Hillary Rodham Clinton
Secretary of State
The Ronald Reagan Building
March 9, 2011
SECRETARY CLINTON: Good morning, everyone. What a wonderful way to start my day, to be here with all of you and talking about something which is so important. It goes, for me, without saying, but it’s nice to hear it said over and over again that America’s commitment to saving lives at birth and meeting the great challenges of development is not only the right thing to do, and derived from our moral obligations, but it is the smart, strategic decision to make as well.
And so I want to thank Raj for his leadership. It is a joy working with him, watching him lead, watching him bring the AID community together on behalf of the changes that are critically necessary in order to produce those results that we are all seeking. And I also am delighted to be here with Melinda, someone whom I admire so much, who has really rolled up her sleeves in every way imaginable to be a great champion for women and children, and to keep preaching the goal of innovation in order to maximize the impact of everything we do in the lives of those whom we serve.
It is, for me, a great honor to be a partner in this collaboration. I want to thank Dr. John Holdren, the President’s science advisor, for being here and for lending his support to AID’s innovation agenda. I want to thank Peter Singer from Grand Challenges Canada. It’s a real delight to be working with our Canadian friends on this matter as well as everything else that we partner on around the world. I want to thank Tore Godal from the Government of Norway, one of our strongest partners on every single imaginable cause, and we turn to Norway, which punches way above its weight all the time. I want to thank Tamar Atinc from the World Bank.
And as you look at the list of those organizations you’ll be hearing from in a minute, you can see that this truly is a collaboration, and that is how we think development has to be done going forward. We don’t want to be duplicating the good work of Canada or Norway. We don’t want to be just repeating what the Gates Foundation does so successfully. We want to coordinate so that we can have a better outcome from all of the efforts that we bring to the table.
So I’m delighted to be here during International Women’s Week to help launch Saving Lives At Birth, the first Grand Challenge for Development. I believe this partnership will spark revolutionary advances that can dramatically reduce maternal and newborn deaths around the world.
Now, you may have noticed there’s a lot going on in the world right now, and you don’t exactly see global health leading the nightly news. But it should be, because improving the health of people around the world isn’t separate or distinct from our foreign policy goals. Many of you have heard me say this over and over again, I’ve come here to AID and said it, I’ve said it on the Hill, I certainly say it all the time at the State Department and in the White House, but I can’t say it often enough, because I see it so clearly, it to me is absolutely the case that we must make. It is essential to our foreign policy goals and to advancing our national security. We invest in global health to strengthen fragile or failing states. We have seen the devastating impact that AIDS has on countries stripped of their farmers, their teachers, their soldiers, their health workers, their professionals, as well as leaving behind millions of orphaned and vulnerable children.
We see the impact that investing in global health has as it promotes social and economic progress and helps the rise of partners who can then turn around and work with us to solve regional and global problems, from climate change to violent extremism. And none of us needs to be reminded, I hope, of how quickly disease can spread in a world where every day, thousands of people step on an airplane in one continent and get off on another.
Now of course, there’s another reason why we do invest in global health. It is a powerful expression of who we are as Americans. It is simply unacceptable that millions and millions of people, women and children, die from conditions that we know how to prevent in a cost-effective way. So the Obama Administration has made a priority of improving health.
We are building on the work started by President Bush with the bipartisan support of Congress on HIV and malaria. We are increasing investments through our Global Health Initiative which sets ambitious new targets for progress and focuses our funding on the areas where we believe we can have the most impact. We’re intensely focused, as Raj has eloquently advocated, on reforms that deliver better results for less money, because we know in the 21st century our old approaches, as Melinda said, are not adequate. And it is somewhat ironic that in a time when 2 billion people have cell phones, we’re still kind of going along in the horse and buggy. We cannot permit that to continue.
Raj and his team – and there are a number of you here today – have put a special focus on advances in science and technology, breakthrough ideas that will drive down the cost of delivery and make it possible to reach more people and save more lives than ever before. We want to focus the world’s best researchers and thinkers on some of the toughest challenges.
Now, as all of you know, one of the toughest challenges is maternal and newborn health. It was wonderful hearing Raj talk about his newborn son, who joined his brother and his sister. But in the developing world, birth can be terrifying because the onset of labor begins a very risky period for both the mother and her baby. Every year, some 358,000 women die during childbirth – 1.2 million stillbirths and nearly a million more newborn deaths in just the first 48 hours after birth. So we’ve seen some progress, but those numbers are still shockingly high. I don’t want to live in a world where nearly 1,000 women die in childbirth every day. Every woman, whoever she is, wherever she lives, should be able to give birth without the fear she’s going to lose her baby or that her baby will lose her mother.
Now, to reach the kind of scale quickly that we’re talking about, we cannot solely rely on the traditional path of development – building roads, infrastructure, hospitals; training highly skilled doctors and nurses – because many of these deaths happen in the hardest to reach places, where there’s no reliable electricity or even clean water. We need new ideas that chart a different course, and here are some of those ideas of breakthroughs that we are focused on.
One breakthrough could help more women give birth with a skilled attendant. The evidence is clear that having a skilled attendant present during delivery greatly increases the chances of survival. Unfortunately, many women go without because they can’t afford to pay the attendant. But in Kenya and Uganda, government health agencies already offer women low-cost paper vouchers that subsidize this critical care. But we could reach far more women if we could distribute those vouchers via text messages. By harnessing the powerful ubiquitous development platform that Raj talked about, we could dramatically expand the reach of care, giving any woman with a cell phone the chance to deliver her child safely.
Another breakthrough could dramatically reduce birth asphyxia, problems with breathing that account for more than a quarter of the newborns who die at birth. Resuscitating a newborn can be a very delicate procedure, requiring significant training. So USAID and the National Institutes of Health partnered with Laerdal Medical to design and deliver a cheap resuscitation device that can be used with minimal training to help a newborn take her first breaths. This resuscitation device and the cell phone vouchers are the kind of simple, low-cost solutions that can become ubiquitous and make childbirth so much healthier.
We want to generate dozens of these out-of-the-box ideas. We’ve identified some of the biggest barriers. Through the Savings Lives At Birth Grand Challenge, we’re calling on the inventors and innovators, creative thinkers, whoever they are and whatever their expertise, to help us get beyond the barriers. Now, we’re not interested in technology for its own sake. We will target our funding toward advances that can work in the developing world. They have to be affordable, sustainable, and scalable in even the most remote villages. It might be a way to use cell phones to keep mothers up to date on the best ways to care for their babies and themselves, or a new method for recruiting, training, and paying community health workers, or a new system for identifying pregnant women with severe complications and creating a transportation network to take them to a clinic or hospital. We’re looking for dramatic impact that could increase access to healthcare for women and newborns by at least 50 percent. That is an ambitious goal, but that’s what makes it a Grand Challenge.
And this is just the beginning. There are so many other ways that we can benefit development through breakthroughs in science and technology. Imagine our collective wisdom working to provide lighting for the millions of people who live in darkness off the electric grid, or to educate children who will never, at this point in their lives, step foot inside a schoolhouse. So over the next two years, we’ll be announcing a series of other Grand Challenges. And if you’re a scientist or a technology expert or a dreamer or a creator or a garage inventor, keep your ears and eyes open.
And I just want to end by following up on something Raj said. Everyone knows that we’re in a difficult budget environment. And I have been to the Hill three times, I will go again tomorrow, to make the case for our State Department and USAID budget. I feel so strongly that we are at a turning point in the rebuilding of AID. I feel that the reforms that you are implementing, the ways you’re looking to make everything from procurement to technology more cost-effective, scrubbing contracts and contractors, really deserves support from the Congress. And I am trying to make that case in every way I know. But we need all of you. We need those of you who are not only at AID, but at the Gates Foundation, at our other partners to help us make the case. Because just when we feel like we have the inputs in better order and that we are poised to really go forth in the 21st century in keeping with the 50th anniversary of AID, we’re facing tremendous budget pressures.
This is a grand challenge for us to make a case for development and to make it to everyone across the political spectrum, to make it to those who’ve long been our supporters, that we’ve got to do it differently, that we can’t do everything and be everything to everybody, and they’ve got to help us really focus this agency. And to those who have been the doubters, we need to convince them that we are in a new era of development as evidenced by this collaboration. So I’m deeply hopeful about the progress that we are making and by the revolutionary solutions in health and development that are waiting for us to capture and apply.
I really believe that we can, in this new era, help more people live up to their own God-given potential starting by helping them survive, saving their lives at birth. We cannot do it without this partnership, and we cannot do it without making the case to our friends on the Hill and the Administration and throughout the country.
The American people are a generous, giving, compassionate people. They believe that our foreign aid budget is about 20 percent of our overall budget and that all we have to do to balance the federal budget is basically eliminate foreign aid. Well, it’s our fault they believe that. That is not the fault of somebody sitting somewhere in our country who thinks that. It is our fault. We have to make the case, and it is a case we can make and convince those who care about what goes on in the rest of the world to also be our partners. Thank you very much. (Applause.)