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The World Health Organization was designed to address threats exactly like COVID-19—where global cooperation is our only chance of success.

The global community is racing to slow down the spread of COVID-19, a pandemic that has claimed the lives of over 160,000 people globally and sickened over 2 million more. As researchers and epidemiologists work around the clock to find a solution to halt both the deaths and the spread of the disease, our health workers are leaving loved ones at home to fight on the front lines of this crisis. I am moved daily by the stories of those doctors, midwives, nurses and other essential workers, who are working tirelessly to keep us safe, facing the dangers head-on, often with inadequate equipment and information.

Much of the world is locked down, isolated in households and communities, renewing and deploying the age-old and time-tested techniques of personal, social, surface and environmental hygiene, which all depend on the availability of clean water—an essential resource often scant where it is needed most. In Africa, the virus has spread to dozens of countries within weeks. Governments and health authorities across the continent are striving to limit widespread infections.

As always in times of crisis, the most vulnerable among us will be the ones hit hardest. Women and girls will suffer the most from this disease, and we have already seen a rise in gender-based violence and rights violations of pregnant women. Sufferers of domestic violence are now locked down with their abusers, isolated from their support systems, and other at-risk groups are unable to access routine services. The ripple effect of COVID-19 runs far beyond the disease itself. Humanity will bear the scars of this pandemic for many years to come.

Around the world, we are seeing countries and communities acting both together and apart. Fear is impeding mechanisms for an effective response to the coronavirus pandemic, giving rise to anger, racism, a rhetoric of blame and a dangerous spread of misinformation. Beyond health services, countries with large ratios of informal economic sector citizens are struggling to feed themselves, increasing the present hunger and suffering, as well as the undeniably unwelcome prospects of unrest.

Now more than ever, the world needs a well-functioning global organization designed to facilitate international coordination. The global community must unite behind a strong World Health Organization, an institution designed to address exactly this kind of global issue, our standard-bearer in these unprecedented times for this unprecedented virus. Countries need factual information based strictly in science with the benefit of a global perspective to ensure the most vulnerable communities have the support and information they need to survive.

The WHO works closely with governments to provide evidence-based guidelines for response and facilitate adaptation to the country context. Remote support is being provided to affected countries on the use of electronic data tools, so national health authorities can better understand the outbreak in their countries. Preparedness and response to previous epidemics is providing a firm foundation for many African countries to tackle the spread of COVID-19. Following their lead, which has urged nations to track and trace in order to tackle and treat the coronavirus, my organization, the Wellbeing Foundation Africa, has partnered with Pocket Patient MD to launch an app-based digital platform that enables individuals across Nigeria to run a health check and identify early symptoms of COVID-19.

Where basic preventative measures by individuals and communities remain the most powerful tool to prevent the spread of COVID-19, the WHO is helping local authorities craft radio messaging and TV spots to inform the public about the risks of COVID-19 and what measures should be taken. The organization is also helping to counter disinformation and is guiding countries on setting up call centers to ensure the public is informed. Every country is a beneficiary and a partner of the WHO’s work.

In the same vein, it is inconceivable to imagine a healthy future for our world without acknowledging the pivotal role of the United States in ensuring we realize it. The WHO has operated with the majority of its funding coming via the U.S. government throughout its 70-year history. We must recognize and respect the interconnected nature of our world, the relationships between countries and institutions, and the significant roles of member states in enabling such important institutions to function and deliver during these crucial times. We must prioritize unity and diplomacy at all levels.

COVID-19 is cruel in many ways. Many of us have been shaken by the loss of a loved one, made all the harder by separation enforced by lockdowns. But we cannot allow it to divide us, to pit us against one another—against countries, organizations and neighbors. If we allow that perspective to prevail, we will not only lose ourselves and experience greater isolation, we will also make ourselves more vulnerable. We must come together to manage this shared challenge, show solidarity as country and institutional leaders, advocates and allies, health workers and communities. We know, through hard-earned experience, that global cooperation is our only chance of success.

While many nations have attempted to build health security borders to combat the pandemic, COVID-19 is a stark reminder that humans are connected, and that what happens in one country can impact the everyday lives, social fabrics and economies of countries far away. Working individually does not shield us from the global framework in which we are operating – we are part of an interconnected world, and when we respond accordingly, we can more accurately and effectively combat our shared challenges.

Human connectivity holds power. The positive impact of our collective will to physically distance from one another alone shows what power we hold. In working together to promote unity, overcome global inequality and support measures to protect public health, we are striving to ensure that no one is left behind in our response to the pandemic.

Toyin Saraki is the founder and president of the Wellbeing Foundation Africa, the inaugural global goodwill ambassador for the International Confederation of Midwives and special adviser to the independent advisory group of the World Health Organization’s regional office for Africa.

The views expressed in this article are the writer’s own.

From labor shortages to racial bias, the barriers to achieving Sustainable Development Goal 3 – “ensure healthy lives and promote well-being for all at all ages” – are as diverse as they are high. But the chances of success are significantly better if we listen to those who understand the situation on the ground.

ABUJA – We have a decade left to achieve the United Nations Sustainable Development Goals (SDGs), and we are nowhere near where we need to be to succeed. One crucial reason is that women remain largely excluded from decision-making processes, which leads to policies that do not provide women the support they need to prosper – or even to survive. Nowhere is this dynamic more apparent than in the health sector.

Women comprise roughly 70% of the global health workforce, and perform the majority of the sector’s most challenging, dangerous, and labor-intensive jobs. Yet they hold only 25% of the health sector’s senior roles, and are rarely represented adequately in policymaking. Instead, they are often expected to remain passive actors, quietly finding ways to do their jobs in difficult – even impossible – circumstances.

The reality for women health workers was reflected in a recent letter to the medical journal The Lancet from two Chinese nurses describing the conditions they and their colleagues face on the frontlines of the battle against the new coronavirus, COVID-19, at its source in Wuhan, China. It may be an extreme case (and the letter has now been retracted over claims that it was not a firsthand account), but the challenges described, from shortages of protective equipment to chronic overwork and exhaustion, are all too familiar to health workers everywhere.

Such conditions make essential health-sector jobs unattractive, contributing to severe labor shortages worldwide. The World Health Organization estimates that, for all countries to achieve SDG 3 (“ensure healthy lives and promote well-being for all at all ages”), an additional nine million nurses and midwives will be needed globally by the year 2030.

Closing this gap is matter of life and death. For example, midwives are often the difference between safe childbirth and newborn or maternal mortality. Lack of access to them – especially for vulnerable populations, such as poor rural dwellers – is a major reason why two-thirds of all maternal deaths occur in Sub-Saharan Africa. The WHO estimates that adequate midwifery care (including family planning) could prevent 83% of all maternal deaths, stillbirths, and newborn deaths.

Infant and maternal mortality are hardly limited to developing countries. In the United States, the maternal mortality rate has actually increased in recent decades, from 7.2 deaths per 100,000 live births in 1987 to 16.7 deaths per 100,000 live births in 2016. More than half of these deaths could have been prevented if the mothers had better understood the importance of – and had easier access to – quality prenatal and postpartum care.

There is a clear racial dimension to this disturbing trend. In the US, a black woman is 3-4 times more likely than a white woman to die from complications in pregnancy. In the United Kingdom, that multiple rises to five. While this discrepancy may be partly explained by health complications black women experience, racial bias also plays a role. Black women often report feeling that they are not taken seriously by medical professionals.

The health consequences of not listening to women extend further. Children born to healthy mothers are more likely to remain healthier throughout their lives. Because a woman is most likely to engage with the health sector during pregnancy, the support of a midwife or nurse can pull a woman’s entire family into the health-care system.

In a bid to recognize their vital contribution in the health sector, the WHO has designated 2020 as the Year of the Nurse and Midwife. But beyond celebrating nurses and midwives for their hard work, we must seek to rectify structural inequities that exclude women from leadership positions in these professions. That is a key goal of the upcoming Women in Dev conference – a women-led, women-focused initiative that deserves the support of us all.

From labor shortages to racial bias, the barriers to achieving SDG 3 are as diverse as they are high. But the chances of success are significantly better if we listen to those who understand the situation on the ground, and work to enhance inclusion at all levels, taking into account varying socioeconomic conditions. This will require a fundamental shift in mindset, with publics and policymakers alike recognizing that women – as nurses, midwives, and mothers – are often the gatekeepers of health.

A decade of rapid progress toward SDG 3 is possible. But women must be at the helm.

H.E. Toyin Saraki is the President and Founder of The Wellbeing Foundation Africa.

Abuja — Today, as we mark International Universal Health Coverage (UHC) Day, I am encouraged by the growing momentum behind the belief that every single person should have access to the care they need when they need it, and that no one should be forced to suffer financial hardship or forgo treatment they cannot afford.

The Wellbeing Foundation has committed to employing a whole system approach for health for all with ten essential features, centering on the provision of quality primary health care for all, with a focus on women, infants, and children. It has been three months since the High-Level Meeting (UN HLM) on Universal Health Coverage at the 74th UN General Assembly, in which leaders around the world recommitted to their promise of health for all. At the heart of this progress is the understanding that quality maternal care should be at the centre of our drive to achieve universal health coverage.

I believe that it is critical that next year has been identified as the World Health Organization (WHO) Year of The Nurse and The Midwife. The year, which fittingly marks the 200th anniversary of the birth of Florence Nightingale, presents us with a unique opportunity to consider the role of gender parity and equality in health coverage and health provision.

In March 2019, the WHO, the Global Health Workforce Network, and Women in Global Health produced a report on Global Health and Social Workforce entitled “Delivered by Women, Led by Men: A Gender and Equity Analysis of the Global Health and Social Workforce.” Strikingly, the report found that ‘women deliver global health and men lead it’. The report highlighted that women comprise 70% of the global health workforce, but only 25% hold senior roles, while women face gender discrimination, barriers, and inequalities not faced by their male colleagues at work. Gender inequality within the sector is not only unacceptable, but it ultimately weakens the quality of healthcare that we are able to provide.

Nurses and midwives represent half of the professional health workforce and are overwhelming, although not exclusively, women. They play a critical role not only in delivering healthcare to millions of people in every country, but they are key to transforming health policies, disease prevention, emergency care, and supporting the families of patients. They are necessary partners supporting the health and wellbeing of the communities they serve in a multitude of ways that include health care delivery, education, and counselling. If we are to build universal health coverage that is of quality and value, it is essential that we ensure that frontline workers in maternal care have not just a have a seat at the table but sit at the head.

As nations develop UHC frameworks, I am encouraged to see a groundswell in the number of individuals and organisations advocating for sexual and reproductive health and rights (SRHR) and prioritising the needs and rights of women and girls. SRHR means liberating women and girls with access to family planning and empowering them with the information and confidence to make informed decisions about their lives. Strong SRHR frameworks include education, awareness, and choice: the choice to have children in clean and safe conditions. The choice to space children, so that resources can be distributed to maximise the opportunities of each child. The choice to be properly informed and empowered in the decision-making process that surrounds these issues is important for the young. Effective SRHR may prioritise women and girls, but it also cannot afford to exclude men and boys; these are issues that affect everyone.

In 2013, at the World Health Assembly, then-President of the World Bank Group, Dr Jim Yong Kim, asserted that “we must be the generation that delivers universal health coverage.” I couldn’t agree more: now is the time to get this right.

In alignment with World Health Organization recommendations, the Wellbeing Foundation Africa’s whole system approach to UHC is comprised of ten essential components:

1)Pregnant women should receive the right care, at the right time;

2) Newborns should receive essential care immediately after birth;

3) Small and sick babies should be well cared for in a facility;

4) All women and newborns must receive care that prevents hospital-acquired infections;

5) Health facilities must have an appropriate physical environment;

6) Communication with women and their families must be effective and respond to their needs;

7) Women and newborns who need referrals can obtain them without delay;

8) No woman should be subjected to harmful practices during labour, childbirth, and the early postnatal period;

9) Health facilities need well-trained and motivated staff consistently available to provide care;

10) Every woman and newborn should have a complete, accurate, and standardized medical record.

Each of our flagship programmes and initiatives; our Emergency Obstetric and Newborn Care programme, our Water, Sanitation, and Hygiene programme, our Personal Healthcare Record Book initiative, our Alive and Thrive programme, and our MamaCare/MamaCare+N programme are tailored to meet these priorities.

This year, leaders made progress by affirming UHC as a key strategic interest. But millions of lives hang in the balance of this essential promise, a promise on which we must deliver. The WHO cites that today approximately half of the world’s population live without full coverage of fundamental health services while an estimated 100 million people are being forced into extreme poverty due to health care expenses.

The equivalent of one in ten people is spending over 10% of their household budget on critical health care costs. We know that there is a myriad of ways that health will impact the achievement of sustainable development, including, but not limited to the health-specific objectives.

How can we solve poverty if people are forced into bankruptcy themselves to pay for treatment? We will only meet all of the SDGs by 2030 if everybody is able to access affordable, safe, respectful, and quality healthcare.

Today I call on all health partners and stakeholders to urge our leaders to deliver on their promise of UHC. I wholeheartedly believe that we must collectively champion UHC frameworks that are grounded in equality and inclusion and take into consideration not only the unique experiences of women in the health workforce, but that centre on SRHR policies that prioritise women and girls.

Toyin Ojora Saraki is founder-president of Wellbeing Foundation Africa

ABUJA- WIFE of the Former Senate President, Toyin Saraki, has donated breastfeeding equipment to four States, Lagos, Kwara, Kaduna States and the Federal Capital Territory, FCT, Abuja, to help healthcare facilities provide optimal neonatal intensive care feeding for premature and sick infants, and also to ensure fragile neonates benefit from the immunity provided from colostrums, which serves as the first immunity for newborns.

This was disclosed by Saraki on her visit during the World Breastfeeding Week 2019 to the maternity services of Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom, UK, where she met with senior staff of the organization, including Medical Director, Zoe Penn, Interim Director Midwifery, Victoria Cochrane, Medical Director, Women’s Services, Gubby Ayida, and Fundraising Director, ‘CW +’, Kerry Huntington, which acts as the official charity of the NHS Foundation Trust.

Saraki discussed how the 12,000 women a year who give birth at the Foundation, and how they were cared for in a midwifery-led system which also provides an obstetric model of care, including specialist support for more complex pregnancies and health conditions with a foetal medicine unit. She said: “This week the Foundation donated breastfeeding equipment to the Neonatal Intensive Care Units of medical facilities in Lagos, Kwara and Kaduna States and Abuja, to help healthcare facilities provide optimal neonatal intensive care feeding for premature and sick infants, ensuring that fragile neonates may more easily benefit from the immunity provided from colostrums, which serves as the first immunity for newborns. “I commend the Chelsea and Westminster Hospital NHS Foundation Trust for its superb, midwife-led maternity care. I was struck today not only by the excellent standards that women can expect at the hospital but also by the culture of respect that is ubiquitous amongst staff. “I am impressed to observe the workings of primary, secondary and tertiary specialist referrals providing an unbroken continuum of maternity care, as an essential core of universal health coverage services.

“At the Wellbeing Foundation Africa, our MamaCare midwives also lead the way with quality care, saving many lives and helping women and infants to thrive. I look forward to working with the Chelsea and Westminster Hospital NHS Foundation Trust to share research bench to bedside best-practice models of maternity services, and bring the best possible standards of care to women all over the world – no matter where they give birth.” Meanwhile, she (Saraki) revealed that her foundation, Wellbeing Foundation Africa, WFA, is to partner with the Liverpool School of Tropical Medicine’s Centre for Maternal and Newborn Health’s Emergency Management of Obstetric And Newborn Care Simulation Skills Programme in Nigeria. “The Wellbeing Foundation Africa will partner with the Liverpool School of Tropical Medicine’s Centre for Maternal and Newborn Health’s Emergency Management of Obstetric And Newborn Care Simulation Skills Programme in Nigeria.  We have invited the School to visit the hospital”, she said.

To catalyse new global and regional commitments 25 years after Cairo Summit

In a significant high-level global gender and rights commitment,Founder-President of the Wellbeing Foundation Africa (WBFA) Toyin Saraki has accepted the official invitation of the United Nations Population Fund UNFPA, the United Nations’ foremost sexual and reproductive health rights agency,  to join the International Steering Committee of the International Conference on Population and Development, taking place in Nairobi in November 2019.

Convened by the Governments of Kenya and Denmark, and the UNFPA, the ICPD25 Summit in Nairobi from 12–14 November 2019 will bring together heads of state and ministers, parliamentarians, thought-leaders, technical experts, civil society organizations, young people and people with disabilities, business and community leaders, faith-based organizations, international financial institutions, academics and thousands of others interested in the pursuit of reproductive health and rights, in order to mobilize the political will and financial commitments needed to deliver on the commitments made by 179 governments in Cairo in 1994 at the landmark International Conference on Population and Development, the ICPD.

Mrs Saraki joins the ICPD International Steering Committee with a focus on mobilising global and country commitments around five themes:

• Universal access to sexual and reproductive health and rights as a part of universal health coverage
• Financing required to finish the ICPD Programme of Action and to sustain the gains made
• Drawing on demographic trends to drive economic growth and achieve sustainable development
• Ending gender-based violence and harmful practices
• Upholding the right to sexual and reproductive health care even in humanitarian and fragile contexts

Having commenced her new high-level global commitment during multi-lateral meetings at Women Deliver in Vancouver last week, Mrs Saraki commented: “We stand on a gender precipice, from which we must urgently act to transform the lives of women and children. Together with my fellow members of the ICPD International Steering Committee, I envisage a world where every individual and couple, everywhere, can decide freely when to have children, and has the information, education and means to do so.  A world where no woman or girl dies from preventable complications in pregnancy or childbirth:  where no woman has to give birth without the help of a midwife, nurse or doctor. We must forge a world where no one is subjected to violence because of their gender, where no girl is
forced to marry, where no girl or woman is subjected to female genital mutilation or other harmful practices.”

“We are far from the world envisaged by the conference in Cairo 25 years ago. 830 women die every day while giving life, mostly from preventable causes. 33,000 girls are forced into child marriage and 11,000 girls face genital mutilation every day. 5 million pregnant women have been displaced by conflict or disaster and are in need of medical care. They all deserve a better world, across the life-course, from birth to age”

“I am therefore delighted to serve as a member of this important global committee, bringing Africa’s voice to the fore. I look forward to deepening Nigeria’s pivotal national consultations on gender, population and development, in conjunction with the UNFPA Nigeria country office, alongside the International Steering Committee’s global terms of reference.”

Dr. Natalia Kanem, UNFPA Executive Director, commented: “As we celebrate the remarkable progress we have made in advancing the health and rights of women, we must redouble our efforts to reach those who have not yet benefited from the promise of the ICPD. The Nairobi Summit will help us rally a broad coalition of stakeholders to protect the gains made and advance the ICPD agenda to ensure that no one is left behind.”

Mrs Saraki has also served as a pioneer member of the United Nations African Women’s Leadership Network since 2017, and is a contributor to the 2019 UK-France Governments’ International Consultative Dialogue for Prevention of Sexual Violence Initiative (PSVI). Mrs Saraki is the Global Goodwill Ambassador for the International Confederation of Midwives and a Special Adviser to the Independent Advisory Group of the World Health Organization Regional Office for Africa.

The UNFPA as core advocacy partner, seeks to catalyse and accelerate progress towards ‘the Three Zeros’ – three strategic results that it will work to achieve by 2030:

– zero unmet need for family planning;
– zero maternal deaths; and
– zero violence and harmful practices against women and girls, including child marriage and female genital mutilation.

Toyin Saraki, the founder-president of the Wellbeing Foundation Africa tells Emelia Hamilton-Russell how it all began, and how the charity has revolutionised natal healthcare in Nigeria

The word ‘philanthropist’, to me, simply means someone who loves other people. When I was growing up, I always wanted to make sure other people were all right. Nigeria is a very philanthropic nation, and the instinct to help people grew in me as a child.

My mother was a very caring person and taught us to care for people around us as well as caring for the family. My wedding was the biggest wedding of the year – if not the decade – in Nigeria. I was expecting twins at the time, and I went into labour early.

I actually went into labour on the eve of my wedding, which was rather disastrous. Four thousand people were waiting for the bride to appear, but I was in hospital undergoing an emergency caesarean. The babies were only 28 weeks, so they were very early, very premature, and my daughter had quite a fight for life. I had quite a fight for life myself.

The Nigerian hospital simply didn’t have the resources to deal with such a premature, complicated birth. I gave birth to my daughter naturally, but the other twin was stuck and we had to wait 45 minutes for the anaesthetist to come before they could perform the caesarean.

They just couldn’t get the other baby out in time. I was too ill to comprehend and was never formally told, but later I worked out for myself that the second twin must have died. Culturally, we don’t acknowledge a still-birth as the death of a child, so I was never able to see the child, to properly grieve or say goodbye.

I had originally been registered to give birth in the UK – at the Portland – but because I went into labour so early I had to give birth in Nigeria. As soon as I came round from the anaesthetic I was frantically phoning the Portland, asking what I should be doing to maximise the chances of my baby surviving.

They’d tell me what to do and then I’d ask the Nigerian doctors: ‘Please, have you given me steroid injections to help mature the baby’s lungs? Have you cleared her airways?’

I was under anaesthetic when the second twin – the one that died – was born, and I have a feeling my daughter survived because I was awake and I knew what to ask for.