Millions of children's lives saved through low-cost investments

More than 34 million children's lives have been saved since 2000 because of investments in child health programs at a cost of as little as $4,205 per child, according to a new analysis in The Lancet.

This analysis builds off the work of an international collaboration of researchers and, for the first time, creates a scorecard that allows governments, policymakers, and donors to track investments in child health and to link those investments to child deaths averted across countries in a comparable manner. The article, "Keeping score: fostering accountability for children's lives," will be published in The Lancet online on July 2 and in the July 4 print edition.

The leaders of the Institute for Health Metrics and Evaluation (IHME) at the University of Washington and the UN Secretary-General's Special Envoy for Financing the Health Millennium Development Goals and for Malaria found that from 2000 to 2014, low- and middle-income country governments spent $133 billion on child health, and private and public donors - mostly in high-income countries - spent $73.6 billion.

The governments saved about 20 million children in their own countries, and the donors saved an additional 14 million children. Among donor agencies, some of the largest sources of funding also saved the most lives over the period of 2000 to 2014. The United States government, for example, saved the lives of 3.3 million children under the age of 5. The government of the United Kingdom saved 1.7 million children. And the Bill & Melinda Gates Foundation saved 1.5 million lives, according to the analysis.

Those funders channeled their money through a variety of agencies, which also are reflected in the new scorecard. For example, Gavi saved 2.2 million children's lives, more than any other funding channel, while USAID, the World Bank, UNICEF, and the Global Fund all saved more than 1 million child lives each.

"You can spend $4,000 on many different things, but there are very few places where the money would deliver the kind of impact you get by investing it in child health," said Dr. Christopher Murray, IHME Director. "If you invest in the poorest countries, you will see the biggest impact in child health because the costs of things like nutrition programs, vaccines, and primary care are lower."

The article's authors found that to save a child's life, the average cost is US$4,205 in low-income countries such as Tanzania and Haiti, $6,496 in lower-middle-income countries such as India and Zambia, and $10,016 in upper-middle-income countries such as Botswana and Thailand. Costs generally increase as costs of interventions in countries rise.

IHME and the Special Envoy's office hope that the scorecard will be further developed and updated annually to measure the effects of investments, incentivize progress, and drive innovation to fill gaps in funding or interventions.

"," said Ray Chambers, the UN Secretary-General's Special Envoy for Financing the Health Millennium Development Goals and for Malaria. "We know that despite the efforts of governments and donors to improve health in low-income and middle-income countries, too many children die before the age of 5. Without a way to monitor and publicly share progress regularly, we will miss the opportunity to build on the momentum we have seen since the Millennium Declaration."