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Levels and Trends in Child Mortality: Report 2017
by Unicef, Inter-Agency Group for Child Mortality
Oct. 2017
Every day in 2016, 15,000 children died before their fifth birthday, 46 per cent of them – or 7,000 babies – died in the first 28 days of life, according to a new UN report.
Levels and Trends in Child Mortality 2017, reveals that although the number of children dying before the age of five is at a new low– 5.6 million in 2016, compared with nearly 9.9 million in 2000 – the proportion of under-five deaths in the newborn period has increased from 41 per cent to 46 per cent during the same period.
“The lives of 50 million children under-five have been saved since 2000, a testament to the serious commitment by governments and development partners to tackle preventable child deaths,” said UNICEF Chief of Health, Stefan Swartling Peterson.
“But unless we do more to stop babies from dying the day they are born, or days after their birth, this progress will remain incomplete. We have the knowledge and technologies that are required – we just need to take them where they are most needed.”
At current trends, 60 million children will die before their fifth birthday between 2017 and 2030, half of them newborns, according to the report released by UNICEF, the World Health Organization, and the Inter-agency Group for Child Mortality Estimation (IGME).
Most newborn deaths occurred in two regions: Southern Asia (39 per cent) and sub-Saharan Africa (38 per cent). Five countries accounted for half of all new-born deaths: India (24 per cent), Pakistan (10 per cent), Nigeria (9 per cent), the Democratic Republic of the Congo (4 per cent) and Ethiopia (3 per cent).
“To achieve universal health coverage and ensure more newborns survive and thrive, we must serve marginalized families," says Dr Flavia Bustreo, Assistant Director-General for Family, Women’s and Children’s Health at WHO. "To prevent illness, families require financial power, their voices to be heard and access to quality care. Improving quality of services and timely care during and after childbirth must be prioritized.”
The report notes that many lives can be saved if global inequities are reduced. If all countries achieved the average mortality of high-income countries, 87 per cent of under-five deaths could have been averted and almost 5 million lives could have been saved in 2016.
Pneumonia and diarrhea top the list of infectious diseases which claim the lives of millions of children under-five globally, accounting for 16 per cent and 8 per cent of deaths, respectively. Preterm birth complications and complications during labour or child birth were the causes of 30 per cent of newborn deaths in 2016. In addition to the 5.6 million under-5 deaths, 2.6 million babies are stillborn each year, the majority of which could be prevented.
Ending preventable child deaths can be achieved by improving access to skilled health-professionals during pregnancy and at the time of birth; lifesaving interventions, such as immunization, breastfeeding and inexpensive medicines; and increasing access to water and sanitation, that are currently beyond the reach of the world’s poorest communities.
For the first time, mortality data for older children age 5 to 14 was included in the report, capturing other causes of death such as accidents and injuries. Approximately 1 million children aged 5 to 14 died in 2016.
“This new report highlights the significant progress since 2000 in reducing mortality among children under age 5. Despite this progress, large disparities in child survival still exist across regions and countries, especially in sub-Saharan Africa. Yet many deaths at these ages are easily preventable through simple, cost-effective interventions administered before, during and immediately after birth.
Reducing inequities and reaching the most vulnerable newborns, children and mothers are essential for achieving the SDG target on ending preventable childhood deaths and for ensuring that no one will be left behind.”
The report also notes that:
• In sub-Saharan Africa, estimates show that 1 child in 36 dies in the first month, while in the world’s high income countries, the ratio is 1 in 333.
• Unless the rate of progress improves, more than 60 countries will miss the UN Sustainable Development Goal (SDG) to end preventable deaths of newborns by 2030 and half would not meet the target of 12 neonatal deaths per 1,000 live births by 2050.
The data reveals that the rate of newborn deaths is not decreasing as quickly as that of children aged one to five. As a result, newborns account for a growing proportion of child deaths with each passing year. Newborn deaths made up 46 per cent of all child deaths, an increase from 41 per cent in 2000. Most of these deaths are entirely preventable.
Prematurity, complications during labour and birth, and infections like sepsis, pneumonia, tetanus and diarrhoea are among the leading causes – all of which can be treated or prevented with simple, affordable solutions.
But these children are also dying because of who they are and the environment they were born into – whether it be an impoverished family, a marginalized community or a country consumed by conflict.
Of all society’s injustices, this is perhaps the greatest: Children in the poorest households are nearly twice as likely to die before the age of five than those from the richest.
The good news is that ending preventable newborn and child deaths is possible – within our lifetime. With a concerted, coordinated effort among policymakers, businesses, healthcare workers, communities and families, we can work together to provide affordable, quality healthcare for every mother and child.
The risk of dying for a child born in the highest mortality country is about 60 times higher than in the lowest mortality country. All six countries with mortality rates above 100 deaths per 1,000 live births are in sub-Saharan Africa.
Ending newborn and child deaths from preventable infectious diseases is critical. Despite strong advances in fighting childhood illnesses, infectious diseases – which are most often diseases of the poor and thus are a marker of equity – remain highly prevalent, particularly in sub-Saharan Africa and South Asia.
Pneumonia, diarrhoea and malaria remain among the leading causes of death among children under age 5 – accounting for almost a third of global under-five deaths and about 40 per cent of under-five deaths in sub-Saharan Africa.
July 2017
Narrowing the Gaps: The power of investing in the poorest children
From inadequate healthcare and nutrition to vulnerability to infectious diseases, children living in poor communities face inequities every day. But perhaps the most fundamental injustice is this: Children growing up in poverty are nearly twice as likely to die before reaching their fifth birthday as children living in better circumstances. An unconscionable majority of them die unnecessarily.
With practical, low-cost and high-impact interventions like treated mosquito nets, immunizations, rehydration salts or breastfeeding, most of these deaths could be prevented.
The new UNICEF report Narrowing the Gaps: The power of investing in the poorest children, reveals that investing in the health and survival of the most deprived children is not only right in principle, it is also cost-effective.
The report presents compelling evidence that investments in children living in the poorest communities save almost twice as many lives per US$1 million as equivalent investments in non-poor communities. Drawing on new data from 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 nearly three times faster than among non-poor groups.
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. Unless the world makes greater progress in reducing child mortality, by 2030 almost 70 million children will die before reaching their fifth birthday.

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States must act now to fulfil famine victims’ right to food
by Hilal Elver
Special Rapporteur on the right to food
October 2017
The tragic reality of famine around the world has revealed that many States are failing to uphold their legal responsibilities, the UN Special Rapporteur on the right to food, Hilal Elver, told the UN General Assembly in New York today.
She also called for an urgent shift in thinking away from crisis reactions and toward famine prevention.
“Contrary to popular belief, casualties resulting directly from combat usually make up only a small proportion of deaths in conflict zones, with most individuals in fact perishing from hunger and disease,” Ms. Elver said in her annual report to the General Assembly.
The Special Rapporteur said that this year the world has faced the largest humanitarian crisis since the creation of the United Nations. Around 20 million people have faced famine and “devastating” starvation in crises in north-east Nigeria, Somalia, South Sudan, Syria and Yemen, all of which had arisen from conflict.
Another estimated 70 million people in 45 countries currently require emergency food assistance, an increase of 40 per cent from 2015, she said, also highlighting the serious starvation and severe right to food violations currently affecting the Rohingya people.
Ms. Elver hailed the “essential” work of the international humanitarian system in getting food to conflict victims and lowering death tolls.
But she said States and other parties involved in conflicts needed to recognize their own duty to act, and above all, avoid using hunger as a weapon of war. The right to food is an unconditional human right and legal entitlement for all people, not a discretionary option, she stressed.
“The human right to adequate food is a core right, indispensable for the enjoyment of all other human rights,” Ms Elver stated. “Freedom from hunger is accepted as part of customary international law, rendering it binding on all States.
“It is crucial that the international community understands that it is an international crime to intentionally block access to food, food aid, and to destroy production of food. Such acts as crimes against humanity, or war crimes.”
She added that the most serious cases should be referred to the International Criminal Court for investigation and possible prosecution.
“If the international community is serious about the imperative character of the right to food and the eradication of food insecurity in times of war and peace, steps must be taken to encourage the implementation of existing standards and to codify international law principles applicable to the right to food,” the expert said.
The Special Rapporteur urged all governments to focus on long-term policies to break the vicious cycle of recurring famines.
“Human rights violations, war crimes, repression and gross forms of inequality are conditions that frequently give rise to famine,” she said. “The attention and commitment of the international community must, as a matter of the highest priority, be directed toward eliminating the root causes of famine, and not limited to ad hoc responses to the agonizing symptoms of the latest food emergency.”

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