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November 2007: U.S Commitment to Global Child Survival Act

More than 26,000 children under five die every day — that’s nearly 10 million per year. The leading causes of death — pneumonia, diarrheal diseases, measles, malaria and complications at birth — are treatable or preventable. Poor nutrition is an important underlying factor in many of these deaths. 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.

These are not mystery ailments and the cures are well known and cost effective. If universally and equitably available, these basic health services could save million of lives:

• 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

With proven interventions and preventive strategies established, the missing ingredient is the political will to ensure that children have access to the basic health care they need. When these health services are delivered, 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. New data recently released by UNICEF shows that annual global child deaths have now fallen below 10 million — down from 13 million in 1990. Despite this demonstrated success, recent core funding for maternal and child health programs has barely kept pace with inflation, and falls far short of the need. Progress toward Millennium Development Goal 4 to reduce under-five mortality rates by two-thirds is inadequate.

This month, Congress has the opportunity to act on legislation that would put the United States back at the forefront of global efforts to reduce child deaths by advancing the U.S Commitment to Global Child Survival Act (H.R.2266, S.1418). 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 Child Survival Act also mandates a comprehensive, integrated, and effective strategy for U.S. child survival efforts, including directing resources to proven interventions, and sets guidelines and mechanisms for the evaluation of progress made.

To move this legislation forward, members of Congress should: 1) cosponsor the Global Child Survival Act, and 2) actively support its passage through committee and the full House and Senate.

Take Action: Write a Letter to Your Representative and/or Senators Introduce yourself and explain that you are a constituent. Share your concern that over 26,000 children die every day from preventable and treatable diseases in your own voice (share how this makes you feel — bring in feelings about your own children or people you know with children). Explain that the U.S. must join the 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). If your member of Congress is already a cosponsor, as him or her to support bringing the legislation to the floor for a vote by speaking to House and Senate leadership. 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 for a reply. Note: Please fax or e-mail your letter as postal delivery is delayed by several weeks. Address letter to: Rep. __________; U.S. House of Representatives, Washington, DC 20515 or Sen. _________, U.S. Senate, Washington, DC 20510.

More Background: Strong, Bipartisan Support for Expanding Child Survival Funding

In August 2007, the U.S. Coalition for Child Survival sponsored a survey, exploring Americans’ attitudes toward child survival issues. According to the poll results, a majority of Americans say Congress should be doing more to prevent unnecessary deaths among children in the world’s poorest countries.

• Almost all Americans (95 percent) believe the issue of child survival is an important problem facing the world today. Democrats and Republicans find common ground on the issue with 97 percent of Democrats and 94 percent of Republicans citing child survival as important.
• A large majority of Americans (84 percent) support increasing funding to reduce the top preventable causes of death among children.
• Eight in ten Americans (81 percent) support the U.S. Commitment to Global Child Survival Act, even when told it would cost 7 dollars per American per year. Majorities of Republicans and Democrats say they support this act.

The U.S. Should Join Others in Doing More

Even as U.S. funding has stagnated, other donors and agencies are increasingly recognizing that the world must do to more to ensure children are healthy. In September at the Clinton Global Initiative in New York, the Prime Minister of Norway pledged $1 billion toward maternal and child health programs over the next 10 years. Norway was joined by the Netherlands, which pledged an additional $175 million over the next three years. Norway’s commitment follows a 2000 pledge of $1 billion to the GAVI Alliance (Global Alliance for Vaccines and Immunizations). In only six years, GAVI has reached 28 million additional children with basic vaccines, 138 million additional children have been protected with new and underused vaccines, and more than 2.3 million deaths have been prevented.

With support from Canada, UNICEF is working to expand its Accelerated Child Survival and Development Program (ACSD) after enormously successful pilot efforts in West and Central Africa. Between 2002 and 2004, ACSD impacted over 17 million people and child mortality rates were reduced by 20 percent in districts where full services were provided.

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 Goal 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.