Ricardo Cortés Lastra is a Member of the European Parliament, and Chair of the European Parliament Delegation to the EU-Mexico Joint Parliamentary Group. He is an active member of the Development Committee where he acts as the Coordinator for the Group of the Progressive Alliance of Socialists & Democrats. He is also part of the Delegation to the Euro-Latin American Parliamentary Assembly.
This week we are celebrating World Immunization Week. What better occasion to look back on progress made, but also to look at challenges for scaling up and improving child health?
Every day 19,000 children die, mainly of preventable diseases, although the world has made progress over the last 25 years. A 40% reduction in child deaths from 12 million in 1990 to 6.9 million in 2011 demonstrates our ability to implement effective programs that have the power to save thousands of lives.
Nevertheless, most of these 6.2 million child deaths could be prevented through the provision of an integrated program of high-impact, low-cost interventions, especially focusing on maternal and child health during the first thousand days, from conception until the age of two.
This essential service package includes interventions such as pre- and post- natal check-ups, immunizations, promoting exclusive breastfeeding for six months and timely introduction of adequate complementary foods, access to treatment for basic childhood disease, and improved sanitation. If these interventions, which have been shown to be affordable and effective in reducing child mortality, are delivered at scale they could have the power to save millions of lives.
Investing in child health not only saves lives, it also makes sense economically. Because some of the most effective interventions are cheap to deliver and are implemented early in a child’s life, they have a very high return on investment (as the amount spent on the child will be very small when spread out over a child’s life). For example, encouraging exclusive breastfeeding for six months costs very little, but can reduce a child’s chance of death from diarrhea and pneumonia by more than half. Providing micronutrient supplements or fortified foods to children can reduce anemia, which improves a child’s physical and cognitive development and allows the child to reach his or her full potential. It is estimated that maternal and newborn mortality costs countries nearly $15 billion in lost productivity. Countries with high levels of under-nutrition lose 2-3% of their GDP each year.
We know what works, and many countries have successfully reduced maternal and child mortality, as well as under-nutrition. Brazil managed to reduce stunting from 36.1% to 7% over a 20- year period by investing in an integrated programme (the largest cash transfer programme in the world), which included cash transfers to poor families with children on the condition they had their children vaccinated, participated in growth monitoring, and sent their children to school.
However, despite evidence that we know what interventions are effective, many countries are still struggling. Interventions that tackle only one aspect of health cannot effectively tackle child mortality. For instance, delivering improved nutrition alone will not improve a child’s nutritional status if they are constantly contracting diseases from poor sanitation.
We must scale up our support to global initiatives, such as the GAVI Alliance, that have show their effectiveness. The GAVI Alliance helps strengthen routine health systems as well as increasing access to life saving vaccines in poor countries. In a complementary approach, we must invest in integrated health sector programs, especially while promoting free health care at the point of use for essential services.
If integrated, coordinated programs are implemented in an effective way, they will reach as much of the population as possible, including the poorest and hardest to reach. Again, Brazil is a good example, reducing stunting in the poorest segment of society from 59% to 11%. Interventions must reach the entire population, especially the poorest and most vulnerable, to effectively reduce child mortality and under-nutrition.
This is a once-in-a-generation opportunity to bring about a substantial decline in child mortality and improve child survival, thus breaking intergenerational cycles and helping to enable all people to reach their full potential. We need to show the political will necessary to ensure every child reaches his or her fifth birthday.