The opportunity to end preventable child deaths has never been greater than it is today. Thanks to proven solutions and global and national efforts, the lives of 90 million children were saved globally in the past 22 years; children who would otherwise have died if mortality rates had remained at the same levels as in 1990.
Half as many children died in 2012 than in 1990, with the annual number of under-five deaths falling from 12.6 million in 1990 to 6.6 million in 2012.
In Malawi we have also witnessed remarkable progress. While in 1990, as many as 234 out of every 1 000 children born died under the age of five, today, the number has fallen to 71.
As we take a moment to savour this good news, we must also take stock and remember that the world is still failing the more than 18 000 children globally who still die needlessly every day.
It is even more distressing that so many of the children who die do so within the first day and month of life. In Malawi we are losing about 24 babies out of every 1 000 that are born alive before they complete their first month of life, to great angst for the parent and great loss for societies.
Globally almost half (or 44 percent) of under-five children who died worldwide in 2012 did so within the first month of life. A staggering one million babies died on the day they were born. But it doesn’t have to be like this. We know that we have affordable and effective solutions to prevent children’s deaths.
Pneumonia, diarrhoea, and malaria are still the main causes of deaths and kill about 6 000 children younger than five years every day globally. Typically, it’s the poorest and most marginalised children who fall victim to these easily preventable and treatable diseases. Complications due to preterm birth and asphyxia are also key causes of child mortality.
There are simple solutions and innovative ways of saving children’s lives and we need to ensure that those who need them the most, the most vulnerable and the poorest children and families, are receiving them.
Let me give one example. Since the 1970s, oral rehydration salts (ORS) therapy has been the foundation of treatment for the life-threatening dehydration that can result from diarrhoea. ORS is inexpensive and is available in various packet sizes and assorted flavours to encourage use by children.
However, in 2012, less than 30 per cent of children who needed ORS received it in the 15 countries which accounted for three-quarters of all child deaths from diarrhoea.
Other readily available solutions that can save children’s lives include insecticide-treated mosquito nets, vaccines, proper breastfeeding, nutritional supplements and therapeutic food, safe water and sanitation, and medicines.
We also need to make sure that we address all aspects that affect a child’s life. It is not only about health solutions. Poverty reduction, more and better education, protection of children including birth registration and ending child marriage, as well as achieving gender equality are all important elements that will contribute to the survival of children.
We know that under nutrition is an underlying cause in many infant and child deaths. With almost half of Malawi’s children stunted, or too short for their age, we are working hard with the government to improve child nutrition, through the SUN 1 000 days campaign.
Children who thrive are more likely to live longer, stay in school, be productive members of their society, and realise their dreams, creating benefits that reverberate through future generations.
And that is what motivates Unicef to work with partners in the ‘A Promise Renewed’ movement towards eliminating preventable child deaths.
The movement, which is based on shared responsibility for child survival, has indeed grown steadily since its start just over a year ago. We are witnessing commitment in its true sense with pledges turning into action on the ground for children.
So far, 176 governments including Malawi have signed the A Promise Renewed pledge and thousands of civil society groups and private individuals have mobilized actions and resources to dramatically reduce mortality rates even further.
With less than 1 000 days to go before the Millennium Development Goals deadline in 2015, now is the time to step up our efforts to make sure that more children survive past their fifth birthday, and get the chance to realise their full potential in life.
Each and every one of us has to play their role in this quest. There is no one single solution to ending unnecessary child deaths.
—The author is the Unicef Representative in Malawi