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Unreported cuts: 17,000 fewer children under five to die tomorrow

Soraya gets a check up at the local medical health clinic in Parwan Province, Afghanistan. The clinic is funded by the World Bank's Strengthening Health Activities for Rural Poor Project (SHARP). The drops in global child mortality rates since 1990 equate to over 6 million fewer child deaths in 2012. In Afghanistan, it equates to 80,000 fewer deaths last year. Photo: Graham Crouch / World Bank.Since 1990, the proportion of children under five that die each year has nearly halved. According to a recent report from the UN Inter-agency Group for Child Mortality Estimation*, it has dropped by over 50% in all regions except for sub-Saharan Africa and Oceania.

The figures are immense. Despite population growth the number of under-five deaths worldwide has declined from approximately 12.6 million in 1990 to 6.6 million last year. This progress made over 22 years translated to around 17,000 fewer small children dying per day in 2012. Yet, every single day, 18,000 children under age five did die.

These daily totals of deaths – either averted or that could have been averted had there been greater political will – dwarf almost all the suicide bombs, atrocities, accidents, negligence, shootings and abuses that filled the news in the more than two decades since 1990. The 6.6 million that died in 2012 were almost invisible. Programs such as this partnership that cut childbirth deaths in a Sudanese hospital in half are barely reported.

To put these figures in perspective, one could look at mortality rates in conflict-affected countries such as Iraq and Afghanistan. In Iraq the under-five mortality rate still dropped from approximately 45 to 34 per 1000 live births between 2000 and 2012. Last year, there were about 35,000 under-5 deaths but some 11,000 child deaths may have been averted relative to the mortality rate in 2000 and tens of thousands averted over the whole period.

In Afghanistan, the under-five mortality rate has dropped by 26% since 2000. Since 1990, its rate has dropped by an estimated 44%. This equates to about 80,000 fewer deaths of Afghan children in 2012 than if rates had been unchanged.

In what the UN report terms the State of Palestine, child deaths are close to the average rate for upper middle income countries, which still means some 3,000 children under-5 die each year. That is thirty times the average annual number of Palestinian minors of all ages killed by Israeli security forces in the last 13 years.

There has been little public consideration of how many more children might or might not have indirectly survived, or yet survive, if actors in the conflicts in Iraq and Afghanistan had made, or will make, different choices. Since 1990, death rates fell even faster globally than in either country.

Even the mortality figures for Afghanistan are dwarfed by the global numbers of the survival and deaths of millions of young children every year. More than a quarter of all neonatal deaths occur in India though Indian child mortality garners few headlines, unlike victims of violence or dramatic accidents.

Aid budgets have been cut by many donors since 2008. Yet, 100 million children could be innoculated from the leading cause of under-five deaths – undernutrition – for $3 billion. Almost half of global deaths among young children are attributable to undernutrition (45 percent). It is difficult to see how that amount could be better spent.

Pneumonia (17 percent of all under-five deaths), preterm birth complications (15 percent), complications during birth (10 percent), diarrhoea (9 percent) and malaria (7 percent) are also leading causes of death.

Huge numbers. Little reporting.

*Levels and Trends in Child Mortality – Report 2013

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