Helping children survive

Spotlight on Development

Click for larger graph Drawing by David Rooney

Goal: Reduction of mortality rates among infants and small children by two-thirds by 2015. 

Joe was a normal looking child. He looked about the right weight, had a cheery smile and laughed loudly when he played with his many friends. Sadly, Joe fell ill and died a week before his fifth birthday.

Today, some 30 million infants in developing countries are not protected by routine vaccination. And some 11 million children under five die each year, mostly of preventable causes. The under-five mortality rate, one of the best single indicators for measuring social progress, fell by a mere 5% during the 1990s; this is hardly progress enough.

Why are children being betrayed like this? The answer is both simple and complex. It is simple because most countries under-invest in their children’s well-being. Governments in developing countries spend, on average, less than 15% of the national budget on basic social services – some $150 billion. Industrialised countries channel, on average, about 11% of their targeted aid – some $4 billion – to these services. It is not enough. About $100 billion more per year is needed in global spending on basic social services for each and every child to get a good start in life. This may appear as a large sum of money, but it represents only a third of 1% of total world income. That is not a lot of money, particularly if spending it means giving vulnerable children the right to live. Put crudely, it represents a rare investment opportunity. At the Copenhagen Social Summit in 1995 the world’s leaders suggested as a rough guideline that 20% of budgetary expenditure and 20% of aid flows should be allocated to basic social services.

But though the goal of reducing child mortality requires relatively little money, it is certainly not being reached. It is here that the arguments become more complex. It is one thing to invest more in children, but quite another to achieve the equity and efficiency needed to make the investments work. It is partly a question of management, but also a matter of dealing with major hurdles, like the spread of HIV/AIDS, malaria, diarrhoeal diseases and pneumonia, all of which demand vaccines to be developed. Add to this the problem of halting armed conflicts and reducing the crippling debt burden, and the issue of reducing child mortality becomes more than a question of mere budgets.

These are major challenges, though there are some relatively simple things that can be done. For example, education, particularly of girls, is key, not just in its own right, as other articles in this Spotlight emphasise. Rather, the risks of under-five mortality and child malnutrition are closely associated with the level of education of the mother; a child is about two to three times more likely to be malnourished or to die before five when its mother is illiterate than when the mother has completed primary education!

There is also a relationship between education and HIV/AIDS control. In several African countries, HIV infection rates are falling rapidly among educated people. Even in the most affected countries that have seen their under-five mortality rate increase in the 1990s, the risk of premature death among children whose mother has post-primary education has declined. Simply put, education provides protection against HIV infection and other deadly childhood diseases.

The widening education and mortality gaps reflect the growing income inequities between the rich and poor in many countries. Children are a particularly sensitive group that have fallen victim to these trends. A small increase in the global budget and a little bit of imaginative policy-making in education and other social areas would greatly reduce premature child deaths in developing countries. And kids like Joe would be able to grow up and celebrate many more birthdays as a result.


• UNDP, UNESCO, UNFPA, UNICEF, WHO, and the World Bank “Implementing the 20/20 Initiative: Achieving universal access to basic social services”, 1998. UNICEF, New York.

• UNICEF, “Poverty Reduction Begins with Children”, New York, 2000.

• Vandemoortele J.: “Absorbing social shocks, protecting children and reducing poverty”. UNICEF, Staff Working Paper EPP, 2000-01, New York.

©OECD Observer No 223, October 2000 

Economic data

GDP growth: +0.5% Q3 2018 year-on-year
Consumer price inflation: 2.1% Jan 2019 annual
Trade: +0.3% exp, +0.7% imp, Q2 2018
Unemployment: 5.3% Jan 2019
Last update: 12 Mar 2019


Stay up-to-date with the latest news from the OECD by signing up for our e-newsletter :

Twitter feed

Subscribe now

<b>Subscribe now!</b>

To receive your exclusive paper editions delivered to you directly

Online edition
Previous editions

Don't miss

  • Food production will suffer some of the most immediate and brutal effects of climate change, with some regions of the world suffering far more than others. Only through unhindered global trade can we ensure that high-quality, nutritious food reaches those who need it most, Angel Gurría, Secretary-General of the OECD, and José Graziano da Silva, Director-General of the United Nations Food and Agriculture Organization, write in their latest Project Syndicate article. Read the article here.
  • Globalisation will continue and get stronger, and how to harness it is the great challenge, says OECD Secretary-General Gurría on Bloomberg TV. Watch the interview here.
  • OECD Secretary-General Angel Gurría with UN Secretary-General António Guterres at the 73rd Session of the UN General Assembly, in New York City.
  • The new OECD Observer Crossword, with Myles Mellor. Try it online!
  • Watch the webcast of the final press conference of the OECD annual ministerial meeting 2018.
  • Listen to the "Robots are coming for our jobs" episode of The Guardian's "Chips with Everything podcast", in which The Guardian’s economics editor, Larry Elliott, and Jeremy Wyatt, a professor of robotics and artificial intelligence at the University of Birmingham, and Jordan Erica Webber, freelance journalist, discuss the findings of the new OECD report "Automation, skills use and training". Listen here.
  • Do we really know the difference between right and wrong? Alison Taylor of BSR and Susan Hawley of Corruption Watch tell us why it matters to play by the rules. Watch the recording of our Facebook live interview here.
  • Has public decision-making been hijacked by a privileged few? Watch the recording of our Facebook live interview with Stav Shaffir, MK (Zionist Union) Chair of the Knesset Committee on Transparency here.
  • Can a nudge help us make more ethical decisions? Watch the recording of our Facebook live interview with Saugatto Datta, managing director at ideas42 here.
  • The fight against tax evasion is gaining further momentum as Barbados, Côte d’Ivoire, Jamaica, Malaysia, Panama and Tunisia signed the BEPS Multilateral Convention on 24 January, bringing the total number of signatories to 78. The Convention strengthens existing tax treaties and reduces opportunities for tax avoidance by multinational enterprises.
  • Rousseau
  • Do you trust your government? The OECD’s How's life 2017 report finds that only 38% of people in OECD countries trust their government. How can we improve our old "Social contract?" Read more.
  • Globalisation’s many benefits have been unequally shared, and public policy has struggled to keep up with a rapidly-shifting world. The OECD is working alongside governments and international organisations to help improve and harness the gains while tackling the root causes of inequality, and ensuring a level playing field globally. Please watch.
  • Checking out the job situation with the OECD scoreboard of labour market performances: do you want to know how your country compares with neighbours and competitors on income levels or employment?
  • Trade is an important point of focus in today’s international economy. This video presents facts and statistics from OECD’s most recent publications on this topic.
  • The OECD Gender Initiative examines existing barriers to gender equality in education, employment, and entrepreneurship. The gender portal monitors the progress made by governments to promote gender equality in both OECD and non-OECD countries and provides good practices based on analytical tools and reliable data.
  • Interested in a career in Paris at the OECD? The OECD is a major international organisation, with a mission to build better policies for better lives. With our hub based in one of the world's global cities and offices across continents, find out more at .
  • Visit the OECD Gender Data Portal. Selected indicators shedding light on gender inequalities in education, employment and entrepreneurship.

Most Popular Articles

OECD Insights Blog

NOTE: All signed articles in the OECD Observer express the opinions of the authors
and do not necessarily represent the official views of OECD member countries.

All rights reserved. OECD 2019