Remarks of Chairman Donald M. Payne

Hearing of the Subcommittee on Africa and Global Health

Child Survival: The Unfinished Agenda to Reduce Global Child Mortality

2200 Rayburn Thursday, March 13, 2008

10:30 AM

Thank you for joining us for this hearing of the Subcommittee on Africa and Global Health on Child Survival: The Unfinished Agenda to Reduce Global Child Mortality. We have with us a panel of expert witnesses which includes the distinguished former Senate Majority Leader, Bill Frist. I will begin with an opening statement and will introduce the witnesses before each panel.

Every day 27,000 children under the age of 5 die, mostly from preventable diseases and conditions. Factors such as malnutrition, unsafe drinking water, and inadequate access to vaccines contribute greatly to global child mortality. We know how to prevent most of these deaths, but we have not spent the resources necessary to do so. It comes as no surprise that most of these are children born into the developing world, nor that half of them occur in Africa.

In 2000, the United Nations adopted the 8 Millennium Development Goals (MDG’s) and called on member states to provide the necessary resources to reach key targets by 2015. The 4^th goal is to reduce child mortality by two-thirds. Given the fact that malnutrition caused by chronic hunger causes the deaths of more than 5 million children each year, we cannot reach this goal without making strides in the first Millennium Development Goal – halving extreme poverty and hunger. This underscores the need for an integrated approach.

The United Nations Children’s Fund (UNICEF) recently released The State of the World’s Children 2008: Child Survival, which reports that annual deaths among children under 5 fell to 9.7 million a year, the first time below 10 million since we started tracking this in 1960.

The fact that 9.7 million children are dying each year of preventable diseases sends a clear message to us all – we absolutely must do much more. Those figures represent human beings; little children who deserve a shot at life just as much as children born here in the United States.

This is not to say that the work of countless individuals, groups, and governments are not making a difference. On the contrary, their efforts are critical and have made serious inroads in reducing child mortality. Yet, there are some countries where child survival is not improving, such as Sierra Leone, which has the highest child and maternal mortality rates in the world. One in 4 children will not live to see their first birthday.

This means that we must increase our investments in life-saving programs. If there is any good news to report on child survival, it is that according to the World Health Organization (WHO), two-thirds of child deaths are preventable. Moreover, they can be prevented at with small investments.

We are joined today by Congresswoman Betty McCollum of Minnesota and Congressman Chris Shays of Connecticut because of their leadership on child survival. In May of 2007 they introduced HR 2266, the United States Commitment to Global Child Survival Act of 2007, of which I am a proud cosponsor, which directs the President to develop a comprehensive strategy to reduce child mortality and establishes the Interagency Task Force on Child Survival and Maternal Health in Developing Countries. The bill also authorizes ramped up annual funding—starting at $600 million and ending at $1.6 billion in 2012, to save the lives of children around the world.

The significant commitment of the United States to reducing child mortality in the developing world contributed to a 50 percent reduction in the mortality of children under the age of 5 between 1960 and 1990. However, over the past several years funding for child survival and maternal health programs have fluctuated, but have remained between $350 million and $450 million. In the FY2009 budget, the Administration has requested $369.5 million for child survival and maternal health programs, some $77 million less than FY2008 levels.

Two weeks ago this committee voted for a bill which will provide $50 billion in the reauthorization of the President’s Emergency Plan for AIDS Relief (PEPFAR) and this, once passed in both chambers, will be a great victory for the President and for the Congress. PEPFAR will be remembered for years to come as the cornerstone of President Bush’s Africa legacy. It has created such tremendous good will and has saved countless lives in Africa. I fully support PEPFAR and will continue to push for its approval.

At the same time, we must take into account that, according to the US Coalition for Child Survival, more than 90 percent of child deaths are caused by preventable, treatable diseases and conditions other than HIV/AIDS and malaria. So as we ramp up PEPFAR, we must also increase funding for programs to address the basic health needs of children and pregnant mothers – such as immunizations, nutrition assistance, and treatments for diarrhea and other infections.

We can save children’s lives. We can prevent the nearly 10 million child deaths that will occur unnecessarily this year. We must begin by providing significantly increased funding for child survival in FY’09 and then increase our commitment each year, as called for in the McCollum-Shays bill. I urge members of this committee to cosponsor HR 2266 and look forward to hearing from our witnesses.