Global Investments in Children Must Extend "Beyond Survival": Experts

Thirty-one academic experts in children’s health argue that absent urgent action by international aid agencies, 200 million children around the world could sustain serious, lifelong cognitive impairment. The National Academy of Medicine Perspective article makes the case that global policy lags behind the science of brain health, and children must be given the opportunity not just to survive, but thrive.

Neil Boothby, the Allan Rosenfield Professor at Columbia University’s Mailman School of Public Health who helped to provide the strategic framework for the document, and was one of the lead co-authors, writes that global health investments in child mortality have been enormously successful: In the past two decades alone, child deaths have fallen from 12 million to under 6 million. Yet despite global investments of $9.6 billion annually, a fifth of which comes from the United States, some 200 million children still fail to meet their development potential each year.

The article, titled “Beyond Survival: The Case for Investing in Young Children Globally,” presents scientific evidence that extreme poverty, experiencing significant deprivation, violence, and neglect can short-circuit brain development with lifelong negative repercussions for children, limiting their ability to live healthy and productive lives, obtain gainful employment, and contribute to their communities and families. Among the science the authors cite are landmark studies on Adverse Childhood Experiences and “Neurons to Neighborhoods,” and multidisciplinary research by Nobel Laureate James Heckman showing that early childhood development directly influences economic, health, and social outcomes for individuals and society.

“Ensuring survival is critically important, but we can’t stop there,” says Boothby, who leads the Mailman School’s Program on Forced Migration and Health in the Heilburnn Department of Population and Family Health. “We are calling on the United States and other wealthy nations to invest in coordinated programs and policies to ensure that children, families, communities, and nations live up to their full potential.”

These investments must concurrently address the health, nutrition, development, education and protection needs of children, beginning prenatally, and better yet, during the pre-conception period, the authors write.  

The paper argues that international assistance for children in developing countries today is fragmented into programs that focus on single risks or categories of vulnerability—for example, responding to the devastating impacts of HIV/AIDS or malaria, natural disasters or human conflict, exposure to violence, exploitation, or human rights violations such as child marriage. Without a proactive effort to integrate programs for young children, harmonize implementation, and synchronize the measurement of results, important opportunity to maximize results for children is lost, the authors write.

The article concludes: “Evidence from across disciplines—from neuroscience, biological and developmental science to economic science—has clearly demonstrated that investing in young children’s holistic wellbeing is a proven pathway out of poverty and into promise.”

Among additional authors are Mark Canavera, Cassie Landers, Virginia Rauh, Lindsay Stark, Michael Wessells from Columbia’s Mailman School; Irwin Redlener from Columbia’s Earth Institute; and Fred Ssewamala from Columbia’s School of Social Work.

Gillian Huebner, who led the writing of the article, will present its findings at the Biennial Meeting of the CPC Learning Network at the Mailman School on June 22 at 3pm. The event will be livestreamed. For more information, visit the event webpage.