‘A Promise Renewed (APR)’; What promise?

Was there any promise before that warranted renew of the promise? Was the initial promise fulfilled and the renewed serves as reinforcement or it wasn’t fulfilled and the renewed is another promise to fulfil the initial one? To buttress my point above Anthony Lake, Executive Director, and UNICEF in a written Forward to the ‘Committing to Child Survival: A Promise Renewed Progress Report 2013’ observed that “What’s at stake in a promise? If you’ve ever made a promise to a child, you know that she is not likely to forget it. Whether it’s a new toy or a bedtime story, she will hold you accountable for following through — as you should hold yourself.”

According to the report; Committing to Child Survival: A Promise Renewed is a global movement to end preventable child deaths. Under the leadership of participating governments and in support of the United Nations Secretary-General’s Every Woman Every Child strategy, A Promise Renewed brings together public, private and civil society actors committed to advocacy and action for maternal, newborn and child survival. A Promise Renewed emerged from the Child Survival Call to Action, convened in June 2012 by the Governments of Ethiopia, India and the United States, in collaboration with UNICEF. The more than 700 government, civil society and private sector participants who gathered for the Call to Action reaffirmed their shared commitment to scale up progress on child survival.

The report observed that in 2000, the global community made a promise to children to reduce the under-five mortality rate by two thirds between 1990 and 2015. With less than two years left until the deadline, our promise and our credibility are in jeopardy. If current trends continue, the world will not meet the Millennium Development Goal 4 until 2028. Hanging in the balance are the lives of the estimated 35 million children who could die between 2015 and 2028 if we do not accelerate our progress. These staggering figures are all the more tragic because the majority of child deaths are preventable.

Under the banner of Committing to Child Survival: A Promise Renewed, 176 governments signed a pledge, vowing to accelerate progress on child survival. Each pledge represents a serious political commitment to save children from dying of preventable causes. With each passing month, more governments are taking steps to translate the pledge into action. Under the stewardship of the Government of Ethiopia, more than 20 sub- Saharan African leaders took the unprecedented step of coming together to reaffirm their collective commitment to reduce under-five mortality rates to less than 20 deaths per 1,000 live births by 2035.

The report has shown that dramatic reductions in maternal, newborn and child mortality can be achieved, even in the poorest contexts. Progress is most possible through the coordinated efforts of the public, private and civil society sectors, working together to improve outcomes in nutrition, water and sanitation, health, education and other sectors that impact outcomes for women and children.

Key Messages of the 2013 Progress Report.

1. Despite rapid progress in reducing child deaths since 1990, the world is still failing to renew the promise of survival for its most vulnerable citizens. Child survival remains an urgent concern. In 2012, around 6.6 million children died before their fifth birthday, at a rate of around 18,000 per day. And the risk of dying before age 5 varies enormously depending on where a child is born. In Luxembourg, the under-five mortality rate is just 2 deaths per 1,000 live births; in Sierra Leone, it is 182 per 1,000.

2. Without faster progress on reducing preventable diseases, the world will not meet its child survival goal (MDG 4) until 2028 — 13 years after the deadline — and 35 million children will die between 2015 and 2028 who would otherwise have lived had we met the goal on time. At the current rate of reduction in under-five mortality, the world will only make MDG 4 by 2028 — 13 years after the deadline — and 35 million more children will die between 2015 and 2028 whose lives could be saved if we were able to make the goal on time in 2015 and continue that trend.

3. Accelerating progress in child survival urgently requires greater attention to ending preventable child deaths in subSaharan Africa and South Asia, which together account for 4 out of 5 under-five deaths globally. Sub-Saharan Africa faces a unique and urgent challenge in accelerating progress. By mid-century it will be the region with the single biggest population of children under 5, accounting for 37% of the global total and close to 40% of all live births. And it is the region with least progress on underfive mortality to date.

4. West and Central Africa in particular requires a special focus for child survival, as it is lagging behind in all other regions, including Eastern and Southern Africa, and has seen virtually no reduction in its annual number of child deaths since 1990. Within sub-Saharan Africa, there is beginning to be a divergence in child survival trends between Eastern and Southern Africa, and West and Central Africa. This has important implications for strategies, priorities, resources and leadership in the global drive to end preventable child deaths. West and Central Africa is also the only region not to have at least halved its rate of under-five mortality since 1990, and the only region to have seen virtually no reduction in the absolute number of children dying over the past 22 years.

In conclusion to renew our commitment across countries with the highest burden of child death, it requires simple and cost effective interventions backed by a strong political will galvanizing resources deployed to all children under five.

All comments to Dr Aminu Magashi at healthweekly@yahoo.com