Urgent action needed to stop preventable deaths of children around the world
Around the world, more children are surviving than ever before, according to a new report from an inter-agency group led by UNICEF and the World Health Organization (WHO). Deaths of children under the age of five have been nearly halved since 2000. Yet we still lost 5.3 million children under the age of five last year. More than 290,000 mothers also lost their lives during pregnancy or childbirth according to the latest estimates, which greatly increases the risk of their children dying.
Let me take a moment to put that into perspective: 5.3 million is greater than the entire population of South Carolina. Put another way, 5.3 million children dying each year is equivalent to an airplane carrying 300 children crashing every 30 minutes, every day last year. Imagine if that happened?
The world would be heartbroken, outraged, moved to action. And yet, children are dying every day and it barely makes the news headlines. As a practicing pediatrician who has committed his life to reducing inequity in maternal and child health in the U.S. and globally, I know these deaths are unacceptable because they are largely preventable.
We know these deaths are preventable because we have seen it done. Since 2000, all but one of the low- and middle-income countries where the majority of child deaths occur has lowered their mortality rates, according to another recent report by the Bill & Melinda Gates Foundation.
This progress would not be possible without dedicated efforts by researchers, health-care providers, governments, philanthropists, non-governmental organizations, and the private sector around the world. The U.S. government plays an important role by providing funding and technical expertise to help partner countries strengthen their health programs.
This global effort has resulted in better understanding of the drivers of ill-health and death for children and increased access to simple, lifesaving interventions. Today, globally, more pregnant women are attended by and deliver their babies with trained health-care workers. More children are being immunized and are eating nutritious, balanced meals. Clean water and sanitation practices are improved.
But we still have much more work to do, and importantly, this progress has not been spread equitably. For example, the UNICEF/WHO report reveals more than half of the child deaths in 2018 occurred in Sub-Saharan Africa, where children are 16 times more likely to die before the age of five than children in high-income countries. Within all countries, the poorest women and children continue to die at higher rates. Even here in the U.S., inequity abounds. Black American women are up to four times more likely to die during childbirth, and their infants are twice as likely to die compared to white infants.
So, while we should pause to celebrate incremental annual declines in child and maternal mortality, they frankly aren’t enough.
A look at newborn deaths illustrates this point. Newborn death rates remain stubbornly high in the world’s poorest countries. A recent study showed that at the current rate of decline it will take 80 years for newborns in low-income countries to reach the same rate of survival as those in high-income countries. Waiting 80 years to close a gap like that when we have the tools and expertise we need to prevent most of these deaths is unconscionable. We should be doubling down on our efforts to save lives.
The U.S. has a long history of leadership in reducing child and maternal mortality, stemming from the “child survival revolution” in the 1980s, which brought greater focus and measurable actions by governments. Under President Reagan, the U.S. government significantly increased its efforts, resulting in millions of children’s lives saved.
This bipartisan support has been sustained across numerous presidential administrations. However, in each of the last three years the current administration has proposed steep cuts to global health programs including maternal and child health. Thankfully, champions in Congress have stood up against these cuts.
The U.S. Agency for International Development estimates it has saved the lives of more than 5 million children in the past 10 years. This is remarkable progress that we should be celebrating, not threatening to pull back.
In the time it has taken you to read this article, approximately 30 children have died somewhere around the world. We need a renewed commitment to end these needless deaths and the U.S. government has a vital role to play. With the right investments made today, it need not take 80 years to close the gap. But we must act now to save generations of children.
Cyril Engmann, M.D., is the global program leader for Maternal, Newborn, Child Health and Nutrition at PATH, a global organization dedicated to accelerating health equity. He is a practicing physician, board-certified in pediatrics and neonatology and a professor of pediatrics and public health at the University of Washington.