69m children will die of preventable causes, says Unicef

Less than a year after the world promised to leave no one behind by signing up to an ambitious 15-year blueprint to end inequality, the UN children’s agency says that 69 million children will die from mostly preventable causes by 2030, and 167 million will be living in extreme poverty, unless world leaders turn rhetoric into reality.

In its latest State of the World’s Children report, Unicef also says 750 million women will have been married as children by 2030, the date by which the sustainable development goals to tackle poverty and secure the planet’s future are supposed to have been achieved.

Nearly half of the 69 million children whose deaths the report foresees will be in sub-Saharan Africa, where at least 247 million children – two in every three – are deprived of what they need to survive and develop.

"Before they draw their first breath, the life chances of poor and excluded children are often being shaped by inequities. Disadvantage and discrimination against their communities and families will help determine whether they live or die, whether they have a chance to learn, and later earn a decent living," Unicef’s executive director, Anthony Lake, writes in the report.

"For the most part, the constraints on reaching these children are not technical. They are a matter of political commitment. They are a matter of resources. And they are a matter of collective will – joining forces to tackle inequity and inequality head-on by focusing greater investment and effort on reaching the children who are being left behind. The time to act is now."

Although substantial progress has been made in tackling child mortality, school enrolment and poverty reduction – key targets under the millennium development goals that expired last year – the report says that the world’s most disadvantaged are still missing out: the poorest children are still twice as likely to die before their fifth birthday, and be chronically malnourished, as the richest.

In sub-Saharan Africa, that figure is even bleaker: children will be 10 times more likely to die before their fifth birthdays than children in high-income countries by 2030. The continent will also be home to nine out of 10 children living in poverty.

The report’s lead author, Kevin Watkins, said there was a risk that progress on child survival could falter because of a lack of commitment to reducing inequality, despite lip-service being paid to the sustainable development goals, which were adopted at the UN last September.

"The truth is that governments have signed up to these commitments on leaving no one behind with absolutely no intention, for the most part, of doing anything that will promote the interests of those who are being left behind … The challenge really is how do we use this new framing, the ‘no one left behind’ language … to galvanise the movement that can push governments to deliver," he says.

Despite the myriad of ways that education boosts opportunities for children, the number who do not attend school has increased since 2011. Again, sub-Saharan Africa fares badly with the report forecasting that by 2030 the region will account for more than half of the 60 million children of primary school age who are not in school.

Watkins, who is executive director of the Overseas Development Institute and will become chief executive of Save the Children UK in September, says particular attention must be paid to tackling child labour and early or forced marriage, and getting vulnerable youngsters back into the classroom.

"We’ve already hit the buffers on education so out-of-school numbers are not coming down any more unless we can shift the focus on to these issues like child labour and early marriage," says Watkins.

One hotspot for child labour can be found among millions of young Syrians who have been displaced and taken poorly paid jobs to support their families. Watkins says that once these children reach the age of 12 or 13, they quickly move away from the education system, sometimes permanently. Despite the length of the conflict in their home country, he says, donors had failed to come up with a coherent strategy on education for these displaced children.

"To be honest, it’s a travesty. We have one summit after another, we have all these headline pledges, but nothing gets done. [We have] this talk of no lost generation. Unfortunately, we’ve already got a lost generation now and we need to start moving very urgently to repair that damage."

The Unicef report proposes five ways to improve the state of children: increase information on those being left behind; integrate efforts across sectors to tackle the many deprivations faced by children; harness innovation to accelerate progress; find new ways to finance efforts to reach the most disadvantaged children; and involve communities, businesses and citizens.

One proposed solution involves using cash transfers to provide incentives for children to stay in school rather than enter labour markets, or early marriages. Watkins says cash transfers would address monetary poverty among children as well as create incentives for schooling.

"Unfortunately, despite all of the evidence, donors and governments in developing countries have been slow to reap all the benefits that are available," he says. "It’s another example of where the gap between the rhetoric of leaving no one behind, and the reality of what donors and governments do is very, very stark."