Sitting in the comfort of my room and sipping a cup of tea, I listened to Melinda Gates and others this morning – live. The TedxChange was an event organized by the Bill and Melinda Gates Foundation and TEDx to mark the tenth anniversary of inception of the millennium development goals. Focused on the theme “The Future We Make”, the event took place in New York City, but was watched by thousands of others, like me, live on the internet.
The first thing that came to my mind was “isn’t technology amazing?” To make such an event reach thousands of people across the continents would have required much more resources a few decades ago. I understand that the internet is still an unattainable luxury in many parts of the world but, at the same time, I believe that its sheer potential to connect people will turn it into a necessary commodity in the near future.
The event itself was amazing. It started with Hans Rosling’s fact finding mission. Rosling, professor of international health at the Karolinska Institute in Sweden, questioned what constituted progress in child mortality in Africa, where the progress in millennium development goals is said to be the slowest. He brought forward one of the fallacies of millennium development goals – to see progress relative to a fixed point of 1990. He demonstrated the importance of looking at recent trends rather than at a fixed point through the example of Kenya, where, although progress was very slow in the 90s, it has been substantial in the last decade.
Hans then moved on to show global trends in child mortality. As usual, through his interactive and enjoyable graphs he showed positive correlation between child mortality and number of children per women. He also talked about recent research from the Institute of Health Metrics and Evaluation, published in The Lancet, which shows that almost 50% reduction in child mortality between 1970 and 2009 can be attributed to female education.
Melinda Gates, on the other hand, focused on the entrepreneurial aspects of getting health projects and interventions to the most rural of communities. I liked her example of the coca-cola industry. Indeed, quite like what Melinda said, even in Nepal, I have seen coca-cola and wai wai, a Nepalese noodle, available in the remote areas of the country. She said that one of the reasons that this is possible is because industries like coca-cola involve local communities in the transport and sale in the remote areas. Also, coca-cola is sought after because of its marketing which is built on local aspirations.
On the other hand, health message marketing is usually based on avoidance rather than aspirations. Melinda gave the example of condoms. We market condoms as “if you use condoms, you will not get AIDS” instead of associating the use of condom with positive outcomes that communities aspire for. That makes a whole lot of sense.
Mechai Viravaidya shared his experiences about marketing health messages and involving communities in developmental projects in Thailand where child mortality fell quickly and where they have been able to fight the HIV/AIDS situation effectively. He highlighted the importance of innovative and inspiring public health messages. For instance, the condoms in Thailand have been marketed as “weapons of mass protection” and then there are programs such as “cops and rubbers” in which policemen distribute condoms to motorists.
The last of the speakers, Graca Machel, talked about her experiences from Africa and how Africa needs to accelerate towards achieving millennium development goals. She said that political clarity and commitment was the prerequisite. She suggested that even in the poorest of countries positive change is possible with the right leadership. She gave the example of Malawi where lessons learnt from a previous famine prevented the next one. She also talked about Rwanda where women are in key leadership positions.
The 90 minute webcast was thought provoking and inspiring. The millennium development goals have come a long way in the last decade. It seems the goals are at a crossroads now. A lot of progress has been made and a lot is still to be done. The next five years are going to be even more crucial. It is like the marathon’s final sprint which decides who wins and who loses. The outcome is still uncertain, but we, everyone, needs to give their all.
Siddhartha Yadav is a Nepalese doctor currently living in the US and a former BMJ Clegg Scholar