Saving the Lives of the Under Fives

If you have ever worried about your own sick child, you can appreciate how frantic, desperate and helpless you would feel if you lived in the handful of countries where improvements in under 5 mortality have slowed to a trickle. If you are a mother in one of these countries, you are justified in your grave desperation, because half of the kids that die do so from the very mundane afflictions of diarrhea, pneumonia and measles. Another 40% are lost from neonatal causes that are also largely preventable. While globally we have reduced under 5 mortality by nearly 35% since 1990, nearly 7.6 million little ones still die each year.

Last week’s Call to Action sought to change all this, challenging the world to commit to a new set of goals for keeping kids alive. Currently, 78/1,000 children die before age 5. The goal is to reduce this to 15/1,000 by 2035. This represents a dramatic acceleration in the rate of improvement compared to what we have seen in the past.

The meetings in Washington set in motion a plan to tackle this issue head-on, with a strategic focus on the worst countries – India, Pakistan, Ethiopia, Nigeria and the Democratic Congo, with a package of interventions that will hit the diseases and related conditions that matter most. Convened by the US Government, Ethiopia and India, in collaboration with UNICEF the event brought together 700 stakeholders from across government agencies, private companies, NGOs, faith based organizations to discuss the global approach. The role of the private sector is rarely spelled out with great detail in these types of meetings, but this time things were different.

On Friday, Gary Cohen, Executive Vice President at Becton Dickinson presented the Private Sector Engagement Guide that FSG authored for the Partnership for Maternal, Newborn and Child Health. The guide makes the case that companies, from across a diverse set of industries, have a key role to play in ensuring that women and children have access to health products and services that are provided through an effective health care delivery system. We reviewed 70 case studies of companies engaged in maternal and child health to determine that companies can not only do this from a charitable orientation, but more powerfully they can do this from a commercial orientation and create both social and economic value. Shared value in action that ensures today’s efforts are not temporary.

In the guide we also describe how companies must work through a collective impact model to ensure that their innovations are part of a larger effort with both the public and private health systems. Moving the needle on child mortality won’t happen unless there is a health system that works, in a given place, to address the range of issues that take a child’s life before age five.

So what will this look like if we are to meet the new under 5 mortality targets? Within any country, the effort must be led by country governments who use analytics to set priorities, allocate resources and implement evidence based strategies. Development partners will align their funding with national priorities. Companies will bring innovations in products and services to fill gaps or strengthen the overall system from a sustainable, commercial perspective. Civil society will engage communities and support families through outreach and advocacy. All of these actors will need to align around one strategy suitable for the country’s specific needs, agree to a common set of metrics to track progress towards the goals (scorecards have already been drafted), share progress through ongoing communications, and coordinate activity to avoid redundancies and manage gaps. In order to keep all of these pieces moving in concert, there must be a coordinating agency, a backbone organization, that is funded and empowered to transparently monitor and support the diverse set of organizations that are key to success.

The ultimate success will be when the mothers in these countries are no longer struck with fear at every cough or loose stool. When taking kids to the clinic is routine and easy and yields results in a predictable way. When pregnancy doesn’t suggest a death sentence and when we can all look back on the past with disbelief that the world was ever so.

We all have a role to play. What will you do? What will your company do? How will you do it in concert with others?

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