This article originally appeared on Economist.com.
When historians write about the first quarter of the 21st century, they often summarize it like this. Two decades of unprecedented progress followed by five years of stagnation.
This applies to nearly every issue the Bill & Melinda Gates Foundation works on, from poverty reduction to elementary school access. But nowhere is the contrast more stark and tragic than in health.
From 2000 to 2020, the world witnessed a global health boom. Child mortality has decreased by 50%. In 2000, more than 10 million children died each year; today that number is less than 5 million. The spread of the world’s deadliest infectious disease has also been cut in half. Most of all, it’s great to see progress being made in areas where the burden of disease has been highest. Sub-Saharan Africa and South Asia saw the greatest improvement.
We must invest in global health to protect children from the worst effects of hunger…
Then the coronavirus hit, and progress came to a screeching halt.
The world is grappling with more challenges today than at any point in my adult life, including inflation, debt, and new wars. We are also tackling malnutrition, the worst child health crisis. Unfortunately, aid has not kept pace with these needs, especially in the areas that need it most.
When children die, half of the underlying causes are malnutrition. Climate change is making the situation worse. Some 40 million more children will be stunted and 28 million more will suffer from wasting between 2024 and 2050 as a result of climate change, according to new data from the Institute for Health Metrics and Evaluation. These conditions are the most acute form of malnutrition and mean children are unable to reach their full potential both mentally and physically.
The health and economic impacts are devastating. Children who are severely malnourished before the age of three complete five years less schooling than well-nourished children, and those who go hungry as children earn 10% less over their lifetime. , research shows they are 33% less likely to abscond. poverty.
For an expanded version of this article, check out our 2024 Goalkeeper Report.
We must invest in global health to protect children from the worst effects of hunger, mitigate the effects of climate change and boost economic growth. And looking to the past can provide inspiration on how to reignite progress.
The global health boom had many causes. A new generation of political leaders embraced humanitarianism. Hundreds of thousands of medical workers spread across the globe, bringing cutting-edge medicines to places rarely visited by doctors. But one factor that was often overlooked was the small but significant increase in funding.
Since 2000, the world’s richest countries have steadily increased their funding to supplement lower-income countries while increasing investment in their own health. During the first two decades of this century, OECD countries steadily increased foreign aid from an average of 0.22% to 0.33% of gross national income, with the most generous countries providing about 1%. In 2020, low-income countries received an average of $10.47 per person. It doesn’t sound like much, but that $10.47 made an amazing difference. It has fueled the work of organizations such as Gavi, the Vaccine Alliance and the Global Fund to Fight AIDS, Tuberculosis and Malaria to provide poor countries with access to life-saving vaccines, medicines and other medical breakthroughs.
The impact of this generosity was amazing. The work isn’t finished yet. More than half of all child deaths still occur in sub-Saharan Africa. Since 2010, the share of the world’s poor living in this region has increased by more than 20 percentage points to nearly 60%. Yet, over the same period, its share of total foreign aid to Africa has fallen from nearly 40% to just 25%, the lowest share in 20 years. Fewer resources mean more children die from preventable causes.
The global health boom is over. But for how long? That’s a question I’ve been struggling with for the past five years. Will we look back on this period as the end of the Golden Age? Or is it just a short hiatus before the next boom begins?
I’m still an optimist. I think we can give global health a second act, even in a world where competing challenges require expanding government budgets. Doing this requires a two-pronged approach.
First, the world needs to recommit to the efforts that drove progress in the early 2000s, especially investing in critical vaccines and medicines. They still save millions of lives every year.
We also need to look forward. The research and development pipeline is full of powerful and incredibly cost-effective breakthroughs. We need to use them to fight the most prevalent health crisis. And it starts with good nutrition.
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One of the few failures of the global health boom was the lack of understanding of the importance of nutrition. But over the past 15 years, doctors have begun to uncover how the stomach influences every aspect of human health. If we can solve malnutrition, many other problems will become easier to solve. We solve extreme poverty. Vaccines are more effective. And deadly diseases like malaria and pneumonia are much less deadly.
This knowledge is now being translated into incredibly cost-effective innovations such as super-fortified broths and more effective prenatal vitamins. The impact of scaling up these innovations will be staggering. In Nigeria, models show that fortifying bouillon cubes not only prevents anemia; It would also prevent more than 11,000 deaths from birth defects of the central nervous system known as neural tube defects. And nearly half a million lives could be saved by 2040 if low- and middle-income countries adopted the most complete form of prenatal vitamins, called multimicronutrient supplements.
The early global health boom is over. “But for how long?” That is still a question for humanity to decide. I believe that by providing children with the nutrients they need to grow, we can create a second global health boom.
