More than 6 million children die annually around the globe from largely preventable problems such as diarrhea and pneumonia, but a $500 million, five-year effort led by the Baltimore-based nonprofit Jhpiego aims to put a big dent in those statistics.
The money is the second-largest award the Johns Hopkins University affiliate has ever managed and is the flagship grant this year from the U.S. Agency for International Development, the nation's foreign aid bureau that spends $1.5 billion annually to prevent mother and baby deaths in poor countries.
"We do know what the problems are, and we also know what the solutions are," said Dr. Koki Agarwal, who will head the new Maternal and Child Survival Program at Jhpiego. "Unfortunately, these solutions are not delivered to these countries. They don't benefit. We need to make sure every woman, no matter where she lives, can access health care."
USAID announced the award Wednesday as part of a broad effort to reduce deaths by 500,000 by the end of 2015 and an international "Call to Action" that aims to end preventable child deaths by 2035.
The Jhpiego funding will target 24 countries with the worst records by providing a specific, cost-effective collection of services, such as administration of vaccines and antibiotics.
In addition to drugs, the Jhpiego funding will pay for other medical supplies and equipment, training for medical providers and improving communications with the women in mainly rural areas and urban slums, according to Jhpiego and USAID.
Jhpiego will coordinate with a host of other nonprofits as well as the countries' leadership. Relationships were forged with many of them during the past six years as Jhpiego was running another $600 million USAID-funded effort to improve health.
The groups will target the leading causes of mortality among mothers, such as uncontrolled bleeding after birth, infections and high blood pressure during pregnancy. Among newborns, the biggest causes of death include asphyxia and low birth weight. And for children under 5, the main culprits are pneumonia, malaria and diarrhea.
Efforts by the American agency, international aid groups and other nations have helped cut the global child mortality rate nearly in half since 1990 to 6.6 million in 2012, according to USAID data.
Specifically in the 24 target countries, largely in Asia and Africa, newborn deaths have dropped by a third, and deaths of children younger than 5 have been reduced by half in that time. Maternal deaths dropped by more than half.
But millions of children and mothers still die every year of preventable diseases, said Dr. Rajiv Shah, USAID administrator.
"This award will empower our agency to tackle the leading causes of maternal and child death, even in the world's most difficult environments," Shah said. "By scaling up high-impact, cost-effective solutions that expand access to life-saving care, we can unlock opportunity and growth for the world's most vulnerable people."
He called the program "an extraordinary push that never happened this way before."
One of the most cost-effective tools may be training more skilled midwives, according to research reported this week in the journal The Lancet from Hopkins' Bloomberg School of Public Health, one of Jhpiego's partners on the new and past awards.
A 10 percent increase in midwife coverage every five years through 2025 could prevent more than a quarter of mother, fetus and infant deaths in 26 of the poorest countries, the research found.
Jhpiego's target countries
Afghanistan, Bangladesh, Democratic Republic of Congo, Ethiopia, Ghana, Haiti, India, Indonesia, Kenya, Liberia, Madagascar, Malawi, Mali, Mozambique, Nepal, Nigeria, Pakistan, Rwanda, Senegal, South Sudan, Tanzania, Uganda, Yemen and Zambia.