Celebrating the child survival revolution: where we are now and advocacy to come

Today and all this month of March, we celebrate the anniversary of a revolution that has saved millions of lives over 10 years — the Child Survival Call to Action. In 2013, political leaders and the global health community committed to collective action for mothers and children. RESULTS advocates helped to generate the political support to take bold action on maternal and child survival and to make the resulting progress possible. This week, the U.S. Agency for International Development (USAID), UNICEF, and other partners aim to refocus and reinvigorate the revolution in the face of new challenges.

Over the past decade, substantial progress has been made. The global under-five mortality rate has declined by 21 percent — from 48 per 1,000 live births in 2012 to 38 per 1,000 live births in 2021. This figure will likely be uplifted at a USAID/UNICEF event launching the next phase of this revolution. Let’s take a moment to celebrate the advocacy that has helped make this progress possible — and the advocacy that’s needed to ensure all pregnant people, newborns, and children can survive and thrive.

When I began my career in advocacy, a colleague told me “advocacy is about showing up, being bold, continuing to show up…and never going away.”

High-level political events and conferences can be useful. But RESULTS’ ongoing advocacy is crucial to sustaining this political will. While large global gatherings occur infrequently, RESULTS advocates are continuously meeting with our elected officials to hold them accountable, year after year.

In 1980, 12 people gathered in a living room in Los Angeles to write letters to Congress urging them to take action on global hunger. That was the birth of RESULTS. Now, our movement has grown by thousands and spans multiple states, countries, and continents.

In the 1990s, RESULTS volunteers successfully supported Congress to create a special account for global child survival and health programs, extending these life-saving efforts and protecting them from future budget cuts — it received $300 million in initial funding. Last year, we garnered support from nearly 180 members of the House of Representatives on a letter requesting $1.1 billion for that account.

Now, the world is at a crossroads. The combination of multiple crises — including the COVID-19 pandemic, increasing global conflict, price shocks and inflation, and the effects of climate change — threaten hard-won global health gains. In many places (including the U.S.), we’ve begun seeing reversals in child and maternal survival. Our voices and our tenacious advocacy are needed now more than ever.

The world is experiencing the largest backslide in childhood vaccinations in a generation. UNICEF and Gavi, the Vaccine Alliance have sounded the alarm that in 2021 alone, 25 million children around the world missed out on vaccines. That’s six million more than in 2019. The task ahead of us is daunting, but we have overcome tougher odds before. In 2011, RESULTS and our global partners in the ACTION Global Health Advocacy Partnership worked with Gavi to exceed its global goal of raising $7.5 billion. That funding supported countries to save the lives of more than five million children. Our advocacy can and will help create the conditions for progress like this if we don’t let up.

RESULTS has been committed to child survival since our founding in 1980. We never stopped showing up. Our tenacity helped ensure the U.S. remained the largest donor to maternal and child health in the world — through changes in Congress and the White House, through recessions and domestic crises, we urged policymakers not to turn away from the global community. The work ahead of us is great, but we can accomplish anything together. And as long as there are people living in poverty, we are not going away.