By Rebecca Oas, Ph.D.
NEW YORK, May 9 (C-FAM) The Guttmacher Institute announced its new president this week: an abortion advocate who argued against transparency with health statistics, preferring to “lock all the academics in a black box” until they agree to “a consensus set of numbers.”
Ann Starrs, who co-founded the abortion-promoting Family Care International, will shortly assume leadership of the research institute founded by Planned Parenthood. Guttmacher positions itself as the definitive source of data on reproduction and sexuality.
While Starrs’ approach to the relationship between facts and advocacy may align with her new employer, the need for open discussion of global health statistics has never been greater, as illustrated by the dispute involving the UN’s estimates of the number of women dying from causes related to pregnancy and childbirth.
In 2010, the Institute for Health Metrics and Evaluation (IHME), led by former World Health Organization (WHO) employee Dr. Christopher Murray, published a study in the journal Lancet refuting the UN’s numbers, showing maternal mortality levels were far lower than the WHO had long claimed. Lancet editor Dr. Richard Horton faced pressure from advocacy groups to delay publication. Among them was Ann Starrs, who urged the scientists to “at least hide that there is disagreement” lest the conflicting numbers compromise advocacy efforts.
UN leaders echoed Starrs’ call for “consensus” statistics over scholarly independence. Months later, the UN group led by the WHO published its own revised numbers, which were much closer to the IHME estimates for that year.
This was not the only time the WHO’s rivals disputed their data. The IHME found malaria had caused twice the number of deaths reported by the WHO, particularly among children.
While both groups reported similar levels of maternal mortality last year, they have dramatically different perspectives on the amount of progress this represents.
Last week, IHME published an update on maternal mortality worldwide in the Lancet. They report close to 300,000 annual maternal deaths in 2013, which marks a 22% decrease since 1990. However, the WHO-led group claims that maternal mortality dropped by 45% in the same time frame. Both estimates fall well short of the Millennium Development Goal (MDG) aiming to reduce maternal deaths by three quarters between 1990 and 2015. [See figure.]
The disputed 1990 estimate–376,034 maternal deaths according to IHME and 523,000 according to WHO–has important policy implications for the future.
“The whole [maternal health advocacy] community has been living off 500,000 women dying a year for the last 30 years,” Dr. Murray told the Guardian. Advocates used the inflated number to create a sense of crisis. He presented the new numbers as a cause for great optimism.
According to IHME, maternal mortality has declined steadily but far more gradually than previously thought. Furthermore, improvement began prior to the MDGs, and it is not readily apparent that the MDGs have accelerated the process.
As UN member states decide the new Sustainable Development Goals that will replace the MDGs, transparency and accurate data are essential to ensuring that finite resources are put to the best possible use. This is particularly critical when activists equate championing specific “solutions” – such as abortion – with advocacy for women’s health more broadly.
When told at last year’s Women Deliver conference that a medication to stop bleeding after childbirth could not be accurately described as “life-saving,” Starrs replied that due to “the attention span and the expectations of policy makers” there needed to be “a little bit of hyperbole embedded” in advocacy messages.