Child mortality and stunting is the modern face of poverty and inequality today. If you knew how to save the 18,000 children who die every day, would you? In 2000, the global community made a promise to children: to reduce by two-thirds the risk that a child will not live to see his or her fifth birthday. The deadline for this promise is 2015.
A new UNICEF report shows that, despite impressive progress, we are way behind schedule. It is a human rights and political failure. This is the reason for “A Promise Renewed,” a global movement to end preventable child deaths. I fully support this goal.
In fact we need to galvanise the political will to ensure no child dies of causes that can be prevented. This means aiming for an under-five mortality rate of 20 or fewer child deaths per 1,000 live births. Right now, some countries have under-five mortality rates of close to 200 deaths per 1,000.
Most of these countries are in sub-Saharan Africa, which now accounts for 50% of all child deaths in the world. At 45 deaths per 1,000, SA’s ranking sits at 57th in the world, a considerable improvement to devastating toll of the lunatic HIV/Aids denial debacle era. But nearly 1 in 4 children suffer from malnutrition today. In a country so rich, that is an indictment on us. It is not money but the lack of political will that cause the deaths of our children.
The UN meetings here in New York boast of progress. We have saved nearly 90 million lives over the past two decades. That’s nearly double the population of South Africa.
But right now, we are 13 years behind schedule. That means we won’t meet MDG 4 until 2028. And 35 million more children will die – children whose lives could have been saved had we kept our promise in 2015.
Over the past year, more than 175 governments signed a pledge, renewing their promise to accelerate progress on child survival. Each pledge is an important commitment to give every single child the best possible start in life.
We know it’s going to take more than political promises to get the job done. It’s going take every one of us to take action, and hold governments to their promise.
I sit on the UN Lead Committee on Nutrition set up by Secretary General Ban Ki-moon and chaired by Tony Lake, the Executive Director of UNICEF. Alongside global leaders we are building a campaign against malnutrition. Today we know that nearly half of all preventable child deaths are as a result of malnutrition and one in four children are stunted. That’s 8,000 children a day dying and 165 million stunted.
What we need is a comprehensive integrated set of actions that provide solutions, not more speeches and resolutions.
We know what works! We know what we need to do to save children’s lives. It’s a quality health system that delivers vaccines and antibiotics. That prioritises healthy nutrition and maternal and newborn care. It ensures all our children receive quality education and that girls are kept in school and we prevent teenage pregnancies. It’s about an efficient state that delivers clean water and sanitation so that our children do not have water borne diseases like diarrhea.
The first 1,000 days from pregnancy to two years is the crucial window of opportunity. Promoting exclusive breastfeeding in the first six months of a child’s life and ensuring that the child has access to high quality complementary foods or vitamin supplementation from 6-24 months builds the foundation of nutrition for life. We need to ensure the right of healthy affordable food either on the marketplace or through the public delivery systems.
Science is now proven that failing to address under nutrition in the first 1,000 days is linked to the growing epidemic of obesity, cardiovascular and cone disease, diabetes and hypertension later in life. We are able to measure the economic cost which equates to 11 % of GDP growth being lost in Africa or the equivalent of 10% of the potential earnings of an individual over a lifetime. We cannot afford to ignore this reality anymore.
At the core of our strategy has to be the principle of nutrition and gender justice.
All evidence is that improving women`s rights, empowerment and incomes as key to solving child deaths and malnutrition. As President Kikwete of Tanzania said, “In my country women who are pregnant are told not to eat eggs. It is a superstition that we need to change through education. We must be able to challenge harmful cultural practices.”
He goes on, “When I was young we ate a lot of fish. But my mother, who cooked it for us, did not eat it because of its taste. She ended up with goiter. We must encourage our people to eat a healthy diet and to exercise.”
In Africa we need leadership from the top like this. So many Heads of State make promises here in New York at the UN General Assembly that they have no intention of implementing at home.
As we scale up action it will be important to recognise the critical role of organised small-hold farmers; local fishermen; indigenous groups; family, faith-based, women’s and community-based organisations. Government must open up to these voices even if it is uncomfortable. If we are to stop junk food being dumped on the market we need to include business. Governments rarely make the food the poor eat. It is private entrepreneurs. They have expertise, logistics management and technology that can be harnessed to ensure access to nutritious and affordable foods.
Our goal is to build participation and accountability from the bottom. We do not need gatekeepers – our overriding goal to save lives of our children who die of preventable causes.
Citizens will always know more than their leaders what the solutions to their problems are. We have to have the courage to place our people at the centre of policy making and implementation of programmes.
Too much of our discussions are focused on bureaucratic processes. I look at our experience over the Eastern Cape health crisis. Ultimately it was an organised active citizenry led by fearless social movements, unions and NGOs that exposed the dereliction and thieving of a provincial predatory elite which led to babies and our people dying. And they were given a voice but courageous independent journalists. It was an empathetic national minister who acknowledged the report and acted decisively to guarantee the right of people to their constitutional right to quality health care.
But we know that change will die a stillbirth if we do not remain organised and vigilant. Lest we forget the old adage – that power corrupts and absolute power corrupts absolutely. DM
Jay Naidoo is a member of the Lead Committee on Nutrition set up by the UNSG. He is attending meetings around the UN General Assembly.He is also the Chair of the Global Alliance for Improved Nutrition. www.gainhealth.org
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