A health worker at a rural Ugandan facility prepares to administer medicine to mothers and children. (Photo courtesy of Merck) 

Despite the United Nations Millennium Development Goal to reduce maternal deaths by three-quarters, the world continues to lose about 1,000 mothers a day. Most die from hemorrhage, high blood pressure, and other preventable complications of pregnancy and childbirth. Merck for Mothers, a 10-year, $500 million initiative launched last fall by the pharmaceutical giant, aims to improve the odds for vulnerable women around the globe.

“We want to bend that curve back to where it needs to be,” says Julie Gerberding, president of Merck’s vaccines division, who serves on the steering committee of Merck for Mothers.

The scale of the new initiative “is certainly staggering—a positive signal to the whole field,” acknowledges Meg Wirth, founder of Maternova, a social enterprise that aims to improve maternal and neonatal health. “It adds to the growing recognition of how serious this problem is and how many different players it will take to overcome the issue of maternal mortality.” Wirth, who spent 15 years working on global maternal health policy issues, adds, “When the announcement was made, everyone gasped—and then asked, what will it be spent on?”

To answer that question, Merck is investing first in active listening. Gerberding says the company’s initial step was to reach out to the United Nations, which under Secretary-General Ban Ki-moon’s leadership has started an ambitious maternal and child health campaign called Every Woman Every Child. “Rather than thinking up a project on our own,” says Gerberding, “we asked the UN how Merck could be most helpful in accomplishing its goals.”

Conversations with those on the front lines have helped Merck understand challenges in parts of the world where big pharma companies currently have little impact. “We want to reach that 80 percent of the world’s population that global health companies don’t currently reach,” Gerberding says. Merck for Mothers will focus on new product innovation, accelerating access to proven solutions for issues like preeclampsia and postpartum hemorrhage, and improving access to prenatal care and family planning services, along with ongoing advocacy efforts.

When it comes to product innovation, a team of research scientists is working to develop a heat-stable compound to treat hemorrhage during labor and delivery. A product that could be used in resource-poor conditions, without needing refrigeration, to treat one of the leading causes of maternal death “could be a game changer,” adds Wirth.

At the same time, the initiative is looking to leverage Merck’s expertise to speed the development and distribution of already existing products. One of the first grants awarded will enable PATH, a global health nonprofit, to evaluate more than 30 technologies that show promise for treating preeclampsia and postpartum hemorrhage. Merck researchers are collaborating with PATH on the $2.5 million project.

New public-private partnerships are likely to emerge around the globe. “We’re talking with heads of government, NGOs, and others to see if we can’t come up with ideas that would be relevant to their unique epidemiology,” says Gerberding. “Not everything is going through the UN or the US government. We’re trying a variety of models of engagement,” in countries as diverse as Zambia, Brazil, and India.

One nonprofit leader suggests transparency will be important as Merck for Mothers makes funding commitments and evaluates results. The initiative website (merckformothers.com) will be “a hub of information” as the program ramps up, Gerberding says. “Our full dashboard of metrics is being developed now.” Results in partner countries will be tracked closely, along with overall impact.

“It’s important not to gloss over how big this problem is,” Gerberding adds, “but fundamentally, we want to help achieve the Millennium Development Goals. That’s why we got started down this path.”

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