August 2007: Global Child Survival Act

Nearly 28,000 children die every day — more than 10 million per year — most from preventable disease and malnutrition. The real tragedy is that the handful of diseases that kill the majority of these children can be treated and prevented at very low cost; e.g., a measles vaccine costs just 26 cents, and for only 33 cents, a child can receive oral rehydration salts to avert death from diarrheal disease, which results from poor sanitation and unsafe drinking water. Despite the development of cost-effective and proven interventions, the global disparity remains appalling: 90 percent of deaths in children under-five occur in just 42 poor countries.

Enormous progress is possible. U.S. commitments to global child survival efforts contributed to a 50 percent reduction in the under-five child death rate between 1960 and 1990. As we now stand at the halfway point toward the 2015 deadline for achieving the Millennium Development Goals, including MDG #4 — “to reduce the under-five mortality rate by two-thirds” — much more must be done to fulfill our Millennium Promise to the world’s children. In addition, we must remember that progress on the MDGs is interlinked — improving child and maternal heath is linked to overall poverty reduction and broad economic progress; declining child and maternal mortality rates lead to smaller, healthier families, empowered women, and better-educated children.

Passage of the U.S. Commitment to Global Child Survival Act (H.R.2266, S.1418) would be a major step in combating child mortality. The bill calls for yearly increases in funding for child and maternal health interventions: $600 million for FY 2008, $900 million for FY 2009, $1.2 billion for FY 2010, and $1.6 billion for FY 2011 and 2012. The Global Child Survival Act also mandates a comprehensive, integrated, and effective strategy for the U.S. Child Survival efforts, including directing resources to proven interventions (UNICEF, GAVI — see descriptions below), and sets guidelines and mechanisms for the evaluation of the progress made.

In addition to enacting the Global Child Survival Act as a framework for our efforts, Congress can also act immediately to ensure increased funding for child survival interventions in next year’s annual foreign aid spending bill, which will be finalized by the Congress this fall. The Senate 2008 foreign aid spending bill provides $476 million for Child Survival and Maternal Health Programs, roughly $100 million more than in the House bill, and more than $100 million over last year’s level.

Members of Congress should: 1) cosponsor and actively support the passage of the Global Child Survival Act, and 2) speak personally and write to key decision makers on the appropriations subcommittee that oversees the annual foreign aid spending bill to support the Senate’s higher funding level for Child Survival and Maternal Health Programs for 2008.

Write a Letter to Your Representative and/or Senators

Introduce yourself and explain that you are a constituent.
Share your concern that nearly 28,000 children die every day from largely preventable malnutrition and disease in your own voice (share how this makes you feel).
Explain that the U.S. must lead in a concerted global effort to protect children from unnecessary suffering and death.
Ask your legislator to cosponsor the U.S. Commitment to Global Child Survival Act (H.R.2266, S.1418) introduced by Reps. McCollum (D-MN) and Shays (R-CT) and Senators Dodd (D-CT) and Smith (R-OR).
Provide some details about what this legislation would do to increase the authorization for child survival funding and develop an integrated strategy for supporting the improvement of child and maternal health.
Ask them to also weigh in with the key decision makers who oversee the annual foreign aid appropriations (spending) bill and urge support for the Senate’s higher appropriation for Child Survival interventions — $476 million for 2008.
Ask for a reply.

Note: Please fax or e-mail your letter, since postal delivery is delayed by several weeks. Rep. __________; U.S. House of Representatives, Washington, DC 20515 or Sen. _________, U.S. Senate, Washington, DC 20510.

Proven, Cost-Effective Interventions Save Children’s Lives

Proven, cost-effective interventions can save the lives of millions of children each year.

Immunizations still do not reach an estimated 30 million children, despite the global success in reducing deaths and disability from diseases including polio and measles. Measles and tetanus still kill more than 1 million children under five each year.
Vitamin A supplementation costs only 2 cents for each capsule, and given to a child 2–3 times a year, it helps prevent blindness and death. Although vitamin A supplementation saved an estimated 2.3 million lives between 1999 and 2004, only half of young children in poor countries receive it. Between 250,000 and 500,000 children become blind every year due to vitamin A deficiency, with 70 percent dying within 12 months.
Oral Rehydration Therapy (ORT) costs just $0.33 and has helped reduce deaths from diarrheal dehydration by half, saving 1 million lives annually. Yet more than 2 million children still die from diarrhea-related causes each year.
Essential newborn care, including immunizing mothers against tetanus, ensuring clean delivery practices in a hygienic birthing environment, providing necessary warmth, promoting immediate and continued breastfeeding, providing immunization, and treating infections with antibiotics could save the lives of 3 million newborns annually.
Improved sanitation and access to clean drinking water can reduce childhood infections and diarrhea. Over 40 percent of the world’s population lacks access to basic sanitation, and more than 1 billion people use unsafe sources of drinking water.

Two examples of the enormous success in combating child mortality are the Accelerated Child Survival and Development Program (ACSD), launched by UNICEF after enormously successful pilot efforts in West and Central Africa, and the GAVI Alliance (Global Alliance for Vaccines and Immunizations):

ACSD: In 2002–2004, over 17 million people had been impacted and child mortality rates were reduced by 20 percent in districts where full services were provided.
GAVI: In only 6 years, 28 million additional children were reached with basic vaccines, 138 million additional children have been protected with new and underused vaccines, and more than 2.3 million deaths had been prevented.

The Global Child Survival Act

The U.S. Commitment to Global Child Survival Act is key legislation to realize the U.S. commitment to the Millennium Development Goals, in particular #4 (to reduce the rate of under-five child mortality by two-thirds). Introduced in the House (H.R.2266) by Reps. Betty McCollum (D-MN) and Chris Shays (R-CT), and in the Senate (S.1418) by Senators Chris Dodd (D-CT) and Gordon Smith (R-OR), the Global Child Survival Act would formally establish a Child Survival Fund to support sustained reductions in maternal and child mortality rates worldwide; prioritize proven, cost-effective international child and maternal health interventions and programs, including the Global Vaccines Initiative and UNICEF; set guidelines for child survival programs and require the U.S. to develop an integrated strategy for child and maternal health, including the creation of a coordinating interagency child and maternal health task force; require the president to submit an annual report to Congress detailing U.S. efforts; and authorize the expansion of a Child Survival and Health Grants Program. With the passing of the Global Child Survival Act, hundreds of thousands of lives will be saved.

United States Leadership Saves Lives

The significant commitment of the United States to reducing child mortality in the developing world contributed to a 50 percent reduction in the deaths of children under the age of 5 between 1960 and 1990. When RESULTS first started lobbying on child health issues, UNICEF estimated that 41,000 children died every day from largely preventable malnutrition and disease; today the estimate is just under 28,000 per day. Despite this success, funding for maternal and child health programs has declined 20 percent in real terms since 1997.

What Should the U.S. Congress Do?

Soon, Congress will begin debating the Global Child Survival Act in the House Foreign Affairs and Senate Foreign Relations Committees. It is imperative that this legislation reach the full House and Senate and be passed this fall; the longer we wait, the more children die. Also, Congress must approve an increase in funding for Child Survival Programs in the 2008 foreign aid spending bill to not less than the Senate’s level of $476 million. This money is urgently needed to save lives and ensure healthy futures for the poorest women and children on the planet.

Please urge your representative and senators to cosponsor the Global Child Survival Act if they have not already done so, and ask them to support the Senate’s higher funding level for Child Survival programs in the 2008 foreign aid spending bill, and to focus those increased resources on key priority interventions/proven strategies, including GAVI and ACSD.