Affordability of the MDG for child survival

A recent LANCET article¹ estimates the cost of delivering comprehensive child survival interventions in 42 countries where 90% of global child deaths occurred in 2000. The modelling exercise was undertaken in order to find out whether the achievement of the Millennium Development Goal (MDG) for child survival falls within the financial capacities of donors and developing countries.

All child survival interventions shown to reduce mortality from the major causes of death in children younger than 5 years were incorporated into a delivery timetable. This timetable comprised of 18 contacts between a child or mother and a health-care provider in the period from before birth until the child reached five years. The running costs of delivering the interventions at universal coverage levels were calculated as the sum of unit costs for drugs and materials, delivery costs, and programme management and support costs, including supervision. Costs were estimated at coverage levels reported for 2000 and the additional costs of providing services at universal coverage levels.

The study found that US$5.1 billion in new resources is needed annually to save six million child lives in the 42 countries responsible for 90% of child deaths in 2000. This cost represents $1.23 per head in these countries, or an average cost per child life saved of $887. Sensitivity analyses for salary levels for community delivery agents, drug costs and coverage rates for 2000 were used to develop uncertainty estimates around the US$5.1 billion annual price tag, that ranged from about $3.1 billion to $8.0 billion.

Achieving the MDG for child survival is affordable for donors and developing countries. Scaling up health delivery is the challenge, and along with the lack of funds, will be the limiting factor in reducing child mortality by two-thirds by 2015.

¹Bryce. J (2005). Can the world afford to save the lives of 6 million children each year? The Lancet, vol 365, June 25, 2005, pp 2193- 2201