Controlling Vitamin and Mineral Deficiency Could “Fast-track” Region’s Development Prospects

JOHANNESBURG, 7 October 2004 – A report released today says that Africa is fighting back against vitamin and mineral deficiencies, saving millions of women and children from death and debilitation through simple, cost effective strategies such as fortifying staple foods. But millions of children can still be helped if current strategies and partnerships are extended to reach every country and every child.

Several countries in sub-Saharan Africa have made tremendous progress in ensuring that women and children have access to essential vitamins and minerals – easing the suffering of “hidden hunger” which still leaves millions on the brink of survival.  Accordingly, micronutrient malnutrition is recognized as one of the most serious obstacles to human development and survival by the West African Health Organization (WAHO) and is at the forefront of WAHO’s agenda, their commitment and support being critical to those nations which are grappling with competing priorities and scarce resources to address vitamin and mineral deficiencies. 

According to the report by UNICEF, the WHO, the New Economic Partnership for African Development (NEPAD), the Development Bank of Southern Africa (DBSA), the Micronutrient Initiative (MI), and the Global Alliance for Improved Nutrition (GAIN), over two-thirds of the populations in sub-Saharan Africa have access to iodized salt and millions of children have been reached with vitamin A supplements. Countries like Eritrea, the Democratic Republic of Congo, Kenya and Nigeria have made progress under difficult circumstances but competing priorities and insufficient capacity are holding back progress in other countries.  

Yet ending vitamin and mineral deficiency could be a major catalyst for Africa to achieve the Millennium Development Goals of eradicating extreme poverty and hunger, improving maternal health, and reducing child deaths by two-thirds by 2015.

“By controlling these deficiencies in children, African nations have a great opportunity to advance the development of the entire continent in a relatively short time,” says Kul Gautam, UNICEF’s Deputy Executive Director.   “We have the right strategies – food fortification, supplementation and basic nutritional education – and the right partnerships to implement them.  The challenge is simply our will to reach out to every child.”

Malnutrition is still a major underlying cause of child mortality in Africa, where one in five children will never live to see their fifth birthday.  And older children struggle to thrive when their bodies and minds are weakened by lack of these tiny but vital essentials, holding back productivity and national economic development.

“Micronutrient deficiency also has many invisible economic effects that are widely underestimated,” said Jay Naidoo, Chairperson of the Development Bank of Southern Africa, “because they sap the energy of working-age people and hurt the learning ability of children, causing billions of dollars in lost productivity in developing countries that can least afford it.”

“Resources and technologies to bring vitamin and mineral deficiency under control do exist,” said Venkatesh Mannar, President of the Micronutrient Initiative. “What we need is the will and the action to mobilize resources and deploy technologies to fix this problem. The return on our investment will be huge.”

Reaching out to particularly vulnerable population groups – young children and women -fortifying staple foods with essential vitamins and minerals and providing supplements to those at highest risk of vitamin and mineral deficiency are some of the necessary actions highlighted by the report.

While it has been known for years that the lack of key vitamins and minerals inflicts anaemia, cretinism and blindness, attention in the last decade has shifted to the economic and social impact on populations. Vitamin and mineral deficiencies impair intellectual development, compromise immune systems, provoke birth defects and consign millions to living below their full physical and mental potential. It is estimated that vitamin and mineral deficiencies are costing sub-Saharan economies more than $2.3 billion in lost productivity.

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For further information, please contact:

Lisa Thomas,  Tel: +27 11 548 2000, thomasl@fleishman.co.za
Belinda Mills, Tel: +27 11 548 2000 millsb@fleishman.co.za
Joanne Sewell, Tel: +27 11 548 2000, sewellj@fleishman.co.za
Claire Hajaj, Tel: +1 212 326 7566, chajaj@unicef.org
The Micronutrient initiative, Tel: + 1 (613) 782 6800, mi@micronutrient.org

UNICEF continues to appeal for restoration of electricity and water in the North

DAKAR - 11 November, 2004 - As civil unrest continues to engulf Cote D’Ivoire, UNICEF again calls on all parties to the conflict to ensure basic services and humanitarian access throughout the country. Water and electricity to large parts of the north have been cut for over a week.

“It is imperative that water and electricity supplies be immediately restored in the north by the Ivorian authorities, otherwise the health status of already vulnerable populations - including over 2 million children and women - may deteriorate sharply in just a matter of days,” said UNICEF Regional Director for West and Central Africa, Rima Salah. “The lack of access to safe drinking water greatly heightens the risk of water born diseases like cholera and diarrhea, which can be deadly killers to the most vulnerable: young children. Already people are reduced to drinking unclean, unsafe river water in the north.”

UNICEF is extremely concerned that Bouake, Korhogo and large areas of the north have now been without electricity or a safe, dependable water supply for over a week.  Areas of the west, such as the town of Man, are experiencing only sporadic electricity and water supplies. In addition to the risk of disease due to the lack of safe water, the lack of electricity is having a serious negative impact on the health services that hospitals and health centers are able to provide throughout the north.  Access to safe drinking water was already alarmingly low countrywide, with over 65% of hand pumps in rural areas no longer functioning.  The figure runs to over 80% of pumps non-functioning in some zones of the west.

“If this insecurity continues, we risk losing two years of steady progress made by the national reconciliation government, most importantly in terms of getting schools and health care services open again in the north,” added Salah. “Together, we must do everything possible to continue building on the progress made for children in Cote d’Ivoire.”

UNICEF has provided emergency medical supplies and drugs for some 68 health centers in and around Bouake, Ivory Coast’s second largest city, as an initial humanitarian response to the emergency that is unfolding in the country. In an effort to save precious doses of routine vaccines stored in Bouake, UNICEF has also provided fuel to maintain their cold storage for another 3 to 5 days. 

UNICEF calls on all parties to the conflict to take every action necessary to ensure that public services such as health centers and schools continue to function properly, and that the rights of children and women be fully respected. Throughout the week, schools have been closed in Abidjan and other parts of the country. Schools provide a protective environment and a sense of normalcy for children and their communities during times of crisis.

The medical kits and essential drugs supplied by UNICEF Cote d’Ivoire will be distributed in Bouake by ICRC, and were financed by the European Union.  Items include antibiotics, chloroquine, disposable syringes, rehydration serum and essential drugs.

For further information, please contact:

UNICEF Cote d’Ivoire: Jeff Brez: +225-05-853118 or +221-869-5858; jabrez@unicef.org
UNICEF West and Central Africa Region: Kent Page: +221-545-8580 or +221-869-5876: kpage@unicef.org
UNICEF Geneva: Damien Personnaz: +41-22-909-5716 or +41-79-216-9401: dpersonnaz@unicef.org
UNICEF New York: Oliver Phillips: +1-212-326-7583: ophillips@unicef.org

GENEVA / NEW YORK, 18 April 2002 - One out of twelve children will die before age five, almost all from preventable causes, the United Nations announced today as it released an updated version of its landmark publication on the world’s children. The child mortality rate and other statistics contained in the report lend gravity to the basic United Nations assertion that serious investment in the rights and development of children is essential to overcoming poverty.

We the Children: Meeting the Promises of the World Summit for Children, a report by UN Secretary-General Kofi Annan, is the most comprehensive study ever released on the condition of children. Backed with data from nearly 150 countries, it shows that the disparities and pervasive poverty of today are directly related to under-investment in young people, especially their health, education and protection. The report says that if governments are truly serious about reducing poverty, then they must make children their first priority.

The report was compiled for the May 8-10 UN General Assembly Special Session on Children, where more than 70 world leaders and 170 national delegations will commit to a series of concrete goals on the survival, development and protection of young people. According to UNICEF, the meeting is a critical follow-up to the recent International Conference on Financing for Development, held in Monterrey, Mexico. While the Monterrey conference led to a pledge of substantially more development assistance from donor countries, the Special Session on Children will help define where a large share of that money should go.

We the Children provides a detailed look at the progress made on behalf of children since 1990’s World Summit on Children, where governments agreed to specific goals on the development of children. Systematic and rigorous monitoring has left an indelible imprint of where the world has succeeded, where it has failed - and why. The overall results reflect the world’s failure to invest adequately in young people: over 10.5 million still die each year, often from readily preventable causes; an estimated 150 million are malnourished; and over 120 million never go to school, the majority of them girls.

“Clearly, the world’s children have not had the promised ‘first call’ on resources - despite the extraordinary growth of the global economy. Consequently, much more needs to be done now, and with the greatest urgency,” the report says. “National leaders must act on the past decade’s most important lesson: that investing in children from the earliest years is neither a charitable gesture nor an extravagance, but is rather the best way to ensure long-term development.”

A Roadmap for the Future

The Special Session on Children comes in the middle of an important series of international conferences that are drawing a roadmap for reducing poverty world-wide. For the Special Session, the framework for moving forward is spelled out in documents like We the Children and the draft outcome document, A World Fit for Children.

We the Children is a revised and updated version of a draft report first released last June in preparation for the Special Session on Children, which was postponed from last September by the attacks on New York and Washington, DC. The 102-page report and an all-new statistical appendix - complete with colour graphics, statistical tables and charts - analyzes the progress of countries over the last decade in areas of child heath, education, nutrition and protection.

“Thanks to work at the national and international levels, the knowledge and guidelines are already in place,” says Patricia Durrant, Jamaica’s Permanent Representative to the United Nations, who is chairing the Special Session’s preparatory process. “What we need is the commitment of leaders, both financial and political, to see that children are given the priority they deserve. We will address this at the Special Session. ”

Investing in Children is Key

In asserting that economic development and social cohesion start with investing in children, the UN is drawing on a proven historical record. During Europe’s era of rapid progress in the 19th century, countries across the continent invested in universal primary education and broad public access to healthcare. In the 20th century, several East Asian countries successfully used similar policies. With comprehensive funding and political will, the same is possible in the 21st century for countries that are home to the estimated one billion people living on less than US$1 a day.

The programmes to help children are straightforward and highly effective: immunization, nutrition, sanitation, and good quality education for every child. The economic benefits of such investments are well-documented. A 1998 study by the Rand Corporation found that for every $1 invested in the physical and cognitive development of infants and young children, there is a $7 return, mainly from future savings on costs such as health care, remedial education, unemployment and crime. Other studies show large-scale returns on investment in health and education.

“Unfortunately, many governments don’t give children the resources they deserve - and that goes for both developing countries and the donor nations that provide funds,” said Carol Bellamy, Executive Director of the United Nations Children’s Fund (UNICEF.) “So we will continue to state what may seem obvious to many. Healthy and educated children are a critical force driving economic development. If we want to overcome poverty, that means, first and foremost, we must invest in them.”

We the Children: Major Trends

We the Children and its statistical supplement present the results of the largest effort to survey, extract and analyze information on how well the world has kept its promises to women and children. Some examples of goals set in 1990 and where the world stood in 2000:

Infant and under-five mortality: reduce this rate by one-third. The latest figures show the global average has declined by 11 per cent, from 93 to 83 deaths per 1,000 live births. More than 60 countries achieved the target of one-third reduction. But the mortality rates are extremely high in Africa and South Asia, with malnutrition playing a role in half of all deaths.
Child malnutrition: reduce severe and moderate malnutrition in under-fives by half. The report shows that underweight prevalence - the key measure for determining malnutrition - has only declined from 32 to 28 per cent in developing countries. These high levels pose a major challenge to development and expose children to myriad diseases while also hindering their complete development.
Primary education: universal access to basic education, with completion of primary school by 80 per cent of children. By 2000, around 82 per cent of primary school age children are enrolled and/or attend class - up from 80 per cent in 1990. Yet completion rates remain much lower - a quarter of all those who start school drop out by grade five. Moreover, nearly 120 million children do not go to school at all.

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For further information, please contact:
Liza Barrie, UNICEF Media Chief, New York (212) 326-7593
Patsy Robertson, UNICEF Media, New York (212) 326-7270
Laufey Love, UN Department of Public Information, New York (212) 963-3507
Alfred Ironside, UNICEF Media, New York (212) 326-7261

View and order the Special Session video b-roll at http://www.unicef.org/broadcast/brolls/specialsession/

A live satellite news feed will be available twice daily during the Special Session.
Learn more at: http://www.unicef.org/rss/index.html

VAN, TURKEY, 17 June 2003 - One in every eight girls is out of school in Turkey on the eve of the launch of a major new campaign to get girls back into the classroom. The Advocacy Campaign for Girls’ Education launched by UNICEF and The Turkish Ministry of National Education today aims to have every girl in school by 2005.

Launching the campaign in the eastern Turkish Province of Van, UNICEF Executive Director Carol Bellamy said, “Education is the right of all children. Fulfilling the right of every girl to a quality basic education is the key to promoting true equality between boys and girls and men and women. Turkey can make no better investment in preparing for the European Union than investing in education ”

The campaign will begin in 10 provinces this year before expanding to 40 more by the end of 2005. Local authorities will back the campaign by promoting the benefits of girls’ education to families and communities.

“We don’t want to waste half of our human resources for lack of education” says minister Huseyin Celik. “We should make the message clear everywhere that education is for all. It can not be a privilege conferred on specific groups.”

The theme of girls’ education harmonizes with the new drive launched in Istanbul earlier this week, Leave No Child Out. It envisions a world in which no child is discriminated against or excluded, like 120 million children around the world who are not in school, the majority of them girls.

The Girls’ Education Campaign is part of ’25 by 2005’ an intensive effort in 25 countries to get as many girls as boys into school by 2005. Every year a girl spends in school is a step towards eliminating poverty, advancing human development and promoting gender equality. The benefits of educating girls are passed from one generation to the next. Educated girls become educated mothers, which means lower child mortality, better nourished and healthier children and economic growth.

For more information please contact:

Sema Hosta 0 533 413 91 16
Nilgun Atalay 0 532 367 27 01

With Goal of Two-Thirds Reduction by 2015, 98 Countries Are Off the Mark; AIDS and Conflict Send Some Nations Spiralling in Wrong Direction

NEW YORK, 7 October 2004 – New country-by-country data reveals alarmingly slow progress on reducing child deaths despite the availability of proven, low-cost interventions, a UNICEF survey revealed today.  UNICEF said that while 90 countries are on track to meet the target of reducing child deaths by two-thirds by 2015, 98 countries are considerably off track, and globally the pace of progress is far too slow.

At the current rate of progress, the average global under-five death rate will have dropped by roughly one-quarter by 2015, far below the two-thirds reduction agreed to by world leaders.

“A child’s right to survive is the first measure of equality, possibility, and freedom,” UNICEF Executive Director Carol Bellamy said, launching Progress for Children in New York.  “It is incredible that in an age of technological and medical marvels, child survival is so tenuous in so many places, especially for the poor and marginalized. We can do better than this.”

Progress for Children ranks countries on their average annual rate of progress since 1990, which is the baseline year for the global goal of reducing child mortality by two-thirds by 2015 – a goal agreed to by all governments as part of the UN’s Millennium Development Goals. 

Child mortality refers to the number of children who die before their fifth birthday, and is measured per 1,000 live births.  For example, in 2002, the most recent year for which comprehensive data is available, industrialized countries had an average child mortality rate of 7 deaths per 1,000 live births; the least developed countries had a rate of 158 deaths per 1,000 births.  UNICEF considers child mortality rates the basic measure of a country’s advancement. 

The regional tables in the report provide comparisons of how quickly or slowly nations have made progress on child mortality between 1990 and 2002.  The goal of a two-thirds reduction assumed an average annual rate of progress of roughly 4.4 per cent between 1990 and 2015.  The report reveals that no region has met that standard, though nearly 50 individual countries have.  Some 78 countries have failed to average even two percent progress per year in reducing child mortality.

The figures make clear that those countries that have fallen short on progress since 1990 now have a much more daunting task.  At least 39 countries must now reduce mortality by more than 8 per cent per year, on average, during the remaining years to 2015 in order to reach the goal. 

Heading in Reverse

Child mortality rates vary considerably among regions and countries, but the most disturbing findings are those countries whose annual rate of progress has been negative; in other words, they are heading in reverse, with rising child mortality rates.  In several countries in sub-Saharan Africa and the Commonwealth of Independent States, children are less likely to make it to their fifth birthdays than they were in 1990.

HIV/AIDS remains one of the chief underlying causes affecting child mortality trends, particularly in sub-Saharan Africa. Botswana, Zimbabwe and Swaziland, which registered the second, third and fourth fastest increases in under-five deaths, also have the world’s highest national HIV prevalence rates - about 37, 25 and 39 per cent, respectively. Other key factors behind spiking child mortality rates, as in the case of Iraq and Afghanistan, are the effects of armed conflict and social instability.

Despite a slight improvement, Sierra Leone continues to have the world’s highest rate of child mortality, with more than one in four children dying before age five (284 deaths per 1,000 births annually).

Latin America and Caribbean countries have seen the most substantial improvement on average, although alarming gaps are opening up within countries there. Poverty and discrimination are preventing large groups of children within these countries from accessing basic services.

Malaysia, Malta and Egypt have made the most dramatic leaps forward overall, although Egypt is still battling polio.  Iraq has lost the most ground since 1990.

Root Causes

Inadequate birthing conditions – meaning little or no health care for mothers, and the lack of skilled attendants during deliveries – cause the largest proportion of preventable deaths.  Infectious and parasitic diseases, such as diarrhoea and acute respiratory infections, followed by malaria and measles are the next biggest killers. Acute respiratory infections and diarrhoea are at the root of roughly one-third of child deaths.

Malnutrition contributes to more than half of all child deaths. Unsafe water and poor sanitation are also contributing factors.
 
“The world has the tools to improve child survival, if only it would use them,” Bellamy said. “Vaccines, micronutrient supplements and insecticide-treated mosquito nets don’t cost much, and would save millions of children. But not enough children are being reached with these basic life-savers.  That’s what has to change.  No government should be allowed to let another ten years pass with so little progress for children.  Leaders have agreed to goals and they must be held accountable.”

Regionally, much of the Middle East and Northern Africa, Latin America and the Caribbean, and East Asia and the Pacific are on track to reach the goal. But Central and Eastern Europe, South Asia, and sub-Saharan Africa will require dramatic measures if they are to come close.

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For further information, please contact:

Alfred Ironside, UNICEF, Media New York: (1-212) 326-7261,
Oliver Phillips, UNICEF Media, New York: (1-212) 326-7583,
Marixie Mercado, UNICEF Media, New York: (1-212) 326-7133

CF/DOC/PR/2004-095

Pan-African Forum Promotes Role of Local Community in Child Health

DAKAR, 18 October 2004 –  Religious and traditional leaders and senior media representatives from across the continent are gathering here this week to explore how their unique influence in hard-to-reach communities can boost immunization rates and support child survival efforts in Africa, where two-thirds of child deaths are entirely preventable.

“No one can doubt that the survival of children in Africa is in peril,” said President Abdoulaye Wade of Senegal in his opening address to the forum. “We are gathered here to join forces in the fight to keep these children alive and healthy.  We are here to help battle poverty, inadequate health infrastructure, and insufficient resources.” 

Immunization and child survival rates across Africa have faltered in the past decade, according to UNICEF country data released last week in the Progress for Children report.  Of the nearly 11 million children who die each year under the age of five, 42 per cent are in sub-Saharan Africa.

“We have paid insufficient attention to the community of religious and traditional leaders whose influence in the family and community can ensure that children not only survive, but thrive,” said UNICEF Executive Director Carol Bellamy. “We believe that without the engagement of people with direct and immediate community influence, even the best health programmes will not reach all the children who need them. The active participation of religious and traditional groups is crucial to the success of any child survival effort.”

Bellamy noted that while many communities lack schools, health facilities or sanitation, few are without places of worship. For many people, religious institutions are an important, readily available source of information and advice on many matters, including health.

“Religious and traditional leaders have enormous potential to build trust and ensure that children receive life-saving health care, but it remains largely untapped,” said Religions for Peace Secretary-General Dr. William Vendley. “This meeting offers a unique opportunity to harness that potential by renewing commitments, strengthening inter-religious cooperation, and promoting partnerships.  These important African leaders have a huge role in protecting children.”

Delegates to the Pan-African Forum on Building Trust for Immunization and Child Survival also include leading figures from the continent’s most influential media, who are an equally strong ally in promoting public trust in immunization.

UNICEF and Religions for Peace believe that the media should help people make informed decisions, and that they have an irreplaceable role to play in creating demand for live-saving health care for children. 

“The way in which the media represents, misrepresents, or even ignores children’s issues can influence decisions taken on behalf of children,” said Bellamy.  “The media have a growing influence on how society regards children, and how we treat children.  So they have a responsibility to promote facts and attitudes that will save lives.”

Over 200 delegates will share their diverse experiences on immunization and child survival – from the perspective of Muslim communities, Christian communities, and traditional communities.  They will hear presentations on immunization trends and polio eradication by UNICEF and WHO health experts and take part in discussing subjects such as HIV/AIDS.

Interfaith, peace, and media consultative working groups will also be conducted, leading toward a joint Call to Action promoting a grass-roots partnership in immunization and child survival.

Background

The Pan African Forum on Building Trust for Immunization and Child Survival, co-sponsored by UNICEF and the World Conference for Religion and Peace, will be attended by more than 200 religious and traditional leaders and senior media representatives from across Africa.

A representative from the Commission of the African Union; David L. Heymann, WHO Director-General for Polio Eradication; Rima Salah, UNICEF Regional Director for West & Central Africa; and Per Engebak, UNICEF Regional Director for East & Southern Africa will also be among those taking part.

*   *   *

For further information:

Kent Page, UNICEF Dakar: 221-869-5876
Alfred Ironside, UNICEF New York: 1-212-326-7261,
Damien Personnaz, UNICEF Geneva:  41 22 909 5716,

NEW YORK, 17 January 2005 – UNICEF today welcomed the UN Millennium Project  report directed by Prof. Jeffrey Sachs and his team, calling it an “indispensable road map to reaching the Millennium Development Goals.” 

The report, Investing in Development, calls for affordable interventions with long term benefits for development.  These “quick wins” include bed-nets to fight malaria, vaccinations to fight infectious disease, bore wells for safe drinking water and antiretroviral therapies to fight AIDS.  If implemented on a wide scale, many of its recommendations could make a measurable difference in the lives of children, UNICEF said. 

Launched at the UN Headquarters, the report calls for governments and the international community to commit resources and take urgent and sustained actions to the universal achievement of the Millennium Development Goals (MDGs).   UNICEF welcomed this focus and encouraged its government counterparts to do their part in investing in development.  

“The MDGs are all about investing in children, and this report is fundamental to the global effort to create a world that is fit for children,” said UNICEF Executive Director Carol Bellamy. “We could not support it more strongly.”
 
The Millennium Goals present a series of time-bound, quantifiable development targets, many of them focused directly on children.   Some examples of how UNICEF is working with governments to achieve the goals include:

• Providing an expanded set of immunizations against childhood diseases, as well as basic health care for children
• Efforts to ensure that all boys and girls have a quality basic education
• Raising awareness about HIV/AIDS to give young people the knowledge, skills and support they need to protect themselves
• Working to protect children from violence, abuse, exploitation and discrimination
• Providing children in their earliest years with services they need to survive and thrive, including sound nutrition and clean water

The Millennium Project report was presented to Secretary-General Kofi Annan today.

For further information, please contact:
Jehane Sedky-Lavandero, UNICEF Media, 1 212 326 – 7269, jsedky@unicef.org

New focus on preventing neonatal deaths needed

LONDON, 1 March 2005, Thank you.  I am very pleased to be here representing UNICEF and the committed individuals from across UNICEF who played such a key role in the development of this series.

In particular I’d like to thank Dr. Rudolf Knippenberg – seated here in the front – for his lead role in authoring article 3 in the series, and to Neff Walker, Genevieve Begkoyian, and Pascal Villeneuve, who contributed across the series.

Backing the leading contributions of these three are UNICEF field staff throughout the countries we are talking about, whose work on the ground with our partners and with governments and communities have added substantially to the knowledge base of this series.  Their ongoing work over many years is aimed at contributing real-world experience, observation, and knowledge to the global discussion, and I thank the Lancet and the Bellagio Group for initiating this series and providing a forum for the best knowledge and practices to be highlighted and promoted.

I have listened with great interest to my fellow panelists, and fully support what they have presented both here today and in the series itself.  I have just a few observations I would like to add.

The focus of this series on neonatal deaths is important and timely.  It is apparent from the data presented that the crucial first month of life, even the first week and first day, have been overlooked in global child survival programs.  The good news is that this gap comes to light as a result of gains being made in child survival after the first month of life.  Today in Geneva, for example, UNICEF and WHO will announce major progress in the reduction of under-five deaths due to measles – a reduction of some 38% since 1999.

But as this series makes clear, despite this type of progress in general under-five mortality we will not succeed in reaching MDG-4 without a renewed emphasis on reducing preventable deaths in the neonatal period. 

This is a critical focus, and UNICEF’s strategic plan for 2006 thru 2009 places special emphasis on neonatal survival as a critical component of overall child survival.  Our strategy – which is being finalized by the UNICEF board – reflects the global consensus on what needs to be done presented in both this and the earlier Lancet series.

Simply put, UNICEF strongly endorses the findings put forward in this series and we are committed to playing our part in the recommendations set forward in article four.  In particular, I believe UNICEF will play an increasingly important role in helping governments develop the vigorous evidence-based programs and monitoring systems needed to attract new resources.  And we will play an important role in pushing all the players to focus on reaching the most marginalized and empowering local communities to help design, manage and provide feedback on new initiatives.

In addition to the excellent case studies the series presents on work in India, Madagascar, Ethiopia, and Sri Lanka, we have also been working for the past six years on packages of interventions in several West African countries that use the approaches outlined in this series.  Indications are very encouraging, with marked improvements not just in coverage rates for basic packages of interventions, but also in reduced mortality rates.  Those findings will be published soon.

UNICEF’s ongoing work in these areas, in partnership with the World Bank, WHO, and governments, is at the heart of paper three, on how to move from analysis to action. 

The series suggests that roughly $4 billion would be required over and above what is now being spent in order to reach virtually all children with the full set of packages, scaled up including clinical care.  Getting there will take real time and investment.  But what our work in West Africa suggests, and what the papers make very clear, is that we can save as many as a million newborns with much less expensive interventions based on family care and community outreach programs.  Things as simple as prevention of malaria and tetanus; keeping the newborn warm: exclusive breastfeeding; and early recognition of illness and seeking care can make huge inroads with much more modest resources.  These are low-technology things we can do now, even in the poorest environments with weaker health systems.  And this is where UNICEF will be placing its emphasis over the next four years.

Finally, I’d like to say a few words on the importance of women’s health and empowerment.  While the focus here is clearly on newborns, the articles make it clear that the continuity of care from mother to newborn to child is essential to success.  And while we focus on health packages that strengthen this continuum of care, we must put equal emphasis on the overall status of women in many of the countries where the mortality rates are highest.

Articles one and three emphasize the need not just for good programs but for good overall policy.  And that means involving local communities, especially women.  It means in the short term empowering women with basic knowledge.  It means providing essential commodities for use at household level.  And in the longer run it means ensuring that all boys and all girls get a quality basic education. 

For me one of the most striking statistics in this series is the fact that 60 to 80 percent of all neonatal deaths occur in children who suffer from low birth weight.  What does that tell us?  It tells us that the nutritional status and probably the economic status of the mother is poor to begin with.  She was not in a strong position to give birth.

Sustaining success in reducing neonatal mortality in the long-term is dependent on many factors, including our own focus and commitment.  But it surely depends on the empowerment of women – and that is not only a health issue, but a human rights issue.

I am proud to say that as part of its strategic contributions to sustaining progress over the long-term, UNICEF has made education for all boys and girls a vital part of its work.  As I said at the opening of the Beijing +10 conference in New York this week, some have called me a “radical feminist” for arguing that human rights and equality for all men and women have something to do with the long-term survival and thriving of all children. 

So I am pleased to see that these vital issues have been highlighted in the Lancet series as part of the external environment – along with AIDS and conflict – that impacts our work – and which we in turn must seek to have an impact upon. 

I thank the authors of this series for their hard work and vigorous commitment to the issues.  All of us who care about children are enriched by this excellent summary of where we are and where we need to go.    Thank you very much.