10 million Under 5s Die each year – Time To Act


Universe Column

Save the Children recently published a damning report on the level of infant mortality worldwide: “Saving Children’s Lives – Why Equity Matters” The stark facts make for chilling reading.

Some 10 million children die under the age of five every year: nearly 4 million dead within the first 28 days of their lives. Three million babies live less than a week, including 2 million who die on their first day of life. Each and every one of these statistics represents a throbbing heart, a cherished baby, a new life prematurely extinguished – the triumph of our indifference over love.

In the year 2000 the world community pledged itself to do something about this haemorrhaging of human life. They published their Millennium Development Goals – eight targets for poverty reduction and development. One of the targets, MDG4, specifically calls for a two thirds reduction in under child mortality rates by the year 2015. At the present rate of progress that target would not be reached for another 37 years, until the year 2045. Between now and then 370 million children under the age of five will have died.

Save the Children insist that “These deaths are not random events beyond our control. To a considerable extent, they are the outcome of political and policy choices taken (or not taken) by governments. “ Save the Children argue that a coherent international approach, geared to achievable objectives and outcomes, would save life on a massive scale.

What are the principal causes of these deaths?

I was struck by the situation in sub-Saharan Africa – where 160 out of every 1,000 children die under the age of five each year. Sub-Saharan Africa accounts for around 4.8 million of all child deaths.

Anyone who has been to war ravaged areas within that region is immediately struck by the link between conflict, abject poverty, compromised health, malnutrition, forced migration, and the fragility of life in make shift refugee camps. Young children are always bound to be at great risk and among the most likely to die first.

The UK’s department for International Development admits that “Nearly half of all children who die before the age of five are born in fragile states. Child mortality is almost two and a half times higher than in other poor countries and maternal mortality is also more than two and a half times higher.” Eight of the ten countries with the highest under-five mortality rates have recently experienced violent conflict. In four of them, Afghanistan, Angola, Niger and Sierra Leone, more than one in every four children will die. What a damning indictment of our failure to resolve conflict.

These children’s deaths are not all necessarily the result of direct violence – more often it is the consequences of it: vast human displacement of thousands of people form regions like Darfur into camps in places like Chad, consequential reduced access to healthcare and food, and the accelerated spread of disease in unhygienic and cramped conditions. These factors are even more lethal than the bands of marauding war lords or the proxy militias or governments like that of Sudan.

Africa’s most pressing need is to resolve the conflicts that are killing its children and destroying its future.

Beyond conflict there are many other things that can be done.

The prevention of major diseases – such as malaria, pneumonia, HIV and AIDS, measles, diarrhoea and neonatal condition – could all be accelerated if children had access to treatments available in countries like our own.

Dirty water is another core issue and British Government Ministers have confirmed to me that If a set of public health and nutrition interventions could be made at very low cost, the situation would dramatically change”. Surely it is not beyond our wit and ingenuity to make that change happen.

If a set of public health and nutrition interventions were made – often very low cost initiatives – situation would dramatically improve for the better.

Grinding poverty also plays its part in this horrific loss of young life. It is poverty, not population that needs to be targeted. Reduce poverty, increase life expectancy, and population growth declines naturally.

Research undertaken in 50 developing countries discovered that babies born to mothers in the poorest fifth of the population were nearly 30% more likely to die compared to those in the richest fifth. This affects children in a variety of ways. In Guatemala, for instance, 65% of the poorest 20% of households are home to stunted children; and in North Korea I have seen firsthand how years of famine have led to the stunting of large numbers of people.

In a country like Nigeria, while the child mortality rates are significantly improving for the better-off households, they are simultaneously declining in the poorer ones. In Nigeria children from the poorest rural areas have to travel seven times as far to get to a health facility as children from the better off homes. Working out what to do about this isn’t rocket science.

We could also save countless lives if we did more to improve the health of mothers.

Save the Children say that “Poor mothers are more likely to lack adequate nutrition during pregnancy, struggle to access basic health services and be unaware of cost-free steps that could enhance the survival prospects of their children.”

Most of the 40% of those children who die in the first few days of life do so because their condition is related to that of their mother. If we were to effectively tackle maternal health we would make a dramatic impact on the health of under-fives.

In some parts of the world, child mortality may also be linked to issues such as gender. A girl in India, for instance, is far more likely to die before her fifth birthday than a boy (even if she has managed to survive pregnancy, when Indian girls are routinely aborted).  Globally, however, more boys than girls die before reaching their fifth birthday.

The Prime Minister, Gordon Brown,  has said he wants to make this a year of emergency action to get the world back on track to achieve the millennium development goals.  If he is serious about that ,he should put MDG4  – child mortality – onto the agenda for the European Heads of States summit in June, the G8 Summit in July, and the Special Session of the United Nations General Assembly in September.  With 10 million under fives dying every year, waiting until 2045 should not be seen as an option.