5 June 2017

Africa: We Have the Right Medicine - Now We Need the Commitment

opinion

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It is my hope that the ground-breaking tranexamic acid will mark a new era in maternal care around the globe

Widely acclaimed as a breakthrough in reducing maternal mortality ratios, tranexamic acid offers a glimmer of hope to the millions of women around the world at risk of dying during childbirth every year. This new drug presents clear evidence that we have the knowledge and technology to save lives: the challenge now is its distribution and effective implementation in regions at greatest risk.

Previously used to reduce heavy menstrual periods in Western countries, tranexamic acid has been in medical use since its discovery in Japan in the 1960s. But in April of this year, an extensive trial conducted by the London School of Tropical Medicine and Hygiene revealed a more far-reaching use of the drug, which has the effect of stopping blood clots from breaking down. When administered to women experiencing postpartum haemorrhage (or PPH), which affects around 6% of births, the drug can lower the amount of blood lost by mothers, and was shown to reduce maternal deaths from PPH by a 30%. What's more, the drug is already readily available, and costs just $3 per injection.

In the developed world, death during childbirth is rare - in fact the OECD average maternal mortality ratio I just 11 deaths per every 100,000 births. Sadly, this is not the case everywhere. In Nigeria, the country of my birth, a woman incurs a 1 in 23 risk of dying during child birth in her lifetime. In Chad, with one of the highest maternal mortality ratios in the world, this figure is closer to 1 in 17.

It is countries such as these that can benefit the most from tranexamic acid. Maternal mortality is the second biggest global killer of women of child bearing age globally. This fact is made ever more poignant when national, or continental figures are compared. In Europe, for example, maternal mortality is a near-negligible figure. But in Sub-Saharan Africa, the risk of maternal mortality remains painstakingly high. A drug as cheap and effective as tranexamic acid provides a rare opportunity for continental divides to converge - by preventing a third of PPH deaths worldwide (of which a shocking 99% are from Sub-Saharan Africa), we are a significant step closer to fair and equal maternal care around the world.

As the Founder-President of the Wellbeing Foundation Africa, Africa's premier maternal health and gender rights charity, I have dedicated much of my life towards the fight for equality and justice for mothers and infants. Tranexamic acid has the potential to create radical, irreversible change in the field of global midwifery and maternal care, and as an advocate of improved maternal outcomes, it is my duty and my wish to drive it. We have the knowledge, now we need the commitment.

The world can ignore the dire state of the world's midwifery no longer. Gaping disparities between rich and poor countries present both the challenge, and the steadfast drive, to strive for better outcomes for women in a world where no woman need fear death during childbirth.

Immediate and widespread distribution of tranexamic acid is undoubtedly a step in the right direction but this needs to be met with a greater commitment from governments to boosting maternal health outcomes. Just $3 can save the life of a woman - a mother. We are also bound by a global commitment to reduce maternal mortality; outlined in SDG 3, the goal is to reduce maternal mortality rates to 70 per 100,000 live births by 2030. Maternal deaths not only signify a waste of life, but serve to massively and negatively impact the lives of their infants and communities, and remain a constant, and impenetrable barrier to development. Investing in better maternal health therefore serves as both a means in itself, and an end, to be prioritised accordingly.

When I established my foundation over 25 years ago, the outlook for maternal care in Nigeria, and beyond, looked bleak. Since then, Nigeria's maternal mortality ratio has nearly halved. Although this achievement is commendable, it can only go so far in addressing the inadequacies in maternal care in Nigeria and in Africa. Progress has been made, but there remains much work to be done.

It is my hope that the ground-breaking tranexamic acid will mark a new era in maternal care around the globe, and that its positive impact can be matched, through heightened investment and commitment to the cause. The drug provides hope - now we must follow through.

Toyin Ojora Saraki is the Founder and President of the Wellbeing Foundation Africa, a pan-African maternal health and gender rights organisation, headquartered in Nigeria.

More on This

The Trial Explained

The WOMAN trial, coordinated by the London School of Hygiene & Tropical Medicine (LSHTM) Clinical Trials Unit (CTU)… Read more »

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