While dramatic progress has been made on some problems related to the Millennium Development Goals (MDGs) and the children of Africa, enormous challenges still remain, according to participants in a meeting of the Executive Board of the United Nations Children's Fund (UNICEF) in New York on 17 January 2007.

UNICEF Executive Director Anne M. Veneman opened the event with encouraging news. The first results of the "Accelerated Child Development and Survival" programme--implemented in 11 countries and whose goal had been to achieve a 15-per cent reduction in child mortality at a cost of $1,000 per life saved--showed a 20-per cent reduction at a cost of $500 per life saved. UNICEF sought to "scale-up this programme to see if these results can be sustained over the long term", she said, and established partnerships with the World Health Organization (WHO), the World Bank and many non-governmental organizations. The eight Millennium Development Goals (MDGs) - which range from halving extreme poverty to halting the spread of HIV/AIDS and providing universal primary education, by 2015 - form a blueprint that has galvanized unprecedented efforts to meet the needs of the world's poorest.

Ms. Veneman said UNICEF chose to focus its efforts on Africa because of the great hardship the continent's people face. Although sub-Saharan Africa has only 11 per cent of the global population, the region is the source of one half of the world's victims of mortality for children under five years old. "Pneumonia is the number one killer of children, and it takes the lives of over 1 million children in sub-Saharan every year", she said, adding that malaria and diarrhoea were the next main causes of death. All of these diseases are entirely preventable, she added.

"Child mortality in sub-Saharan Africa needs to decline more than 8 per cent per year if we are going to meet the MDG of reducing child mortality by two thirds by the year 2015. Currently, child mortality is declining at the rate of 0.7 per cent, so if we continue at that rate, the MDG would not be met until 2115, one hundred years late", Ms. Veneman said. These figures persist because interventions, such immunization, micronutrients, water and sanitation, and insecticide-treated bed nets do not reach enough people. "Community-based approaches, working with the community to educate them on how to make a difference in taking care of children and newborns, diarrhoeal disease, oral rehydration therapy, how to use bed nets", had made a dramatic difference in places like a district in Ghana that had seen as high as a 50-per cent reduction in child mortality, she said.

Ernest Loevinsohn of the Canadian International Development Agency advocated for a "balanced approach that looks at the achievements and opportunities in Africa", saying that there were 40 per cent more girls in school in Africa than a decade earlier. "That is a remarkable achievement in a key area, yet if you read the newspapers you would never know that this kind of progress is happening in Africa, thanks to the work of UNICEF and its partners", he said, mentioning further that a recent WHO/UNICEF campaign had brought measles down "75 per cent in only six or seven years, dramatically surpassing the target".

Interventions, such as immunizations and bed nets, were reaching wealthier children who live in urban environments and not impoverished rural children, noted Jennifer Bryce of the Johns Hopkins School for Public Health. If she had to give a grade to efforts to reduce child mortality, she said she "would be hard pressed to say we are doing 'average'. We have to do better, we can do better."