Given Bustreo’s quote, Grady clearly tried to find a health advocate who would go on the record with his or her concerns that the Lancet study would affect the ability to win support for maternal mortality reduction projects. Nobody appears to have been willing to do that, however, which is why it’s surprising that she didn’t even mention the competing analysis from Countdown to 2015. The group’s name comes from the U.N. Millennium Development Goals of reducing maternal and newborn/child mortality by 75 percent and 66 percent below 1990 levels, respectively, by 2015—and, judging from the press release, the main point of its analysis was to stress a lack of progress and an estimated $20 billion funding gap for meeting U.N goals.
(Countdown to 2015’s report got much less attention than the Lancet study, but oddly enough, the AP covered it in a separate article from the one where Cheng misidentified its origins. Agence France-Presse covered it, too, but also called it a U.N. report and flubbed a number of other details as well.)
That’s not to say that Countdown to 2015 would have advocated postponing publication of the mortality study published in The Lancet (which came from the University of Washington and the University of Queensland in Brisbane, Australia, and was funded by the Bill and Melinda Gates Foundation). But getting into the group’s analysis might have led Grady to include the important caveat (missing from her article) that there was a high degree of uncertainty associated with the sanguine statistics presented in The Lancet.
While Horton, the journal’s editor, stressed that the study published there was well designed and that “the overall message, for the first time in a generation, is one of persistent and welcome progress,” he added that “concerns about uncertainty estimates, in particular, were common” during the peer-review process and that “these results will provoke intense debate among the global health measurement community.”
Ultimately, Horton concluded, “given the dramatic difference” between the results of the Lancet study and those reported by the U.N. in 2008 (pdf), which found that little progress had been made toward reducing maternal mortality, “a process needs to be put in place urgently to discuss these figures, their implications, and the actions, global and in country, that should follow.” That perspective, as well a mention of uncertainties in the maternal mortality data, should have been included in the Times’s story.
Readers should not have to read half a dozen articles and still be left with only a vague sense of the whole story. With a host of meetings at the United Nations and elsewhere focused on women’s and child health in coming months, we need more comprehensive and insightful explanations of the data and political battles related to maternal mortality.