Seeing a child die from pneumonia, diarrhea or a mosquito bite is simply unimaginable to most parents, but that is the sad reality for many families each day. Last year over seven million children under five died of largely preventable causes.
For centuries, childhood deaths seemed inevitable, but considerable progress has been made in the past 50 years. In 1960 about 20 million children died annually. The number dropped to 12 million by 1990 and 7.6 million in 2010.
Countries that have made the best progress have concentrated on extending simple evidence-based measures to rural areas that target survival during the period of pregnancy to birth and as an infant at home and in the community.
Look to Ethiopia, one of the poorest and most drought-prone countries in Africa, which trained 30,000 community health workers to prevent, treat and sensitize the community on a whole array of health pariahs like malaria, malnutrition, HIV and pneumonia–the major killers of kids.
Twenty years ago, every fifth child died by the age of five. Today, 10 out of 11 make it past their fifth birthday. And with the introduction of the pneumococcal vaccine, health workers have added a new weapon in their arsenal of simple preventive measures to fight child deaths. The vaccine complements a broader scale-up in community-based treatment of pneumonia with oral antibiotics. Soon, health workers will not only be immunizing children against pneumonia but also treating the disease.
Progress in Ethiopia and others like Tanzania, Rwanda and Bangladesh show us that real progress is possible.
However, 30 years after the launch of UNICEF’s Child Survival Revolution and a decade after 180 nations endorsed A World Fit for Children in a special Session of the United Nations General Assembly, we are at a crossroad.
Today, the global community has the knowledge and the affordable tools to change the course of history. A $4 bed net protects a mom and child from malaria. Cost-effective vaccines offer life-long protection from diseases like pneumonia and diarrhea. A trained community health worker can help a mother survive childbirth and ensure every infant takes its first breath. Treatment can prevent mother-to-child transmission of HIV. And adequate nutrition in the first 1,000 days can determine the rest of the child’s life.
At the current annual rate of decline of 2.6 percent, the gap in child death between rich and poor countries would persist until nearly the end of this century–but we are capable of much more. By working closely with countries and continuing our results-oriented investments in global health, we can bring the rate of child mortality in poor countries to the same level it is in rich countries.
Development is full of problems we have few ways to solve. Helping a child reach their fifth birthday is not one of them.
This is the vision for the Child Survival: Call to Action in Washington, D.C. June 14-15 where the governments of the United States, India and Ethiopia, together with UNICEF and many others, are mobilizing the world to end preventable child deaths. It is not a pledging conference. Rather, our focus is on building political will, driving collective action around a global roadmap and developing mechanisms to hold all countries to account.
The goal of the Call to Action is to shift the focus of the dialogue on child survival from the “what” (the causes of child deaths) to the “how” (prioritizing the strategic investments and the most effective strategies to accelerate progress). Some of the strategies include scaling-up coverage, addressing the social determinants of health, removing barriers to access and increasing the demand for essential health services through cost-effective investments and technical innovation.
The vision is ambitious but achievable, if globally owned. Smarter, targeted investments on evidence-based interventions in countries will drive down child mortality. The lessons of the child survival revolution of the 1980s are valuable today. The killers of the past are the killers of the present (diarrhea, pneumonia and malaria), just as they were in 1980. The interventions needed to prevent child deaths already exist and their efficacy is proven.
Every country and every stakeholder–from the government to civil society to the faith community to private sector–is responsible for the survival of the world’s children. And their existing commitments, as well as future commitments, must be fulfilled.
Difficult, complex problems like child survival require global action, country ownership and accountability. Just five countries account for 50 percent of child deaths, two of which (India and Ethiopia) have committed to leading the world in this effort.
By providing a common rallying point, generating sufficient political will, encouraging mutual accountability, generating consensus around a global roadmap for action and targeting investments we will translate political commitments into tangible results for the world’s children.
Every Child Deserves a 5th Birthday–a campaign led by the U.S. Agency for International Development to raise awareness ahead of the Call to Action. Please join me in posting a photo from your fifth birthday (if you can’t find one, any photo of you or your kids at five will work) and sharing it via our website and social media outlets: 5thBDay.usaid.gov.
Everyone has a role to play when it comes to the survival of the world’s children. All we have to do is act.