Twenty-four years ago, Sebsebila Nassir was born in Dalocha, Ethiopia. But for the first several weeks of her life, she wasn’t Sebsebila. She didn’t have a name at all.
In Ethiopia, where losing a child was tragically common, it was customary to wait until newborns survived their first, most perilous weeks before giving them names. At the time, roughly one of every five Ethiopian children died before their fifth birthdays — a tragic toll that included two of Sebsebila’s own siblings. So even after her first weeks were healthy ones, Sebsebila’s parents continued to worry.
For most of human history, parents everywhere had reason to expect the worst when it came to their children’s health. The joy of welcoming a newborn into the world was coupled with the dark knowledge that no child’s survival could be taken for granted.
But as September’s United Nations annual report on child mortality makes clear, that story is starting to change. In 1990, the year Sebsebila was born, 12.7 million children died before their fifth birthday. Last year, according to estimates from UN statisticians, that number was down to 6.3 million. And while it’s hard to feel anything but sorrow at the loss of these children’s lives, even in the face of such a staggering number, I feel optimistic about the future. Here’s why.
While 6.3 million is no one’s idea of a low number, it’s also the lowest this number has ever been. Every year, for at least the last 43 years, child mortality rates have fallen. Part of the reason is that children everywhere have benefited as technology has improved, poverty has decreased and quality of life has gone up around the world. But the most dramatic progress has not happened on its own; it is the result of a deliberate and concerted global effort to save children’s lives.
In 2000, the global community made reducing child mortality a priority by naming it one of the world’s eight Millennium Development Goals, which aim to improve the health and well-being of the world’s poorest people. Together, the world set an ambitious target: to cut child mortality rates by two-thirds by the year 2015. And together, the world has spent 14 years rising to meet that challenge. As a global community, we have mobilised a massive effort to provide every child in every country with better health care, insecticide-treated mosquito nets to shield against malaria and vaccines against childhood’s deadliest diseases.
While we still have a long way to go before reaching that ambitious two-thirds reduction target, the forward movement is unmistakable. In Sebsebila’s lifetime alone, child mortality rates have been cut nearly in half. The world has saved almost 100 million children — at the rate of 17,000 lives each day. The numbers are moving in only one direction — and it’s the right one. What’s more, this movement is gaining speed. Since the early 1990s, the annual rate of reduction has increased threefold.
These trend lines prove that when we invest in health, we get results. And even more important, they prove that progress is possible.
That’s reason enough for optimism — but it’s only the beginning. Declining child mortality rates are an important barometer of the world’s broader progress. In addition to telling us how many lives we have saved, they tell us about the quality of the lives these children are living.
We know that as these numbers go down, more children are living lives free of disease, more communities are thriving and children born today have more opportunities to reach their full potential than ever before. The same interventions that are saving children’s lives are making them better.
I am also optimistic because these results prove that not only is progress possible — it’s possible for children born in the world’s poorest places. In fact, everywhere except for sub-Saharan Africa, the most dramatic rate of improvement is in the world’s poorest households. For the first time ever, we are now within reach of a world where even in the poorest places on earth, no child is born destined to die.
Two years ago, Sebsebila had a daughter of her own. While Sebsebila was born on the dirt floor of her family’s home, her daughter was born in a medical facility, where both mother and newborn received care from a trained attendant. Shortly after she was born, Sebsebila’s daughter received her first round of vaccines.
What happened next was even more remarkable: Right there in the hospital, Sebsebila gave her newborn daughter a name. She decided to call her Amira, Arabic for “princess”. Child mortality rates have fallen so precipitously in Ethiopia that Sebsebila can approach parenthood with more confidence about her daughter’s health, and more certainty about the future, than her own parents felt at her birth.
Stories like Sebsebila’s and Amira’s are reasons to be optimistic — but they are also reasons to be impatient. It’s going to take decisive action to drive next year’s child mortality number as close to zero as possible. We know how to save more lives with vaccines, bed nets and treatments, like oral rehydration therapy.
Now, we need to ensure that these interventions reach the people who need them.
We must also ensure that children of all ages are part of this success story. The first 30 days of life continue to be a child’s most vulnerable, and 44 per cent of children who die before age 5 die within those first 30 days.
By increasing the use of just a few inexpensive, proven solutions — including umbilical cord care with a basic antiseptic called chlorhexidine to prevent infections; immediate and exclusive breast-feeding to help a baby’s first immunisation by delivering antibodies from mother to child; and skin-to-skin contact to keep babies warm — we can improve the outcomes for newborns in what I call the next frontier of child mortality.
We know now that progress is possible. But we also know that it doesn’t happen on its own. We have 11 months until the UN issues its next report. What is written in its pages begins with us today. NYT