The Life-or-Death Lottery: inequality and injustice in the fight to save children's lives

A major new report from Save the Children today reveals the best and worst performers in the fight to keep children in the world's poorest countries alive.

Monday 18 February 2008

The report contains a new 'Wealth and Survival Index' which compares child mortality in a country to its national income per person. It shows who is making the most of what they have and who is squandering their resources. The index states how many children's lives the worst performing countries should be expected to save each year, given their national wealth.

Save the Children's director of policy, David Mepham said: "A child's chance of making it to its fifth birthday depends on the country or community it is born into. This sounds like a lottery, something beyond human control, but this should not be the case. While poverty and inequality are consistent underlying causes of child deaths, all countries, even the poorest, can cut child mortality if they pursue the right policies and prioritise their poorest families. Good government choices save children's lives but bad ones are a death sentence."

The index shows that:

  • Bangladesh is a success story. In 1998 the government put its resources and its political weight behind a national initiative to tackle childhood illness and reduce levels of fertility. Ten years later that policy decision has paid off. Bangladesh, despite its relatively low Gross National Income (GNI), is one of the few countries on track to meet the child survival Millennium Development Goal - to reduce the number of children dying before their fifth birthday by two-thirds by 2015

  • oil-rich Angola comes bottom for failing to convert its relatively high income into a real difference to the number of child deaths. With nearly three times the income of next-on-the-list Sierra Leone, the most recent data for Angola shows that it has only a slightly lower under-five mortality rate. Save the Children states that Angola's child mortality rate of 260 per 1,000 is 162 higher than would be predicted for the size of the country's economy

  • sub-Saharan Africa, which is home to 19 of the worst performing countries but which has economic growth almost three times that of the global average, should be learning more from countries that are making progress, like Malawi and Tanzania 

  • some countries are better at translating their economic growth into saving children's lives. For example, between 2000 and 2006 Bangladesh's GNI per capita grew 23%, and its child mortality rate dropped by 25%. Whereas India's GNI per capita increased by 82% but its child mortality rate only declined by 19%.

Today marks the launch of Save the Children's biggest ever campaign to get the Millennium Development Goal on child survival on track. We want 10 million people to take action by 2010 for the 10 million children who die every year, and it is crucial to see the action start in 2008 if we are to have any hope of saving millions of children's lives.
 
David Mepham said: "Change is possible. This report shows what can and must be done to help save children's lives. If we want to get the world on track to deliver the goals, we need to maximise the big opportunities of 2008 like the G8 in July and the UN General Assembly in September."

Save the Children is calling on developing country governments and international donors to:
  • invest in free healthcare, clean water and sanitation, support for women's education and action against poverty 
  • convene a global summit on child and maternal hunger bringing together governments, international institutions, the private sector and civil society to inspire action
  • agree clear targets focused on the impact of their policies on maternal and child health and nutrition. It is impossible to make progress without facts, openness and clarity
  • tackle inequality as part of the Millennium Development Goals by including a target of halving the gap in child mortality between the richest and poorest 20%.

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