World Health Day falls every April 7 amidst fanfare in capital cities, proclamations of commitment from earnest politicians, and the deaths of 30,000 children under five (10,000 of whom are newborns). Meanwhile, 1,440 women will die of pregnancy-related complications, and for every woman who dies, another 30 will suffer injury, infection or disease. The vast majority of these deaths occur in the developing world, where the under-five mortality rate ranges from 6.5 percent in Namibia to 28.4 percent in Sierra Leone (to give some perspective, the U.S. child mortality rate is .08 percent.) The theme of this World Health Day is “making every woman and child count.” Instead of counting their deaths, let’s make their lives count before it’s too late.
Despite the staggering prevalence of child mortality, quick solutions do exist for most of the major childhood diseases. Almost two out of three of these child and newborn deaths occur from easily preventable or treatable diseases such as diarrhea, pneumonia, malaria and measles, and from conditions like malnutrition and premature birth. Fifteen cents covers the cost of a five-day course of oral antibiotics for a child with pneumonia. Oral rehydration therapy is a 20-cent solution to diarrhea, which kills around 1.4 million children each year. A child can be immunized against six major childhood diseases for only $17, including the cost of the vaccines, materials and a trained health care worker. Each year we could save as many as 6 million children with low-cost, low-tech interventions. The death toll of next year’s World Health Day could be halved if we take advantage of these cheap, effective treatments.
The question involved is not a moral one: We have the resources and these children need them. The issue at stake is the mechanism through which we should provide assistance. Most African nations are too impoverished to provide basic health care to their citizens, and some governments have proven themselves incapable or unwilling to put aid to its proper use. Western governments are increasingly uncomfortable with direct bilateral aid, knowing that funds are siphoned off through corruption.
The Global Fund to Fight Aids, Tuberculosis, and Malaria was created in 2002 to provide a multilateral channel for aid distribution to the most effective programs, and is designed to foster policy ownership within recipient nations. It has disbursed $3 billion since its inception three years ago, and is now the world’s largest financier of programs to fight tuberculosis and malaria. More than 99 percent of each dollar the Fund receives goes directly to country programs. The Global Fund needs a total of $5 billion in 2006 to continue its work, and the United States should contribute around $1.5 billion, given our share of the world economy. The fund needs at least half of that to keep existing programs in place. Sens. Santorum and Durbin succeeded in increasing the appropriations for the Global Fund to $800 million from the president’s request of $300 million. With these funds, the Global Fund can maintain the health programs it sponsors, but we will not see further successes without more funding from both the United States and other nations.
Foreign aid is no panacea to the global health crisis, but it is a strong first step. With national governments, civil society and NGOs working in partnership, we will continue to see dramatic improvements in child and maternal health. Leaders of poor countries must be held accountable for spending more and spending it better to protect their most vulnerable citizens. Leaders of rich countries and donor agencies must demonstrate their professed commitment to combating the spread of disease by investing both human and financial resources through effective institutions like the Global Fund. Twenty children have died since you started reading this article. Let’s cut that number in half by the next World Health Day.
Molly Lewis is a junior in Saybrook College and a member of Yale’s Student Campaign for Child Survival.