This past June, we marked the second anniversary of the Child Survival Call to Action, when the world came together to craft a global goal to end preventable child deaths by 2035. In the past two years, we pioneered an approach that has empowered partner countries to lead with robust business plans and evidence-based report cards. With a strong foundation in place, now is the time for the global community to mobilize around focused and results-oriented country action plans to realize a world where all children live to celebrate their 5th birthday.
Since the beginning of the Obama administration, the U.S. has invested $13 billion in child and maternal survival. Emblematic of the strong bipartisan legacy of American leadership in global health, this commitment represents a 56 percent increase in annual funding since 2008. Most importantly, we have aligned our resources in priority countries and toward the life-saving interventions that have the greatest impacts on mortality. We have focused on the 24 countries, primarily in sub-Saharan Africa and South Asia, that account for 70 percent of child and maternal deaths and half of the unmet need for family planning.
Throughout the past 18 months, USAID has undertaken an ambitious review of every dollar we spend to prevent child and maternal mortality in these 24 countries in order to identify inefficiencies and accelerate reductions in child and maternal mortality. Our recently published report, Acting on the Call, demonstrates with unprecedented transparency how we are advancing President Obama’s commitment to bend the curve of progress.
Ending preventable child and maternal deaths requires a new model of development that harnesses the power of science and business to push the boundaries of possibility. In Southeast Asia, for example, we supported randomized control trials and feasibility studies demonstrating that chlorhexidine could cut infant mortality by 23 percent. We partnered with a local Nepali pharmaceutical company and community health workers to deliver the life-saving antiseptic to expectant mothers. Today, efforts to introduce it are underway in 15 other countries.
The results from this approach have been extraordinary. In two years alone, we’ve helped achieve an 8 percent reduction in under-five mortality in the 24 focus countries, saving 500,000 lives. Maternal mortality has fallen by half in these same countries over two decades. In 2013 alone, the U.S. provided 12.8 million pregnant women with HIV testing and counseling, as well as helped to protect 240,000 babies who would otherwise have started life with the virus.
We are proud of this progress, but even more must be done to ensure that every child survives and thrives, and that no mother dies from preventable causes as a consequence of pregnancy and childbirth. More than ever, we need our partners to join with us and align their investments with country-owned plans that focus on delivering results for the most vulnerable families in the most vulnerable communities. By accelerating our rate of progress together, we can save the lives of 15 million children and almost 600,000 mothers by 2020.
Ending preventable child death and realizing an AIDS-free generation will only be possible if we continue our investments in health workers. The 24 priority countries face severe challenges not only in terms of employing quality health workers, but also in sending them where they are needed most. To tackle these challenges, we have evolved from simply focusing on building and educating cadres of health workers to developing innovative approaches that address their deployment, retention and management. In Uganda, for instance, we helped to improve human resources information systems and explored new incentive schemes to retain staff. As a result, the Ministry of Health was able to hire 6,000 additional health workers and double physician salaries.
Two years in a row, President Obama has called upon us in his State of the Union address to join the world in ending extreme poverty and its most devastating consequences – child hunger and child death – in the next two decades. It is an ambitious but achievable vision. With a clear path for action going forward, we can deliver on this fundamental human aspiration and usher in one of the greatest contributions to progress in history.
Adapted from USAID’s new report, Acting on the Call: Ending Preventable Child and Maternal Death.
Photo: Administrator Shah visits a small clinic that belongs to PSI’s Sun Quality Health franchise in Yangon, Myanmar. (Credit: © Richard Nyberg/USAID)