“No child should be born to die,” Melinda Gates told a summit hosted by Prime Minister Stephen Harper on maternal and child health, saying the investment in saving newborns is an act of love, but also a “hard-headed business case.”

Gates made the case for further investment in maternal, child and newborn health to a packed audience during her Thursday afternoon keynote at the summit. She said both the health and the economic returns make such investment worthwhile.

“When mothers have healthy pregnancies and when children thrive, the benefits that come out of that last a lifetime,” Gates said.

An immunized child is a healthy child, Gates said, who can go on to get an education and become a productive member of society.

Studies are also starting to link maternal and child health with lower rates of non-communicable disease, such as diabetes, cardiovascular disease and obesity, she said. And the links between public health and economic growth are clear, she said. Lower mortality rates account for economic growth rates of 11 per cent in low- and middle-income countries.

And every dollar invested in reproductive, maternal, newborn and child health leads to $9 in economic benefits, she said.

“How well we care for women and children is going to determine the future that is going to come to pass,” Gates said.

Gates’s call to action followed a series of high-profile keynote speeches by other experts at Harper’s Maternal, Newborn and Child Health summit.

Thursday morning, the Aga Khan said that improving maternal, newborn and child health should be “one of the highest priorities on the global development agenda.”

The Aga Khan, whose development foundation runs a variety of health care programs in developing countries, told a rapt audience that he can think of “no other field in which a well-directed effort can make as great or as rapid an impact.”

The summit is a continuation of an effort Harper launched in 2010, at the close of the G8 summit he hosted in Muskoka. At the time, he launched the Muskoka Initiative with $1.1 billion in new funding over five years, in addition to maintaining existing funding of $1.75 billion over the same period, for maternal, newborn and child health initiatives.

The Department of Foreign Affairs and International Trade says 80 per cent of that funding has been disbursed, and a further funding commitment is expected to be announced before the close of the summit on Friday.

Meanwhile, stakeholders are participating in plenary sessions on a variety of topics, from nutrition and vaccinations to finding innovative funding partnerships, all of which are closed to the media.

In his keynote address, the Aga Khan said he has “enormous respect” for the Harper government’s “leadership role” on the issue of maternal and child health. The announcement of the Muskoka Initiative led to “important new efforts” of his Aga Khan Development Network, he said, which has saved lives across the developing world.

Community-based networks of health centres with trained health workers and nurse-midwives, partly funded by the Canadian government, “now serve some two-and-a-half million people in 15 countries, with 180 health centres both in urban and rural areas, often in high-conflict zones and embracing some of the world’s poorest and most remote populations,” the Aga Khan said.

He made several recommendations for addressing maternal and child health, including making long-term commitments, designing community-oriented programs and focusing on the “broad spectrum” of health care.

Efforts should focus “on reaching those who are hardest to reach” he said, and should be “comprehensive, working across the broad spectrum of social development.

As Harper did on Wednesday, the Aga Khan acknowledged that the Millennium Development Goals aimed at reducing maternal and child mortality, set and agreed by 189 countries in 2000, will not be met.

“The truth is that our efforts have been insufficient, and uneven,” he said.

The Millennium Declaration included eight goals with a deadline of 2015. The so-called Millennium Development Goals (MDGs) included reducing mortality rates of children under five by two-thirds, and reducing maternal mortality rates by three-quarters.

But in progress reports issued in 2012 and 2013, the WHO warns that significant gains have been made in both areas, but the MDGs have not been met.

The number of women who died in 2013 due to complications during pregnancy or childbirth was 289,000, down from 523,000 in 1990, or a reduction of 45 per cent, less than what is called for in the MDG.

Meanwhile, child mortality rates have been cut nearly in half since 1990, from 12.6 million then to 6.6 million in 2012, but that is also less than called for in the MDG.

In her keynote speech at the summit, Queen Rania of Jordan noted that every year, 2.5 million newborns die, another 2.6 babies are stillborn, and a woman dies from complications related to pregnancy or childbirth every 90 seconds.

"These figures are more than a source of discontent," she said. "They are an outrage, an injustice and they have no place in our common humanity."

She detailed corrective four steps, including a call for skilled health workers to be in attendance at birth, and for health care workers to visit newborns at home within a few days of their birth.

She also said the international community must intervene with health programs in war-torn countries, where women give birth in grossly inappropriate settings, often just with the help of a friend or family member.

She also called for investment in girls' education, noting that a child born to a literate mother is 50 per cent more likely to survive past age five than a child of a mother who has not attended school.

Girls, she said, "are at the heart of development progress," and must be offered an education no matter where in the world they live.

"We must find them," she said. "We must give them tools to help them fulfill their potential and change mindsets. If we don't put girls and women at the heart of the post-2015 agenda, we will be having this same conversation 15 or 20 years from now on our way to Muskoka Number Nine."

On Wednesday, Harper called on the international community to renew its commitments to the MDG targets because “It’s the right thing to do, it’s essential to be done, and they are very doable, and we can measure that we are doing them.”