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Child survival and development strategy

Statement by Mr. Youssouf Oomar, Resident Representative

Abidjan, 11 June 2007

• Honourable Minister of Health and Public Hygiene,• Excellency, Ambassador-Delegate of the European Union,
• Dear Colleagues of the United Nations System,
• Distinguished Representatives of the Administration,
• Distinguished Representatives of National and International Institutions and NGOs,
• Distinguished Representatives of the Press,
• Ladies and Gentlemen,
• Dear Friends,

The subject that has brought us together today is so important that I would like to tackle directly the issue that concerns us most. And what we cherish most are children who are dying in the world, particularly in Côte d’Ivoire. Paradoxically, these children are dying of causes we can avoid.

Let me give you some statistics that speak for themselves:

• Every year, 10.6 million children aged below 5 years die in the world, including 4.6 million or 43% in (sub-Sahelian) Africa;

• Concerning maternal mortality, Côte d’Ivoire has one of the highest rates in the world. In fact, out of 100,000 deliveries, 690 women die while giving life.

• In the case of HIV/AIDS, the national prevalence of 4.7%, and more than 8% among women, place Côte d’Ivoire on top of the most affected countries in West and Central Africa.

• Here in Côte d’Ivoire, the infant mortality rate is 118 out of 1,000 live births while the rate among children under five years is 194 for 1,000.

Let me say it once again, most of these deaths are due to causes we can avoid. We can save children from Malaria by using a bed net, which costs between 1,500 and 3,000 CFA Francs (for a non-treated bed net). Today, 26% of children under 5 are sleeping under a bed net and only 6% under an insecticide-treated bed net. And this is where we should accept responsibility. This is also what led the Heads of State and Government from the whole world to meet in 2000 in New York, where they solemnly and personally pledged to attain the 8 core goals of the Millennium, 3 of which were directly associated with Child Survival, namely:

1. Reducing by two-thirds the mortality rate among children under 5 years by 2015;

2. Reducing by three quarters maternal mortality rate by 2015;

3. Halting by 2015, the spread HIV/AIDS and beginning to reverse the current trend and reducing the prevalence of malaria.

As you can see, these objectives were signed in 2000, we are now in 2007, not very far from 2015, and you have just heard the worrying situation, as reflected by the figures on child mortality I just communicated to you.
This explains the new commitment made by the Heads of State of the African Union during the third ordinary session held from 2 - 5 July 2005 in Syrte, Libya, with the adoption of the declaration affirming their commitment to reduce the annual number of deaths of children in Africa by 1.5 million by 2010, and thereby achieve MDG 4 by 2015.

The Ministries of Health of the African Union followed close behind the Heads of State and Government  at their meeting in September 2006, during which they pledged to implement the Child Survival and Development Strategy.

In fact, this strategy is already being implemented since 2002 in 11 countries in West and Central Africa with financial support from the Government of Canada.

The initial results are encouraging. Indeed, between 2002 and 2005, it was estimated that, thanks to this strategy, Cameroon reduced the mortality rate among children under 5 years by 5%, Guinea Bissau by more than 14%, Ghana by 17%, Mali by 21% and Senegal by 25%.
Today, it is essential that we accelerate this programme if we want to attain the MDGs within the set time frame. UNICEF, WHO and the World Bank have officially sealed at the international level the deployment of joint efforts in the implementation of the “Accelerated Child Survival and Development Strategy” (ACSDS). This new alliance has been extended to other sister Agencies.

At the level of UNICEF, we have officially adopted this strategy through our 2007 Cooperation Programme. In a highly efficient collaboration with the Ministry of Health and Public Hygiene, we have identified intervention packages with high impact on the reduction of infant-child and maternal mortality, which we are currently implementing, notably in the 41 districts of the Centre, North, West zone. However, whatever the goodwill of the donors and our own goodwill, this programme will always be a modest one in view of the enormous needs revealed by the above statistics.

I am saying this to stress, on this solemn occasion, the need to strengthen this programme both qualitatively and quantitatively.

This should be achieved through:

1) The improvement of the health system by strengthening capacities at all levels and by providing quality services for at least priority interventions with high impact on the reduction of maternal and child mortality. In this regard, we do not believe that the multiplication of administrative structures is the panacea. We should rather ensure rational use of existing resources, efficient coordination, efficient governance and an increase of the budget allocated to health. We cannot succeed in ensuring the survival of the child if considerable efforts are not deployed at the supply levels. And, if I should give an example we are all familiar with, there can be no success if today part of the health establishments lack essential drugs or if we continue to register shortages of vaccine ….

2) The empowerment of families and communities, notably the most marginalized. The communities are capable of catering for themselves and contributing to the efficient management of health establishments when they are involved.

3) Advocacy for harmonization of programmes aimed at attaining the MDGs. We all have programmes, that are directly or indirectly aimed at reducing child and maternal mortality, but we have not often had the opportunity to coordinate and integrate them in a harmonious manner.

4) The building of an operational partnership for implementing interventions with high impact on child and maternal mortality. This partnership should involve donors, NGOs, the private sector and all stakeholders in the programme.

5) The development of a resource mobilization plan at the international, national and governmental levels for rapidly scaling up interventions with high impact on child and maternal mortality. It is obvious that without this scaling-up, we shall loose a major part of the efficiency of the Survival strategy.

Here are a few proposals we wish to share with you on the occasion of the launching of the ACSDS. Also to support the ACSDS programme, we deemed it opportune to put at the disposal of the Ministry of Health and Public Hygiene: 
- 21 old vehicles acquired under the Emergency and Rehabilitation Programme (ERP2) funded by the European Union,

- 10 new vehicles for supervision missions by the District Core Teams and the mobile strategies,

- 170 motorcycles for the enhanced strategies,

- 965 bicycles for monitoring community activities.

These latest means of transportation were acquired with funding from our Executive Director, in the framework of the intensification of the Child Survival and Development Strategy.

I wish to end my statement by expressing our sincere thanks to all our donors, particularly the European Union. I wish to reiterate once again UNICEF’s commitment to deploy all necessary efforts to contribute to reduce mortality among children, support their self-fulfilment and development, and ensure a better world for them. A world, where the rights of every child shall be respected.

Thank you.




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