UN Leadership in Disarray as Scientific Dispute Shatters Consensus on Maternal Health

Deep divisions with top United Nations (UN) officials and abortion activists on one side and maternal health researchers on the other became public this week during the Women Deliver 2 conference in Washington DC. The dispute threatens to derail hopes of raising $30B for family planning at international development conferences in the coming months. These include the Group of Eight summit this month and the UN High Level Millennium Development Goals (MDG) Review in September.

The medical journal The Lancet published a study in April refuting UN research claiming 500,000+ annual maternal deaths has remained unchanged for decades. The new study put the figure at 342,900 with 60,000 of those from HIV/AIDS, and said the number has been declining since 1980.

World Health Organization (WHO) executive director Margaret Chan told journalist Christiane Amanpour that legal abortion was a key factor in reducing maternal deaths, but the Lancet study she referred to never mentioned abortion. Thoraya Obaid, director of the UN Population Fund (UNFPA), said the UN’s own report on maternal health would be published in September and show similar trends. But WHO’s top statistician Ties Boerma said the UN report would likely not be published until 2011, and when pressed stated cryptically that one could expect it to have similar findings if it were to use the same data.

Such collaboration seemed unlikely due to a sharp disagreement between UN staff who want only one set of UN-centered “consensus” statistics, and other scientists, such as the new study’s author Christopher Murray and Lancet‘s editor Richard Horton, who called for more scholarly independence.

Scientists flatly refused to back up the 20 year-old claim by UN agencies and activists that family planning improves maternal health. The Guttmacher Institute’s president, Sharon Camp, asked Murray whether his study’s finding linking declining global fertility rates to better maternal health supports the idea that more family planning will reduce maternal deaths. Murray replied that “there is no scientific way to prove that.”

Scientists also undercut UN staff’s use of the world’s slow progress toward MDG 5 as a basis for urgent pleas for family planning funds. Boerma and Murray both said that its aim of reducing maternal deaths 75% by 2015 was unrealistic since it was not based upon “historical trends.” The world would need an 8% annual drop, whereas 4% has been the best so far.

Downplaying the remarks, Guttmacher’s Camp defended a joint Guttmacher-UNFPA report which was based on the now discredited UN figures, and which calls for a doubling of family planning funds in order to reduce maternal deaths by 70%.  Camp did not explain why the same amount of funding would be required for a smaller overall reduction.

Hans Rosling, professor at the prestigious Karolinska Institute, said that the world’s dramatic drop in fertility cannot be tied to policy interventions, citing instead improved personal income. He cited Sri Lanka, whose sharp decline in maternal deaths was the basis for setting the MDG 5 goal to reduce maternal deaths 75% by 2015. He asserted that the island nation benefited from asphalt roads and other infrastructure put in place under its period of colonialism. Not mentioned was the fact that abortion is highly restricted there.

Basing his findings on data reaching back to 1800, Rosling jibed the UN’s 20 year-old maternal health statistics, saying maternal health research predates the UN.

The disarray of UN leadership on the maternal health data comes in the same week that UN member states begin negotiating the outcome document for this September’s high-level meeting on maternal health.

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