13 September 2012

UNICEF: Child Mortality Declining; More Work to be Done

Global progress against child mortality has made some stunning advances over the past two decades. A new UNICEF report shows that the number of children under five who die each year is down from 12 million in 1990 to 6.9 million in 2011. However, more work needs to be done in order to meet the Millennium Development Goal for child mortality.

The report comes on the heels of stunning findings by Gabriel Demombynes and Karina Trommlerova regarding the decline in under-five mortality in Sub Saharan Africa. Of the 20 countries with a demographic and health survey since 2005, 16 saw a decline in child mortality. More than half fell at a rate that meets or exceeds the rate of 4% that is required to meet the Millennium Development Goal.

What stood out at the time was the fact that the declines were not directly connected to economic growth. The UNICEF report highlights this finding further as it shows that low, middle and high income countries all experienced lowering rates of child mortality.

While the gains are reason to celebrate, Anthony Lake, UNICEF's Executive Director, stresses that more work needs to be done. “The global decline in under-five mortality is a significant success that is a testament to the work and dedication of many, including governments, donors, agencies and families. But there is also unfinished business: Millions of children under five are still dying each year from largely preventable causes for which there are proven, affordable interventions,” says Lake.

Drops Not Drones, Vaccines Not Marines
A child receives oral polio vaccine drops from a house-to-house polio vaccination team in Maksoodpur village in Patna district. (Bihar, India, 2010) Credit: Gates Foundation
USAID made it clear that it intends to focus on reducing child mortality by launching the campaign Every Child Deserves a 5th Birthday and holding the Child Survival Call to Action in June.

Actor Ben Affleck highlighted some of the simple solutions available in the effort to reduce child mortality at the event. He said, “Much of the time saving a child’s life is as simple as ensuring kids sleep under bed nets to avoid malaria and that they receive nutritional supplements and that they have immediate access to healthcare. This could save millions of lives a year alone and would cost less than $30 a child.”

Vaccines play a role as well. UNICEF points out that the inequities in easing the vaccines against pneumonia and Haemophilus influenzae type b (Hib) are easing, but the gap between access for high and low income countries is still wide in the case of pneumonia. "The fact remains that, on average, around 19,000 children still die every day from largely preventable causes. With necessary vaccines, adequate nutrition and basic medical and maternal care, most of these young lives could be saved," says Lake in his introduction to the report.

Over half of the child deaths caused by pneumonia and diarrhea take place in four countries: Democratic Republic of the Congo, India, Nigeria and Pakistan. USAID Administrator Raj Shah expressed optimism in writing about the challenge to reduce child mortality. "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."

The concentration of deaths amounts to nearly one-third of all child deaths. This fact causes UNICEF to stress the importance of focusing on the countries that carry the highest burden. "The potential is demonstrated by successes in the area of measles immunization, which has produced the stunning result of lowering global measles deaths by more than three-quarters in the last decade," writes UNICEF in the report.

UNICEF is taking further steps through its A Promise Renewed campaign that will seek to increase commitments towards child survival. With the support of partners, UNICEF will facilitate evidence-based country plans, transparency and mutual accountability and global communication and social mobilization.

All is held together through a pledge signed more than half of the world's governments since June saying, "Through national action and international cooperation, we pledge to take action to accelerate progress on newborn, child and maternal survival. We hold ourselves accountable for our collective progress towards this goal. And on behalf of all children everywhere, we recommit the efforts of our respective governments to give every child the best possible start in life."

The events this year all stress the need for collective action to reduce the number of deaths among children under five. Administrator Shah drove home this point in his remarks following the release of the report. "All of us are responsible for the survival of the world’s children. If we act now, we can usher in an end to preventable child death, which would be a great accelerator for reducing population growth, spurring economic progress, and creating a more secure world. More than that, ensuring that no family needlessly suffers the loss of a child would be one of the great moral victories of our time," he said.