This has been a remarkable day – and an encouraging one. For the commitments we renew today – and the action those commitments compel – will help save millions of lives. Each life, an individual child. Together, a growing part of the coming generation.
So I am deeply grateful to the governments of Ethiopia, India, and the United States for convening this Call to Action as we rally once again to the cause of children everywhere.
I thank especially Secretary of State Clinton and Administrator Shah, not only for hosting us but also for their unflagging leadership on behalf of the world’s most vulnerable children.
And I am grateful to United Nations Secretary General Ban Ki-moon, for his vision of a world where the health and wellbeing of every woman and every child is nurtured and protected – the better to nurture and protect all humanity.
It is a vision we all share.
In 1990, the Convention on the Rights of the Child came into force … and at the World Summit for Children, the largest group of world leaders in previous history pledged to give every child a better future. They declared then that there was no cause more noble, nor more necessary.
At the turn of the century, the global community united behind the Millennium Declaration and then the Millennium Development Goals – putting the lives and futures of children at the heart of eight critical targets for human development.
And ten years ago, the General Assembly passed its landmark resolution to work in concerted action to build a World Fit for Children.
Historic moments. Singular commitments. And implicit in each one, an absolute promise to children: That we would do everything we could to help them survive … thrive … and have a better chance to reach their highest potential.
For millions upon millions of children, we have kept that promise.
For the millions of children vaccinated, or treated with oral rehydration salts and zinc, we have kept it…
For the millions drinking cleaner water and getting better nutrition …
For the millions of children, especially girls, who have been able to attend school for the first time …
For millions of children no longer living in the most extreme poverty, for them, we have kept it.
And we have kept that most fundamental promise: saving millions of children’s lives … reducing the number of children who die before their fifth birthdays by well over a third since 1990.
This forum is a celebration of that success – won through the immense dedication and vision of so many, including many here today.
The forum is an examination of how it was achieved – the innovations in medicine, technology, and development that have made it possible.
And it is most of all a necessary assessment of the technical and political obstacles that still remain – and a commitment to overcoming them, together.
Because despite everything we have learned over the last decades about how to save children’s lives, we are not keeping our promise to the millions of young children who still die every year – 7.6 million in 2010 – mostly from causes we have the power to prevent … and diseases we have the ability to treat.
They are often the most disadvantaged children, living in the poorest and most remote communities, subject to the greatest deprivations. Children with disabilities … children from indigenous communities and ethnic minorities … children in the shantytowns, favelas, and poor urban communities – including some only miles from this beautiful campus.
And even as the world has made tremendous progress in both saving and enhancing children’s lives, gaps between the poorest and wealthiest children –both among and within nations – are actually growing, often concealed by global and national averages.
Nowhere is this inequity more glaring, or more galling, than child mortality.
In some countries, children from the poorest households are twice as likely as those in the richest households to die before reaching their fifth birthdays.
That statistic alone is bad enough. But worse still is this: In 18 out of a sample of 26 countries where the national under-five mortality rate has declined by 10 per cent or more since 1990, the gap between child mortality rates in the richest and poorest quintiles has remained unchanged… or even grown.
This is wrong. And it is all the more unjust because it is unnecessary.
Many have long believed that reaching the hardest to reach is a worthy goal, but neither practical nor cost effective. This is no longer true.
Now, innovation – more effective, easier to deliver interventions, new uses of existing technology like SMS texting – means that services can be extended to the poor more effectively and inexpensively than ever before. And recent studies have shown that an equity focus is cost-effective – averting more deaths for every extra dollar invested than the path we are now on.
So there is no justification, in either principle or practice, for leaving the most disadvantaged mothers and children behind.
And as today’s rich discussion and the modelling we have talked about make clear, there has never been a better time for us to recommit to our cause.
We have the tools, the treatments, and the technology to lower child mortality rates in developing countries to levels approaching those in wealthier nations – and to reduce disparities within countries.
We must not waste this opportunity.
First, we must focus on the diseases that kill children the most and hit the poorest children hardest: diarrhoea … pneumonia … pre-term birth complications … and malaria. Expanding coverage of cost-effective interventions to treat these conditions will drive down child mortality significantly.
Second, we must expand national immunization programmes, which save the lives of over two million children every year – and with new vaccines, have the potential to save many more. And to win a final victory over the scourge of polio.
Last month, the World Health Assembly endorsed a new Global Vaccine Action Plan. In this, the Decade of Vaccines, we need to fully implement that plan.
Third, we need to do more to improve neonatal and maternal health – by expanding services all along the continuum of care to reach more newborns and more mothers, too, as recommended by the Commission on Lifesaving Commodities. The Commission should complete its report by September.
Fourth, we need to address all the determinants of child survival, not only coverage of health interventions. These include better nutrition … safe water and improved sanitation … and stronger mechanisms to protect children from violence, exploitation and abuse.
And this most certainly includes education for girls and women. A recent analysis shows that better educated mothers have a greater collective impact on reducing child mortality than increasing gross domestic product.
Why? Because the longer a girl stays in school, the more likely she is to understand the health benefits of breast feeding … the necessity of seeking treatment for HIV … and the lifesaving value of vaccination and regular health check-ups.
The road to ending preventable child deaths may be clearly marked, but the journey will not be easy. It will take political will and persistent effort. And it will take renewed commitment to child survival.
That is why today, we are launching Committing to Child Survival: A Promise Renewed, a commitment to work together to achieve the goals we have discussed today – and which bear repeating:
In high burden countries, reduce child deaths to 20 deaths or fewer per 1,000 live births by 2035.
In countries which have already achieved such levels, sustain national progress.
And, in all, look beyond national averages to reach the children and communities that are being left behind.
These goals are ambitious – especially for nations with the highest under-five mortality rates and the slowest annual rates of reduction. But the data, the modelling, and the real experiences of many nations show that they are attainable, even in difficult economic times.
Consider Nepal – a nation which has reduced child mortality by 67% over the last 20 years despite a GDP per capita average annual growth rate of 1.9 per cent during the same period. And countries as different as Rwanda, Ethiopia, and Bangladesh have achieved remarkable drops in child mortality, despite significant challenges.
We know what we have to do. And if we succeed, we will have saved an additional 45 million lives between 2010 and 2035.
All of us must play our part – with governments leading the way to sharpen their national child survival plans and monitor their progress – and with all of us supporting their efforts.
Development partners and other donors can align their support with government-led action plans and priorities, and help fill financing gaps.
Civil society and faith-based organizations can drive greater global attention to child survival … and, even more important, support the communities and families whose decisions ultimately have the greatest impact on our progress.
Private sector partners can help spur innovation and identify new resources for child survival.
And all of us can work to better coordinate our efforts, becoming ever more efficient.
We at UNICEF today most wholeheartedly renew our own promise to do all we can in this grand cause – which must be our common cause.
We will establish a small secretariat within UNICEF – working with our country offices, sister UN agencies, and partners to support the efforts of governments through action and advocacy. And we will issue annual reports to learn from our successes and setbacks, and identify new obstacles.
We will travel down the road together … learning from each other, spurring each other on, and most importantly, making progress together for millions of children … and ultimately, their societies.
So now, I invite Minister Tedros of Ethiopia, Minister [TBC] of India, and Secretary Sebelius of the United States to sign on behalf of their governments the first pledges of A Promise Renewed. We hope the leadership of these nations will inspire others to follow – today and in the coming days.
Earlier this afternoon, representatives from a diverse group of faith-based organizations made a similar commitment – grounded, as they put it, in the ‘moral conviction that we must save children from needless deaths.’ We are grateful for their support, and look forward to continuing our work together.
Civil society organizations have also prepared their own pledge – and it is my pleasure now to invite Mr. Mayowa Joel, Director of the Communication for Development Centre in Nigeria, to sign it on behalf of his own organization and as a representative of the many other organizations whose dedication have helped make this pledge – and all our progress – possible.
Immediately following the close of our session today is an informal reception hosted by civil society organizations. I hope you will all join us – and I hope those Ministers and representatives of Civil Society who wish to do so will sign the two pledges at the tables we have provided there.
So I thank you all once again for being here – and for your commitment to our common cause. By renewing our promise – and acting on it – we will no longer have to imagine a world where the right to survive can be realized for all children, everywhere. Our children, and their children, will live in it.