Accountability? At the UN? This should be interesting...

Stephen Lewis says it's 'crazy' and a 'complete default of responsibility' that Canada has withdrawn funding from the international AIDS vaccine initiative and the international partnership on microbicides. (Frank Gunn/Canadian Press)

First, we must save the mothers and children. No, wait! First, we must make sure this isn't another gigantic, United Nations festival of corruption.

Then, we must save the mothers and children.

It's no secret that great humanitarian schemes can go horribly awry. Remember the UN's Oil-for-Food program in Iraq? Yes, that was the mother of all boondoggles. To this day, nobody knows how many billions were stolen.

This time, Prime Minister Stephen Harper is wading into a program which is certainly gigantic: the UN's $40-billion project to cut the death rate among the world's most impoverished women and children.

Is it possible that some of that enormous pile of money could go astray? Definitely. Remember, this kind of funding is directed at places like Afghanistan, Somalia, Yemen...

So, having pledged more than a billion dollars of Canadians' money to the cause as the chair of last year's G8 summit in Muskoka, Harper is now co-chairing a UN "Accountability Commission" to make sure the cash isn't pocketed by sticky-fingered autocrats and bureaucrats.

Thus far, the omens are not good. At the UN last year, Harper pledged $540 million to another grand scheme to cut the death rate of the most vulnerable. And...?

And now, donors are getting queasy.

The Associated Press reports that internal auditors have recovered only $19 million of $34 million that somehow went missing in Africa from the Global Fund to Fight AIDS, Malaria and Tuberculosis. Global Fund administrators have frozen grants to Mali, a focus of Canadian aid where $4 million was misappropriated. Sweden has frozen support for the Global Fund and a statement from Canada's International Development Minister, Bev Oda, says the government is "deeply concerned."

It's not a pretty backdrop for Harper's work with the new UN commission - but it does explain why it matters. So far, that eye-popping figure of $40 billion is mostly hot air - pledges, not cash. Good luck getting it all delivered if donors get cold feet...

Notice, too, that the sticky fingers at the Global Fund were discovered by its own internal auditors - so something went right. The theory now is, let's do more to nip corruption in the bud before w e all get egg on our faces.

So Harper is teaming up with the President of Tanzania, Jakaya Kikwete, to hold the reins of the maternal health initiative. They plan to track the pledges and to ensure transparency in how the money is spent. They also hope to set up a monitoring system so we can know if we're really saving lives - and where, and how.

Lifetime risk of dying in pregnancy or childbirth

• Canada:  1 in 5,600
• Afghanistan: 1 in 11
• Somalia:  1 in 14
• Niger: 1 in 16
• Sierra Leone:  1 in 21

(Source: UNICEF, 2008)

As it is, the numbers of lives lost make it unnecessary to explain why a massive effort is required. In Canada, a woman has only one chance in 5,600 of dying in pregnancy or childbirth; in Afghanistan, it's one chance in 11. Around the world, about 340,000 mothers die annually from routine complications of pregnancy and childbirth.

That's down - but not down fast enough to meet the UN's goals. The death rate for children is even more ghastly: each year, roughly 8 million die before their fifth birthday - and they die of easily preventable causes like diarrhea.

Collectively, the United Nations and its members have decided that these numbers are a disgrace - and that concerted action can save 16 million lives by 2015.

Inevitably, there are skeptics about whether a grand UN commission is really going to get this work moving - or maybe slow it down, instead.

Count Stephen Lewis among the unimpressed. Lewis has been tracking these issues for years as Canada's UN Ambassador and then as a UN envoy for AIDS in Africa. He says the UN's teams on the ground know exactly what needs to be done - so the focus should be on "implementation," not "pageantry." Lewis calls the Accountability Commission "a bit of hocus-pocus."

More importantly, he says, Harper is not matching his words with action.

"The protestations about concern for maternal and child health are not evident in Canadian public policy," Lewis says. "We have withdrawn funding from the international partnership on microbicides at precisely the moment when a microbicide has been discovered which may save god knows how many lives over time. And we've withdrawn funding from the international AIDS vaccine initiative, right at the moment when the world feels we may be on the verge of a breakthrough."

"It's crazy as far as I am concerned," Lewis continues, "and a complete default of responsibility around the priorities for mothers and children."

As for Harper, Lewis says the prime minister may be trying to "rehabilitate" himself internationally after Canada' s failure to win a seat on the UN Security Council last year. Harper, he says, "has entered his international therapy program."

Other experts are not so rough on Harper. Bridget Lynch, who heads the International Confederation of Midwives, has delivered babies all over the developing world and says Harper's role at the UN Commission is "a coup for Canada."

"We need accountability," says Lynch. "We need to know that the monies that are being spent are doing the right thing."

Lynch applauds Harper's involvement even though she disagrees with his decision to exclude abortion funding from Canada's contribution.

David Toycen, the CEO of World Vision, is another expert who gives Harper a thumbs-up. After all, he says, nothing much will be achieved if wary donors don't make good on their pledges. That 40 billion, he says, is "not on the table yet."

"There's been a lot of words spoken," Toycen adds. "A lot of public commitments. But, until it' s actually given, we won't know for sure."

The fear, then, is that donors - mostly, governments with alarming deficits - will snap their wallets shut if they don't see a watchdog commission making sure their money's not buying yachts for fat cats.

Can this vast project be boondoggle-proofed? We don't know that yet. But what we do know is that lives depend on it.