ABSTRACT

In this section we provide suggestions for framing the targets and indicators of a child’s right to survival and to the highest attainable standard of health, building on this analysis of the power of numbers in MDG4. This paper has documented some of the unintended consequences flowing from the framing of MDG4, its target and indicators in a limited manner that:

(1) was set by an elite inter-governmental process divorced from a coalition of veterans of the child survival revolution, which allowed for neither national political nor societal participation, slowing the pursuit of MDG4;

(2) was a “one-size-fits-all” goal with no national adaptation and taking no account of a country’s starting point or resources, leading to a distortion in measuring “success”;

(3) over-simplified the relationship between child survival and child health, by singling out measles, the simplest, but smallest share of mortality to monitor, and failing to monitor indicators of interrelated causes that made up the greatest share of child mortality;

(4) was set as a global average, which did not help to decrease inequalities in health, gave unfair treatment to the poorest countries as well as the poorest children; and

(5) failed to incorporate the Millennium Declaration’s human rights framework, which not only contributed to leaving the poorest behind, but to lack of popular participation in setting and monitoring benchmarks of progressive realization, and a lack of accountability or legal remedy.