If 10,000 children were miraculously saved from death today, you'd probably expect it to make headlines on every news channel in America. But what if that life-saving story was happening every day for more than 27 years? Apparently, it'd come with little fanfare.
A new report from Our World In Data illustrates an amazing downward trend in child mortality since 1990. During that year, the Institute for Health Metrics and Evaluation (IHME) estimated that more than 12 million children died. Many of those deaths were preventable and related to illness or poverty.
In 2015, the number was more like 5.8 million. The 6.3 million death decrease per year over the course of 25 years is a staggering 17,258 fewer deaths per day.
While this chart lays out the details of what diseases and causes might lead to child mortality, there is a significant omission. David Pelletier, President at The Society for Implementation Science in Nutrition and professor at Cornell University, says malnutrition plays a role in each of these causes.
"Malnutrition increases the severity of most infectious diseases," Pelletier said. "If children were not malnourished, the mortality due to those diseases would be cut in half. This includes pneumonia, which seems to interest you most, but your message should go beyond that because in quantitative terms malnutrition is more important than pneumonia."
Because IMHE and the Global Deaths by Cause, two databases that chart child mortality, consider malnutrition a "risk factor" and not a cause, it's often omitted from the data. But the malnutrition factor is extremely important in discussing this decline in child mortality.
"These sources only regard infectious diseases as the true 'causes,'" Pelletier said. "This is a misinterpretation of the science. Malnutrition and disease interact at the biological level within the child, to kill children. They are co-equal causes."
Bill and Melinda Gates broke down the success of tackling child mortality since 1990 in a public letter they wrote to Warren Buffet that was published this week. In it, they credit the progress to the efforts impoverished people have made on their own, the generous giving of philanthropists like Buffet, and the efforts of wealthy nations like the U.S. to lift up the poor.
"More children survived in 2015 than in 2014," Bill Gates wrote. "More survived in 2014 than in 2013, and so on. If you add it all up, 122 million children under age five have been saved over the past 25 years. These are children who would have died if mortality rates had stayed where they were in 1990."
The advancements that have led to this declining mortality rate are numerous: better education, medicine, gender equity and economic growth all contribute. Tackling poverty has always an important element of addressing child mortality, and global poverty has simultaneously been plummeting with child mortality rates since 1990.
But Bill and Melinda Gates also emphasize a lesser known contribution: access to contraceptives.
"When a mother can choose how many children to have, her children are healthier," Bill wrote. "They're better nourished, their mental capacities are higher—and parents have more time and money to spend on each child's health and schooling. That's how families and countries get out of poverty."
That initiative is one they've been taking action on. As we reported last week. Melinda Gates recently wrote an essay on advocating contraceptives for women across the globe and her goal to reach 60 million women with family planning services by 2020.
But specific solutions also go beyond economic gains and contraceptives. Vaccines and access to them have been a huge help. While child mortality rates decreased, newborn mortality actually went up. Rwanda, however, was an outlier for poor nations because of actions they took with newborns: they used breastfeeding, hygienic umbilical cord cutting, and skin to skin care to help reduce newborn mortality rates by 30 percent.
So what's the lesson here? According to the Gates, it's that the solutions are out there. People just need to embrace and understand them.
"Extreme poverty has been cut in half over the last 25 years," Bill wrote. "That's a big accomplishment that ought to make everyone more optimistic. But almost no one knows about it. In a recent survey, just 1 percent knew we had cut extreme poverty in half, and 99 percent underestimated the progress. That survey wasn't just testing knowledge; it was testing optimism—and the world didn't score so well."
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