DURING the last two decades the world has made huge strides in reducing child deaths through new vaccines, better health care, investments in education and strong commitments from governments. Last week UNICEF and partners released new figures showing that the number of children dying before their fifth birthday has nearly halved from 12 million in 1990 to 6.9 million in 2011. Yet, despite progress, here in the Pacific, over 15,000 children still die annually, or at least 40 child deaths every day, from preventable causes.
The story of child survival in the past two decades is one of striking success and unfinished business. Country after country has shown that prioritising and investing in child survival and improving children's early years mean fewer deaths, better lives and long-term benefits for societies as a whole. But that lesson is not always clear, and even though the pace of saving young lives has been rising in both rich and poor countries, some regions, countries and areas within countries, still struggle.
In the Pacific, Papua New Guinea, Federated States of Micronesia, Kiribati, Nauru and Tuvalu carry the highest burden of child mortality with under-five mortality rates above 30 per 1000 live births. Children from poor rural areas are much more likely to die before their fifth birthday than those in urban areas; and disadvantaged and marginalised populations bear this burden.
A concerted push is needed to ensure all children, no matter where and to whom they are born, survive and thrive. The good news is that we collectively have the knowledge, tools, treatments, and technology to save millions of lives every year.
We know the biggest killers of young children here in the Pacific are: pneumonia, diarrhoea, malaria (endemic in Papua New Guinea, Solomons and Vanuatu), low birth-weight and under-nutrition — all causes that can be prevented or diseases that can be treated at a relatively low cost. Thanks to successful childhood immunisation programs, the Pacific has been polio-free since 2000 and has not reported measles since 2008.
We know that most child deaths occur during the first crucial month of life; that a child's chances of survival improve when the mother is healthy; and that poor nutrition is an underlying cause in many under-five deaths. And we know what to do about it!
Inexpensive solutions lie within reach, such as vaccines against measles and polio; actions to prevent mother-to-child transmission of HIV; oral-rehydration salts and zinc to treat diarrhoea; antibiotics for pneumonia; and oxytocin preventing women from bleeding to death after childbirth.
In addition, UNICEF studies show, that when women receive proper prenatal care, and have access to skilled birth attendants and to emergency obstetric care, the benefits for mothers and their babies are enormous. It is important to note that for every woman who dies on account of pregnancy or childbirth, 30 others suffer significant disability (from anaemia, chronic infection and other causes). And the baby left behind soon after the death of his/her mother soon falls by the wayside, unable to vindicate the mother's sacrifice. Neither do the older siblings fare better; sooner than later they suffer violation, exploitation and abuse without the mother's primary protection.
But let me emphasise this; saving lives is not only about health interventions. Access to improved water and sanitation, hand washing with soap, exclusive breastfeeding for the first six months of the baby's life, better nutrition for mothers and babies is crucial if we want to prevent the deaths of countless women and children.
Education is another part of the equation. A child born to a woman who can read is much more likely to live past his or her fifth year birthday than one born to an illiterate mother. Every extra year of a mother's schooling reduces the probability of an infant dying by up to 10 per cent.
The message is clear: we can radically reduce child deaths, in the world as a whole and here in the Pacific. Sound strategies, scale-up of known and effective interventions; adequate resources, and above all, political will are imperative.
We're making progress and in time we can make child deaths a thing of the past. Despite PNG, FSM, Kiribati, Nauru and Tuvalu having under-five mortality rates above 30 per 1000 live births, they must be commended for their promotion of cost-effective and proven interventions such as the use of oral rehydration therapy to control diarrhoea and antibiotic treatment for suspected pneumonia.
In 1990, nine Pacific Island countries had under-five mortality rates above 30 per 1000 live births. Since 2010, the number of countries above this threshold has been reduced to five. In 20 years, the Pacific has managed to dramatically reduce child mortality. To further accelerate progress, the focus must now be on reducing deaths in the first month of life, because the majority of child deaths now occur then.
Under the banner of, Committing to Child Survival: A Promise Renewed, UNICEF and partners are inviting governments, civil society, faith-based organisations and private sector to unite around the clear and compelling goal: to give every last child the best possible start in life.
Every child deserves to celebrate their fifth birthday. The poorest and most disadvantaged children are still missing out on life-saving health services and are dying every day of completely treatable and preventable diseases. In June this year, leaders and global experts renewed their commitment to child health, and we must all hold ourselves accountable for achieving greater progress on this critical challenge.
Over 100 governments and numerous organisations including all Pacific Island countries have already signed a pledge and renewed their commitment to increasing efforts to prevent all child deaths. This is a remarkable and compelling signal by Pacific governments that no effort will be spared in pushing to prevent all child deaths.
We must seize the opportunity to build on the achievements of the past two decades. Everybody has a role to play whether in government, in civil society organisations or in individual families! And give each and every child an equal opportunity to survive. I believe we can and will end preventable child deaths together.