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Johns Hopkins Bloomberg School of Public Health

Child Survival Solutions

According to UNICEF, nearly 8 million children under age five died worldwide in 2010.1

Tragically, more than half of these childhood deaths are preventable with existing tools and interventions. Existing vaccines alone can prevent an estimated 25% of under-five deaths. In fact, researchers predict that the utilization of existing tools and interventions around the world could save more than 6 million young lives every year.2

Poor countries bear a disproportionate burden of child mortality. Children in developing countries are more than 10 times more likely to die before reaching the age of five than children in developed countries.1 Over 80% of the total deaths among children under age five occur in Sub-Saharan Africa.3

The large number of preventable deaths among children, particularly in poor countries, is unacceptable. The good news is that solutions exist to improve child health, and increase child survival.

The Millennium Development Goal 4 multimedia feature outlines action steps to promote child survival, which focuses on a three-pronged approach:

  • Governments in the priority countries must strengthen their health systems and management.
  • Availability and access to medical supplies, interventions and new technologies must be dramatically improved. This means ensuring that treatment is available for children suffering from neglected diseases, such as pneumonia, and increasing access to other low–cost interventions that can save lives.
  • Donors must increase their financial commitments

In 2008, the United Nations outlined measures to achieve MDG #4 :

  • Ensure full coverage of immunization programmes.
  • Scale up vitamin A supplementation.
  • Pursue exclusive breastfeeding for children under 6 months of age and breastfeeding plus appropriate complementary feeding for children aged 6 months to two years.
  • Provide adequate nourishment for children of poor families, despite food price rises.
  • Promote hand-washing and treatment of home drinking water.
  • Target the underlying socioeconomic causes of child mortality such as mothers’ access to reproductive health, education and employment.
  • Prevent and provide effective treatment of pneumonia, diarrhoea, malaria and other infectious diseases.
  • Promote comprehensive and universal coverage of primary health-care systems — with the engagement of community health workers — accompanied by sustained delivery of health services and women’s education programmes.
  • Inject additional aid flows, on the order of $10.2 billion per year, to ensure sufficient financing for the strengthening of health systems to meet the demand for maternal and childcare and other reproductive health services.

Pneumonia is the number one killer of children worldwide. The bacteria Streptococcus pneumoniae, or pneumococcus, is the leading case of serious pneumonia. It can also cause other other life-threatening diseases, like meningitis and sepsis. That is why preventing and treatment pneumonia and other pneumococcal diseases is an essential part of the solution to child morbidity and mortality.

Many of the solutions to child pneumonia and other pneumococcal diseases can also help control other diseases, and have the capacity to greatly improve child survival

  • Protection: Ensuring that children have adequate nutrition, including exclusive breastfeeding during the first six months of life, can help protect them from pneumonia and other diseases. Children who are undernourished are at greater risk of suffering death or disability during childhood than those who receive adequate nutrition. Reducing environmental risk factors, such as overcrowding in homes, exposure to tobacco smoke and indoor air pollution are also important protective measures.
  • Prevention: Vaccines are a well-tolerated and effective option for preventing pneumococcal diseases and a host of other deadly diseases that can affect children.
  • Treatment: Early diagnosis to ensure that children receive early and appropriate medical care for pneumonia and other life-threatening diseases is critical. Proper treatment with antibiotics that typically cost less than one dollar per day can be life-saving.


  1. UNICEF. The State of the World’s Children. 2012.
  2. The Bellagio Study Group on Child Survival. Knowledge into action for child survival. Lancet 2003; 362: 323–27.
  3. World Health Organization. Children: reducing mortality. 2012.