As many of the world’s leaders convene in South Africa for the G20, we face a sobering truth: Progress for women, children and adolescents — the foundation of human development — is faltering. Decades of hard-won gains in survival, education and equality are at risk. In too many countries, maternal and child deaths are rising, conflicts are eroding health systems, and climate and economic shocks are widening inequalities.
This is not acceptable. Women and children’s well-being is not a secondary issue to be revisited once geopolitical crises subside. It is central to peace, stability and prosperity. No nation can achieve sustainable development, nor ensure its own security, while half its population is denied health, safety and opportunity.
Healthy women and children are a key measure of national welfare. Yet more than 5 million women and children die every year during pregnancy, childbirth or shortly thereafter, most from preventable causes. Nearly 250 million children younger than 5 (one in three) are at risk of not reaching their full potential because of malnutrition, disease and lack of early learning opportunities.
Illustration: Mountain People
These statistics hide painful human realities. Even now a woman somewhere in the world still bleeds to death while giving birth, often because a clinic lacks basic supplies or skilled care. Meanwhile, we witness unprecedented advances in wealth and technology, yet the benefits remain unevenly shared. These contrasts reveal a profound moral failure in our priorities.
When health systems fail women and children, societies suffer long after the immediate crisis fades. Studies show that every US$1 invested in maternal, newborn and child health yields up to US$20 in economic and social returns. By contrast, neglecting these investments undermines labor markets, productivity and social cohesion.
We cannot speak of progress for women and children without addressing their sexual and reproductive well-being. Each year about 21 million adolescent girls become pregnant and 12 million give birth. This is often due to early marriage or lack of access to essential health information and services. Many still face barriers to voluntary family planning and basic maternal care, putting their health and futures at risk. Supporting adolescent girls with education, information and access to quality healthcare is one of the smartest investments any society can make.
Women’s, children’s and adolescents’ health is not only a development issue, it is a moral and strategic imperative. It is rooted in the universal right to health and dignity, enshrined in the Universal Declaration of Human Rights and reaffirmed in the UN Sustainable Development Goals, but human rights commitments mean little without resources, accountability and political will. The rate of reduction in mortality has decreased since 2015, and in some countries maternal deaths are rising. Importantly, 64 percent of preventable maternal and child deaths occur in conflict and fragile settings. Each loss is both a personal tragedy and a sign of collective failure.
The link between peace and women’s welfare has been well established. Countries with greater gender equality are less likely to go to war, more resilient to conflict and more stable. When women participate meaningfully in peace processes, the probability of an agreement lasting at least two years increases by 20 percent, and the prospect of lasting 15 years by 35 percent.
The G20 is meeting at a time of deep geopolitical tension, amid wars, climate catastrophes and economic uncertainty. Global solidarity is under strain and development assistance is facing renewed pressures. Yet this is precisely when leadership matters most. Investing in women and children is not charity, it is strategy. It builds human capital, strengthens economies and stabilizes societies. A strong global economy depends on strong families, and strong families depend on healthy women and children.
Consider the demographic reality: A majority of the world’s population lives in low and middle-income countries, where most maternal and child deaths occur. If these nations cannot protect and educate their young people, the consequences would be global. This manifests itself as lost productivity, migration pressures and insecurity.
The G20, which represents 80 percent of the global economy, holds the power to reverse this dangerous drift. We urge G20 leaders to make women’s, children’s and adolescents’ health a central pillar of global recovery and security. This requires three urgent steps:
RECOMMIT TO GLOBAL TARGETS
The world is on track to miss the UN Sustainable Development Goals by 2030. G20 nations must reaffirm their commitment to reducing maternal and child mortality, ensuring universal access to sexual and reproductive health, and protecting adolescent health and rights.
PROTECT AND EXPAND FINANCING
Despite economic pressures, investment in primary healthcare and community health workers remains one of the highest-return interventions available. Diversified financing mechanisms can help sustain progress.
INTEGRATE WOMEN’S, CHILDREN’S AND ADOLESCENTS’ HEALTH INTO PEACE AND SECURITY AGENDAS
Humanitarian aid, efforts to build peace and global security strategies must explicitly prioritize women and children, not as passive victims, but as agents of recovery and resilience.
On the margins of the 80th UN General Assembly, the Global Leaders’ Network for Women’s, Children’s and Adolescents’ Health reaffirmed the urgency of placing women, children and young people at the center of global health and development agendas. As global citizens, we must lead by example, championing investment, accountability and action.
The faltering progress is not inevitable. It is the result of choices. We can choose to turn away, distracted by crises and competition, or we can choose to lead, placing human well-being at the center of decisionmaking. As the G20 deliberates on growth, finance and security, it must remember a simple truth: Nations cannot succeed when mothers die of preventable causes giving birth and children go hungry.
The test of leadership today is in action, not rhetoric. Let this G20 be remembered as the moment the world renewed its commitment to those who make life possible and to the future they represent.
Cyril Ramaphosa is the president of South Africa and chair of the Global Leaders Network. Helen Clark is a former prime minister of New Zealand and chair of the Partnership for Maternal, Newborn and Child Health. This column reflects the personal views of the authors and does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.
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