These days it’s easy to feel let down by the direction the world is taking or the scale of the challenges we face. When I start feeling this way, I remind myself of the number ‘48 million’. That’s the number of early child deaths that have been prevented since 2000 and a testament to what can be achieved if we work together.
Childhood mortality in sub-Saharan Africa has declined by 46 per cent between 2000 and 2015. This progress has been achieved through the remarkable collective efforts of Africa’s leaders, donor countries, international health agencies and organisations like the Bill & Melinda Gates Foundation.
Tackling child mortality is at the heart of our efforts at the foundation. Everything we do here in Africa – whether providing vaccines, helping farmers grow more food or building tools to help families to save for their future – is geared towards reducing childhood deaths.
There is good reason why it is our driving force. The foundation was set up by Bill and Melinda after they realised on a visit to Africa just how many children were still dying of diseases such as malaria, pneumonia and diarrhoea – diseases that were no longer death sentences for their counterparts in the developed world. But it is also because while saving children’s lives is a hugely worthwhile goal in itself, it has a dramatic and positive impact on many other challenges.
Healthy, educated children grow into productive adults who help countries cut poverty and increase opportunity. This knock-on effect is why it’s such great news that the number of deaths of under-fives has fallen from 13.9 million in 1990 to 5.9 million now. Over this same period, sub-Saharan Africa saw a 28 per cent reduction in the number of people who live in extreme poverty.
But we can’t be complacent. Despite all the progress we have seen, sub-Saharan Africa still has the world’s highest child mortality rate, according to the UN. And while the successes we have seen are worth celebrating, they also point to areas that still need to be improved.
As the number of child deaths has fallen overall, the proportion who die in the first hours and days of their lives has jumped. Worldwide, one million babies don’t survive their first day. What is distressing is that, for all the advances in medical knowledge, we don’t really understand why. This terrible loss of life remains one of the biggest mysteries in global health.We have learned that some simple steps such as cutting the umbilical cord hygienically and breast-feeding in the first hour after birth and then exclusively for the first six months of a child’s life can have a big impact on infant mortality. But there is still a great deal more to learn.
We know, of course, the major reasons for this tragic death toll, such as infection, difficulty in breathing and premature birth. But these broad categories don’t really identify the underlying causes or how we can prevent them.
It is an area where the foundation and its partners are putting in a great deal of effort. But the people who really have the power to make this search for answers possible are the bereaved parents who are aiding researchers by allowing scientists to use minute tissue samples from the bodies of their children and the latest scientific methods to pinpoint why they died.
We were told that parents would be too distraught to allow such tests. But when asked, the overwhelming majority agreed. They wanted us to find out what had killed their children so other families can escape their loss.
Our hope is the knowledge we are building up through the Child Health and Mortality Prevention Surveillance Network, which is being piloted here in Africa, will enable us to meet this ambition.
It might teach us how to make better use of existing tools like antibiotics. Or it could help us develop new solutions, such as vaccines for mothers who could pass protection against certain diseases to their unborn child.
This quest for answers is a great example of what can be achieved by working together. United in their goal of sparing mothers and fathers the grief of losing a child, scientists, governments and parents each hold a piece to the puzzle of child mortality.
There is more, much more, for this team to work on. Over the last 25 years, we have halved the number of children dying across the world. It is a remarkable achievement. But our goal now is to halve this number again within the next 15 years – with Africa in the lead.
