The world stands at a historic juncture of achievement, loss and opportunity. At the dawn of the millennium, global leaders made an ambitious promise to meet the needs of the poor within 15 years. With the finish line of these Millennium Development Goals now in sight, we should celebrate that every day, 17,000 fewer children die of preventable causes, that more than 2 billion people have gained access to safe drinking.
And yet we must acknowledge that flaws in the goals — aggregate targets that drove policymakers to focus on those easiest to reach — have meant over a billion people on the margins of society have been passed over, unable to benefit from the tide that lifted their neighbors.
Consider that worldwide, young children in the poorest households are two to three times more likely to die or be malnourished than those in the better-off households. That children born in rural areas are at a greater risk of dying than children in urban areas, and the under-5 mortality rate for children born to uneducated mothers is almost three times higher than for those whose mothers have secondary education.
We can do better. The post-2015 development targets that will replace the Millennium Development Goals must be different.
World Vision believes issues affecting newborns and children deserve explicit priority within any new development goals. Healthy, cared for, safe and engaged children have the best chances of becoming productive adults and of contributing to healthy, peaceful, productive societies.
We know a 5 percent improvement in child survival raises economic growth by 1 percent per year over the subsequent decade. The converse also holds true. Failing to invest in children comes at a price. The annual costs associated with child undernutrition in Africa have been found to be between 1.9 percent and 16.5 percent of gross domestic product.
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In practical terms, this means getting the building blocks right through a concerted global effort to prioritize the first 1,000 days of a child’s life. The first 1,000 days, during pregnancy and up to age 2, form the critical foundation on which a person’s potential and that of their society is built. Earliest childhood represents a unique window of opportunity for investing in a child’s cognitive and physical development. If lost, it cannot be recovered.
Vulnerable children are at the greatest risk of being deprived during this early period.
Accumulated developmental deficits in early childhood place children on a lower lifetime path, with negative implications for adults’ cognitive and psychological functioning — which in turn perpetuates inequalities into the next generation.
What can be done? Improving nutrition during a newborn’s critical 1,000-day window is one of the most cost-effective investments we can make towards lasting progress in health and development. This is because undernutrition remains the single-biggest cause of preventable deaths of young children, responsible for almost half of the 6.3 million under-5 child deaths in 2013. One in four of all children under 5 are stunted, and 52 million suffer from wasting. Improving nutrition for the hardest-to-reach will require quality interventions that promote effective feeding practices, access to the right types of food for pregnant mothers and very young children, and early education.
Increasing exclusive breastfeeding rates is especially critical: Exclusive breastfeeding up to six months followed by continued breastfeeding alongside complementary foods has the greatest potential impact on child survival of all preventive interventions and could save up to 800,000 lives each year.
The potential return on investment for health and nutrition is overwhelming. A recent study found that increasing annual health spending by just $5 per person until 2035 in 74 high-burden countries could yield nine-fold economic and social benefits and prevent the deaths of 147 million children and 5 million women, as well as 32 million stillbirths.
Yet current investments in health in many countries are neither sufficient nor equitable. More than a billion people cannot access the health services they need, either because the services are unavailable or because they cannot afford them. To achieve long-term improvements in the well-being of the most vulnerable children, the next development framework must refocus efforts to reach those furthest away from quality health services.
One of the greatest challenges in reaching the unreached will be finding out who and where they are. Just two-thirds of the world’s children are registered at birth; more than 230 million others are unknown and unseen, at risk of slipping through the cracks. It is only when they are included that health or social protection systems can adequately cater to their needs.
World Vision is calling for post-2015 targets to require free, universal legal identity, measured by the percentage of children under 5 registered at birth and the existence of universally effective civil registration and vital statistics systems.
The coming year — in which post-2015 goals will be debated and decided — presents an unparalleled opportunity to improve the lives of millions of the most at-risk children. We know there are vast challenges, but we also know there are solutions. A world in which zero children are dying from preventable causes, or are undernourished, is possible. World Vision is calling for leaders to “stop at nothing” to make this happen.
Healthy Means is an online conversation hosted by Devex in partnership with Concern Worldwide, Gavi, GlaxoSmithKline, International Federation of Pharmaceutical Manufacturers & Associations, International Federation of Red Cross and Red Crescent Societies, Johnson & Johnson and the United Nations Population Fund to showcase new ideas and ways we can work together to expand health care and live better lives.