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Harper's plan for maternal health not nearly good enough

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When Stephen Harper first announced his big new Maternal and Newborn Child Health initiative (the Muskoka Initiative) back in 2010, Canadians deeply committed to the issue were slow to offer three cheers. The idea was just too unHarperish. He had never broached this important issue before. His government was cutting overall foreign aid and had entirely cut off eight African countries where maternal and child mortality were greatest. At home, he was enthusiastically defunding women's activist groups and other fine NGOs that had long worked to improve the well-being of women in poor countries.

What's worse, the spin was preposterously self-serving. If you didn't know better, you'd be led to believe that Canada was now going to lead the world in meeting the crisis of high maternal and child mortality. Nothing could have been further from the truth. The issue was already a priority for rich countries, including Canada. A decade before Muskoka, the world had adopted eight "Millennium Development Goals"; two of the eight were to reduce child mortality and to improve maternal health. For years UN agencies plus government aid agencies in rich countries plus thousands of NGOs had been working on the issue. Stephen Harper was very much a latecomer to this party, though you'd never know that from the government's spin.

The cynicism this engendered was deeply compounded when it was learned that programs the government would now fund would exclude anything to do with family planning and abortion. Ignoring birth control -- literally a motherhood issue-- would have discredited the initiative from the get-go, and eventually was included. But abortion has remained out of bounds from the first.

For those who believe that most of the Harper government's foreign policy is based on domestic political considerations, the abortion ban added considerable weight. As the World Health Organization has made only too clear, if you truly care about women's health, safe abortions are crucial. This is no peripheral matter, no add-on; it's central. Twenty million women have unsafe abortions every year in poor countries, some 47,000 of whom die of complications. That's close to 13 per cent of all maternal deaths. So it's hard not to conclude that playing to the Conservative base's opposition to abortion trumped the well-being of those thousands of poor women in poor countries.

This week Stephen Harper has been hosting a high-profile conference in Toronto to mark the fourth anniversary of this Muskoka Initiative. Its theme is "Saving every women, every child." Given his position on abortion, you know that it's just not so.

For much of the past four years, it would be reasonable to assume the initiative had simply disappeared. The Prime Minister himself raised it only occasionally. Most Canadians knew nothing about it. This week's conference seems as abrupt and unexpected as the original initiative itself.

But as usual, the government had to spoil things, by failing to invite the opposition parties to participate (hardly the first time this had happened). Hélène Laverdière, NDP opposition critic on international development, had to request an invitation three times and was only invited at the last moment -- exactly two days after she told CBC's The House that her requests had been ignored.

Mr. Harper budgeted $1.1 billion in new funding for the Muskoka Initiative. Strangely enough, this was actually less than the $1.75 billion the government had already allocated pre-Muskoka for the same purposes for the same five-year period. In any event, $2.85 billion is serious money and we are told that 80 per cent of it has gone to Africa, where it belongs.

What progress have these funds delivered? The truth is it's impossible to know yet. Some vocal fans of the Muskoka Initiative say it's been major. I'm not sure how they know, since Canadian funds are often intermixed with other funds, transparency is lacking on exactly how the funds are being spent, and it always takes some years before conclusions can reliably be drawn. Still, we can surely assume that almost $3 billion brought some real improvements, which must be applauded.

But everyone, including the Prime Minister, understands there are miles yet to go. The MDG goals, for example, are mostly unachieved. Too many women still die in pregnancy and childbirth and too many children die before they're five. Much more funding is required, and Mr. Harper deserves praise for committing another $3.5 billion over the next five years. Alas, abortion remains in the back allies, and though family planning was conspicuously nowhere on the conference's agenda, it seems still to be some part of the Initiative.

The Prime Minister's foreign guests, who lavished such praise on him, encountered a Stephen Harper Canadians have rarely seen -- engaged, thoughtful, human -- and perhaps weren't aware that several conference sessions were unaccountably closed to the media. The many uninvited civil society groups meeting on the outskirts of the conference could have told them those closed sessions were more typical of the Stephen Harper they know.

Will the substantial expertise and experience of these NGOs finally be tapped by the Harper government? Will we have to wait another four years for the next public airing of this great cause? Will transparency be increased? Laudable as it is, you can't help thinking Mr. Harper's initiative could be even more -- if it were not for Mr. Harper.

 This article originally appeared in The Globe and Mail.

Image: Wikimedia Commons

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