Investments in child health yield broader social and economic returns that ultimately benefit everyone, writes Anthony Lake, Executive Director, UNICEF
Winston Churchill once observed that healthy citizens are the greatest asset any country can have. And he was right. Because the ambitions of a society can only be realised through the ability of its people to realise their own ambitions.
But were he speaking today, he might sharpen the focus on children. Evidence increasingly shows what common sense has always told us: healthy, well-educated, well-nourished children are the foundation of sustainable growth for every society – and one of the smartest investments we can make in our common future.
For generations, improvements in child health have primarily been seen as a dividend of economic growth: the more developed the country, the healthier the children – the result of better nutrition, routine vaccination and more widely available health services. Certainly, all societies are morally obligated to use their prosperity to benefit their youngest citizens.
But seeking improvements in child health is not only a moral obligation, nor a mere bonus of boom times. Investments in child health are a driver of sustained and sustainable growth – creating a ladder of opportunity from which families, communities and countries can realise their ambitions.
Consider child survival. The Lancet Commission on Investing in Health reported that 24% of full income growth in low- and middle-income countries between 2000 and 2011 was attributable to health improvements – especially lower child mortality and healthier children.
Or consider malnutrition and stunting, which affect millions of children around the world, undermining their health for life and interfering with the development of their brains – at enormous cost both to them and to their societies. A World Bank study says improving basic nutrition can boost a poor country’s gross domestic product (GDP) by two to three times annually.
And tackling malnutrition yields an enormous global return. Preliminary UNICEF research, reported during the recent Conference on Financing for Development in Addis Ababa, indicates that reducing stunting by 40% can result in a global economic benefit of $9.3 trillion by 2030. This benefit stretches over the lifetimes of the entire generation born in six regions between 2015 and 2030.
Consider immunisation. Two studies by the Johns Hopkins Bloomberg School of Public Health show that if we scale up the use of existing vaccines in 72 of the poorest countries, we could save 6.4 millions lives and avert $6.2 billion in treatment costs and $145 billion in productivity losses over the next decade.
A better start in life
Investments in child health also serve as a buffer in bad times – as healthier children are better able to withstand and recover from adversity. In a world where approximately 230 million children were affected in 2014 by violent conflicts and millions more saw their lives disrupted by natural disasters and the effects of climate change, this is critically important.
Investing in child health is also highly cost effective. This is especially important now, as the global community embarks on a new era of international development – and world leaders must deliver on the promises they have made in agreeing to the Sustainable Development Goals (SDGs).
The highly respected Copenhagen Consensus think tank recently evaluated the social, environmental and economic costs and benefits of the proposed SDG targets, which have now been agreed upon at the 2015 United Nations General Assembly. The results of analysis and evaluation make clear that investing in child health is the best value for money in development. Of the 19 targets the Copenhagen Consensus identifies as providing the best return on investment, more than 13 concern child health – and require child-related programming to achieve.
According to this analysis, reducing chronic child malnutrition by 40% can prevent 68 million children from becoming malnourished every year. Reducing newborn mortality by protecting mothers and providing skilled birth attendants and postnatal care can prevent two million newborn deaths every year. Increasing immunisation by expanding the number of children who are immunised against leading child killers such as pneumonia, diarrhoeal disease and influenza can save the lives of one million children every year. Halving malaria can save the lives of more than 440,000 people every year – most of them children in Africa.
According to the expert panel, reaching these and other cost-effective goals by 2030 will return more than $15 of good for every dollar spent.
More broadly, the Lancet found that increasing health expenditures by just $5 per person each year in 74 high-burden countries until 2035 would not only save and improve millions of lives, but would also generate about nine times the value of that investment in social and economic benefits. Why? Because better health means improved productivity, which in turn means greater GDP growth – and thus, more jobs and opportunities for citizens now and in the future.
Reduced healthcare costs
At the same time, investments in one sector can affect the success of efforts in other sectors. For example, approximately half of the dramatic decrease in under-five child mortality in low- and middle-income countries between 1990 and 2010 was due to investments beyond the health sector, such as in WASH (water, sanitation and hygiene), nutrition, education, the empowerment of women and social protection.
Every dollar invested in water and sanitation yields a $4.30 return, in the form of reduced healthcare costs for individuals and societies around the world.
Similarly, preventing undernutrition in early childhood helps children learn better in schools, which can translate into at least 20% in hourly earnings and at least 48% in wage rates.
So we must work across sectors, investing in the whole child – in all the areas that affect health and that health affects – including education and protection. This is especially true during early childhood – a unique time of opportunity during which children’s brains develop rapidly, affecting their future health, their future capacity to learn, their future success, and even their future happiness.
Far-reaching benefits of health investments
The full, far-reaching benefits of investing in child health depend on targeting investments to ensure the most disadvantaged and marginalised children are reached – those living in extreme poverty, in remote rural communities and urban slums, children from indigenous and minority communities, children with disabilities, girls. We have made enormous progress over the past 25 years, but we are still leaving behind millions of children.
Again, this is more than a moral responsibility. It is a tremendous opportunity for us all. Because the results of investing in the most disadvantaged children outweigh the additional costs of doing so.
When children are denied a fair chance to live healthy lives, when they are denied vaccinations, proper nutrition, access to health services, and when they are denied education, protection, clean water and adequate hygiene, they are not only being denied a basic human right. Their societies are being denied their greatest asset, and thus, the chance to realise their own greatest ambitions, and by extension our shared ambitions for a better world.