1. A Promise Renewed
- the knowledge, the
tools and the will to
end preventable
child deaths
Rotary United Nations Day
New York, 3 November 2012
Ian Pett
Chief, Health Systems and Strategic Planning

2. The global burden of under-five deaths has fallen steadily
since 1990
Global number of under-five deaths, selected years
14
12.0
12
10.8
Millions of under-five deaths
10 9.6
8.2
8
6.9
6
4
2
0
1990
1995
2000
2005
2011
Source: The UN Inter-agency Group for Child Mortality Estimation, 2012;
provided by SMS/DPS/UNICEF

3. The global under-five mortality rate has fallen by 41% from
1990 to 2011
Under-five and neonatal mortality rate, 1990-2010
100
U5MR
87
90
NMR
80
Deaths per 1,000 live births
70
60
51
50
40
30 MDG Target: 29
32
20
22
10
0
1990 1995 2000 2005 2010 2015
Source: The UN Inter-agency Group for Child Mortality Estimation, 2012;
provided by SMS/DPS/UNICEF

4. The global burden of under-five deaths is increasingly
concentrated in sub-Saharan Africa and South Asia
Share of under-five deaths by region (%)
100%
90%
80%
Share of under-five deaths
70%
60%
50%
40%
30%
20%
10%
0%
1990 1995 2000 2005 2010
Sub-Saharan Africa South Asia
East Asia and Pacific Middle East and North Africa
Latin America and the Caribbean CEE/CIS
Rest of the World
Source: The UN Inter-agency Group for Child Mortality Estimation, 2012;
provided by SMS/DPS/UNICEF

5. Half of global under-five deaths occurred in just 5 countries
Number of under-five deaths by country (in thousands)
India, 1,655
Other
countries, 2,
716
Nigeria, 756
Democratic
Afghanistan, Republic of
128 the
Congo, 465
Uganda, 131
Pakistan, 352
Bangladesh,
134 China, 249
Indonesia, 13 Ethiopia, 194
4
Source: The UN Inter-agency Group for Child Mortality Estimation, 2012;
provided by SMS/DPS/UNICEF

6. 8 of the 10 countries with the highest under five
child mortality rates are affected by violence or
in ‘fragile situations’
1) Sierra Leone(185 per 1000 live births) 11) Cameroon
2) Somalia 12) Guinea
3) Mali 13) Niger
4) Chad 14) Nigeria
5) Democratic Republic of the Congo 15) South Sudan
6) Central African Republic 16) Equatorial Guinea
7) Guinea-Bissau 17) Mauritania
8) Angola 18) Togo
9) Burkina Faso 19) Benin
10) Burundi 20) Swaziland (104 per 1000 live births)
Source for mortality rank: UN Inter-agency Group for Child Mortality Estimation 2012; Fragile Situation countries
are shown in red (source: World Bank 2011)
6

7. Global Causes of Under-Five Deaths in 2010
Through synergy with infectious diseases
undernutrition causes 35% of child deaths

8. Every Woman, Every Child - the Global
Strategy For Women’s And Children’s
Health

10. 164 Governments Pledged to date
Plus Hundreds of
• Civil Society organisations
• Faith Based organisations
• and individuals
www.apromiserenewed.org

12. Child Health Progress
on intervention
coverage addressing
Neonatal deaths
PMTCT
Vaccine preventable diseases
Pneumonia
Diarrhoea
Malaria
through addressing disparities and
using more effective service delivery
models, particularly community based
health care

13. Global Polio Eradication Initiative:
The Global Picture

14. Context: Poliovirus Distribution 1988-2012
1988
Endemic
Re-established
2012

15. The Remaining Polio Sanctuaries in priority
countries
Total cases in 2012: 175
In 2011 (to date): 650
Total in 2011: 489
Data as of Oct 29, 2012

16. Polio-paralyzed children at 29 Oct 2011 vs. 2012
150
2011 2012
125
100
Cases
75
50
25
0
Pakistan Afghanistan Nigeria Chad

17. UNICEF’s role in GPEI
UNICEF leads in :
– Communication and social mobilization in priority
countries
– Vaccine procurement and delivery
– Cold chain and logistics support
UNICEF supports
– Global advocacy and resource mobilization
– Funding through own contributions
– Technical support to SIAs at country level
– Operation financing in selected countries
– Strengthening routine immunization

18. Vaccine Security to support GPEI
Sustained, uninterrupted supply of affordable,
quality vaccines
• tOPV, mOPV1, mOPV3; bOPV (first time used in Dec 2009)
• In 2011, UNICEF has procured over 1.6 billion doses of
OPV, with value of over $185 million, for delivery to 76
countries for routine immunization and SIAs
~85% of procurement for SIAs
• Supply Division is continuously working with partners and
manufacturers to address the changing epidemiology
(outbreaks, circulation), and changing availability of polio
vaccines (pre-qualification, registration, licensing, etc)

19. GPEI Financing 2012-2013: $1.48 billion in contributions
G8
14%
UK Russian
USCDC Federation EC Domestic
Japan Canada USAID Resources
Bangladesh
23%
Japan International
India
Cooperation Agency
Loan Conversion Nigeria
UNICEF Angola
Multilateral
Sector
6% Australia
WHO Luxembourg
IFFIm Others
World Bank
Non-G8 OECD/
Bill and Melinda Other 2%
Gates Foundation
Rotary
International
Current Funding Gap: US$ 700 m of US$ 2.18 b budget
Private Sector Firm Prospects: US$ 360m
20% Best Case Gap: US$ 340m
‘Other’ includes: the Governments of Austria, Brunei, Estonia, Finland, Monaco, Nepal and Turkey, plus other Institutions: Chevron (Angola), Central
Emergency Response Fund (CERF), Common Humanitarian Fund (South Sudan), the GOOGLE Foundation/Matching Grant, Total E&P (Angola) and
WHO core resources.

20. 2013-2018 Headline Endgame
Costs
WHO/UNICEF Gates
2013 - 18 2013 - 18
Total costs
$6.3B $6.9B
with Gov India
Total costs w/o
$5.2B $5.5B
Gov of India
20

21. Summary
Currently GPEI is reporting the lowest number of cases in the fewest areas and
the least number of infected countries ever
Achievements remain fragile and require continued vigilance
Approaching the low season there is urgency in addressing remaining risks by:
• Improving quality of activities in the sanctuaries: focusing on both
operations and communication in the highest risk areas
• Addressing the significant funding gap
• Securing commitment and ownership at all levels
• Addressing the decline in access to children in high threat environments

22. 22