PHA-Exch> The Lancet hits U.N. agencies on child mortality data (2)

[Claudio Schuftan]

   From:    kent at hawaii.edu


The last paragraph says:

  UNICEF said last week global efforts to promote childhood immunization,
breast-feeding and anti-malaria measures had helped cut the death rate of
children under age 5 by nearly a quarter since 1990 and more than 60 percent
since 1960.

Helped, yes. But by how much?

 This reminds me of boasts, years ago, from the United States Agency for
International Development's program on child survival, when they pointed out
that child mortality rates were declining in most of the countries in which
they were working. Well, yes, but that was because there has been a steady
worldwide decline in child mortality rates in recent decades that has been
occurring independently of any specific interventions. Child mortality rates
decline just about everywhere if there are no extraordinary events such as
widespread armed conflict or a massive HIV/AIDS epidemic.


Some of these agencies seem to want to take credit for improvements that
probably would have taken place just about as well in their absence.


Take a close look at the so-called progress reports relating to the
Millennium Development Project. They cite improvements in various
indicators, but they do not offer any evidence that these improvements were
related in any significant way to the activities of that project.


The question that these agencies need to address is not simply whether there
has been some improvement in key indicators, but whether the improvements
were significantly greater as a result of their activities. The evidence on
this is not clear and strong.
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