Hi, I am so pleased to join you all. This is a critical time. We've been diverted from our attention to our children and we are now paying the price—after decades of momentum in ending preventable deaths among children—our progress has been staggered. 

Thank you. Thank you to the Child Health task force for sponsoring this virtual conference and for your unwavering leadership to prevent child deaths around the world. Over the past 30 years, efforts of this community have driven a dramatic decline in the annual number of child deaths. 

It's just extraordinary. 7.5 million fewer children died in 2021 than in 1990. That's a 60 percent drop, and it happened because of specific, tangible changes. Children are now better protected from deadly diseases due to vaccines and better nutrition. Children recover more quickly after falling ill because of better access to quality, life-saving treatments. More couples are able to practice the healthy timing and spacing of pregnancy due to voluntary family planning. More families have access to clean water and nutritious food. And we have more community health workers and health facilities with a skilled workforce delivering quality care with essential commodities. That is worth celebrating, but we have the harsh reality that five million children are still dying every year—most of them preventable. 

Today, 54 countries are not on track to achieve the child mortality reduction target established by the Sustainable Development Goals, in 2030. During COVID, many health systems’ resources were diverted from childhood immunization and from quality care for children in communities and facilities. Disruptions of basic services were reported by WHO to be occurring in virtually every country; and that has hampered health workers’ ability to address many of the feasible, effective ways we have to save children's lives. Given our current global, macroeconomic trends, we also see that many USAID countries where we work are expected to be flat lining their budget investments in health or cutting them. Progress in child survival is especially elusive in the Sub-Saharan African region. There we face high-frequency and severity of shocks and stresses due to conflict, population displacements, infectious disease outbreaks. and natural disasters, compounding everything every, everything that countries have been through during the pandemic. And, these are settings that already had some of the highest rates of child mortality in the world. 

The Child Survival Action initiative is an urgent call to change this. It's a call to action for governments, civil society, communities, and stakeholders, for all of us to reclaim our lost momentum. Now, that's not going to happen doing things the same way we used to do then. We've already seen that much of the low hanging fruit, the easier to grab opportunities to improve children's lives, have been accomplished. Deaths are now occurring where the deepest gaps exist, including fragile and conflict- ridden zones. And so, identifying the hardest to reach children, who are all also often in remote, rural, or in challenging urban areas. That's incredibly important, just as important as addressing the underlying resiliency of the system, the shocks and strains that countries are enduring, they are going to continue. 

So, at USAID we are contributing to child survival action by adjusting our approaches to addressing these challenges. Our Administrator, Samantha Power, recently launched USAID’s new strategic framework for preventing child and maternal deaths. In that framework, we seek to identify and reach those children who are at highest risk or are hardest to reach. We also commit to building the delivery and resilience of high quality child health services through a stronger primary health care workforce. Our framework commits to ensuring multi-sectoral action for children to survive and thrive. It also elevates local partnerships and it prioritizes data for decision-making and commitment and accountability. 

You, as a community, have solutions for saving children's lives. You've made enormous progress and proven yourselves. You have identified the evidence-based interventions that can save the lives of the vast majority of the five million children lost every year. And, you have established a pipeline of innovations that could save even more. So, as we look ahead to 2030 we need to reclaim our lost progress. We need to support countries to redouble their investments and their commitments, and we need to hold one another accountable. I wish you a very productive conference. It matters for all of us and I challenge you to please come away with clear and time-bound actions that leaders and stakeholders in every country can use to reach every child with the opportunity to live long and healthy lives. Thank you.
 

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