As the U.N. General Assembly opens, we are in the midst of a global health revolution. Our collective work has delivered extraordinary results – a 70 percent decline in child mortality over the last 50 years, a 41 percent reduction since 1990 alone. We have also made great strides in diminishing the desperation that has come with the threat of AIDS. We can celebrate these great accomplishments, while acknowledging the remaining challenges and embracing a bold, action-oriented vision – to end preventable child deaths, create an AIDS-free generation, invest in women and save mothers, and build the health system foundations for universal health coverage. At UNGA, I and others will continue to focus on these themes and this vision, and I have confidence that the leaders gathered also now have global health and child survival included among their highest priorities.
These are not just aspirational or ambitious goals, but a collective moral and ethical test for humanity. Delivered more than 50 years ago, President Kennedy’s stirring “moon speech” rings true of the promise for global health today. “We choose…because that goal will serve to organize and measure the best of our energies and skills, because that challenge is one that we are willing to accept, one we are unwilling to postpone, and one which we intend to win.” For health, “reaching the moon” will advance human progress—helping families escape devastating cycles of poverty and disease that drain vital health and economic resources, hold back communities and nations, and prevent young children from living up to their God-given potential.
In June, at the Child Survival Call to Action in Washington D.C., world leaders embraced the strategic shifts necessary to speed up progress in reducing preventable maternal, newborn and child deaths. These shifts included increasing efforts in the countries where most deaths occur, focusing on vulnerable populations like the very poor, and investing in high impact solutions to address the biggest killers, such as neonatal complications.
More than 141 governments, 119 civil society organizations, 90 faith-based organizations, and 20 new private sector partnerships made pledges and commitments to keep our promise and work to end preventable child death in a generation. And those numbers continue to grow. First, these partners agreed to accelerate actions to achieve MDG 4 and 5 targets. They went further to embrace an aspiration of getting below 20 child deaths per 1000 births by 2035, and to reduce disparities within countries already at or below that level. And they agreed to hold themselves mutually accountable for achieving this accelerated progress. This is not a far-fetched dream, and countries themselves are the key partners in making this vision a reality. For example, domestic health spending may double in many of USAID’s partner countries within the current decade, marking a signiﬁcant economic transition for health and an opportunity to maximize the impact of that increased spending.
Nearly 30 years ago, USAID and the United Nations Children’s Fund (UNICEF), with the support of the U.S. Congress, launched a “child survival revolution” aimed at reducing the number of deaths among young children in developing countries. At the time, an estimated 15 million children under age 5 in the developing world died from common, preventable diseases each year. Without reduced rates of mortality, the number of deaths today would be about 17 million each year. Instead, it is 6.9 million. Of course, 19,000 children dying of largely preventable causes is far too many, but our progress in the past gives us great hope for success in the future.
The last generation went to the moon, and this generation has an equally incredible opportunity to meet the moral challenge I’ve discussed here. We need to end preventable child and maternal deaths. This is not just a vision for health, but a fundamental pillar of sustainable development. This is a shared vision and opportunity we can all work toward, and neither the moon nor the end to preventable child death are too far away.