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Bill & Melinda Gates Foundation

Preventing Preterm Birth Is Long Overdue

November 07, 2011

I was born on December 25th, more than a month before expected, as a surprise “Christmas present” for my family. Like many preterm babies, I was small and had trouble breathing on my own. But unlike most, I had access to expensive medical technologies, like oxygen and breathing machines—and highly trained caregivers. Half of all births globally still occur without skilled medical care. Fortunately, after a week of close supervision and many prayers, I went home to my parents healthy.

I was lucky. The statistics for preterm birth are staggering. It is the leading cause of death for newborns, taking the lives of 1 million babies every year. And it affects rich and poor countries alike—the rates of preterm birth in the U.S. are similar to those of Sub-Saharan Africa. This impact can also be measured in financial terms. In the U.S. alone, the cost of short-term healthcare for preterm infants annually exceeds $25 billion.

Despite this devastating toll, the medical research community has largely neglected preterm birth. Instead, we have embraced the status quo: caring for preterm infants with costly medicines and machines, while doing very little for prevention. So instead of a robust pipeline of bold solutions and new ideas, such as those we witness in cancer or immunization, we settle for small improvements with limited impact. Even if we fully implemented proven prevention measures such as progesterone treatment and smoking cessation, we would alleviate only about 15 percent of cases.

We can do better than this. That’s why I’m excited that the Gates Foundation is teaming up with the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS) to engage the world’s best scientists in this effort. The initiative, Preventing Preterm Birth, is part of the Grand Challenges in Global Health program, which brings together diverse groups of researchers and partners to find innovations that overcome today’s greatest health and development challenges. We are applying the Grand Challenges model to family health and expanding on the number of groundbreaking ideas that can help women and children live more prosperous and healthy lives.

Skeptics say that preterm birth is too complex, or an unfortunate but natural consequence of human reproduction. To me, this is equivalent to the old beliefs that malaria was caused by “bad air”, or that the bubonic plague resulted from an unfortunate alignment of the planets. There will be obstacles and wrong-turns to be sure. But, we cannot let that stop us from asking the right questions and seeking bold answers. With application of new scientific tools, we can develop a new generation of solutions—and inspire a new generation of scientists—to help give everyone a healthy start to life.

 
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