Nearly 50 million lives saved since 2000; millions more can be saved by 2030: UNICEF

New-born shows an improving health status after being treated at Yekatit 12 Hospital Medical College, in Neonatal intensive care unit.
Premature newborn health is improving after being treated at Yekatit 12 Hospital Medical College, in Neonatal intensive care unit. Addis Ababa, Ethiopia ©UNICEF Ethiopia/2015/Mersha

NEW YORK/Addis Ababa, 9 September 2015 – The rate of decline in mortality among the world’s youngest children has more than doubled over a generation, and an additional 38 million lives could be saved by 2030 if progress accelerates further, in line with the Sustainable Development Goals (SDGs) world leaders are set to approve later this month.

Since 2000, when governments committed to achieving the Millennium Development Goals (MDGs), the lives of 48 million children under the age of five have been saved. This remarkable progress is the result of sustained action by leaders – to make saving children’s lives a policy and a political priority, to improve and use data about child survival, and to scale up proven interventions.

The number of children who die from mostly preventable causes before they turn five now stands at 5.9 million a year – a 53 per cent drop since 1990. At 3.9 percent the global annual rate of reduction of under-five mortality between 2000 and 2015 was more than twice as high as what it was in the 1990s.

Some of the world’s poorest countries have demonstrated that substantial reductions in child mortality can be achieved despite formidable obstacles:

  • 24 out of 81 low- and lower-middle income countries, including Cambodia, Ethiopia, Bangladesh and Uganda, achieved the MDG of reducing the under-five mortality rate by two-thirds or more.[1]
  • Between 2000 and 2015, twenty-one sub-Saharan African countries reversed a rising mortality trend or at least tripled their pace of progress compared to the 1990s.

Low income countries are: Cambodia, Ethiopia, Eritrea, Liberia, Madagascar, Malawi, Mozambique, Nepal, Niger, Rwanda, Uganda, and the United Republic of Tanzania. Lower-middle income countries are: Armenia, Bangladesh, Bhutan, Bolivia (Plurinational State of), Egypt, El Salvador, Georgia, Indonesia, Kyrgyzstan; Nicaragua; Timor-Leste; Yemen.

To reiterate the agenda, A Call to Action Summit took place from 27-28 August 2015 in New Delhi, India with the aim of ending preventable deaths of children and mothers by 2035. This was a prelude to the United Nations Summit for the adoption of post-2015 development agenda that will be held as a high-level plenary meeting of the UN General Assembly in September 2015.The two-day Leadership Summit was a confluence of health ministers from over 10 priority countries that committed to the global Call to Action for Child Survival in June 2012 including Ethiopia.

At the Summit, Ethiopia was represented by His Excellency Dr. Kesetebirhan Admasu accompanied by the technical team, including representatives from CSOs. In addition, Abelone Melese, UNICEF National Ambassador to Ethiopia, deliberated a speech and recited two songs entitled, “Welaj Enat” and “Happy Birthdays” to the participants of the Summit.

Dr. Kesete presented the progress accomplished by the Government of Ethiopia during the last decade and the new priorities- Ensuring “Quality” & Equity” in health care. He said, “The Government of Ethiopia is committed to end preventable maternal and child deaths. This will be possible through unwavering political commitment, community ownership, and universal health

coverage of high impact interventions. To consolidate the gains that were made during the MDGs and accelerate the progress towards the noble cause of ending preventable maternal and child deaths, the Ministry of Health has developed a 5-year-Health Sector Transformation Plan (HSTP) 2015-2020. The plan has set out ambitious goals to be achieved in this period. I would like to state four of the transformational agendas that were set out in this plan. Ensuring “Quality” & Equity” in health care: Equity and quality are the core goals of the health sector transformation plan, which aspires to build a high performing health system”.

UNICEF will continue to support the Government of Ethiopia to sustain the gains made on Child Survival and ensure that the unfinished business of neonatal and maternal mortality are rapidly addressed.

“Saving the lives of millions of children in urban and rural settings, in wealthy and poor countries, is one of the first great achievements of the new millennium — and one of the biggest challenges of the next 15 years is to further accelerate this progress” said UNICEF Deputy Executive Director Yoka Brandt. “The data tell us that millions of children do not have to die — if we focus greater effort on reaching every child.”

Simple, high-impact, cost effective solutions that contributed to this dramatic reduction of under-five deaths include skilled antenatal, delivery and postnatal care; breastfeeding; immunization; insecticide-treated mosquito nets; improved water and sanitation; oral rehydration therapy for diarrhoea; antibiotics for pneumonia; nutritional supplements and therapeutic foods.

Despite this impressive progress, the world has not met the MDG target of reducing under-five mortality by two-thirds.

Between 1990 and the end of 2015, an estimated 236 million children will have died from mostly preventable causes before turning five. Today, leading causes of under-five deaths include prematurity; pneumonia; complications during labour and delivery; diarrhoea; and malaria. Under-nutrition contributes to nearly half of all under-five deaths.

The SDGs challenge countries to significantly increase their efforts to bring rates of under-five mortality down to 25 deaths (or fewer) per 1,000 live births by 2030. By picking up the pace, especially in countries that are lagging, the world stands to save the lives of 38 million more children under the age of five.

About A Promise Renewed

Since its initiation in 2012, A Promise Renewed has focused on promoting the Millennium Development Goal (MDG) 4 of reducing the under-five mortality rate by two-thirds between 1990 and 2015, and continuing the effort until no child or mother dies from preventable causes. Partners that support A Promise Renewed have committed to five priority actions:

  1. Increasing efforts in the countries facing the greatest challenges on under-five mortality;
  2. Scaling up access to underserved populations everywhere;
  3. Addressing the causes that account for the majority of under-five deaths;
  4. Increasing emphasis on the underlying drivers of child mortality, such as women’s education and empowerment;
  5. Rallying around a shared goal and using common metrics to track progress.

Download the report

In Ethiopia, pneumonia is a leading single disease killing under-five children

Kokeb Negussie and her husband Teshome watch their two month old son Moges rest in Romey Village-Amhara Region
Kokeb Negussie and her husband Teshome watch their two month old son Moges rest in Romey Village-Amhara Region ©UNICEF Ethiopia/2012/Getachew

NEW YORK/Addis Ababa, 12 November 2014 – Significant declines in child deaths from pneumonia prove that strategies to defeat the disease are working, UNICEF said on the fifth World Pneumonia Day. But much more is needed to stop hundreds of thousands of children from succumbing to this preventable illness each year.

Pneumonia is still among the leading killers of children – accounting for 15 per cent of deaths, or approximately 940,000 children per year – but deaths from the disease have declined by 44 per cent since 2000, according to figures released recently by UNICEF.

“Pneumonia is still a very dangerous disease – it kills more children under five than HIV/AIDS, malaria, injuries and measles combined – and though the numbers are declining, with nearly 1 million deaths a year, there is no room for complacency,” said Dr. Mickey Chopra, head of UNICEF’s global health programmes. “Poverty is the biggest risk factor, and that means our efforts need to reach every child, no matter how marginalized.”

Deaths from pneumonia are highest in poor rural communities. Household air pollution is a major cause of pneumonia, so children from households which rely on solid fuels such as wood, dung or charcoal for cooking or heating, are at high risk. Overcrowded homes also contribute to higher pneumonia levels. In addition poor children are less likely to be immunized against measles and whooping cough, which are also among major causes of the disease.

Health Extension Worker Shewaye Berhanu administers the PCV vaccine
Health Extension Worker Shewaye Berhanu administers the PCV vaccine ©UNICEF Ethiopia/2011/Lemma

In Ethiopia, pneumonia is a leading single disease killing under-five children. It is estimated that 3,370,000 children encounter pneumonia annually which contributes to 20 per cent of all causes of deaths killing over 40,000 under-five children every year[1]. These deaths are easily preventable and treatable through simple and cost effective interventions. Immunization, good nutrition, exclusive breast feeding, appropriate complementary feeding and hand washing are among the preventive while administration of amoxicillin dispersible tablets and other antibiotics are among the curative methods which can save lives.

With the objective of increasing access to these lifesaving interventions, Ethiopia has made a policy breakthrough of introducing community based treatment of pneumonia through health extension workers in 2010[2]. Since then over 38,000 health extension workers from nearly 15,000 health posts are equipped with the skills and supplies to treat pneumonia at community level using the integrated community case management (iCCM) approach.[3]

Early diagnosis and treatment of pneumonia, and access to health care, will save lives, thus strategies must target low income communities.

The increased use of pneumonia vaccines, particularly in low income countries has led to progress against the disease, but inequities exist even in countries with wide coverage.

 “Closing the treatment gap between the poor and the better off is crucial to bringing down preventable deaths from pneumonia,” Dr Chopra said. “The more we focus on the causes and the known solutions, the faster we will bring this childhood scourge under control.”

UNICEF’s Supply Division has today put out a call to innovators for new, improved and more easily affordable respiratory rate timers to aid in the timely recognition and management of pneumonia.

One simple treatment has had great success: trained community health workers give sick children the antibiotic amoxicillin in a child-friendly tablet form, as part of an integrated case management programme at the community level. Scaling up the availability of similar inexpensive medicines will help to reduce the treatment gap especially among hard to reach populations.

Simple measures such as early and exclusive breastfeeding; handwashing with soap; vaccination; and provision of micronutrients will also reduce the incidence of pneumonia.

[1] Fischer Walker, 2013

[2] National plan on Integrated Community Case management of common childhood illness, FMOH, 2010

[3] UNICEF, Ethiopia Central Data Base, October 2014