Over the last few weeks, I’ve been in close contact with Save the Children’s teams in sub-Saharan Africa. As many of you will know, the region has so far escaped the worst effects of the pandemic. There are many uncertainties over whether this picture will change over the weeks and months ahead. However, it is now clear that the secondary effects of COVID-19 are likely to be far more severe than the immediate health effects.
Some of the early warning signs are now very visible. Several of our country offices report a marked dip in attendance at health and nutrition clinics. This is part of a broader picture linked to the disruption of supply chains, the diversion of resources, the absence of health workers, and wider lockdown effects. Modelling by Johns Hopkins University School of Medicine, with whom we partner in our work on pneumonia, has provided us with some indications of the possible effects associated with declining health service utilisation. Briefly summarised, it finds that a 15% decline in demand for routine health services over a six-month period could lead to an additional 250,000 child deaths.
That finding merits far greater attention than it has been getting. The risks it identifies are not abstract scenarios played out on a computer programme. This is about children being left unimmunised, untreated for killer diseases like pneumonia, malaria and sepsis, and without adequate nutrition. I joined with Dr Tedros at the WHO, Henrietta Fore at UNICEF, and Natalia Kanem at UNFPA in highlighting what is at stake and setting out an agenda for action.
Perfect storm conditions
We are now heading into dramatically deteriorating economic conditions. Poverty levels are set to rise for the first time since 1998. Malnutrition is likely to follow suit. These are perfect storm conditions for an unprecedented reversal in human development. Tackling those conditions will require multilateral agencies like the World Bank and the IMF to redefine fiscal and monetary policy for the poorest countries. To their credit, leaders of these institutions have sought to move in the right direction, but too many of the major shareholders are either dragging their feet or obstructing progress. We’ve today supported this call for the G20 to meet and agree a $2.5 trillion coronavirus global health and economic recovery plan.
While the world is now obsessed with the number of ventilators in Africa, few are directing their attention to one of the starkest examples of health inequity I can think of: the appalling lack of access children and women have to even the most rudimentary provision of medical oxygen. Some of you might recall the British Prime Minister emerging from his hospital stay for COVID-19 treatment telling the media his life was saved by ‘litres and litres of oxygen’. Medical oxygen is an essential medicine in the treatment not just of COVID-19, but of diseases and conditions associated with well over half of global child deaths.
This is an opportunity for us to see what a ‘build back better’ agenda in health might look like. We are working with governments in nine countries, several partners, and the Every Breath Counts coalition to promote that agenda.
Reasons to be hopeful
All of our country offices are now implementing pandemic response plans. These are underpinned by our Global Response Plan to prevent, mitigate and respond to the COVID-19 crisis. Our response has four priorities: protecting access to essential health services, safety-nets, education and protection. In order to reach 69 million children and adults by the end of the year, we are targeting US$649m through a mixture of institutional financing and public appeals. Progress to date has been encouraging, but there is a long way to go.
Here in the UK we are scaling up our emergency grants programme targeting some of the poorest families in the country. Looking ahead, our UK team is focused on preventing a ‘great reversal’ on child poverty. Following the 2008/2009 crisis, the burden of austerity fell far too heavily on vulnerable children, as reflected by the subsequent steep increase in child poverty. In effect, children in some of the poorest households were left to pay for the debt accumulated during the crisis response. That cannot happen again. My colleague Kirsty McNeill, Executive Director of Policy, Advocacy and Campaigns, has co-edited and contributed to a brilliant report #OurOtherNationalDebt, challenging policy makers (and all of us) to reflect on who has made the greatest sacrifices during the crisis, and what we can do to protect our most vulnerable citizens.
On a lighter note, some of you may have seen our #SavewithStories campaign. We have been lucky enough to have some wonderful actors, authors, and others read their favourite children’s book. The Duke and Duchess of Sussex (and baby Archie!) participated with a lovely reading of Duck! Rabbit! So far, the story has attracted over one million views on Instagram. If only blogs on oxygen for the World Bank got similar ratings…
It’s more important than ever that we stand together to protect every child. As we call on governments across the globe to protect children during this crisis, we’re asking you to join us in forging an unbreakable chain of solidarity with your families around the world to ensure we are #TogetherEverywhere.
A final thought: like many of you, I’ve been following the events in the US since the killing of George Floyd, and strongly recommend reading this opinion piece in the Los Angeles Times by Kareem Abdul-Jabbar. It’s not just a comment on the US or an individual case: it’s a call to solidarity for all of us, all of the time. Staying silent and ignoring racism is not neutrality but complicity – and Save the Children is committed to ‘cleaning the dust of racism’ wherever it lands, including in our own organisation.