Lives Saved — Bad Metrics, Bad Faith
Is saving a life the same as averting a death? Not exactly—one involves leaving a survivor, while the other deals with theoretical probabilities. But that subtle distinction has huge implications for how global health programs are structured, how billions of dollars are spent, and ultimately how human lives around the world are valued.
As an advocacy strategy, the “lives saved” metric is powerful. If saving just one life makes one a hero, imagine what saving millions of lives must mean.
The tools that experts have at their disposal are just as impressive. Scholars and policy experts can create estimates of how many lives can be saved with this or that package of interventions, and how many more if you were to scale it up here or there. They can tailor it to the rates of death for this cause or for that one. They can base it on the latest data about success rates and the cost of each, particular, intervention. Then they can create amazing graphs that predict how many lives you can save for how much money. All that’s needed is funding, the rest is already worked out.
Make no mistake, this is not all bad. In fact, these metrics are a significant accomplishment considering the fact that not all countries and regions maintain accurate records of the births and deaths that do occur. And these metrics have been vetted by scholarly peers who complain that, despite being very popular for advocacy, estimates of lives saved are often flawed in their underlying methodology, tendencies toward overestimation, and the fact that they are simply impossible to verify.
There is one big problem, though, that has gotten little or no attention. That is, while lives are saved on paper, there are not always real people walking around to show for it. This is not just a question of bad metrics, it’s a problem of bad faith.
The claim to have saved a life rests on the basic assumption that there was a life there to begin with, and that a timely intervention relieved a specific threat to that life. Family planning advocates are increasingly turning that assumption on its head by using lives-saved modeling to argue that the best way to prevent maternal deaths is to prevent pregnancy, and the best way to prevent child deaths is to reduce the number of children born.
This attempt to distort the very concept of saving a life is troubling at a conceptual level. Its use as a ploy to redirect much-needed funds away from maternal and child health programming toward contraceptive promotion is both cynical and dangerous. But given the relentlessly pro-abortion agenda within the international family planning movement, it is important that the pro-life community be aware of how bad metrics are being used to fund and empower their opponents on the global stage—at the expense of mothers and children.