Why should we care about the health of people in developing countries? And why do we need to help women in particular? The Yomiuri Shimbun posed those questions to Marian Wentworth, a top official at a U.S.-based international nonprofit organization that has been working on global health systems for nearly half a century. The following is excerpted from the interview.
Humanity is waging a global battle against disease, which is a merciless foe. In 2015, 5.8 million children died before reaching the age of five, the vast majority of them in low- and middle-income countries. Every day, 800 women die from pregnancy or childbirth-related complications. Almost all of these deaths -- 99 percent -- occur in developing countries. These countries need our help. We can and should help them, and not just because it's the right thing to do. We also need to consider that the world is only as healthy as the weakest health-care system.
Diseases travel. Ebola broke out in Guinea and, months later, infected a nurse in Dallas, Texas, via a traveler from Liberia. Diseases like SARS and HIV hitch rides with airplane passengers as they crisscross the globe. Weak health systems incubate those diseases; they go undetected and untreated much longer. We're also facing the dire threat of antimicrobial resistance (AMR), in which standard treatments are losing their effectiveness against deadly infections. Climate change and political unrest, too, are sending shockwaves through health-care systems.
Meanwhile, the incidence of non-communicable disease has been growing. Heart disease, diabetes, cancer -- once thought of as diseases of the rich -- are on the rise in low- and middle-income countries. These countries, already suffering under weak health systems and infectious diseases, increasingly have to deal with the challenges of the rich and of the poor all at the same time. However, we know what is effective in improving health: strong health systems.
Looking at things from another perspective, we also know that strengthening health-care systems is good for the global economy. Stable countries and healthy citizens mean new business markets.
Women's health is particularly important in this context. I want to say to anyone who thinks that women's health is a women's problem, it is not. It is everyone's problem. Women are not just half of the population, their health has a disproportional impact on their local society. That is because women in general are a primary component of the infrastructure of a society. Girls and women spend 90 percent of their earned income on their families, men spend far less, only 30-40 percent.
However, women also suffer disproportionately from disease and poor health conditions. A woman is more likely than a man to acquire HIV. She is more likely to die from heart disease. She is more likely to suffer from malnutrition, and she is more likely to face severe complications from diabetes, and this is a statistic close to my work experience and close to my heart. A quarter of a million (266,000) women die each year from cervical cancer, 80 percent of them in low income countries.
Health system strengthening is a core operational mandate at Management Sciences for Health (MSH). We have worked for more than 45 years in some 150 countries. At MSH, we design and help implement systems-strengthening activities that include all levels of the health-care systems, from ministries to remote clinics. We help create and implement solutions of particular relevance to women and children, like family planning and antenatal care, and prevention and treatment of top childhood killers like pneumonia and malaria. We help countries execute programs to prevent, detect, and treat infectious diseases, and work with governments and institutions to train top-notch health leaders, from health ministers to hospital managers.
It's complex work, and we can't do it alone. The priorities of donor governments are changing. Without the private sector, we cannot continue to make meaningful progress in global health. We need more collaboration on the global stage. And it's starting to happen. For example, a number of countries, along with Japan, Australia, Canada, the Republic of Korea, the United Kingdom, and others have committed substantial resources to build health security throughout the world.
Japan has made great contributions to global health. The country has made a commitment to universal health care (UHC), hosting a UHC Forum in December 2017, leading to the Tokyo Declaration: All Together to Accelerate Progress towards UHC. Japan has been tackling AMR issues since the 2000s with a national surveillance program organized by the Health, Labor and Welfare Ministry. In fact, Tokyo hosted the AMR One-Health Conference in November of 2017.
As a global science and technology leader, too, Japan's capabilities are critical to taking health to the next level, as developing countries face a huge gap where health technology is concerned. MSH has been working with scores of companies on introducing technology that helps countries manage information better. But we need much more.
And Japan's passion for the field was, in fact, the beginning of MSH's story. The founder of our company, Ron O'Connor, learned the basics of global health by working side-by-side in the field with Dr. Noboru Iwamura, a Japanese physician who had been working in Nepal to help stem the spread of tuberculosis. Dr. Iwamura's philosophy of service and cultural sensitivity inspired his student to form our organization in 1971, and we still follow his approach to leadership to this day.
I hope that we together can carry this flame of inspiration and spirit of collaboration to improve the lives and health outcomes for countries throughout the world.
--This interview was conducted by Yomiuri Shimbun Senior Writer Makoto Hattori.
--Marian Wentworth
President and chief executive officer of Management Sciences for Health
Born in 1965, Wentworth has a B.A. in mathematics from Harvard University. She has more than 25 years of experience managing and leading complex international public health initiatives at Merck & Co., also known as MSD, where she led global strategy across marketing, manufacturing and research for a vaccines business. She took up her current post in March 2017.
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