Nine million deaths ‘greatest child rights violation of our time’

Nine million deaths ‘greatest child rights violation of our time’

November saw the 20th anniversary of the UN Convention on the Rights of the Child. Here, John Githongo writes why thousands of children dying is the biggest child rights violation of our time.

Travelling in the heart of Kenya’s Rift Valley that was epicenter of some of the most fierce violence following the failed election in 2007 a woman told me: “What has happened here has cursed us; we saw people killing each other and murdering even children – little angels who have no tribe and belong to no political party.”

Twenty years ago, the United Nations Convention on the Rights of the Child was born; the first binding international instrument to recognise and realise the full range of human rights – civil, cultural, economic, political and social – for children.

And this week (20th November), on its twentieth birthday, more than 168,000 children across the world will die, deprived of the most basic right of all – survival.

As a recent report from World Vision for the launch of its Child Health Now campaign argues, this is the greatest child rights violation of our time.

Preventable causes

The reasons why almost nine million children a year still dying before their fifth birthday – the vast majority from easily preventable causes such as pneumonia, diarrhoea and malaria – are complex. But underlying the failure to make good on the Convention on the Rights of the Child lies a fundamental mismatch between where the nature of the problem and where governments are directing their efforts.

To achieve the UN goal of cutting child deaths by two thirds between 1990 and 2015, we must see a rebalancing of the global approach to child health.

Much greater emphasis must be placed on low-cost, proven preventive measures that make a lasting difference – the provision of oral rehydration for cases of diarrhoea, treated bed nets to prevent malaria, and exclusive breast feeding to improve survival chances could save 16,000 children daily.

More donor funding is needed but urgent action is also required by national governments and the international community to address the gross inequity that characterises healthcare in many developing countries.

It is in these countries that 99 per cent of under-five child deaths occur, and where funding must reach those in greatest need.

Healthcare desert

More than 270 million of the world’s poorest children live in a healthcare desert, lacking access to even the most basic services.

In a number of countries, including my own homeland, Kenya, the situation is deteriorating when it comes to the fight to reduce preventable child deaths – we have seen a 25 per cent increase in child mortality since 2000.

This is despite Kenya being the richest nation in the region and considerable investment in the infrastructure of health.

Several things have caused this that are not unique to Kenya and point to a global trend in many poor countries that needs to be checked.

In these nations, the national budget is heavily skewed towards a formal medical system that doesn’t reach children in rural areas or those who live in teeming slums, who often die from simple causes. Political difficulties have compounded the challenges.

The 200,000 children under five who die each year in Kenya are not high on either the government or donors’ agenda.

In too many countries very little of the government’s health spend is reaching the poorest and most vulnerable. The cost of these inequalities are generational in the scale of their impact. And yet there would appear to be a silent emergency of needless child deaths that is being met with fatal indifference by those with the power to effect change.

Fees
 
It doesn’t have to be this way, however. Malawi is one source of optimisim. The country has reduced its child mortality from one in five children each year to one in ten, despite having one of the lowest GDPs in the world.

Zambia is another. Since it abolished fees for healthcare in 2006, health service use has increased by 50 per cent.

And Tanzania has achieved a 10 per cent decrease in child mortality year on year since increasing its health budget in 1998 and focusing on immunisation and bed net provision in communities.

To cut child deaths by two-thirds by 2015, every country currently off-target must adopt a clear, costed and time-bound plan to reduce mortality rates. These plans must include, but go beyond, continued focus on formal health systems and single-disease initiatives. The wider international community has a duty of care to support national efforts, and ensure no health plan is allowed to fail for lack of resources.

This is not only a moral necessity but the most important investment we can make in our collective future.

John Githongo is a former journalist and anti-corruption campaigner. He is trustee of the Zinduko Trust and head of Twaweza Kenya, as well as special adviser to World Vision.