On November 15, the world population is projected to reach 8 billion people. As we approach that milestone, there’s no denying that our rapidly growing human population also places extraordinary pressure on the environment. The human population has doubled in the last 50 years, while wildlife populations have been cut in half.

Of COVID-19’s many lessons, one is most critical to our collective next steps:

Business as usual in global health is no longer possible.

The pandemic exposed weaknesses in health systems across the world, and particularly in the delivery of equitable, high-quality reproductive, maternal, newborn, adolescent, and child health (RMNCAH) services. It also reinforced that effectively addressing these challenges requires rapid, responsive approaches driven and owned by countries and local institutions.

More than 60 percent of preventable maternal deaths and 45 percent of newborn deaths take place in countries affected by recent conflict, natural disaster, or both. Yet as Sarah B. Barnes, Project Director of the Maternal Health Initiative, observed at a recent event hosted by the Wilson Center and UNFPA, in collaboration with the Inter-agency Working Group on Reproductive Health in Crisis (IAWG) and White Ribbon Alliance, “the leading causes of both maternal and newborn death occurring in humanitarian settings are considered to be preventable if managed by skilled providers and adequate resources.”

Reducing maternal mortality is key to promoting population health. It is also a main priority of the UN General Assembly’s Sustainable Development Goals. And the reasons for concern are clear. Globally, 800 women and 6,500 infants die during pregnancy and birth every day. More than 94 percent of these deaths occur in low-and-middle-income countries (LMICs).

The UN Environment Programme has ranked Iraq as the fifth most vulnerable country to climate change. In recent years, it has increasingly witnessed extreme heatwaves with temperatures reaching above 50°C. Iraq’s mean annual temperature also is predicted to increase by two degrees Celsius by 2050. 

In recent years, Mexican women have experienced a significant downgrade in the quality and accessibility of public healthcare – and not due to the COVID-19 pandemic – said Irene Tello, Executive Director of Mexican impunity watchdog Impunidad Cero, at a recent event hosted by the Wilson Center’s Mexico Institute. The expert panel agreed that the greatest barriers for Mexican women seeking medical attention lie in the current government’s nearsighted health policies and mismanagement of the public health sector.

Greater than one third of all women experience mistreatment during facility-based childbirth. Mistreatment, particularly in humanitarian settings, may include verbal or physical abuse, poor patient-provider rapport, a lack of information about maternal and newborn health (MNH) services for both pregnant women and providers, lack of privacy within facilities, challenges with receiving informed consent from women for medical procedures due to language and cultural barriers, and denied or delayed care. Such mistreatment can stem from historical tensions between populations seeking care and health workers (both foreign and local) as well as systemic mistreatment of providers who are burned out and possibly carry their own biases. Evidence shows that some women delay seeking care, or avoid care entirely because of social fears stemming from negative stigma or negative perceptions of their situation. 

Evidence shows that in low- and middle-income countries, the expansion of health coverage or access to care has not always reduced overall mortality, said Dr. Patricia Jodrey, Child Health Team Lead in the Office of Maternal and Child Health and Nutrition at the U.S. Agency for International Development (USAID). “However, the analysis also showed that when countries have progressed in improving the quality of their health systems, the survival rate tends to improve,” she said.