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June 7, 2010 - MELISSA BLOCK, host:

Here in Washington today, Melinda Gates took the stage at a global health conference and called on world leaders to step up their commitment to improving care for mothers and children. And to show her commitment, she announced a grant worth one and a half billion dollars from the Bill and Melinda Gates Foundation.

Ms. MELINDA GATES (Co-Chair and Trustee, Bill and Melinda Gates Foundation): It's not that the world doesn't know how to save the 350,000 women every year that die in childbirth. And it's not that we don't know how to save those three million newborns who die every year. It's that we haven't tried hard enough.

BLOCK: The Gates' grant will help fund a number of projects in the developing world, among them: nutrition programs, staff training and the expansion of family planning services.

Ms. GATES: There are safe and effective tools that help a woman plan when to get pregnant and when not to. And quite simply, it's reckless to prevent women from using them.

BLOCK: Our colleague Michele Norris talked with Melinda Gates shortly after her address at the Women Deliver Conference.

MICHELE NORRIS, host: Melinda Gates, thank you so much for making time for us.

Ms. GATES: Thank you.

NORRIS: You know, you talked about in the speech you just delivered, that policymakers don't always put the needs of women and children at the top of the agenda. Are you willing to use not just your money but your influence to cajole or try to influence people who don't always attend to the needs of women and children?

Ms. GATES: Absolutely. Bill and I are both going to put our voice behind that issue. We both travel to a whole host of developing nations every single year. And while we're there, we meet with the prime ministers and the presidents and the vice presidents. And we say, if it's already on the agenda, we talk to them about what they're doing, how they're seeing that go. If it's not on the agenda, I will bring it up and say, do you understand that your neighboring countries are doing this and look at the progress they're getting. It's possible.

NORRIS: One of the things you've talked about is family planning and you describe it as a basic right. But that's not a basic right everywhere. How do you overcome the cultural obstacles in places where women don't have that kind of basic right, where they don't have access to contraception, and the idea of even thinking about contraception would be anathema in their communities?

Ms. GATES: Well, in a lot of the communities I visit, which has really surprised me, women both know about their reproductive rights, and they are beginning to have the tools. And so a lot of times, you'll go into a country where they'll have supply-chain issues, where they might have had it nine months ago, and now the women can't get it. The women are absolutely begging for the tools.

And so, in that situation, it's really for us to go into the government and say, what's broken here? Why is it not working? Is it a funding issue? Is it the way the supply chain is set up?

I actually think the biggest barrier is sometimes the American public. The way we think about reproductive rights is pretty different from the European women do or the women I meet in Africa and even the governments in Africa.

And so I don't actually think the cultural obstacle is there as much as we in America make it seem. It's more that we seem to have an issue about should we get these tools out and why. We make it a big debate, and it really shouldn't be.

NORRIS: Now, you didn't talk specifically about abortion today, but the conference, Women Deliver, is calling for safe and legal abortions as one of the tools that would help combat maternal death. Do you agree for this push? Is that a good idea, this push for access to safe and legal abortions? Or is that getting into a big of a tricky area?

Ms. GATES: I understand in their case why they're calling for that, and I think that makes sense, but the foundation specifically doesn't take a stance on abortion for exactly this reason, is we don't want to be part of the controversy or stem that controversy.

We're much more trying to work upstream on reproductive health rights. If you work upstream on that, and you say to a woman today, you know, would you like to have an injection that you could come in once a month or an implant where you came in once every three years, and you give them the choices or the different tools, then you don't even have to get into the issue of abortion downstream.

So we have 200 million women that can't even get the tools they need to plan their family. We have that problem to solve first.

NORRIS: How do you take an issue like maternal health and make sure that it's top of mind? I mean, the international aid community is always whip-sawed by the latest disaster. People are so concerned about AIDS and other issues in developing countries. This is not always at the top of the agenda. You're trying to change that. How do you do that?

Ms. GATES: Well, I think if you'd asked me eight years ago, is AIDS at the top of the agenda, I would've said absolutely not. And if you asked me six years ago, was malaria at the top of the agenda, I would say no way.

We put those things, as a community, on the map. We said AIDS is important. We said malaria is important. We're saying now, maternal and child deaths are important. And guess what, it's actually possible to fix them. And when you start to make sure that people understand it's a priority, and we have those conversations, and you get real government funding behind them, you can absolutely make change.

So I hope you come back to me and say, you know, five years from now, well, of course, we've been talking about maternal and child health. It's this other thing we haven't been talking about. That's what we ought to do. That's the movement we're trying to spur.

NORRIS: Melinda Gates, thank you very much for your time.

Ms. GATES: Thank you, Michele.

BLOCK: Thats Melinda Gates, co-chair of the Bill and Melinda Gates Foundation, speaking with our co-host, Michele Norris.

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