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Towards Millennium Development Goal Four
  1. M Ellis1,
  2. S Allen2
  1. 1Centre for Child and Adolescent Health, Hampton House, Bristol, UK
  2. 2The School of Medicine, Singleton Park, Swansea University, Swansea, UK
  1. Correspondence to:
    Dr M Ellis
    Centre for Child and Adolescent Health, Hampton House, Cotham Hill, Bristol BS6 6JS, UK; m.ellis{at}

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The second child survival revolution

The first child survival revolution led by UNICEF saw a fall in global under five child mortality (U5MR) from 121 in 1980 to 88 in 1986.1 It brought together the big players in international health and built momentum through a strategy of social mobilisation. This focused on four low cost primary care interventions (growth monitoring, oral rehydration, breast feeding, and immunisation). The second child survival revolution is now gathering pace and paediatricians are being called on to play our part.


The Child Survival Countdown to 2015 Conference held in London in December 2005 provided the first of what are planned to be biennial opportunities to review progress. In his commentary on the meeting, the editor of The Lancet calls for a strengthening of the science base of child health and specifically charges paediatric organisations from high income countries to do more to build collaborations with colleagues in lower income settings.2 He urges us all to do more to increase the visibility of child and maternal survival on the global political agenda. What are the issues and how best can we engage?


The Millennium Development Goals (MDGs) are the latest of a series of targets set by the UN to express the world’s aspirations and focus efforts for global human development.3 Using baseline data from 1990, the Goals set for 2015 include:

  • Halving poverty and hunger

  • Achieving universal primary education and gender equality

  • Reducing child (under 5) mortality by two thirds (MDG 4)

  • Reducing maternal mortality by three quarters (MDG 5)

  • Reversing the spread of HIV/AIDS (MDG 6)

  • Halving the proportion of people without access to safe water.


A WHO led epidemiological effort has achieved a revised consensus on the current global causes of child death.4 In each of the first three …

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  • Competing interests: none declared

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