The theme for World Health Day is 'healthy beginnings, hopeful futures' and aims to encourage governments to take actions to reduce mothers' deaths during pregnancy and childbirth.
World Health Day is marked on 7 April to increase global awareness of health issues around the world. Sponsored by the World Health Organisation (WHO), the day was chosen to mark the anniversary of the founding of the WHO in 1948. The theme of World Health Day 2025 is “healthy beginnings, hopeful futures”. The specific focus is on encouraging governments to increase actions to prevent newborn deaths as well as to put a stop to the 300 000 women who lose their life due to pregnancy and childbirth every year.
In 1990, about 12 million children died before their fifth birthday, most from preventable diseases. In statistical terms this translates to a global child mortality rate of 9.3% (just over nine deaths per 100 births before the age of five). In 2021 this number had declined to about five million deaths a year (child mortality rate of 3.7%).
Translated into number of lives saved, more than 132 million more children would have died in those 31 years. By any metric this is one of the most remarkable achievements in improving global health in the last 50 years and should be celebrated.
What were the reasons for this achievement? As with everything there is a plethora of reasons ranging from the number of people escaping absolute poverty globally to highly effective global advocacy leading to system change across the world.
The millennium development goals (2000 to 2015) was a set of eight goals established by the UN that aimed to improve the lives of people. One of the goals was to reduce child mortality. With this framework, governments, funders, researchers and implementers joined forces to work on the problem.
Towards the end of the millennium development goals period there was an increasing awareness of that, while the improved survival of children across the world was something to be celebrated, the question arose — what then? No parent just wants their child to survive. All parents want their children to thrive and to meet their developmental potential. So, while millions of children were now surviving, many continued to live lives curtailed by extreme poverty and adversity.
In a provocative piece titled Saving the Children For the Tobacco Industry, which speaks to this issue, Mark Nichter and Elizabeth Cartwright juxtaposed the early successes of child survival programmes with the growth of the tobacco industry, environmental degradation and the active promotion of smoking in Africa, and China and other countries, by the US government and industry. Were children simply being saved to become consumers of tobacco leading to a survival problem — just at the end of life rather than the start?
The UN published the Global Strategy for Women’s Children’s and Adolescent Health in 2015, which provided a framework for response and made the powerful case for the importance of children not only surviving but also thriving. Linked to this, the 17 sustainable development goals (2015 to 2030) were a shared blueprint for peace and prosperity.
Where are we now? Save for a few indicators, the world is not going to get anywhere close to meeting the sustainable development goals in 2030. Part of this was baked in from the start, given that one of the goals was to end poverty in all its forms everywhere (in 15 years). Any hope, however faint, of achieving even most of the goals was dealt a major blow by the Covid-19 pandemic. Global health worsened by virtually every metric during and post the pandemic.
In the past year or two, there were some tenuous signs of recovery but then we had the victory of Donald Trump in the November elections in the US. Trump and his henchman Elon Musk have proceeded to destroy USAid, withdrawn from the WHO and cancelled billions of dollars of global health funding. And while USAid had its (many) faults, for millions of pregnant mothers and their newborns in Africa, it was USAid that lay between them and possible death.
In these times of uncertainty and disquiet it is easy to become disheartened. I am struck by how many people I know have told me that they cannot believe we are only a quarter of the way into 2025. That it feels like they have lived a year. They have spoken about how deeply tired they are. In fact, the entire world feels tired.
With such a backdrop of uncertainty, of fear, where the richest country in the world (if California were a country it would be the fifth largest economy in the world) somehow feels it still does not have enough, what does the “healthy beginnings, hopeful futures” of World Health Day even mean? Are we simply deluding ourselves?
When I feel hopeless, I always turn to Rebecca Solnit. In her most wonderful short book Hope in the Dark she dissects what hope is. Two quotes from her book have helped me in moments like this, at times when we need something to hold onto.
The first: “Hope is an embrace of the unknown and the unknowable, an alternative to the certainty of both optimists and pessimists,” quells the part of me that tends to be able to see a dark cloud in every silver lining. The second is: “Hope just means another world might be possible, not promised, not guaranteed. Hope calls for action; action is impossible without hope.” This speaks directly to our current situation.
If one of the things that the idiot in the White House achieves is to drive us to action, then that will be a good thing. There is something about getting things right for our children at the start of their lives, and then throughout their childhoods, which might just be the single greatest thing we can do.
If we commit to a response to not only ensure that women do not die during childbirth, that newborns survive, but also create the kind of societies that enable children to thrive we will not only be doing the most wonderful thing for our children and our country, but also will be taking our first step to cutting ourselves from a dependency on an increasingly erratic America.
Professor Mark Tomlinson is the co-director of the Institute for Life Course Health Research in the Department of Global Health at Stellenbosch University.