Tens of millions of pregnant women, young mothers and teenagers in the developing world will be given access to free healthcare for the first time under plans to be launched by Britain this month.
As ministers admit that international goals to tackle maternal and child mortality are “significantly off track”, Gordon Brown is preparing to lead a push at the UN to scrap health charges in countries from Nepal to Sierra Leone.
The plans come amid warnings from aid groups that half a million women die needlessly during childbirth or pregnancy in the developing world each year. Barbara Stocking, the chief executive of Oxfam, described the deaths as “deplorable”, saying that they could be avoided through relatively small investments.
Douglas Alexander, the international development secretary, says progress on the millennium development goals on maternal and child mortality is “significantly off track”. The goals – to reduce mortality by 75% – are meant to be met by 2015.
In a Guardian interview, Alexander said that he and Brown will lead a renewed push at the UN general assembly in New York later this month to scrap health “user fees”.
Alexander has negotiated deals with a group of African leaders and the World Bank. As a result, free healthcare will be introduced or extended in Nepal – where a newborn baby dies every 20 minutes – Burundi, Sierra Leone and Malawi.
Free healthcare in Ghana, which now expires for patients at the age of five, will be extended to cover patients up to 18. Average life expectancy in Ghana is 58 years.
“It is a fact that in many African countries today the most dangerous day of a young woman’s life is the day she gives birth,” Alexander said.
“More than 4m babies are dying in the first month of their life still today. About 99% of maternal deaths today are in developing countries. In Sierra Leone one in seven mothers die in childbirth.”
Britain believes that much more free healthcare can be provided relatively cheaply. Uganda removed user fees in 2001 by spending an extra $1 per person.
Alexander said: “We will specifically be supporting the scrapping of health user fees, enabling people to visit doctors and nurses for free for services ranging from basic check-ups to lifesaving treatment … studies have shown that these fees are a major barrier for the poorest families in particular, leading to poor health and death from preventable diseases, and generate about 5% of the health budgets.
“We are urging African and other poor nations to start by scrapping fees for pregnant women and children, paving the way for it to be rolled out across the developing world.”
Britain will devote some of the £6bn it is spending on health in the developing world between 2008-15 to extending free care. It will also be encouraging developing countries to increase spending in the way Uganda has and asking other countries in the developed world to offer support.
The international finance facility, worth $5.4bn (£3.2bn) until 2025, would be expanded to cover healthcare. Britain, which has pledged £1.38bn to the facility until 2025, will be offering an extra £200m at the UN, and is expecting other countries to contribute.
As he prepared for his visit to New York on 23 September with Brown, Alexander experienced a busy week with one of the main subjects in his portfolio: Afghanistan. Ministers fear in private that public support for the war, which has not been strong, is weakening in the face of what is generally regarded as a deeply flawed presidential election.
Alexander, who last visited the country in July, chose his words carefully as he said that Britain always knew that the first Afghan-run elections in decades would take place in “difficult circumstances”. Britain will leave it to the independent election commission in Afghanistan to rule on the vote.
He also said he wanted more international aid to be funneled through the Afghan government despite concerns over corruption, arguing it was vital that the Afghan government built capacity. He said the American government had agreed to this change in strategy.
