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Big-spending SA failing on UN goals
Tamar Kahn, Business Day
2008-04-18
SA is making no progress towards the Millennium Development Goals (MDGs) of reducing deaths among mothers and children under the age of five, warns a new report. The report raises the question why, despite its resources, SA is doing so badly. About 10,5% of the governments total spending (R716bn) is earmarked for health (R75,5bn), yet SA is one of the worst performers among the 68 countries assessed for the report because of their high death rates. SA is one of only 12 countries with rising child mortality rates, which climbed 15% between 1990 and 2006, from 60 to 69 deaths per 1000 live births. Maternal deaths remained constant at 400 per 100000 live births.
The MDG targets are to cut child deaths by two-thirds and maternal deaths by three-quarters by 2015. The Countdown to 2015: Maternal, Newborn and Child Survival report for 2008, published in The Lancet medical journal, is the result of collaboration between several agencies including the United Nations. A hard-hitting editorial in the journal argued that HIV/AIDS, inequality, and political indifference had combined to deadly effect in SA.
Leadership and accountability are vital if SA is to achieve the standard of population health that is rightly expected of a country of its international status and wealth, said The Lancet. The report, which drew on existing data, reinforced the message from the recent Every Death Counts study which showed that every year in SA 1600 mothers died from pregnancy or childbirth complications, 20000 babies were stillborn, and another 75000 children did not live to see their fifth birthday. The report attributed 57% of deaths among children under five to HIV/AIDS. A third of the deaths among young children occurred in newborn babies. It showed the under-five mortality rate in SA was at least four times higher among the poorest quarter of the population than it was among the richest quarter. All the 10 worst-performing countries with regard to child deaths were in sub-Saharan Africa. They include Chad, Cameroon, SA , Equatorial Guinea, Congo, Kenya, Lesotho, Zimbabwe, Swaziland and Botswana. The countries making most progress were Peru, Brazil, Indonesia, Egypt, Nepal, Morocco, Laos, Bangladesh, Bolivia and Guatemala.
Unicefs chief of health, Peter Salama, said many of the nations making progress towards the targets had done so despite their poverty and lack of doctors. Many of these countries have looked at training lower levels of cadres of healthcare workers on a very large scale. Nepal is one of them it has reduced under-five mortality by about 58%. Ethiopia is also making very strong progress. Its great to have more doctors and more money, but its not enough, he said. The report called on the international community to step up funding for programmes for child and maternal health. Although donor funding had increased from 2,1bn to 3,5bn between 2003 and 2006, a further 10bn was needed to improve health services for mothers and children.
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