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Dr. Nils Daulaire
President and CEO
Global Health Council
Final Plenary Call to Action: A Campaign for Children’s Lives
As a medical student more than three decades ago, I stood in a hot makeshift ward in rural Bangladesh and held a limp rag of a child who had died in my arms moments before I could start an IV. She had suffered from days of diarrhea, her family was poor, they lived in a remote village. It didn’t matter to them that just a few miles away, the International Centre for Diarrhoeal Disease Research of Bangladesh had recently announced the discovery of a life-saving simple solution called ORS.
Five years later, I bent over another young child, this time in Mali, who had reached our clinic too late to be saved from his raging cerebral malaria. Even though chloroquine was still highly effective in this region of Africa, there were no supplies or trained workers in his village.
A decade later still, in the remote mountains of Nepal, I visited with a family as they carried their three-year old daughter into their courtyard, worried about her labored breathing. We found she had severe pneumonia, but the closest hospital was two days walk away, and although we started her on antibiotics immediately, she didn’t make it through the night. There had been no one there to diagnose and treat her in time.
These failures, not of science and knowledge, but of application and execution, have dogged my steps over the years, and while I have had the personal joy of witnessing tens of thousands of young lives saved and futures preserved by simple, affordable measures over these years, I find myself always thinking, “What if…”
What if the world’s leaders actually put their money where their mouths have been and fully funded programs and strategies that work for saving children’s lives?
What if our scientists and researchers took the fruits of their studies and figured out how best to apply them where those most in need actually live?
What if the nurses, paramedics and community health workers actually had the training, the support, and the means to carry out what they are already eminently qualified to do?
What if 10 million needless deaths a year really mattered to those who make the world’s big decisions?
Today, I want to let you know what your Global Health Council is doing in the fight for children’s lives, our plans for the future and how you can participate.
Why now?
Child health is re-emerging on the global stage after a long period of being pushed into the background by newer health threats and well-meaning activists with an eye only on “their” disease. Today, we see a host of emerging coalitions, partnerships and other efforts, some of which didn’t exist just a year ago. As a doctor who has centered my work on the health of our young, I am profoundly heartened by this renewed awareness and interest in child survival issues. The good news is that the global health community is re-focusing on this issue, recognizing that it is at the heart of global public health.
We must seize the moment and capitalize on this renewed interest to move the child health agenda forward in tangible and lasting ways.
As Richard (Horton) and Alice (Albright) so clearly described, we have most of the tools and knowledge needed. Research will continue to bring us new medicines and interventions. But, we don’t need a new discovery or breakthrough to begin saving millions more lives right now. Today.
Most of the existing interventions are very affordable:
- Long-lasting bednets for malaria cost about $5 a net.
- Two tetanus toxoid injections cost about 40 cents.
- An oral rehydration packet costs about 20 cents.
- Kangaroo care, which emphasizes the importance of warmth and touch to the health of newborns, requires some costs for educating the parents, but the rewards are, of course, priceless.
Other interventions – such as ensuring that every woman has a safe delivery with a trained attendant present – will cost more, but safe deliveries and newborn care are still a bargain when you consider the dismal alternative.
And we have the technical expertise. Forty years of incremental, albeit uneven, improvements in child survival have demonstrated that health-care workers, even those working in the poorest countries, can prevent most deaths and treat most children successfully. The methods of saving children’s lives are known.
We also know that it is possible to save children’s lives and strengthen health systems at the same time; in fact it is impossible to do one without the other. It is time for the endless debate on vertical versus horizontal approaches to end. We must do both at the same time, and our new mantra needs to be a commitment to the diagonal. Isn’t that really what most of our lives are like?
What remains is to ensure that families everywhere have access to the tools and the know-how that will assure the survival of their children. Francisco (Songane) and Yvonne (Chaka Chaka) have laid you before the tragedy of too much strategy and too little action.
Why is partnership essential?
No issue more clearly calls for a commitment to partnerships at every level and on multiple levels, as I am sure Francisco would agree. The challenge of reducing child mortality by two-thirds means that many actors must play their part, all of us pulling together. We need mechanisms and forums to build real working partnerships:
- Governments have the principal responsibility for creating a national context and coordinating mechanism within which all players can participate and make a contribution. International donors should make their fair contribution to national plans and harmonize their programs. Those countries and communities that are most severely affected by high numbers of child deaths must take priority.
- Community leaders and non-governmental organizations must be full participants in every partnership and coalition that is working toward ensuring child survival. These are real children and real families who need real services and health interventions; and often, it is the NGO or faith-based organization that is at the front lines of child health care. National governments and international donors must listen to civil society about what works, what doesn’t, and how barriers to child survival can be overcome, and all of us must work together.
- Business has a critical role to play. Our corporate partners – those involved in the pharmaceutical and medical devices industries, those who are large employers in high mortality countries and those committed to social responsibility – must all be at the table. Their tools of marketing, management and accountability are indispensable.
- For every high mortality country, there must be a transparent and consistent accounting of national and international contributions for maternal and child health assistance, remaining gaps, and progress toward the MDGs. The global investment need, an additional $7 billion a year, is miniscule in a global economy worth tens of trillions.
Saving children will require a global compact among all the donors, government partners and civil society contributors, and we applaud those who are now taking the lead on this. Transparency, accountability and public attention are critical to sustaining this compact.
What is the Council’s Role?
As your advocate and collective voice, the Global Health Council is aggressively advocating for child health. Our position is clear:
- Investment in child health must increase to achieve the goal of saving an additional 6.6 million children each year. Governments – both northern and southern – multilateral organizations, private donors and civil society must all make their fair contribution to achieving this goal.
- Resources must be targeted to the countries and populations where child mortality is greatest, not the ones that serve alternative geopolitical interests.
Priority must be given to interventions of proven effectiveness and we should follow the evidence rather than ideology in our programming decisions.
- Investments in child health must simultaneously strengthen health systems capacity for the long term.
- Progress must be scrupulously evaluated and regularly reported.
We are acting in support of these positions:
- While applauding the proposed dramatic increases for HIV/AIDS and malaria, the Council was deeply disappointed by President Bush’s proposed cuts in maternal and child health and family planning in his 2008 budget request submitted to Congress. We responded by publishing an analysis showing this continuing decline, and we strongly believe this will not stand. And while we are encouraged by this week’s announcement of a doubled commitment to AIDS, we will work to assure that it does not come at the cost of essential maternal, child and reproductive health programs.
- We held congressional briefings on newborn health. We testified before Senate appropriators on maternal and child health and the importance of increasing U.S. support by the hundreds of millions of dollars. We called upon the United States Congress to exhibit leadership, principle and courage and re-commit the United States to ending the appalling and needless loss of children.
- We published a new policy brief describing the experience of Mexico and Bangladesh, both of which are on track to meet MDG 4. And we released our new position paper on child health. Both the policy brief and the position paper are available at the back of the room after this session, and on our website at any time.
But we must do more to meet our obligations to the world’s children, and to you, our members.
The Global Health Council is committed to playing its part as an advocate for children in the concerned partnerships, including the Partnership for Maternal, Newborn and Child Health, UNICEF’s Countdown to 2015 Child Survival Taskforce, the Health Metrics Network, GAVI and the Global Business Plan currently being developed under the leadership of the Norwegian Prime Minister. And we will of course continue to be actively involved with the U.S. Coalition for Child Survival as we work to assure increased U.S. funding for maternal and child health and passage of the Global Child Survival Act.
Most of child health takes place in the home and in the community. So next year, our conference theme will be Community Health: Engaging, Serving, Delivering, Leading. We have already confirmed one co-chair, Dr. Zafrullah Chowdhury of Bangladesh’s People’s Health Centre – in whose clinic I learned my first harsh lessons 30 years ago. In addition, Dr. Margaret Chan, Director-General of WHO, will keynote. Stay tuned for more. And I again encourage you to assure full participation by our southern colleagues by filling out a commitment to our scholarship fund, found in your red cards.
Last year at our closing plenary, I announced the Global Health Council’s determination to reverse the slide in U.S. support for reproductive health and family planning. We have made progress, and our commitment continues. Today, as we work together to build a movement for child health, I am announcing the formation of the Campaign for Children’s Lives, which will focus on mobilizing and supporting child health advocacy by the Global Health Council’s members, partners and their communities.
Join with us. Let us know what we can do to help your own efforts. On our part, we will keep you up to date on global partnerships, coalitions and working groups to which you can contribute. In close coordination with our partners, the Council will provide advocacy messages and tools; analyses of child health issues and information on child health investment needs. We will highlight events and keep you advised of best practices and policies. We will share ways that civil society, academia, implementing groups and corporate partners can work together to advance child health. We will solicit your involvement in advocacy efforts directed at governments and donors around the world.
Soon after this conference concludes, more information on the Campaign for Children’s Lives and how you can be involved will be available on the Council’s website.
The goal of the Campaign for Children’s Lives is simple – to put an end to the global tragedy of losing 28,000 children every single day between their first breath and age five. The world can achieve MDG 4 and save an additional 6 million children with the information and tools we have today. What is needed is the political will to prevent most deaths to children under the age of five, even in the poorest countries. And saving these children is just the first step toward the goal we all share: creating a world where child survival can be truly taken for granted, and where families everywhere are confident that their children will survive and thrive.
For too many years I have held too many dying children and said, “If only…” all too often.
I’ve had enough.
The time to act is now. Failure to act is not passive; it is a cruel choice to continue to waste these precious lives.
Read Child Health Report >
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