Children are our best investment. What we do for our children, for the world’s children, more than anything else we leave behind, forms our legacy as political leaders in the world. For that reason, I, as the Prime Minister of Norway, call for courageous steps to protect our children, our common future.

The new millennium have given mankind unprecedented opportunities. Today we are moving towards a tightly knit global community in an accelerating pace. What we do as individual countries, what we do together will determine the character of this emerging global community, its values, its welfare and our future.

Investing in our children’s health
Protecting our children is a moral and political imperative. It is also essential to socio-economic development.

As an economist, I am convinced by the research in recent years that have shown the economic benefits that accrue from investing in health in general, and in children’s health in particular. Professors Bloom and colleagues have shown that one third to half of the growth in East Asia from 1965 to 1990 could be attributed to reduced child mortality and its consequences 1Bloom DE, Cunning D, Weston M. World Economics 2005;6(3):15-39. More recently Bloom et al found that the economic returns from vaccination of children is a staggering 12-18% on an annual basis. Scientists have also estimated that, between 1965 and 1990, child morbidity and mortality rates contributed to stifling economic growth in Africa and to about half of the unfavorable gap in economic growth rate between Africa and the rest of the world 2Bloom, D.E., and J.D. Sachs. 1998. “Geography, Demography and Economic Growth in Africa.” Brookings Papers on Economic Activity, pp. 207–95. Washington, DC: Brookings Institute. The health of our children affects the economic health of our nations. It makes sense. A healthy child can attend school and its cognitive development and performance will be enhanced. A healthy child can give a helping hand at home and to younger children. When a child survives, the parents need fewer children to ensure their own support in older age.

The moral imperative
More than 10 million children die every year from diseases that are largely preventable and treatable 3Black RE, Morris SS, Bryce J. Where and why are 10 million children dying every year? Lancet 2003;361:2226-34. More than 99% of these deaths are concentrated among the worlds poorest families. This is a tragedy of unacceptable scale.

To put this in perspective, the number of preventable newborn and child deaths each year is double the number of people who die from HIV/AIDS, malaria and tuberculosis, combined. While the world contributed with unprecedented compassion and generosity to assist the victims of the South-Asian tsunami, we have failed to protect our children sufficiently against the silent tsunami of preventable neonatal and child deaths that occur every week.

What’s worse is the truth that two third of these deaths could be avoided with the tools and knowledge we currently have 4Darmstadt GL, Bhutta ZA, Cousens S, Adam T, Walker N, De Bernis L. Evidence-based, cost-effective interventions: how many newborn babies can we save? Lancet 2005;365:977-88. 5Jones G, Steketee RW, Black RE, Bhutta ZA, Morris SS. How many child deaths can we prevent this year? Lancet 2003;362:65-71

Our stated commitment
In 2000, we laid out the common vision for global development at the United Nations. We adopted the eight Millennium Development Goals (MDG). In adopting these goals every country in the world committed to the targets they prescribe. MDG 4 specifically addresses neonatal and child mortality and we agreed to reduce child mortality by two-thirds by 2015.

Despite the availability of solutions and our declared commitment, to date, we have not achieved the progress needed to achieve MDG 4.The problem is not a lack of cost-effective interventions, but the access to them. 6Freedman LP, Waldman RJ, de Pinho H, Wirth ME, Chowdhury AM, Rosenfield A. Transforming health systems to improve the lives of women and children. Lancet 2005;365:997-1000

The Norwegian strategy to achieve MDG 4
Since 2001 we became one of the largest contributors to the Global Alliance for Vaccines and Immunization, GAVI and we have been actively engaged in shaping the alliance. We are also a large contributor to UNICEF, WHO and the Global Fund to fight AIDS, Malaria and Tuberculosis, all of which contribute to the fight against child mortality.

More recently, to tackle more aggressively the lack of progress in child mortality reduction, my government decided to add another component to the MDG 4 strategy: the development of partnerships with a few large countries. This program is still unfolding, but the characteristics can be gleaned from the first one that will be with India.

Norway is also committed to work together with others countries and their leaders, Prime Ministers and Presidents, particularly the leaders of the G8 countries, in international and global forums. This is not only aimed at ensuring an increased level of investment, but also a better coordinated and more effective action and an honest sharing of lessons learned, not just as we look back but as we proceed.

The Norway India Partnership on MDG 4
In both countries we are making large investments to enhance equity, solidarity and inclusiveness. But investments may not be enough in themselves. They require innovation to acquire maximal impact. To this end Prime Minister Singh and I have initiated a Partnership. The Norway India Partnership Initiative will use creative resources in both countries to overcome constraints to access. It will have a catalytic role to facilitate the delivery of the recently launched, multibillion dollar National Rural Health Mission of India. It has the ambitious goal of saving 500 000 children lives per year by 2009, and will focus on the five states that together account for 60% of child mortality in India, and 18% of the world’s deaths in children under five years of age.

The creation of a flexible, problem solving, management enabling mechanism is key to the success of the partnership. It embodies the paradox of designing a system that can react and re-assess and respond to the countless unforeseen problems that will arise. These problems will vary at the national, state, district, and block levels, and from village to village. They need solutions locally designed, owned and implemented.

The stakes for us are high, but so are the benefits. It will take courage, perseverance, and our sustained high level attention to ensure its success, but we are firmly committed to getting real results for the lives of our children.

Fulfilling our commitment

A man or the government of a country can only be judged by its actions…

Mahatma Gandhi 7 p. 130 in TO MY COUNTRYMEN by M.K. GANDHI

We, as our nations’ leaders, need to put our words and our deeds behind our promises. We need to fulfill our commitment to children in the world and to shape a better common future.

Only these will be the actions we can be judged on by the generations to follow.

Jens Stoltenberg
Prime Minister of Norway
Oslo, Norway