Child Mortality Drops Worldwide Thanks to Scaled Up, Smart Investments in Global Health

Washington, D.C.-Thanks to scaled up support for simple, relatively inexpensive solutions like anti-malaria mosquito nets, measles vaccinations and vitamin supplements, the number of children dying before their fifth birthdays each year has been cut to the lowest level ever on record, 8.8 million, according to a report released today by Unicef.

“This enormous global progress-10,000 fewer children dying each day than in 1990-is something to celebrate and carry forward,” said ONE President and CEO David Lane. “We know that in countries where we invest in smart ways, we get results that save children’s lives. But 8.8 million children are still dying each year. There is much more work to do. Now is the time to accelerate the progress we’ve seen by expanding investments to tackle diseases that have yet to be targeted and to reach countries that are not seeing gains.”

The Unicef report found that the child mortality rate declined by more than a quarter in the last two decades, to 65 per 1,000 live births last year from 90 in 1990. The 8.8 million children who died last year worldwide was down from 12.5 million in 1990. The data also shows that the rate of decrease in child mortality has accelerated since the 1990s.

Much of this success is thanks to recent global health investments that have supported simple yet vital interventions, such as immunizations, anti-malaria bed nets, Vitamin A supplements, rehydration tablets and improved prevention of mother-to-child transmission of HIV. These investments have been scaled up globally in recent years, and have incorporated more measures of accountability and transparency. This results-driven aid, which can be seen in U.S. initiatives like the President’s Malaria Initiative and in U.S.-backed global initiatives like the Global Fund to Fight AIDS, Tuberculosis and Malaria and the Global Alliance for Vaccines and Immunizations (GAVI), has also worked in closer partnership with recipient governments and NGOs on the ground.

In Africa, this assistance has helped spur the impressive rates of child mortality reduction in countries like Malawi, Ethiopia, and Mozambique-extremely poor countries that have had strong health leadership and seen increased investments from donors.

In Malawi, for example, under-five mortality has fallen dramatically, from 225 deaths per 1,000 live births in 1990 to 100 per 1,000 in 2008. One reason has been cost-effective investments in anti-malaria bed nets. In 2000, only 3 percent of children under five slept under a mosquito net, but by 2006 this had risen to 25 percent.

However, while enormous progress has been made in many African countries, much more is needed in many parts of the continent. Because of high fertility in the region, the number of actual deaths has increased in sub-Saharan Africa from 4.0 million per year in 1990 to 4.4 million between in 2008. The rate of death in Africa is 24 times the rate of child deaths in industrialized countries. Sub-Saharan Africa also now accounts for 51 percent of child deaths worldwide. Also, while diseases like malaria and measles have started to be targeted in concerted ways, a lack of investment in pneumonia and diarrheal diseases have now made them the two main causes of deaths worldwide.

“In order to carry forward the successes we’ve seen globally, we must continue to invest in areas that have delivered results-malaria, vaccinations, and HIV/AIDS,” said Lane. “But we also must invest in areas we have ignored-particularly the two largest killers of children, pneumonia and diarrheal diseases.”