UNICEF released a major study today analyzing trends of child mortality around the world and the news is very encouraging.  The number of children under the age of five who die before their fifth birthday has dropped sharply from nearly 12 million in 1990 to less than 7 million last year.  Take a look at this graph.

14,000 fewer children die each day than they did just two decades ago. What’s more these trends cannot be chalked up to modest improvements in rapidly developing countries with huge populations like China or India. Progress has been universal.

“Between 1990 and 2011, nine low-income countries — Bangladesh, Cambodia, Ethiopia, Liberia, Madagascar, Malawi, Nepal, Niger and Rwanda — reduced their under-five mortality rate by 60% or more. Nineteen middle-income countries, among them Brazil, China, Mexico and Turkey, and 10 high-income countries, including Estonia, Oman, Portugal and Saudi Arabia, are also making great progress, reducing under-five mortality by two-thirds or more over the same period.”

How did we get here? The report largely credits inexpensive interventions targeting three diseases that have historically exacted a heavy burden on children under five: polio, measles and malaria.  Vaccination campaigns, which have picked up steam in recent years thanks to Gates Foundation backed programs like the GAVI Alliance, and the advent in 2002 of the Global Fund to fight AIDS, Tuberculosis, and Malaria deserve a lot of credit. Inoculating a child and giving her a bed net under which to sleep dramatically increases her chances of having a fifth birthday.

Despite this progress, some very big challenges remain. 6.9 million children a year is still an unimaginably tragic number of preventable deaths. Apart from neonatal causes, pneumonia and diarrhea are now the leading causes of under-five mortality; and these deaths are overwhelmingly concentrated in just 5 countries: India, Nigeria, China, the Democratic Republic of the Congo, and Pakistan.

There are heartening signs of a renewed international commitment to this cause. This year, the United States government hosted a major meeting in Washington called a Child Survival Call to Action.  Under the rubric of “Every Child Deserves a Fifth Birthday,” celebrities like Anna Kournikova posted photos of themselves as a five year old to draw attention to the cause. But the “action” part was arguably more significant: countries with the highest child mortality rates burdens set concrete goals to reduce child deaths and donors made concrete pledges to help them achieve their targets. The goal set by the US government in which call to action is to reduce child mortality to below 20 child deaths per 1000 live births in every country by 2035. “Assuming countries already on track continue to make progress at their current rates, achieving this target will save an additional 5.6 million children’s lives every year,” says USAID Administrator Raj Shah. “That means 50 million more children will survive and thrive.”

The progress that humanity has made over the past 20 years shows that interventions aimed at reducing child mortality can and do work.  This is a great global story.

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