As I prepare to attend the 75th World Health Assembly in Geneva next week, I am struck by the remarkable fact that this will be the first Assembly since 2019 where we are able to meet in person to address some of the most pressing challenges in global health that we face today.
Over the last two years the COVID-19 pandemic has disrupted the global order – demonstrating how rapidly weaknesses in our health systems can impact our health, our economy, our social cohesion, and our trust in institutions. Health systems around the world have been more stretched than ever as they work to respond to COVID-19 cases, deliver the tools necessary to end the acute phase of the pandemic and maintain the delivery of essential health and nutrition services that meet the day-to-day needs of our communities. For families around the world the closure of birthing facilities, childhood vaccinations programmes, family planning services, nutrition and mental health services have left women and children at increased risk of preventable illnesses. In 2020, 23 million children missed out on life-saving childhood vaccines, the highest number since 2009 and a major backslide in immunisation rates, putting them at increased risk of potentially fatal diseases like pneumonia, polio and measles.
COVID-19 leaves a legacy of widening inequality, but for many of the countries in which Save the Children work, COVID-19 is not the only factor. Ongoing conflict and the effects of climate change have pushed many towards acute hunger and malnutrition. In 2020, 45 million children under five were acutely malnourished. By the end of 2022, it’s feared the number of acutely malnourished children could surge by up to 13.6 million. For millions already struggling to cope with the impacts of COVID-19, the hunger crisis we’re seeing play out is yet another shock which increases the vulnerability of children and families around the world.
BACK TO BASICS: THE VALUE OF STRONG HEALTH SYSTEMS
For Save the Children, the last two years have pushed us to redouble our efforts to ensure that we reach children most impacted by inequalities and discrimination with the lifesaving interventions and health services they need. In Nigeria and Kenya, we have trained and equipped over 2,000 community health workers to better support mothers through safe delivery with a skilled birth attendant. In Ethiopia, we have worked with partners to strengthen immunisation coverage by training health workers, expanding vaccine outreach programmes and equipping immunisation facilities, reaching over 350,000 children with routine immunisation services.
We also continue to advocate and campaign for the introduction of critical vaccines into national immunisation schedules to fight high burden diseases like pneumonia and diarrhoea, which account for 23% of all deaths in children under the age of five. These diseases disproportionally affect poor children, often living in fragile or humanitarian settings, who face multiple deprivations and risks, including food insecurity and lack of access to quality health care, safe water, and sanitation. Investment and progress to reduce child deaths from pneumonia and diarrhoea are crucial for countries to achieve the Sustainable Development Goal (SDG) target for child survival of less than 25 deaths of children under five per 1,000 live births.
Our Emergency Health Unit has made 40+ deployments since 2019, responding to humanitarian needs of communities, including Cox’s Bazar, Somalia, Yemen, and Democratic Republic of Congo and reaching over 2 million children with lifesaving interventions. Last year, we responded to 103 humanitarian crises in 61 countries. The COVID-19 pandemic has also shone a light onto the critical role of oxygen as an essential medicine and a vital part of strong health systems. Every year, at least 7.2 million with pneumonia enter hospitals in low-and-middle-income countries (LMICs) needing medical oxygen to survive. In partnership with the Every Breath Counts coalition, we worked to mitigate global deficits in medical oxygen, exacerbated by the pandemic. We have joined new initiatives like the ACT-A Oxygen Emergency Taskforce, launched to help poorer countries secure oxygen supplies and technical support to avert oxygen shortages and related deaths. This massive investment in oxygen will also benefit other patient populations, especially newborns and children, providing the new oxygen equipment is available in paediatric wards and NICUs and paediatric staff are trained to operate and maintain it.
For the countries that fared better throughout the pandemic a well-resourced, integrated health system equipped to deliver to people the care they need, when they need it has been a crucial armoury. Coupled with the glaring evidence from the pandemic that we are all so closely connected, this should be a bold warning to donors who are seemingly rolling back aid contributions to maternal, newborn and child health in the poorest regions at a time when families need the greatest support.
COLLECTIVE ACTION TO REDEFINE OUR FUTURE
As world leaders, delegates and global health partners arrive at the World Health Assembly next week, high on the agenda is the need to strengthen global preparedness and response, to help protect populations from future health threats. Global health leaders have set out interesting proposals to prevent the next pandemic. Key to this is much better global collaboration and evidence-based approaches. To that, I’d also add that we need to double down on equitable and resilient health systems that actively contribute to the prevention of infectious diseases and are resilient enough to continue providing – and expand access to – essential health services during health emergencies. We must prioritise communities and children by building strong primary healthcare systems and integrate preparedness initiatives into community-based health service delivery and engagement.
All efforts to strengthen our health systems must focus on child survival – ensuring that children all over the world have a healthy start to life. Current trends indicate that 54 countries will not meet the SDG targets on under-five mortality and 43 million under-five deaths are projected to occur between 2021 and 2030. We must act now to reverse these losses. Key to this, is the need for greater and more sustainable investments in health and nutrition and strong partnerships. Without adequate and sustained investments in good health and nutrition, the SDGs will not be realised.
The last few years have shown us how intrinsically linked we all are. Conflicts can impact global food and fuel prices. The outbreak of an infectious disease in one part of the world can impact the safe birth of a baby in another. But all is not lost. The astonishingly rapid development of COVID-19 vaccines within a single year also proved that when there is an unprecedented need and the universal will, the global community can come together, invest adequate resources, and respond quickly.
Two years on from the start of the pandemic, we find ourselves at a fork in the road– do we return to the status quo or drive forward, ever more ambitious to realise a healthier world?
photo: Children at a reading club in Mindanao, the Philippines (Hanna Adcock/Save the Children)
What next for global health?