Maternal and neonatal tetanus (MNT) was needlessly killing hundreds of thousands of mothers and babies. The U.S. Fund for UNICEF engaged Shared Cause to help marshal the institutional, financial and human resources necessary to eliminate MNT.

The Challenge

The U.S. Fund for UNICEF engaged Shared Cause to help take on a disease that was killing more than 200,000 infants and 30,000 mothers every year in the world’s poorest countries.  Maternal and neonatal tetanus (MNT), caused by lack of immunization and unsanitary childbirth practices, is an entirely preventable disease. 

Beyond the enormous public health consequences of MNT, the disease is also an indicator of inequity in access to immunizations and other maternal, newborn, and child health services in developing countries.  With hygienic delivery and cord care practices, and/or by immunizing children and women with Tetanus vaccines that are inexpensive and very efficacious, the disease could be erased.

The World Health Assembly called for first for the elimination of neonatal tetanus in 1989. By 1999, the goal was expanded to include elimination of the maternal tetanus. At that time, there were 57 countries that had still not eliminated MNT.

The Solution

The U.S. Fund for UNICEF decided to partner with WHO and others in making MNT elimination a top priority.  (MNT elimination in a country is defined as neonatal tetanus rate of less than one case of neonatal tetanus per 1000 live births in every district of the country.)  The U.S. Fund engaged Shared Cause to help marshal the institutional, financial and human resources necessary to eliminate MNT.

Working with senior officers at UNICEF, Shared Cause developed a global plan and funding strategy to raise $100 million to eliminate the disease.  We helped recruit Becton, Dickinson, the world’s leading syringe maker, to be a lead corporate partner, contributing millions in monetary and in-kind support.  We also assisted the US Fund in securing the Bill and Melinda Gates Foundation’s first vaccine-related grant ($26 million).  Subsequently, the US Fund mobilized its sister organizations in other countries to contribute, and built a network of donors that included Ronald McDonald House Charities and Zonta International.

The MNT partnership grew to include the United Nations Population Fund, USAID, the Centers for Disease Control and Prevention, Immunization Basics, Save the Children, Gavi – the Vaccine Alliance, Proctor & Gamble, PATH, RMHC, the Gates Foundation, UNICEF National committees, Kiwanis Foundation and Kiwanis International, and national governments throughout the world. 

The MNT initiative’s role is to:

  • advocate with partners including the national governments to commit to the goal of MNT elimination and support it through allocation of needed resources;
  • fundraise for the initiative to meet the gaps in funding needs for the target countries
  • support national ministries of health in preparing technically and financially viable plans;
  • procure and deliver the vaccines and injections supplies and ensure their proper use
  • monitor progress towards MNT elimination, and validate if success has been reached in a country following the country’s claim of elimination; and
  • work with countries on strategies for maintaining MNT elimination including strengthening of routine immunization.

The US Fund and its partners have achieved tremendous progress.   Between 1999 and March 2019:

  • More than 153 million women have been immunized with two or more doses of TT containing vaccines
  • 46 countries have been validated for elimination of maternal and neonatal tetanus, including:  Bangladesh, Benin, Burkina Faso, Burundi, Cambodia, Chad, China, Cameroon, Comoros, Congo (Republic of), Cote d’Ivoire, Egypt, Equatorial Guinea, Eritrea, Ethiopia, Gabon, Ghana, Guinea Bissau, Haiti, India, Indonesia, Iraq, Kenya, Liberia, Laos PDR, Madagascar, Malawi, Mauritania, Mozambique, Myanmar, Namibia, Nepal, Niger, Philippines, Rwanda, Senegal, Sierra Leone, South Africa, Tanzania, Timor Leste, Turkey, Togo, Uganda, Vietnam, Zambia and Zimbabwe, and Punjab province of Pakistan, South-East zone of Nigeria and Southern Mali.
  • There has been a 96% reduction of Neonatal Tetanus mortality.