take place. Instead, I believe, he simply rolled over. This is despite protestations prior to the election to large constituencies within the Australian electorate leading them to believe that he would not allow such things to happen. He allowed himself to be rolled over on this matter and failed to stand up for the rights of unborn children in overseas countries.
This is a provision that has not been asked for. In Senate estimates, Senator Boswell asked AusAID about whether this was necessary. The Department of Foreign Affairs and Trade responded that they were not aware of any particular request to fund abortion related activities. This is about the priorities of our aid budget. I totally support a strong and growing aid budget to meet the millennium development goals, but we must have priorities for that budget. I fail to see how funding abortions could in any way get to the top of the list of funding priorities for overseas development aid. Given the serious issues that are noted in the motion tonight from the member for Bonner—and I support all of these—I am at a loss to see how funding abortions actually furthers these aims in priority to other initiatives that go directly to supporting the health and wellbeing of women and children in developing countries. The Prime Minster had the opportunity to stand up and be counted on this issue. He chose not to do that. He basically chose to roll over and allow people to pursue a domestic agenda with our foreign aid budget. For that I think the Prime Minister needs to explain himself to all those he led to believe he would do otherwise.
I rise today to speak in favour of the motion proposed by the member for Bonner. The motion outlines the progress the Rudd government has made towards the millennium development goals. There are two MDGs of special interest in this motion. Millennium development goal 4 aims to reduce mortality rates for children under five by two thirds by 2015. Millennium development goal 5 relates to reducing the maternal mortality rate by three-quarters by the same year. The motion quite correctly notes that there is more work to be done in millennium development goals across the world in both child and maternal health.
I, too, applaud the government’s increased commitment to foreign aid. In his speech at the London School of Economics in April 2008, Prime Minister Rudd supported the goal of accelerated progress towards the MDGs. He made a special mention of the government’s goal reducing maternal mortality. In 2008, a woman died in childbirth at a rate of one every minute, which is a truly startling figure. We know that each year 500,000 women die from pregnancy related complications that are largely preventable or treatable. An estimated 90 per cent of newborns whose mother has died will also die within their first year. The World Bank predicts that between 2009 and 2015, infant deaths in developing countries may increase on average between 200,000 and 400,000 per year due to the global recession.
This government is determined to build its role as a development leader among the world community through an increased overseas development aid budget. In the 2009-10 budget, the government committed to increasing overseas development aid so that it reached the target of 0.5 per cent of gross domestic product by 2015. This goal was praised by the OECD and I am sure it is praised by many people in our community. Australia is currently on track to achieve this goal. The government does still retain an objective of 0.7 per cent of GDP, but this is an aspirational goal.
In the 2009-10 financial year Australia provided an estimated $3.8 billion in overseas aid. Rather than being charity, the government views this continued overseas development aid as an investment in our broader community. This investment helps fight the entrenched poverty that could challenge global peace and security. Most of Australia’s aid is targeted at the Asia-Pacific region, which is clearly in our backyard, where an estimated 950 million people live on less than $1 per day. In Southeast Asia 200,000 mothers and 3.2 million children are dying each year from preventable causes. Expansion of aid allocations are planned for Southeast Asia and Africa.
Millennium Development Goals 4 and 5 are a vital part of the government’s aid agenda and spending aid for maternal newborn child health has increased as part of overall increases in overseas development aid. The government believes that the MDGs relating to maternal and child health are achievable but that increased effort and greater cooperation among developing and developed nations is needed.
The motion before us today states:
Australia still requires an increase in total health funding in the foreign aid budget to progress toward the Millennium Development Goals … 4 and 5 …
The reduction of child mortality by two-thirds and the reduction of maternal mortality by three-quarters are goals that I support and I commend the member for Bonner for raising these vital matters in the parliament. These two MDGs are the slowest of all the Millennium Development Goals, as far as progress being achieved in 2015 is concerned. I urge all members to do everything practical to help with these goals, to avoid trivial political points and to really work together as a parliament to assist those in need in our world community.
I would also like to commend the member for Bonner for this motion. The seven Millennium Development Goals were established in 2000 through the UN by 189 governments, including Australia. These goals are crucial targets of social and environmental progress to be achieved by 2015. Goal 4 is to reduce by two-thirds between 1990 and 2015 the under-five mortality rate. Goal 5 is to reduce by three-quarters between 1990 and 2015 the maternal mortality ratio, and achieve universal access to reproductive health by 2015. Sadly, these goals have made the slowest progress of all. In the developing world as a whole there were 480 maternal deaths per 100,000 births in 1990 and in 2005 there were 450 deaths per 100,000 births. The government’s increase in total health funding in the foreign aid budget and the increase in spending to maternal newborn and child health is to be commended. However, great effort and cooperation from all developing and developed nations is required if the goals are to be achieved.
In 1950 our global population was two billion. Currently, it is 6.9 billion and by conservative UN estimates it will be 9.15 billion by 2050. We currently have the largest generation ever entering reproductive age. There are currently one billion living in extreme poverty and 75 million children are not educated. In many poor countries in our region one in 50 women die during pregnancy and delivery. Every year around 536,000 women die in pregnancy and childbirth worldwide. Improved access to family planning is critical. Forty per cent of pregnancies are unplanned. In poorer countries in Africa and the Asia-Pacific region, 40 per cent of maternal deaths would be eliminated if contraceptive needs were met. And there would be a 20 per cent reduction of deaths in children under five if women could use contraception to space their births by two years or more.
Countries that have lower fertility rates spend substantially more on the health and education of their children than those with higher fertility. The majority of maternal deaths are due to obstetric complications such as post-partum haemorrhage, infections, eclampsia, prolonged obstructive labour and complications from unsafe abortions. Anaemia, exacerbated by malaria and other conditions such as HIV, increases the risk of death from haemorrhage. Haemorrhage alone causes 34 per cent of maternal deaths in sub-Saharan Africa. Most of these conditions can be prevented or treated with reproductive health services, antenatal care and assistance at birth.
In reaching goal 4, reducing childhood mortality, effective interventions are required such as nurturing newborns and their mothers, infant and young child feeding, vaccines, case management of diarrhoea, antibiotics for pneumonia and sepsis and malaria control. The WHO estimates that the total additional costs for achieving universal coverage of such essential interventions accumulated over 10 years would be $52.4 billion.
There has been progress in this area, with the proportion of undernourished children under five years of age declining from 27 per cent in 1990 to 20 per cent in 2005: some 27 per cent fewer children died before their fifth birthday in 2007 than in 1990. This decrease has been due to a combination of interventions: the use of insecticide-treated mosquito nets for malaria, oral rehydration therapy for diarrhoea, increased access to vaccinations for a number of infectious diseases and improved water and sanitation. However, preventable and treatable conditions such as pneumonia and diarrhoea continue to kill 3.8 million children aged under five every year.
None of the goals are achievable in isolation. We must stabilise populations for there to be environmental sustainability. Poverty cannot be alleviated without empowering women with education and by meeting their contraceptive needs. We are not isolated from these issues: poverty, population growth and the adverse effects of climate change will exert significant pressure upon worldwide migration. Progress towards the goals is now threatened—(Time expired)