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Downturn Could Kill 400,000 Children, Warns Margaret Chan

Sam Lister

Margaret Chan: 'Past recessions have provided evidence of deaths'

Thousands of women and children are dying as a direct consequence of the current economic crisis which is already derailing efforts to improve maternal care and cut child death rates, the head of the World Health Organisation has warned.

Speaking to The Times after a meeting of world leaders hosted by Gordon Brown yesterday, Margaret Chan, director-general of the WHO, said that risks posed by the credit crunch to poor nations were already taking hold.

Dr Chan said that an estimate of between 200,000 and 400,000 additional child deaths per year caused by the downturn was "entirely credible". She called on world leaders to show solidarity and "walk the talk" of funding pledges to poorer nations.

"There is no reason why we should doubt that this [death toll] will happen if we fail to act," Dr Chan said. "Because if we do not, more women will suffer or die because of complications arising from pregnancy and delivery, and more children will die because of lack of food or immunisation or poor water and sanitation.

"It is very clear. Past recessions have ample evidence to demonstrate the fact. And the two groups that are most vulnerable are women and children, especially girls."

Dr Chan, a member of the Taskforce on Innovative International Financing for Health Systems, which also includes Mr Brown, Robert Zoellick, president of the World Bank, and eight other world leaders, added that she had already encountered evidence of worsening funding problems.

A decline in remittance payments - when people from impoverished countries working in the developed countries send money home - was already impacting on community health, she said. Concerns are also growing that the poorest countries are no longer able to prioritise healthcare from the little funds they have, while donor countries might renege on their aid commitments.

More than half a million women die from preventable complications in pregnancy or childbirth every year, while it is calculated that a child dies from health-related problems every three seconds.

Among the eight Millennium Development Goals, signed up to by all United Nations member states, are pledges to reduce by two-thirds the under-five mortality rate and cut by three quarters the maternal deaths by 2015. Many countries are currently lagging behind these targets, while the funding required to reach them is way off course.

A report published yesterday by the international financing taskforce warns that development funding shortfalls could reach as much as £30 billion a year by 2015. It estimates that this money would save an extra 10 million lives - three millions mothers and seven million children.

The report stresses that even if poorer countries and aid donors meet existing commitments - including all donors achieving 0.7 per cent of gross national income for aid and developing country governments investing 15 per cent expenditure in healthcare - there will still be a funding gap of $7 billion a year.

At the moment, low-income countries spend $24 a head on healthcare compared to $4,000 a head spent in the developed world. While better health systems have led to a fall in HIV AIDS infections and wider availability of malaria and TB vaccines, there is an urgent need to invest more in the fabric of developing country health systems - especially training and employing more health workers, the taskforce concludes.

Dr Chan said that to date she had not heard of a country refusing to honour their aid commitment, "but words are words and countries need to walk the talk".

"Given the financial situation, if funding is not forthcoming the [healthcare] shortfall is only going to get bigger. My first hand experience talking to heads of government, heads of state and ministers of health suggests that some countries that depend on ODAs [official development assistance] or remittance are seeing a reduction in those."

Specific pledges include nearly $1 billion from Britain over the next three years to support national health plans in eight countries.

The Taskforce also discussed yesterday initial proposals for new ways of financing healthcare to meet aid shortfalls. The report highlights the case for frontloading expenditure, using market mechanisms to stimulate health investments, and encouraging greater contributions from the public and the private sector. The Working Group will report its recommendations before the G8 Summit in Italy.

"At this time when every citizen in every country and their political leaders are preoccupied with the financial crisis and what it means to themselves, it is vital that we focus on this solidarity," Dr Chan added.

"It is so important to champion women and children, otherwise once again they will fall by the wayside.

"Recent investment [in infectious disease prevention] is making good progress and we must protect that. We need to show that we have learnt from past recessions. If we take action and introduce prompt measures then hopefully the damage can be reduced."

Douglas Alexander, the International Development secretary, told The Times that with the risk of 90 million people being pushed into extreme poverty by the downturn, the Government remained fully committed to its aid pledges.

"The stark reality is that if the global community fails to find new ways to support and develop health services in the developing world, many millions more will die," he said. "We must act to prevent this financial crisis from becoming a human crisis."

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