Cell phones, fast diagnostic tests, better medicines and innovations are saving millions of lives each year and changing the landscape of global health.

There is a hidden revolution at work is transform the lives of a billion of the poorest people on the planet.

Recent breakthroughs in technology and health systems plus scientific results published recently by the Millennium Villages Project team, coupled with broader trends around the world point towards one end point: we can end the deaths of millions of young children and mothers each year by building on recent and future innovations.

While Sub-Saharan Africa the region has achieved more than 60 percent of the  progress required to reach the Millenium Development Goals such as gender parity, primary completion, access to safe water and extreme poverty by 2015, the region has only made one-third of the progress needed to reach Millennium Development Goal 5 (health) especially as relates to reproductive and maternal health in Africa.

However there have been significant leaps made in saving the lives of millions of vulnerable people in Africa. In 2006, the Millennium Villages Project and impoverished communities around Africa jointly embarked upon the fight against extreme poverty, hunger and disease. The idea was to use low-cost, cutting-edge technologies to overcome ancient scourges like malaria and mothers dying in childbirth.

In three short years, starting from conditions of massive death tolls and a lack of health services, the Millennium Villages were able to reduce the deaths of children under 5-years-old by around 22%, roughly three times the rate of improvement of the countries at large. The progress is continuing as low-cost health services expand.

Progress toward halving the proportion of people who suffer from hunger is mixed in sub-Saharan Africa. Approximately 30% of countries are on track or have achieved the 2015 target. Globally, this means that on average four out of ten countries on track to reach the nutrition goal are in Africa .

Sub-Saharan Africa is also vulnerable to increases in international food prices. In  most countries approximately 50-70 percent of household spending is devoted to  food. Additionally, the region imports about 45 percent of its consumption of rice and  85 percent of its consumption of wheat. Further, high levels of malnutrition result in  38 percent of children being stunted. The situation is most perilous in the drought- and conflict-stricken countries of the Horn of Africa.

Nevertheless, increases in cereal production driven by higher yields since the middle of the last decade improved the continent’s ability to cope with the food price spike of 2011, compared to the experience in 2008.

A child receives an oral polio vaccine in Ivory Coast. Improved vaccines are helping save children's lives globally.

A child receives an oral polio vaccine in Ivory Coast. 

In addition, nutrition has remained a low government priority for decades in the region. Nutrition in many African countries is trapped in a “low priority cycle”, i.e., a vicious circle that starts with low demand for nutrition services – followed by a weak response by governments, and ends up with ineffective implementation and poor results – which in turn feeds into low demand for nutrition.

Senegal provides an example of a country that has made significant strides in the fight against undernutrition through its Multisectoral Forum for the Fight against Malnutrition, a National Executive Office, which ensures the day-to-day management, coordination and monitoring of national nutrition policies. Recent estimates indicate that undernutrition reduction in Senegal is 16 times higher than the regional average.

Poor children die of three main categories of disease: infections, nutritional deficiencies and conditions around childbirth. The technologies and procedures to fight all these causes of death are improving dramatically. Therein lies a great hope.

Consider malaria, one of the biggest killers of children in Africa. A dozen years ago, all seemed lost: The standard medicine had lost its efficacy as the parasite became resistant; insecticide-treated bed nets were little used because they had to be regularly retreated with the insecticide, a practical burden that poor villages could not manage; and diagnosis required that the mother and sick child trek to a distant clinic in the desperate hope the clinic had a functioning laboratory.

Now all this has changed. A new generation of low-cost and highly effective medicines has been deployed. The nets now last five years without the need for retreatment. A trained village-based worker, as part of an expanded health system, can make the diagnosis at the household using a simple rapid test, without the need for a life-and-death journey to a distant clinic. The Millennium Villages have slashed malaria deaths, but much more to the point, malaria deaths are falling sharply across Africa, down by around one-third from their peak roughly a decade ago.

The advances are widespread. New vaccines can fight diarrheal and respiratory diseases that have traditionally killed vast numbers of children. Thanks to vaccines, deaths from measles have plummeted, and polio is on the verge of eradication. New medical procedures can end the transmission of the HIV virus from mother to newborn. Technologies to support higher farm production and low-cost nutritional supplements can bolster inadequate diets.

Perhaps most important, information can flow through even the remotest of villages, thanks to the massive increase in mobile telephones across regions that just a few years ago had no phones at all. The spread of mobile phones may mark the fastest global uptake of a technology in history. From a few million mobile phone subscribers worldwide in 1990, the number has climbed to more than 6 billion today, with more than 250 million subscribers in Africa.

Mobile connectivity and the spread of wireless broadband are greatly strengthening rural health systems. In all of the Millennium Villages, and in more and more villages around the continent, lay community workers are bringing health services from the clinics right to the community. Mobile phones are critical in supporting these outreach workers, enabling them to call the doctors and nurses for advice, summon an ambulance or connect to a computerized expert system via text messaging.

“Mobile phone is no silver bullet,” said Alex Counts, President of the Grameen Foundation, an organisation that blends technology with microfinance in developing countries.

“But it does change the economics around bringing information the last mile to the poor and help them make better decisions around health, business, jobs, and agriculture.”

An example can be found in Ghana where mobile midwife services upload data from the field, registering health information for 14,000 expectant mothers with a central database hosted in the cloud that can be updated by any authorised user – from government workers to local clinicians, saving time and more importantly, lives.

The big picture is encouraging and the result of all the hard work of volunteers, funding bodies and governments is that globally, deaths of young children are falling. In 1990, the worldwide deaths of children under 5 totaled around 12.5 million. By 2010, the deaths were down to around 7.6 million.

The challenge is to keep fighting on because the dream of health for all, even the poorest of the poor, could become a much-needed reality.


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