World Vision: health-related aid spending in the region requires ‘dramatic overhaul’ if more lives are to be saved

On the eve of a Melbourne meeting between the UN and hundreds of charities to discuss the state of global health, World Vision CEO Tim Costello has warned that children in the Pacific region are dying at rates not seen in Australia ‘since before Federation’.

Mr Costello said if the Millennium Development Goals for child and maternal health were to be met, there was a need for a dramatic overhaul of health-related aid expenditure in the region.

“The under five mortality rate in Australia in 1907 was 24 per 1,000 live births. In East Timor today, just a few hundred kilometres off Australian shores, that rate is 93 babies – still almost four times the rate that our grandparents and great-grandparents faced,” said Mr Costello.

“Development efforts have failed to prioritise family care within community, reflecting the fact that in poor countries most antenatal, postnatal and child care activities take place in the community rather than a hospital.

“World Vision estimates that a package of simple, low-cost interventions delivered at the household and community level – such as improved nutrition, hand washing, exclusive breastfeeding and early identification of pneumonia – could save the lives of 2.5 million children around the world annually.”

Conference start of 'last ditch effort' to resuscitate MDG health goals

Mr Costello's warning came ahead of the Advance Global Health – Achieve the Millennium Development Goals conference, which is bringing together more than 300 non-governmental organisations from over 70 countries. Some 1,500 delegates will explore the challenges of meeting the Millennium Development Goals (MDGs) – the world’s blueprint for halving global poverty by 2015.

Mr Costello said the conference was an important precursor to the UN General Assembly at the end of September, when the world’s leaders will gather to review progress towards the MDGs.

“This conference is the beginning of a last ditch effort to get Millennium Development Goals 4 and 5 back on track for their 2015 target,” said Mr Costello.

Solutions are known, cheap and effective

“We're not asking for money to find a cure. Child mortality isn't a 'mystery disease' – almost 40% of children die from just two diseases: pneumonia and diarrhoea,” said Mr Costello. “The world knows the solutions; we just need to implement them.”

The cost of an oral rehydration treatment that can prevent a child dying from diarrhoea is just 30 US cents, while 80% coverage of Vitamin A in Africa could be achieved at a cost of just US$1.20 per child.

Health priorities flawed

“Donor country health aid funding is often inappropriately weighted. Governments that just focus on HIV, tuberculosis and malaria are neglecting unfashionable diseases like diarrhoea, and the underlying causes of child deaths, like basic water and sanitation that kill many more children,” said Mr Costello.

“In 2006, global spending on maternal, newborn and child health was about $3.5 billion. That same year, nearly $9 billion was devoted to HIV and AIDS.”

Just 30 countries account for over 80% of child mortality—more than 7 million deaths each year—yet these same countries receive less than half of global aid commitments for health.

“Governments should be vigilant about their return on investment for health funding,” said Mr Costello. “Donors need to get smarter about how they allocate money – supporting community level preventative care can send mortality rates tumbling.”

Economic benefits

World Vision research has found that significant economic benefits flowed from investing in child and maternal health. Conversely there were significant costs to productivity in countries where health was neglected: 
 Maternal and newborn deaths are responsible for $15 billion dollars in lost potential productivity globally. 
 A 5% improvement in child survival raises economic growth by 1% per year over the subsequent decade. 
 Globally improved water, sanitation and basic hygiene practices are estimated to together save US$7 billion dollars in health care costs each year.

“If for some reason governments are not convinced by the moral arguments for action on child mortality rates, surely the economic benefits should spur action,” said Mr Costello.

Political commitment needed

“Agencies like World Vision are vital in combating this tragic situation. But the reality is that we can’t turn back the tide on child mortality rates unless governments in both developing and developed countries start lifting their weight,” said Mr Costello.

Overall global donor aid for maternal, newborn and child health accounts for only 3% of global aid.

“At present, there is no shortage of high-level declarations and commitments from donor countries, but in practice donor pledges on health have become a debased currency,” he said.

At a global level, rich countries need to increase their commitment to health from the current level of US$16 billion a year to $42.5 billion by 2015 if they’re to meet the health MDGs in all developing countries. To put this funding requirement in context, it is equivalent to 4% of the fiscal stimulus package announced by the G20 for 2009.

“The Australian Government should commit to providing its fair share of predictable, long-term aid: approximately $1.2 billion per year by 2012, including $520 million for the most basic health services,” said Mr Costello.

Currently the Australian Government commits 14% of total overseas aid to health spending. This is well below the allocations given by other OECD nations to health, including the United Kingdom, Ireland and the United States.

World Vision Australia maintains that spending on health should be increased to 20% of overseas development aid.

Tim Costello is available for interview. Please contact Dominic McInerney on 0428 584 809.



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