Bold child health goals: worth the gamble
For most people, the new year means a bit of champagne, a reason to celebrate, and resolutions about personal changes. For Bill and Melinda Gates, the new year brings their annual letter and thoughts about global issues, world progress, and changes for billions of people. And this new year included a bet: in their annual letter, the Gates' bet that “the lives of people in poor countries will improve faster in the next 15 years than at any other time in history. And their lives will improve more than anyone else's.” Gutsy? You bet.
Their ambitious goal is comprised of four pillars, one of which is cutting the number of children who die before age 5 in half… again. Twenty five years ago, one in ten children failed to reach their fifth birthday. Increased access to vaccines and to commodities like oral rehydration salts, zinc, and antibiotics children cut that rate in half: today, in 2015, about one in 20 children die before their fifth birthday. And here's where the gutsy prediction starts: the Gates' are betting that by 2030 - just the next 15 years - that rate will be cut in half again, to one in forty.
Now most people probably ask the simple question - how? The initial halving of the mortality rates took 25 years. How can we make the same progress in just 15? While I won't claim the answer is simple or easy, I will claim that we have the solutions. Access to vaccines continues to improve with more countries introducing vaccines against rotavirus and pneumococcal to prevent two of the leading infectious killers of children. Oral rehydration salts, zinc, amoxicillin, and litany of other treatment interventions continue to make their way to health clinics, pharmacists, and when appropriate, to community health workers. Importantly, improved sanitation is becoming more accessible to even the most poor and rural communities.
And we can't forget newborns. The vast majority of improvements in child health will come from reducing newborn deaths. Improved access to newborn commodities, including resuscitation devices and injectable antibiotics, as well as practices such as breastfeeding will continue to drive down the number of children who die within the first 28 days of life.
But here's the caveat: in order to accomplish the remarkable milestone set forth by the Gates', we have to reach the last mile. We - government leaders, donors, the collective global health community - have to reach the most rural and remote. We have to make sure the most far-flung health clinic has health commodities available and a trained health provider on staff. We have the solutions, but we have to make them work. To me, this is our true test.
I've often hoped that we're all working ourselves out of a job, collectively doing our individual parts to improve the lives of children. And now, more than ever, I see that materializing. Perhaps we won't all be out of jobs in 2030, but if the Gates' bet is right - and something tells me they don't gamble frivolously - we will all begin to see a world where children are thriving. We certainly have our work cut out for us, but I, for one, can't wait until we hit this jackpot.