‘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

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