lives that would have been lost had mortality remained at 1990 rates— a number more than the current population of Germany. Most of these lives saved have been children in South Asia (38%) and sub-Saharan Africa (30%). To achieve MDG 4 by 2015, an additional 3.5 million children’s lives must be saved between 2013 and 2015 above the current trend rate. Breaking this projection down by country indicates where the greatest challenge lies to meet this international goal. One-third of these lives need to be saved in just two countries, Nigeria and the Democratic Republic of the Congo, with a further fifth in India and Pakistan. In total, two-thirds of these lives need to be saved in sub-Saharan Africa and about one-quarter in South Asia. Breakdown of the additional 3.5 million children to be saved, 2013–2015 in order to achieve MDG 4 Additional lives to be saved, 2013–2015 in order to meet MDG 4, by cause of death (thousands and % of total)
FIG. 14
The challenge is immense. To achieve MDG 4 on time, the annual rate of reduction in under-five mortality would need to rise to 15.6% in 2012-2015 — much faster than the highest rate for any country since 1990 (Figure 15). But progress can and must be accelerated, even if the deadline is missed. As Figure 14 shows, stepping up action against pneumonia and diarrhoea, malaria and neonatal deaths is particularly vital — and these conditions are also eminently preventable or treatable. More must also be done to address measles, HIV and AIDS and meningitis. As the next chapter discusses, substantial advances in tackling these diseases and conditions are taking place, but much more can and must be done to save children’s lives in the coming years. Progress in reducing child mortality has accelerated but is insufficient to achieve MDG 4 if current trends continue
FIG. 15
Global annual rate of reduction in under-five mortality, actual 1990–2012, and required to meet MDG 4
es l liv ona d i t i e d Ad e sav to b
Globally, nearly half of all deaths among children under 5 are attributable to undernutrition
Other countries, 896 (26%)
75
% 50
Afghanistan, 73 (2%) Côte d'Ivoire, (3%) 84 (2%) Somalia, 87 (2%) Chad, 94 Kenya, 113 (3%) Angola, 181 (5%) Pakistan, 341 (10%) India, 446 (13%)
25
Democratic Republic of the Congo, 538 (15%)
Nigeria, 652 (19%)
0
Required 2012-2015 to meet MDG 4
Source: UNICEF analysis based on IGME 2013.
100
Source: UNICEF analysis based on IGME, WHO and CHERG 2013.2
Ad to ditio be na sa l liv ve d es
Additional lives to be saved in order to meet MDG 4, by country (thousands and % of total)
13