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The $30 billion 'price tag' for improving maternal, neonatal and child health is inadequate


The Partnership for Maternal, Newborn and Child Health, an international alliance of groups working on maternal and child health argues that $US30 billion of additional funding is needed to save the lives of over 10 million women and children by 2015, but this estimate is misleadingly low because it leaves out crucial service delivery costs. The reasons for, and the implications of, this serious financial underestimate are discussed in a Policy paper by Marco Schäferhoff and colleagues from the Evidence to Policy initiative (E2Pi) based in Berlin, Germany, and University of California San Francisco, USA, and published in PLoS Medicine.

The authors argue that omitting the costs to scale up the system-wide components involved in programs to improve maternal, neonatal, and child health (MNCH)--such as the human resource cost necessary to allow programs to function effectively-- is a serious oversight and risks raising false expectations about the funding needed for impact. They recommend that the US$30 billion "price tag" for improving MNCH be updated before the September 2010 Millennium Development Goals (MDG) Summit in New York. An updated price tag would give donor governments a more realistic picture of what is required to reduce maternal, newborn, and child deaths and successfully achieve MDG targets 4 & 5 (the child and maternal health targets).

The authors conclude that there are two things that they can say with certainty: "First, the current level of aid devoted to MNCH is inadequate, providing only a fraction of the total resources required to achieve the child and maternal health MDGs. Second, donors are not living up to their promises--in 2010, Africa will receive only about US$12 billion of the $25 billion pledged by the G8 at Gleneagles." The authors continue: "Scaling up to reach MDGs 4 and 5 means urgently fixing these shortfalls."


Funding: The Evidence to Policy initiative is fully funded by the Bill & Melinda Gates Foundation. The funder played no role in the preparation of this manuscript or in the decision to submit.

Competing Interests: MS works full time as a policy analyst for the Evidence to Policy Initiative (E2Pi), based at SEEK Development in Berlin, and his post is fully funded by the Bill & Melinda Gates Foundation. CS leads the Berlin hub of the Evidence to Policy initiative; this leadership post is funded by the Bill & Melinda Gates Foundation. She also runs SEEK Development, a global health and development consulting group, based in Berlin. She was previously a senior staff member of the Global Fund to Fight AIDS, TB and Malaria, and has worked as a consultant for the GAVI Alliance and other organizations. GY leads the San Francisco ''hub'' of the Evidence to Policy initiative (E2Pi), based in the Global Health Group (GHG) at University of California, San Francisco. E2Pi is fully funded by the Bill & Melinda Gates Foundation. The GHG's director, Richard Feachem, is a member of the Scientific Oversight Group that advises the board of the Institute for Health Metrics and Evaluation. GY is a former Senior Editor of PLoS Medicine.

Citation: Schaferhoff M, Schrade C, Yamey G (2010) Financing Maternal and Child Health--What Are the Limitations in Estimating Donor Flows and Resource Needs? PLoS Med 7(7): e1000305. doi:10.1371/journal.pmed.1000305




Marco Schäferhoff
Evidence to Policy initiative
SEEK Development
Greifswalder Straße 34-35
Berlin, 10407 Berlin
+49 30 41728172

Gavin Yamey
Evidence to Policy initiative
Global Health Group
50 Beale St, Suite 1200, Box 1224
San Francisco CA 94105
+1 415 597 4985

About E2Pi

The Evidence-to-Policy Initiative (E2Pi) is a new partnership dedicated to narrowing the gap between evidence synthesis and practical policy-making, to support informed decision-making and accelerate progress in global health. More information is available at

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