Race for Survival

winning the

race for survivalwhat needs to be done

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years left to 2015 – the date when world leaders have promised to reduce child mortality by two-thirds

million children die before the age of five every year

the proportion of child deaths each year where malnutrition is an underlying cause

million children are not immunised against killer diseases

billion people never see a health worker in their lives

countries are on track to win the race for survival, including Bangladesh, Nepal and Malawi

countries haven’t left the starting blocksRA

CE

STA

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1990 12 million children die every year 2011

6.9 million children die every year

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6.9

1/3

19.3

1

23

13

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In 2000 world leaders fired the starting pistol in an historic race for survival. By signing up to the Millennium Development Goals (MDGs) they promised to cut the child mortality rate by two-thirds by 2015 and save the lives of millions of children.

The good news is that progress has been made. In 1990, 12 million children died every year before their fifth birthday. Today that number has been cut to 6.9 million.

But we have to do more to win the race by 2015, especially in countries that are falling behind or have made little or no progress.

We’re now entering the final crucial phase and children around the world have joined the race. They’re calling on their governments and world leaders to make the life-saving decisions that will get us to the finishing line.

a race for

survival

2015 Children dying

cut by

two-thirds finiSh

No child under five dies from preventable causes

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the child

killers

• 6.9 million under-fives die each year – nearly 19,000 every day – from causes such as pneumonia, diarrhoea and malaria

• 40% of all under-five deaths occur in the first month of life

• Undernutrition contributes to over one-third of child deaths

Pneumonia 14%

Other non-neonatal 18%

Measles 1%

Meningitis 2%

AIDS 2%

Injury 5%

Malaria 7%

Diarrhoea 10%

4% Pneumonia, neonatal

14% Preterm birth complications

9% Intrapartum-related events

5% Sepsis and meningitis

4% Congenital abnormalities

1% Tetanus

2% Other neonatal

1% Diarrhoea, neonatal

Source: Liu et al, from Countdown to 2015, Building a future for women and children: The 2012 Report

40% neonatal

deaths

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the child survival

pyramid

Getting children the care, medicines, vaccines and food they need to fight killer diseases means investing in healthcare, education and nutrition. It means ending discrimination against women and girls. Cutting child mortality will take a long-term commitment to protecting children from conflict and natural disasters, and stamping out the poverty and exclusion that lies beneath most child deaths.

direct causes

Pneumonia, measles, diarrhoea,

malaria, HIV and AIDS, neonatal conditions

intermediate causes

Weak health systems; maternal and child undernutrition;

limited access to clean water and safe sanitation; lack of girls’ education; lack of

access to family planning, and early pregnancy

underlying causes

Poverty, inequality and exclusion; governace, fragile states and conflict; climate change and natural disasters;

global political economy

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vaccines for all children wherever they live Immunisation works. It has pushed child mortality rates down and new vaccines have the potential to reduce the numbers of children dying even further. But millions of the world’s poorest children are still not being vaccinated against the killer diseases that account for a quarter of all child deaths. By harnessing the enthusiasm and expertise of governments, donors and initiatives like the Global Alliance for Vaccines and Immunisation (GAVI), we have the momentum to close the gap.

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A marathon – not just a sprint

overcoming the

hurdles

a health worker in reach of every child Health workers are lifesavers. They’re our most vital resource in improving the health and survival chances of children, mothers and their families. But there’s a critical shortage of doctors, nurses, midwives and community health workers in many of the world’s poorest countries. Health workers need training, equipment and support. Governments and donors must work together to train and support new and existing health workers, and deploy them where they’re most needed. It’s time to end the health worker crisis.

We know what it takes to win the race for child survival: a health worker in reach of every child, vaccines for all children, and tackling malnutrition.

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a life free from hunger and malnutrition and a healthy diet for all children. One-third of child deaths are related to malnutrition, which also leaves one in three – 170 million – children stunted. Malnutrition makes millions of children vulnerable to life-threatening illness. Hunger is a slow and silent killer that doesn’t show up on death certificates. It’s time to make it visible and set targets to reduce malnutrition.

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A marathon – not just a sprint

1 billion people never get to see a health worker in their lives

One-fifth of the world’s children – 19.3 million – are not fully immunised

Malnutrition is an underlying cause in one-third of child deathseach year and stunts the growth of 170 million children

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The world is still a very unfair place to be born. The following three maps show what countries would look like if their size was based on the number of children who die every year, the shortage of health workers and the number of unimmunised children.

mapping child

mortality

The world according to…

under-five mortality

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number of unimmunised children


shortage of health workers

Maps based on Mercator projection and produced by Worldmapper Project, Sasi Research Group, University of Sheffield.

Sources: Under-five deaths are based on 2010 data from WHO Global Health Observatory Data Repository.

Unimmunised children are calculated based on UNICEF/WHO national DTP3 coverage estimates for 2010 and

population data for surviving infants for the same year obtained from the UN Population Division.

Health worker shortages are calculated according to WHO recommended minimum ratio of 23 doctors, nurses and midwives per 10,000 population, using latest available country data (2000–09) from WHO Global Health Observatory Data Repository and UN population data.

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23 countries on track – proof it can be done!

38 countries lagging – need to speed up

13 countries haven’t left the starting blocks

1 1 1 1 1 1

1 1 1 1 1 1 1

millennium development goal 4

winners and losers

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RE

AL LifE

SCO

RE

BO

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Ddeaths per 1,000

live birthsaverage annual

rate of reduction (%)

1990 2010 1990 – 2010

on trackBangladesh 143 48 5.5Bolivia 121 54 4.0Brazil 59 19 5.7Cambodia 121 51 4.3China 48 18 4.9Egypt 94 22 7.3Eritrea 141 61 4.2Guatemala 78 32 4.5Indonesia 85 35 4.4Iraq 46 39 0.8Korea, DPR 45 33 1.6Kyrgyzstan 72 38 3.2Lao PDR 145 54 4.9Liberia 227 103 4.0Madagascar 159 62 4.7Malawi 222 92 4.4Mexico 49 17 5.3Morocco 86 36 4.4Nepal 141 50 5.2Peru 78 19 7.1Philippines 59 29 3.6Solomon Islands 45 27 2.6Vietnam 51 23 4.0

insufficient progress Afghanistan 209 149 1.7Angola 243 161 2.1Azerbaijan 93 46 3.5Benin 178 115 2.2Botswana 59 48 1.0Burundi 183 142 1.3Comoros 125 86 1.9Congo 116 93 1.1Côte d’Ivoire 151 123 1.0Djibouti 123 91 1.5Equatorial Guinea 190 121 2.3Ethiopia 184 106 2.8Gabon 93 74 1.1Gambia 165 98 2.6Ghana 122 74 2.5Guinea 229 130 2.8Guinea-Bissau 210 150 1.7India 115 63 3.0Mali 255 178 1.8Mozambique 219 135 2.4Myanmar (Burma) 112 66 2.6Niger 311 143 3.9Nigeria 213 143 2.0Pakistan 124 87 1.8Papua New Guinea 90 61 1.9Rwanda 163 91 2.9Senegal 139 75 3.1Sierra Leone 276 174 2.3Sudan* 125 103 1.0Swaziland 96 78 1.0Tajikistan 116 63 3.1Tanzania 155 76 3.6Togo 147 103 1.8Turkmenistan 98 56 2.8Uganda 175 99 2.8Uzbekistan 77 52 2.0Yemen 128 77 2.5Zambia 183 111 2.5

no progress

Burkina Faso 205 176 0.8Cameroon 137 136 0.0Central African Republic 165 159 0.2Chad 207 173 0.9Congo, DR 181 170 0.3Haiti 151 165 -0.4Kenya 99 85 0.8Lesotho 89 85 0.2Mauritania 124 111 0.6São Tomé and Príncipe 94 80 0.8Somalia 180 180 0.0South Africa 60 57 0.3Zimbabwe 78 80 -0.1

The real winners and losers are children and their families.

Countries’ progress is usually judged on their economic growth and per-capita income. But mortality rates among the poorest communities are a much more telling indicator of how well a country is doing.

This table shows how the countries that account for 95% of child deaths are (or aren’t) progressing in the race to achieve MDG 4 – a two-thirds reduction in child mortality by 2015.

Source: Under-five mortality, UNICEF, WHO, World Bank and UNDESA 2011 from Countdown to 2015: Building a future for women and children: The 2012 Report. Countdown tracks progress in the 75 countries where more than 95% of all child deaths occur. The list here covers 74 countries where data are available. See www.countdown2015mnch.org

*Data refer to Sudan in 2010, before South Sudan seceded. Data for South Sudan and Sudan as separate states are not available.

“[The Race for Survival] gives children a chance to show their solidarity with children who face a daily struggle to survive. Please, let’s all together, make sure no child is born to die.”

Patrick Makau, World Marathon record holder

children leading

the raceThe Race for Survival is part of Save the Children’s global EVERY ONE campaign. Our objective? To help get the world on track to achieve MDG 4 and substantially reduce the numbers of young children who die every year.

On 16 October 2012, World Food Day, thousands of children in more than 30 countries will be taking up the baton and urging their governments and world leaders to act fast to save children’s lives.

child survival checklistHow does your country score in the race for child survival? Does it have policies in place and is it taking action to ensure the following?

Reduction in child mortality

Focus on newborn babies

Health worker in reach of every child

Vaccines for all children

Reduction in hunger and malnutrition

Resources for healthcare and education

Narrower gap between rich and poor

Girls’ and women’s rights

Eradication of poverty

© Save the Children International, September 2012Registered Charity No: 1076822

www.everyone.org

Documents

Race for Survival