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	Investments in poor children save more lives by Unicef, Save the Children, The Lancet, agencies   Investments in poor children save more lives. (Unicef)   Unless the world makes faster progress on reducing child mortality, by 2030 almost 70 million children will die before reaching their fifth birthday.   Investing in the health and survival of the most deprived children and communities provides more value for money, saving almost twice as many lives for every US$1 million spent as equivalent investments in less deprived groups, according to a new UNICEF analysis.   Narrowing the Gaps: The power of investing in the poorest children presents compelling new evidence that backs up an unconventional prediction UNICEF made in 2010: the higher cost of reaching the poorest children with life-saving, high-impact health interventions would be outweighed by greater results.   'The evidence is compelling. Investing in the poorest children is not only right in principle it is also right in practice, saving more lives for every dollar spent', said UNICEF Executive Director Anthony Lake.   'This is critical news for governments working to end all preventable child deaths at a time when every dollar counts. Investing equitably in children's health also saves futures and helps break intergenerational cycles of poverty. A healthy child has a better chance of learning more in school and earning more as an adult'.   Unless progress on reducing child mortality accelerates, by 2030 almost 70 million children will die before reaching their fifth birthday.   Drawing on new data from the 51 countries where around 80 per cent of all newborn and under-five deaths occur, the study shows that improvements in coverage of life-saving interventions among poor groups helped decrease child mortality in these countries nearly three times faster than among non-poor groups.   Crucially, the study uses new data and modeling tools to demonstrate that interventions reaching children in poor groups proved 1.8 times more cost-effective in terms of lives saved.   The study selected six key health interventions as indicators to assess access to high-impact maternal, newborn and child health interventions: the use of insecticide-treated bed nets, early initiation of breastfeeding, antenatal care, full vaccination, the presence of a skilled birth attendant during delivery, and seeking care for children with diarrhea, fever or pneumonia.   Specifically, the study found that:   Access to high-impact health and nutrition interventions has improved most rapidly among poor groups in recent years, leading to substantial improvements in equity.   During the period studied, absolute reductions in under-five mortality rates associated with these changes in coverage were nearly three times faster among poor groups than non-poor groups.   Since birth rates were higher among the poor than the non-poor, the reduction in the under-five mortality rate in poor communities translated into 4.2 times more lives saved for every million people.   Of the 1.1 million lives saved across the 51 countries during the final year studied for each country, nearly 85 per cent were among the poor.   While the per capita investment needed to improve coverage among the poor is greater than that required to reach the non-poor, these investments save almost twice as many lives per US$1 million invested as equivalent investments in the non-poor.   The study lists Afghanistan, Bangladesh and Malawi as some of the countries with high rates of under-five mortality where focus on the most deprived has made a difference for children.   Between 1990 and 2015, under-five mortality decreased by half in Afghanistan and by 74 per cent in both Bangladesh and Malawi.   The findings come at a critical time, as governments continue their work towards achieving the Sustainable Development Goals, which set a target of ending all preventable deaths among newborns and children under the age of five by 2030.   Investing in children's health and survival can also support the achievement of other global development goals, such as ending poverty (SDG 1).   Narrowing the Gaps calls on countries to take practical steps to reduce inequities, including: disaggregating data to identify the children being left behind; investing more in proven interventions to prevent and treat the biggest killers of children; strengthening health systems to make quality care more widely available; innovating to find new ways of reaching the unreached; and monitoring equity gaps using household surveys and national information systems.   http://www.unicef.org/press-releases/investments-poor-children-save-more-lives-dollar-spent-new-unicef-study-says   Dec. 2017   100 million pushed into extreme poverty because of health expenses each year - WHO, The Lancet   Half the world lacks access to essential health services, with 100 million people pushed into extreme poverty because of health expenses, a new report from the World Health Organization reveals.   Each year large numbers of households are being pushed into poverty because they must pay for health care out of their own pockets.   Currently, 800 million people spend at least 10 percent of their household budgets on health expenses for themselves, a sick child or other family member.   For almost 100 million people these expenses are high enough to push them into extreme poverty, forcing them to survive on just $1.90 or less a day.   The findings, released this week in Tracking Universal Health Coverage: 2017 Global Monitoring Report, have been simultaneously published in Lancet Global Health.   "It is completely unacceptable that half the world still lacks coverage for the most essential health services," said Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. "And it is unnecessary. A solution exists: universal health coverage (UHC) allows everyone to obtain the health services they need, when and where they need them, without facing financial hardship."   "The report makes clear that if we are serious not just about better health outcomes, but also about ending poverty, we must urgently scale up our efforts on universal health coverage".   "Investments in health, and more generally investments in people, are critical to build human capital and enable sustainable and inclusive economic growth. But the system is broken: we need a fundamental shift in the way we mobilize resources for health and human capital, especially at the country level. We need to help countries spend more and more effectively on people, and increase their progress towards universal health coverage."   There is some good news: The report shows that the 21st century has seen an increase in the number of people able to obtain some key health services, such as immunization and family planning, as well as antiretroviral treatment for HIV and insecticide-treated bed nets to prevent malaria. Progress, however, is very uneven.   There are wide gaps in the availability of services in Sub-Saharan Africa and Southern Asia. In other regions, basic health care services such as family planning and infant immunization are becoming more available, but lack of financial protection means increasing financial distress for families as they pay for these services out of their own pockets.   This is even a challenge in more affluent regions such as Eastern Asia, Latin America and Europe, where a growing number of people are spending at least 10 percent of their household budgets on out-of-pocket health expenses.   Inequalities in health services are seen not just between, but also within countries: national averages can mask low levels of health service coverage in disadvantaged population groups.   For example, only 17 percent of mothers and children in the poorest fifth of households in low and lower-middle income countries received at least six of seven basic maternal and child health interventions, compared to 74 percent for the wealthiest fifth of households.   It is the poorest and most vulnerable people who are routinely forced to choose between healthcare and other necessities for their household, including food and education.   Researchers found that more than 122 million people around the world are forced to live on $3.10 a day, the benchmark for so-called 'moderate poverty', due to healthcare expenditure. Since 2000, this number has increased by 1.5% a year.   Universal health coverage is a key target of the UN sustainable development goals and without a solid commitment from governments this target is out of reach.   'Every country has the resources available to them if they prioritise. This is why we want to see a much greater focus on primary healthcare because it is the poorest who are losing out', said Oxfam's health policy adviser, Anna Marriott.   'Too much funding is going for tertiary hospitals in urban areas that tend to benefit the better off more than the poor, and yet rural areas are neglected, with people left to fend for themselves'.   'We absolutely need a commitment to address inequality in health. You are almost four times as likely to get the essential package of healthcare if you are rich'.   "Without health care, how can children reach their full potential? And without a healthy, productive population, how can societies realize their aspirations?" said UNICEF Executive Director Anthony Lake.   "Universal health coverage can help level the playing field for children today, in turn helping them break intergenerational cycles of poverty and poor health tomorrow."   According to the report, Asia has the highest rate globally of those pushed below the poverty line due to out-of-pocket health costs. An estimated 72% of those spending 25% of their household budgets on healthcare live in Asia.   Africa has seen the fastest increase in the numbers of people who spent at least 10% of their budgets on healthcare.   http://www.who.int/health-topics/universal-health-coverage http://bit.ly/2BoaB00 http://bit.ly/2T1ssCk http://oxfamapps.org/fp2p/i-want-to-convince-you-about-the-importance-of-universal-healthcare-should-i-talk-about-numbers-or-peoples-lives/ http://www.msf.org/en/article/health-policies-must-focus-needs-individuals   Universal health coverage is a human right, says Tedros Adhanom Ghebreyesus from the World Health Organization.   For me, the key question of universal health coverage is an ethical one. Do we want our fellow citizens to die because they are poor? Or millions of families impoverished by catastrophic health expenditures because they lack financial risk protection? Universal health coverage is a human right.   At least 400 million people have no access to essential health services, and 40% of the world's population lack social protection.   Think about the human reality behind these numbers: the young mother who dies in childbirth in a fragile state because she lacks access to health care; a young child dropping out of school due to family impoverishment caused by health expenses; and an adult living in inner city of a middle-income country suffering from chronic non-communicable diseases and not getting treatment.   I know from personal experience that it is possible for all countries to achieve universal health coverage, including key public health interventions.   Even at low levels of national income, countries can make progress. Many countries at different levels of economic development have achieved universal health coverage, showing this to be more a political than an economic challenge.   The world has agreed on universal health coverage. Sustainable Development Goal 3.8 sets the following target by 2030: achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality, and affordable essential medicines and vaccines for all.   Universal health coverage is ultimately a political choice. It is the responsibility of every country and national government to pursue it.   Universal health coverage includes not just heath care but also health promotion and prevention and a broader public health approach. A strong primary health care platform with integrated community engagement within the health system is the backbone of universal health coverage.   Universal health coverage and health emergencies are cousins; two sides of the same coin. Strengthening health systems is the best way to safeguard against health crises.   Outbreaks are inevitable, but epidemics are not. Strong health systems are our best defence to prevent disease outbreaks from becoming epidemics.   Universal health coverage is not an end in itself: its goal is to improve the other health-related Sustainable Development Goals. Let's make universal health coverage a reality for many more people.   http://sdg.iisd.org/news/lancet-commission-stresses-need-for-high-quality-health-systems-for-sdgs/ http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31668-4/fulltext   Nov. 2017   Pneumonia: No infectious disease claims the lives of more children. (Save the Children)   The headline statistics on pneumonia point to a global epidemic. The disease claimed 920,000 young lives in 2015. That represents two fatalities every minute of every day, more than diarrhoea, malaria and measles combined.   Most of the deaths happen in South Asia and sub-Saharan Africa. Over 80% occur among children aged less than two years old, many of them in the first weeks of life.   What the statistics cannot capture is the suffering and distress associated with pneumonia. This is a disease that leaves desperately vulnerable children fighting for breath, and their parents coping with anxiety and, all too often, the distress, grief and trauma that comes with loss.   Pneumonia deaths are falling more slowly than other major causes of child mortality. New research presented in this report shows that, on the current trajectory of progress, there will still be 735,000 pneumonia deaths in 2030.   This is the target date set for the Sustainable Development Goals (SDGs), which include a collective pledge 'to end preventable child deaths'.   Reducing pneumonia deaths to a level of less than 3/1,000 live births, as envisaged by UNICEF and the World Health Organization (WHO) in their Global Action Plan for Pneumonia and Diarrhoea (GAPPD), would put the world on track for the SDG target.   However, analysis in this report shows only four out of 30 high burden countries are on course to reach this target by 2030. Another 17 - including the Democratic Republic of Congo, Nigeria and Pakistan, which have some of the highest numbers of pneumonia deaths, will not achieve the target until after 2050.   These trends do not define destiny. Other futures are possible. Based on modelling carried out by Johns Hopkins University, we chart a plausible path towards a world where pneumonia deaths are reduced to levels compatible with the SDG commitment.   The 2030 target scenario trajectory would save a cumulative total of 5.3 million lives from pneumonia over the next 15 years. Almost 1 million would be saved over the next five years.   Many more lives would be saved as a result of benefits in treating diseases that typically accompany pneumonia, including malnutrition and diarrhoea. We estimate the average annual cost of the interventions required at $4.5bn.   Every pneumonia death is one too many. The disease is eminently preventable and treatable. Effective vaccines are available for immunisation against the most common bacterial strains. Diagnosed accurately and early, pneumonia can be treated with a 3-5 day course of antibiotics costing just $0.40.   Severe and complex cases require referral to facilities equipped to deliver more intensive care. But even here the vast majority of lives can be saved, as they are in rich countries.   Children die from pneumonia because they are denied the benefits of prevention, accurate diagnosis and treatment.   Support from Gavi, the Vaccine Alliance, has expanded coverage of the pneumococcal conjugate vaccine (PCV), saving many lives. But 170 million children aged 0-2 years in low and middle-income countries are not immunised against the world's deadliest disease.   When pneumonia strikes, far too many children are denied access to care. Around 40 million episodes of the disease go untreated each year, placing lives at risk. In sub-Saharan Africa, less than half of children with symptoms are taken to a health care provider.   Reaching a health facility is no guarantee of effective treatment. Inaccurate diagnosis, shortages of frontline antibiotics, and weak referral systems combine to claim lives that could be saved.   Surveys of essential medicine availability show that fewer than 60% of facilities in Tanzania, Kenya, the Democratic Republic of Congo and Mauritania have Amoxicillin DT available, the most effective frontline treatment, falling to less than one-quarter in Nepal and Uganda.   http://reliefweb.int/report/world/fighting-breath-call-action-childhood-pneumonia http://www.savethechildren.org.uk/content/dam/global/reports/health-and-nutrition/fighting-for-breath-low-res.pdf (70pp) Visit the related web page
	Alarming lack of funding for emergency assistance by Jan Egeland Secretary General, Norwegian Refugee Council   Halfway into the year, less than 1/3 of the needs for funding for emergency assistance across the world has been covered.   'The funding gap will claim lives that could have been easily spared if there was enough will among the many wealthy nations, corporations and individuals around the world', warned Secretary General of the Norwegian Refugee Council Jan Egeland.   Every year the UN and humanitarian partners present response plans for the world's largest humanitarian crises. In total, they have appealed for $23.1 billion in 2017 to provide the most basic assistance to people in need. Six months into the year more than $15 billions are still missing.   'The money lacking equals only $2 per person in the world. Some of the world's richest individuals could have covered the gap on their own. Many countries can afford to take the entire bill. That makes it incomprehensible and outrageous that the world jointly is unwilling to provide sufficient assistance', said Egeland.   It is particularly hard to get necessary support to people in neglected crises. The appeals for funding to DR Congo, Sudan, Chad, Cameroon and Mali are all less than 25 per cent covered.   'As a result of lack of funding, many families have had their food rations cut and get no clean drinking water. Many children affected by emergencies have no school and no shelter', said Egeland.   Large unchecked conflicts, historically high displacement figures, droughts and four potential famines have resulted in extraordinary humanitarian needs.   The Norwegian Refugee Council calls on donor countries in Europe, the Americas, Asia and the Gulf region to increase their humanitarian funding, and to prepare for great needs for humanitarian assistance also in the year to come.   'The devastating human costs will continue to increase and destabilise entire regions if we do not act now. In addition to the traditional donors, large and growing economies in Asia and elsewhere need to show more generosity', said Egeland.   The cost of late response to humanitarian crises, by Jan Egeland & Courtenay Cabot. (Norwegian Refugee Council)   The international humanitarian community is trapped in a state of perpetual crisis management. Natural disasters and conflict placed 155 million people at risk in 2015. The humanitarian aid required to respond to these crises reached an unparalleled $28 billion, a six-fold increase from ten years ago.   Despite increasing funding to crises, unprecedented growth in humanitarian need has outrun the capacity of the system to respond; only half of the funding required to meet humanitarian needs was actually provided last year. As a result, an upsurge in funding towards peaks of crises is holding humanitarian action in a cycle of escalating costs and late response.   The irony is that we know where these crises are and where humanitarian aid is needed most. Two-thirds of humanitarian assistance in 2014 went to long term recipients, people who had been receiving assistance for eight years or more. We have time to plan and act early, rather than waiting for the peak of a crisis.   Even more so, mounting evidence suggests that we could save billions of dollars by responding earlier. When aid is provided at the peak of a crisis, food and other goods have escalated in price, and life-saving aid is occasionally airlifted at vast expense.   A recent study on this year's drought in Ethiopia, which affected over 18 million people, estimates that late response cost donors an additional $127 million for food aid alone. This funding could have provided a nine-month food package to 1.4 million people in need of lifesaving support.   At a global level, evidence from the United Nations World Food Program suggests that early procurement of food would cut its costs by approximately one-third. Applying this estimate to the approximate $8 billion that is spent on procurement and transport of food aid each year suggests cost savings could be upwards of $2 billion.   The Norwegian Refugee Council (NRC) works in some of the toughest humanitarian crises, where security risks can make it almost impossible to reach those in need.   NRC, along with other humanitarian organizations, has been increasingly using cash as a means of assisting those in need. Such innovations open up the ability to provide a timely response even in the most challenging of circumstances.   Unfortunately, by the time the rest of the world has become sufficiently agitated to address a crisis, a lot of the damage has already been done.   Private individual donors - you and me - gave $19 billion to humanitarian crises over the last five years. We readily respond to sudden onset emergencies, floods and earthquakes that are newsworthy, the so-called CNN Effect. But we give far less to ongoing crises.   World Vision Australia, for example, raised more in one week for the Nepal earthquake than it managed to raise in four years for its Syria response.   By the time the international media finally catapults a crisis to the top of the headlines, the opportunity for timely response has long passed.   In Northeast Nigeria, the humanitarian community is currently scaling up its response to the Lake Chad crisis, seven years after the conflict began. During that time, basic needs in some areas have moved from critical to catastrophic, and lack of food in particular is not only a threat in itself, but is leading many to use harmful coping mechanisms which create new additional problems.   Our collective inaction is crippling our ability to cope with unprecedented need. And yet the evidence is clear that our dollars could help many more people, and actually avert suffering, if we invested more in prevention and anticipatory action.   The cost savings from timely response are only the tip of the iceberg. Humanitarian aid that is released at the first signs of an impending crisis can release a cascade of positive outcomes.   When response comes late, farmers are forced to consume their food stores and sell off the last of their animals and assets. With an earlier response, farmers can save some seeds for planting, and keep their best animals to bear offspring and provide the family with milk and meat, critical for maintaining nutrition.   When response comes late, families trek miles, up to 10 hours per day, to find clean water. Or worse, they go without, and suffer from water-borne illnesses that can take the lives of those most vulnerable, particularly children.   With an earlier response, families can stay near the homestead, and dedicate their time to other pressing needs that can help them to cope with the crisis.   In the face of conflict, timely humanitarian response is vital to protect those most vulnerable and caught in the cross-fire, and can mean the difference between life and death.   When assistance levels don't meet the needs of those who need it most, children are less likely to go to school, and people begin to migrate to find a better life, putting themselves and their families at risk.   The primary objective of humanitarian aid is to save lives, alleviate suffering, and maintain human dignity. We can better fulfill this mandate, but it requires a shift in the way that we all respond to crises.   Another busy year, by Jan Egeland. (NRC)   "The past year has been a busy one for all of us working to protect refugees and displaced, but I am afraid that the year to come will be even more challenging," says Jan Egeland, the Secretary General of the Norwegian Refugee Council. Still, he remains an optimist and continues believing in the good of people.   Looking back on the last 12 months, he describes the state of aid at the end of 2016:   "I would say that aid is struggling at the end of 2016. We have failed too many. But we have also been a lifeline to more people than probably any time before in human history. We are now providing relief as humanitarians to tens of million of people."   The Norwegian Refugee Council alone reached between 5 and 6 million people.   "More refugees than there are inhabitants in Norway were reached. So we have to really understand that there were too many we could neither protect nor assist. But we also must remember that we were able to save a lot of people. That is one of the things I will carry with me into 2017," says Egeland.   Egeland believes the same disastrous and comprehensive crises that we have experienced in 2016 will continue making headlines and keeping humanitarian workers busy in the year to come. He refers to a list of ten countries that will have the biggest needs for humanitarian aid in 2017, published by The Assessment Capacities Project (ACAPS) in Geneva.   The ten countries are: Afghanistan, Central African Republic (CAR), The Democratic Republic of Congo (DRC), Iraq, Libya, Nigeria, Somalia, South Sudan, Syria and Yemen: http://bit.ly/2gpV7QC   The wars in Syria and Iraq will continue to create enormous humanitarian suffering in 2017. Egeland is also concerned about three countries heading in the wrong direction.   "Beyond Syria and Iraq that are full blown wars with a lot of attention, I am worried about the following three countries: Yemen, that may fall in into the abyss of famine. A kind of biblical famine that we have not seen for many, many years," says Egeland.   Nigeria is the second case of a looming disaster, and Egeland explains: "This is because so many people are not receiving assistance, because there are too little resources in north-eastern Nigeria, where so many millions have been hit by terror and conflict, and there is so little access for humanitarians that are on the ground."   "The third crisis is South Sudan, where this colossal failure by the men with power has led to one civil war after the other. This is really tearing this young nation to pieces, and making it impossible for humanitarians to do our jobs. All of these are all manmade crisis from A to Z. Man can change it in 2017, for the better."   "We have to do more in assistance to people who are in harms way, in Syria, in Afghanistan, in Yemen and in all of the other places, so that they don't have to flee. We have to invest more in hope to all of the tens of millions of refugees."   The six richest countries in the world host less than 9 percent of refugees. Egeland has a clear message to the leaders of the world's richest countries:   "I think that the world's richest countries, and also the whole host of second richest countries, must understand how unbalanced the responsibilities and the burdens of the international community would be, when tiny, poor Lebanon hosts more refugees than most big and rich countries" he says.   According to Egeland, they then should understand that they have to do three things:   "First, invest much more in the ability to assist and protect refugees as close as possible to their homes. Second, enable us to prepare refugees with education, vocational training and other assistance, to return where it is possible. Third, receive refugees to your countries, through a quota system and through asylum seeking. How come we let so many people be trapped within Syria, or within the neighbouring countries, some of them filled to the brim. It will only harvest hopelessness."   Egeland thinks we should not be overwhelmed by all the crises and says that all people can do something to help.   "Ordinary people can help us help refugees and displaced people to help themselves, by becoming regular sponsors of our work. A small sum every single month like I do myself, my mother, my sister, my brother does.   It helps us provide education to children, which means hope not only for the child, but for her parents and grandparents as well. It means that there is hope for communities to rebuild and return. We need funding and we need support from ordinary people. In the political debate there is too much xenophobia, there is too much nationalism, there is too much inwards looking."   "I believe in the good of people because every single day I see courageous humanitarian field workers at times risking their lives to help people so they can help themselves.   I see the energy, the resourcefulness, of the people we assist. They are like you and me. They want to return to their lives. They just need temporary help from us to return to their lives. It is within our means to help them. That gives me hope for the good in mankind that we have many sponsors that help us.. help so many people".   http://www.nrc.no/latest-news/ Visit the related web page
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