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Vol. 24, No. 23 May 19, 1999

GATES FOUNDATION GIVES $50 MILLION TO PUBLIC HEALTH

Columbia University's Joseph L. Mailman School of Public Health has been awarded $50 million from Bill and Melinda Gates for an international health program to prevent one of the most serious, but treatable health problems in developing nations -- maternal death and disability.

Under the leadership of Allan Rosenfield and Deborah Maine of the school's Center for Population and Family Health, the grant will provide vital support to government programs, as well as to national and international non-governmental organizations and local and international women's groups whose aim is to prevent maternal death.

"The Gates Foundation gift is of critical importance because of the long-term impact it will have on millions of lives," said President George Rupp. "With the combined efforts of a private foundation, a research university and government and community-based assistance organizations, we have the best chance of improving health care in areas of the world where the need is greatest."

"I'm proud to be here today on behalf of Bill and Melinda," said William Gates Sr., foundation director. "Our family shares Columbia's vision of raising the standards of maternal care in developing countries. Dr. Rosenfield and his team here at Columbia's Mailman School of Public Health are doing great work to build a program that will put in place permanently the resources to save the lives of hundreds of thousands of women each year."

Every minute of every day, a woman in Asia, Africa or Latin America dies from complications of pregnancy or childbirth. In some parts of Africa, maternal mortality claims 1 out of 12 women, compared to 1 out of 4000 women for Northern Europe.

This is the largest discrepancy between developed and developing countries for any of the common public health problems. What makes this situation truly tragic is that medical practice has had the means, for nearly 50 years, to prevent these deaths, through emergency medical measures such as surgery, drugs, and blood transfusions.

A woman may die because she needs a Caesarean section, and the anesthesia machine in the local hospital doesn't work properly or because the one qualified surgeon has never learned the necessary procedure. Or a woman may die on the way to a distant city hospital because her local hospital is not open when she becomes ill.

Rosenfield and Maine shed light on this important public health problem in a groundbreaking article in The Lancet in 1985. They found that it is access to medical care and comprehensive emergency obstetrical services that are critical to reducing maternal death and disability.

Their research countered the conventional practice that emphasized prenatal and preventive care to reduce deaths. They demonstrated that routine prenatal care cannot predict life-threatening complications since they are true medical emergencies that arise without warning.

The Foundation grant will help to analyze, in partnership with local agencies, existing gaps in emergency health care in countries in Africa, Asia, and Latin America, and it will help to upgrade existing facilities and provide personnel with better training, equipment, and supervision. Once needed changes are made, there will be ongoing monitoring of services to ensure that improvements are maintained.

Rosenfield and Maine intend to begin work in countries such as Egypt, Morocco, Mozambique, Nigeria, Uganda, Bangladesh, India, Pakistan and Peru. "I want to express our deepest appreciation to the Gates Foundation for this extraordinary opportunity to help women around the world," said Rosenfield, who is also dean of the Mailman School of Public Health. "We are honored by the trust that the Foundation has placed in us."

Bill and Melinda Gates have endowed two foundations with $6.5 billion to support philanthropic initiatives in areas that are of particular concern to them. The William H. Gates Foundation provides grants in the area of global health to improve the lives of women and children; education to support access to lifelong learning for young people and adults alike; and community giving in the Pacific Northwest to support civic and arts organizations in the local community that address the needs of children and families.