The G-8 Summit opens today in Hokkaido, Japan, and it's ironic but perhaps not surprising that the media and we civil society representatives are being kept at arm's length from the world leaders who should hear our messages.

The Group of Eight, the world's largest economies, have added health -- and specifically maternal health -- to the agenda of this year's annual meeting, at the behest of this year's host, Prime Minister Yasuo Fukuda. In fact, the G-8 will consider every major global issue during this three-day gathering: world economy, the environment and climate change, development (especially in Africa), and the Millennium Development Goals (MDGs), particularly health, water and education. This year is special -- it marks the halfway point to the 2015 deadline for meeting the MDGs, and it's also the 60th anniversary of the Universal Declaration of Human Rights.

And 2008 is also the start of the First Commitment Period (i.e., the first steps) of the Kyoto Protocol on fighting global warming, and the start of negotiations for the next period. The G-8 leaders will talk about all that, and they are also considering major political issues like strengthening nuclear non-proliferation strategies and building world peace.

Reliable rumor has it that the working draft of the G-8 final communiqué refers favorably to the need for action on the maternal health and child survival but omits the $10 billion "ask" we recommended to the Sherpas -- the personal representatives of the heads of state who prepare for the G-8 each year -- which could save the lives of six million mothers and children each year. This illustrates one of the great G-8 problems: it announces many good intentions and makes sterling promises, but the leaders then consistently fail to deliver. 

We hope the leaders will at least agree to make global health (and maternal health) a part of every G-8 agenda from now on, until they DO deliver; and that they will set up a system to evaluate and track progress on the promises and pledges that are made. That would be a good first step. We shall see. The meeting ends Wednesday night.

The Civil G-8

From April 23 to 24, civil society representatives from around the world convened in Kyoto, Japan and joined selected Japanese civil society groups as part of a series of preparatory sessions leading up to the G-8 Summit in July. Participants were chosen by the Japanese Ministry of Foreign Affairs; in Japan, there's regular dialogue between the foreign ministry and NGOs on global health, and this year the Japanese Organization for International Cooperation on Family Planning (JOICFP) played a significant role in setting up this Civil G-8 session.

That session, the third annual, was small and focused, with about 200 participants (including 50 journalists) organized by Japan's Global Call to Action Against Poverty (GCAP), funded by the foreign ministry and OSI. Its purpose is to come up with joint civil society positions to sell to the G-8, through their Sherpas, who hold their own pre-G-8 meeting every year on world economic issues. An EU representative chaired the session.

There was lots of talk about world financial trends, all downward. Not one of the G-8 has reached the recommended level of contributing 0.7 percent of GDP to overseas development assistance. The countries that are the most on track have commitment from their leaders, who have prioritized it in their budgets; more accountability and transparency, especially on delivery systems; and more media and public debate.

Some of us wanted to push harder on that and on abolishing conditions on aid. Two issues were over-arching: the number of health workers on hand versus the number needed to create global health; and the new food crisis.

After a lot of discussion among the dozen civil society groups focusing on health, we decided three speakers would make presentations to the Sherpas at the April meeting: one on MDGs 4 and 5 (improve maternal and child health - that was me); one on MDG 6 (combat HIV/AIDS, malaria and other diseases - that was Masaki Inaba, Programme Coordinator on HIV/AIDS, Africa Japan Forum); and one on MDG 3 (promote gender equality - Dorothy Shaw, President of the International Federation of Obstetrics and Gynaecology).

The basic message on maternal and child health then and now is: "We know what to do. We know how to do it. We know what it costs. We sadly know what it costs NOT to do it." The full statement from the health-focused groups called for fulfillment of the G-8 commitment made at last year's Summit to provide $60 billion for HIV/AIDS, TB and malaria, and to add an additional $10 billion for maternal and child health.

The Sherpas showed differing levels of interest in what we all had to say. Germany, Japan and the UK were receptive; the U.S. was focused on environment and climate change.

Afterward, nobody in our group was optimistic about getting much more money allocated since current trends in health funding have been downward. But this could change if the right people actually understand the truth of our arguments that investing in women's health is the best way to fight poverty. Again, we shall see.