As the Child Survival Call to Action nears on 14-15 June in Washington, DC, USAID and MCHIP hosted a discussion on the lessons learned from successful efforts to reduce child mortality in the 1980s. Entitled “Learning from the Child Survival Revolution of the 1980s,” the special event was part of USAID's 50th Anniversary Distinguished Speaker Series and moderated by Robert Clay, Deputy Assistant Administrator of USAID’s Global Health Bureau.
The event brought together Kul Gautam, former Deputy Executive Director of UNICEF, who was instrumental in drafting the Declaration and Plan of Action for the World Summit for children in 1990s; Pamela Johnson, Chief Health Officer and Co-founder of Voxiva; Julia Walsh, associate adjunct professor at the University of California; and Michael H. Merson, Director of Duke University’s Global Health Institute. To continue reductions in child mortality around the globe, the panelists stressed the need for specific, measurable and realistic short-term goals to be pursued aggressively.
During the 1980s, the world experienced a revolution in child survival. Spearheaded by UNICEF’s Executive Director James P. Grant, the revolution aimed to reduce child mortality through four low-cost techniques collectively referred to as GOBI:
‘G’ for growth monitoring;
‘O’ for oral rehydration therapy to treat diarrheal disease;
‘B’ for breastfeeding to ensure proper infant nutrition and encourage birth spacing; and
‘I’ for immunization to prevent tuberculosis, diphtheria, whooping cough, tetanus, polio and measles.
These interventions formed the foundation of the revolution to improve children’s health worldwide.
James Grant’s goal was to dramatically increase the number of children immunized each year. At the start of the decade, less than 20% of children in developing countries were fully immunized. UNICEF was determined to reach an immunization rate of 80% by 1990.
In order to achieve this goal, new and innovative methods of advocacy and outreach were needed. UNICEF expanded its efforts past Ministries of Health to include government officials of all kinds from heads of states to municipal leaders. And in addition to government support, UNICEF sought to include religious leaders and sports and entertainment personalities. As a result, the world rallied around UNICEF’s efforts and it is estimated that the lives of 12 million children were saved by the end of the decade.
Looking back, we can be proud of the progress the world has made in addressing infant and child mortality. However, we must acknowledge that 21,000 children continue to die of preventable causes each day.
Much has changed since the 1980s, particularly in terms of technology. Pamela Johnson remarked that today's technology was unavailable to her and her colleagues during the revolution and that these new tools should be used to their greatest potential today in our fight against child mortality.
However, other aspects of the 1980s revolution, such as reaching out to new partners, are as valuable today as they were then. Kul Gautam pointed out that one of the revolutions strengths was James Grant's refusal to rely on conventional partners alone, and that we must be creative when choosing implementing and funding partners.
The panelists concluded their remarks by agreeing that ending preventable childhood deaths will require greater health equity and an ability to reach the world's most marginalized children, achievements that will necessitate renewed commitment and support the world over.