One of the Millennium Development Goals (MDGs) calls for a significant reduction of child mortality by 2015. Two years before the deadline, some countries have already reached that goal.
Ethiopia, Liberia, Malawi and Tanzania in Africa. Bangladesh, Nepal and East Timor in Asia. These countries have something in common - they have all succeeded in reaching a major goal before the 2015 deadline, the goal of reducing child mortality by two-thirds.
The East African state of Ethiopia is a good example of the challenges faced by low income countries. The World Bank lists 36 such countries. In Ethiopia there is one doctor for every 36,000 people. Even by African standards that is a very low figure. Ethiopia, with a population of 85 million, comes second only to Nigeria as Africa's most populous country. It belongs to the 34 countries in the world in which 90 percent of the world's malnourished people live.
Taking health policy out of the cities
Seen against that background, Ethiopia's success in reaching one of the 2015 Millennium Development Goals (MDGs) deadline early is even more impressive. According to the United Nations Children's Fund UNICEF, 68 of every 1,000 children in Ethiopia die before the age of five. In 1990, the year on which the MDGs are based, the number was 204.
Asked by the German Press Agency dpa what Ethiopia has done that is better than its neighbors, UNICEF Representative to Ethiopia Peter Salama pointed to the extensive training of health workers. Since 2003 the government has trained 38,000 health workers and pays their wages. Unlike other countries, Ethiopia has made its rural population a priority group and has sent most of its help to poor, isolated regions. For Salama, this is nothing short of a revolutionary concept. Although Ethiopia is one of many African states that are largely rural, its farmer-focused health policy puts it at the forefront.
Ethiopia's development partners help with logistics, ensure that medicine is transported at the correct temperature, provide beds for births and organize further training courses. The nurses who benefit from such training are not only active in the maternity wards but also treat the many cases of tuberculosis and diarrhea, malaria and malnutrition. Even Ethiopian NGOs are full of praise for the decision by the government to make the prime minister's office responsible for the national action plan, working together with nine ministries.
In one respect Ethiopia has a head start, notes Peter Salama. Many more children in West and Central Africa fall sick with malaria than in the east and south of the continent. A study carried out by Trinity College in Dublin sees malaria as a major threat in Niger. Although the country has made considerable progress since 1990, child mortality there is still at 16.7 percent.
The political stability factor
Between 1990 and 2012, sub-Saharan Africa as a whole succeeded in reducing the mortality rate among children under five by 40 percent on average, thereby failing to meet the two-thirds goal. In Chad, the Democratic Republic of Congo, Somalia, Mali, Burkina Faso and Cameroon, the number of deaths has increased.
An examination of the latest MDG data leads Peter Salama to the conclusion that "politically unstable states tend to fall back, whereas in stable countries there is more progress."
While Burkina Faso and Mali did enjoy relative political stability during the period under review, another country made the downwards transition from beacon of hope to dictatorship. Eritrea, on the Horn of Africa, is one of just four African countries that seem to be well on course to reach another MDG, that of reducing maternal mortality by 75 percent. Eritrea also scores well in other areas, for example it has a literacy rate of 90 percent. But these achievements come at a cost. Eritrea is one of the world's most repressive countries. Neighboring Ethiopia also has an authoritarian regime.
For Africa's youngest children, the latest UNICEF figures are good news. But governments and development aid partners should not relax their efforts. 6.6 million children around the world still die every year before the age of five, many of them in Africa's population giant, Nigeria. Together with India, it remains the country where more than a third of all deaths under five take place.