We call on the government to keep its promise to the world’s poorest children to spend 0.7% of gross national income on foreign aid. The collateral impact of the COVID-19 pandemic is causing severe disruption to preventive and curative health services in the poorest settings, particularly for children. Estimates suggest that more than a million excess child deaths could occur as a result.1 To reduce our commitment further, just as global needs intensify, will result in significant further loss of life, with negative impacts lasting generations.
Over the last three decades, global child mortality has fallen by over half – an achievement unprecedented in human history and substantively supported by increases in aid funding. In 2020, however, an estimated 15,000 children continue to die each day from conditions which are avoidable or preventable.2 In 2019, 2.4 million newborns died within the first month of life – 98% of them in developing countries.3
These are statistics. But behind each number lies a family and a tragedy. In the rich world, we are largely insulated from the horror of children dying needlessly. These rates of death are neither inevitable nor natural. We know that, in recent decades, much has been achieved to improve the survival and life chances of children in even the worst humanitarian crises. RCPCH and ICHG believe a strong factor driving child survival around the world is the UK’s continuing commitment to international aid.4
Aid does work. The evidence, in particular in health, is overwhelming.5 Aid for health is systematically and statistically associated with a reduction in both child and infant mortality.6 In sub-Saharan Africa, a 1% increase in health aid reduces infant deaths by 2.6%.7 For every additional aid dollar allocated to malaria control, the rate of child infection and death falls.8 Aid is associated with decline in the prevalence of HIV and reduction in the rate of children dying from diarrhoeal disease.9 10 Aid for education and health services directed at women has a large positive impact on the wellbeing of children. Healthy child development is associated with stronger economic growth – the kind of growth that enables poor countries to become less aid-dependent, and to take on the funding of their own development.11 12
Aid reduces adolescent fertility and supports reduction in gender inequalities; helping women to deliver safely, care for newborns, and nurture their families.13 14 Empowering women is a critical step in the development and sustainability of global child health associated with safer births, reduced malnutrition, higher levels of child vaccination, improved early child development, better school attendance and performance, reductions in fertility and early pregnancy, and strengthening intergenerational health.
Put simply, aid saves children’s lives and can set them on a path to life-long health. Without doubt, aid should be closely scrutinised and used to achieve maximum benefit; aid should be able to show ‘value for money’. Saving children’s lives is an imperative – a moral act and one of the best and most effective investments for future global growth.
Experience in resource-poor settings can inspire new efficiencies here in the NHS. Over the last decade, we have seen first-hand how seconding British doctors, nurses and midwives to work with their peers in low- and middle-income countries helps save lives; but it also brings innovative ideas for better care and child health back in the UK.
We believe that spending 0.7% of gross national income on international aid, as defined in the 2002 and 2015 international development acts is a cost-effective way of substantiating our moral commitment and legal obligation, whilst at the same time enhancing our leadership in global health – critical to the UK’s upcoming roles in the Security Council and COP26 in a post-COVID world.
- 1. Roberton, T. et al. Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study. Lancet. Glob. Heal. 2020.
- 2. Requejo J & Bhutta Z. The post-2015 agenda: staying the course in maternal and child survival. Arch Dis Child 2015;100(Suppl 1):s76–s81. doi:10.1136/archdischild-2013-305737; ourworldindata.org/child-mortality
- 3. WHO, 2020. Newborns: improving survival and well-being (who.int).
- 4. www.theguardian.com/world/2016/oct/31/uk-aid-and-the-danger-of-short-term-thinking.
- 5. www.theguardian.com/commentisfree/2016/oct/26/the-guardian-view-on-development-aid-do-it-better-but-do-it
- 6. Gyimah-Brempong K & Asiedu E. Aid and Human Capital Formation: Some Evidence. Paper presented at the African Economic Conference, Tunis, Tunisia, 2008; Gyimah-Brempong K. Do African Countries Get Health from Health aid? Journal of African Development 2015, 17(2): 105–142; Mishra P, Newhouse D. 2009. Does Health aid Matter? Journal of Health Economics 28(4): 855–872.
- 7. Negeri K & Halemariam D. Effect of health development assistance on health status in sub-Saharan Africa. Risk Management and Healthcare Policy, 7 April, 2016.
- 8. Yan I, Korenromp E & Bendavid E. Mortality changes after grants from the Global Fund to Fight AIDS, tuberculosis and malaria: an econometric analysis from 1995 to 2010. BMC Public.
- 9. Munyanyi M.E., Awaworyi Churchill S., Skali A. (2020) Foreign Aid and Development Goals: Revisiting the Evidence. In: Awaworyi Churchill S. (eds) Moving from the Millennium to the Sustainable Development Goals. Palgrave Macmillan, Singapore. doi.org/10.1007/978-981-15-1556-9_9.
- 10. Lynda Pickbourn & Léonce Ndikumana (2019) Does Health Aid Reduce Infant and Child Mortality from Diarrhoea in Sub-Saharan Africa?, The Journal of Development Studies, 55:10, 2212-2231, DOI: 10.1080/00220388.2018.1536264.
- 11. Pickbourn L & Ndikumana L. Impact of the sectoral allocation of foreign aid on gender inequality. Journal of International Development, J. Int. Dev. 28, 396–411 (2016).
- 12. Addison T & Tarp F. Aid Policy and the Macroeconomic Management of Aid. World Development Vol. 69, pp. 1–5, 2015.
- 13. Zhuang, H., Wang, M., & Daniels, J. (2020). Foreign Aid and Adolescent Fertility Rate: Cross-Country Evidence, Journal of Globalization and Development, 11(1), 20180051. doi: doi.org/10.1515/jgd-2018-0051.
- 14. Pickbourn & Ndikumana, 2016.