By Dr. Mary-Ann Etiebet, Lead of Merck for Mothers and AVP for Health Equity at Merck
After a decade of Merck’s groundbreaking $500M commitment to help end preventable maternal deaths, have we delivered on our promise to mothers?
When I joined Merck for Mothers five years ago, fellow global health practitioners asked me why Merck had made such a large commitment to address maternal mortality. At first, I didn’t quite know how to answer, so I spoke to my new colleagues – many who shared their own stories of pain as they or loved ones struggled along the path of familyhood. As I learned more, I realized Merck for Mothers was a manifestation of our company’s values and part of its storied legacy of helping to solve some of the world’s more difficult global health challenges.
The pressure was on. Every two minutes a woman was still dying during pregnancy and childbirth mostly due to preventable causes. Maternal mortality was declining too slowly and inequities – between countries and within countries – continued to widen. Were our contributions making a difference? Do we play it safe, or should we take risks? Maybe we should do something radically different? What were women with lived experiences telling us we had to do?
India, Nigeria, and Kenya – three of our focus countries - together represent more than 35% of the global maternal mortality burden. They are diverse, complex societies with vibrant entrepreneurial sectors. There, we decided to focus on harnessing the contributions of the private health care sector in three critical ways: 1) Strengthening efforts to help local private providers improve the quality of care they deliver, as they provide services for up to 40% of women in many low and middle-income countries; 2) Helping to get an innovative medicine for the prevention of postpartum hemorrhage to the bedside of women who need it; 3) Stimulating investment of private capital to scale business solutions that are responding to market demands – the demands of everyday women seeking maternal health care.
In the United States - our other focus country - early research we supported exposed the stark realities of societal factors and systemic racism on maternal health outcomes. We saw that a one-size-fits-all approach to quality improvement did not reduce disparities as much as anticipated. So, we pivoted. Three years ago, we began building an inclusive national movement to translate outrage into collective action to advance maternal health equity. The Safer Childbirth Cities initiative is now 20 cities strong and powered by the leadership of women with lived experience. Community-based coalitions are leveraging community strengths to provide more holistic support for pregnant and birthing people.
Today, as we experience the disruption and devastation of the COVID pandemic on the delivery of essential maternal and reproductive care services, we also bear witness to how this health crisis is exacerbating health inequities by intensifying the impact of the social determinants of health. At the same time, we are also learning how many of Merck for Mothers’ investments to strengthen health systems, build local capacity and connect with women are being relied on to support government responses.
As we look forward to the next phase of Merck for Mothers, our future direction and inspiration can be found in the heroic efforts of our strong network of 100+ collaborators who continue to deliver on the promise to help create a world where no woman has to die while giving life.
Wanda Irving and Raj Kumar
Kenneth C. Frazier
Executive Chairman of the Board and former CEO, Merck
Why We Must Invest in Mothers
Tedros Adhanom Ghebreyesus
Director-General, World Health Organization
Strengthening Health Systems for Mothers
Listening to Mothers and Leading with Equity
U.S. Congresswoman Lauren Underwood (IL-14)
How Innovation and Technology
Can Save Our Mothers
Announcement of the 2021 Recipient of the Kenneth C. Frazier Award for Maternal Health Equity
Robert M. Davis
CEO and President, Merck
Lead, Merck for Mothers and AVP, Health Equity