A Promise Renewed - the knowledge, the tools and the will to end preventable child deaths

Rotary United Nations Day

New York, 3 November 2012

Ian PettChief, Health Systems and Strategic Planning

The global burden of under-five deaths has fallen steadily since 1990Global number of under-five deaths, selected years

1990 1995 2000 2005 20110

2

4

6

8

10

12

14

11.967573

10.770415

9.561924

8.197869

6.914296

Mill

ions

of u

nder

-five

dea

ths

Source: The UN Inter-agency Group for Child Mortality Estimation, 2012;provided by SMS/DPS/UNICEF

The global under-five mortality rate has fallen by 41% from 1990 to 2011Under-five and neonatal mortality rate, 1990-2010

Source: The UN Inter-agency Group for Child Mortality Estimation, 2012; provided by SMS/DPS/UNICEF

1990 1995 2000 2005 2010 20150

10

20

30

40

50

60

70

80

90

100

32

22

87

51

MDG Target: 29

U5MR

NMR

Deat

hs p

er 1

,000

live

birt

hs

The global burden of under-five deaths is increasingly concentrated in sub-Saharan Africa and South AsiaShare of under-five deaths by region (%)

Source: The UN Inter-agency Group for Child Mortality Estimation, 2012; provided by SMS/DPS/UNICEF

19901991

19921993

19941995

19961997

19981999

20002001

20022003

20042005

20062007

20082009

20102011

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Sub-Saharan Africa South Asia East Asia and PacificMiddle East and North Africa Latin America and the Caribbean CEE/CISRest of the World

Shar

e of

und

er-fi

ve d

eath

s

Half of global under-five deaths occurred in just 5 countriesNumber of under-five deaths by country (in thousands)

Source: The UN Inter-agency Group for Child Mortality Estimation, 2012; provided by SMS/DPS/UNICEF

India; 1,655

Nigeria; 756

Demo-cratic

Republic of the Congo;

465

Pakistan; 352

China; 249Ethiopia; 194Indonesia; 134

Bangladesh; 134

Uganda; 131

Afghanistan; 128

Other countries;

2,716

1) Sierra Leone(185 per 1000 live births)

2) Somalia

3) Mali

4) Chad

5) Democratic Republic of the Congo

6) Central African Republic

7) Guinea-Bissau

8) Angola

9) Burkina Faso

10) Burundi

11) Cameroon

12) Guinea

13) Niger

14) Nigeria

15) South Sudan

16) Equatorial Guinea

17) Mauritania

18) Togo

19) Benin

20) Swaziland (104 per 1000 live births)

Source for mortality rank: UN Inter-agency Group for Child Mortality Estimation 2012; Fragile Situation countries are shown in red (source: World Bank 2011)

8 of the 10 countries with the highest under five child mortality rates are affected by violence or in ‘fragile situations’

6

Global Causes of Under-Five Deaths in 2010

Through synergy with infectious diseases undernutrition causes 35% of child deaths

Every Woman, Every Child - the Global Strategy For Women’s And Children’s Health

164 Governments Pledged to datePlus Hundreds of

• Civil Society organisations• Faith Based organisations• and individuals

www.apromiserenewed.org

Child Health Progress on intervention coverage addressingNeonatal deathsPMTCTVaccine preventable diseasesPneumoniaDiarrhoeaMalaria

through addressing disparities and using more effective service delivery models, particularly community based health care

Global Polio Eradication Initiative:The Global Picture

Context: Poliovirus Distribution 1988-2012

1988

2012

EndemicRe-established

The Remaining Polio Sanctuaries in priority countries

Total cases in 2012: 175In 2011 (to date): 650Total in 2011: 489

Data as of Oct 29, 2012

0

25

50

75

100

125

150

Pakistan Afghanistan Nigeria Chad

Cas

es

2011 2012

Polio-paralyzed children at 29 Oct 2011 vs. 2012

UNICEF’s role in GPEIUNICEF leads in :

– Communication and social mobilization in priority countries

– Vaccine procurement and delivery– Cold chain and logistics support

UNICEF supports – Global advocacy and resource mobilization– Funding through own contributions– Technical support to SIAs at country level– Operation financing in selected countries– Strengthening routine immunization

Vaccine Security to support GPEI

Sustained, uninterrupted supply of affordable, quality vaccines• tOPV, mOPV1, mOPV3; bOPV (first time used in Dec 2009)

• In 2011, UNICEF has procured over 1.6 billion doses of OPV, with value of over $185 million, for delivery to 76 countries for routine immunization and SIAs

~85% of procurement for SIAs

• Supply Division is continuously working with partners and manufacturers to address the changing epidemiology (outbreaks, circulation), and changing availability of polio vaccines (pre-qualification, registration, licensing, etc)

Angola

Australia

Luxembourg

Others

Rotary International

Bill and Melinda Gates Foundation

World Bank

IFFIm

WHO

UNICEF

Japan International Coop-eration Agency Loan Con-

version

Japan Canada USAIDUSCDC UK Russian

Federation EC

BangladeshIndia

Nigeria

DomesticResources

23%

Non-G8 OECD/Other 2%

Multilateral Sector

6%

Private Sector 20%

GPEI Financing 2012-2013: $1.48 billion in contributions

G8 14%

‘Other’ includes: the Governments of Austria, Brunei, Estonia, Finland, Monaco, Nepal and Turkey, plus other Institutions: Chevron (Angola), Central Emergency Response Fund (CERF), Common Humanitarian Fund (South Sudan), the GOOGLE Foundation/Matching Grant, Total E&P (Angola) and WHO core resources.

Current Funding Gap: US$ 700 m of US$ 2.18 b budgetFirm Prospects: US$ 360mBest Case Gap: US$ 340m

20

WHO/UNICEF 2013 - 18

Gates 2013 - 18

Total costs with Gov India $6.3B $6.9B

Total costs w/o Gov of India $5.2B $5.5B

2013-2018 Headline Endgame Costs

Currently GPEI is reporting the lowest number of cases in the fewest areas and the least number of infected countries ever

Achievements remain fragile and require continued vigilance

Approaching the low season there is urgency in addressing remaining risks by:

• Improving quality of activities in the sanctuaries: focusing on both operations and communication in the highest risk areas

• Addressing the significant funding gap

• Securing commitment and ownership at all levels

• Addressing the decline in access to children in high threat environments

Summary

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