Africa is Experiencing Some of the Biggest Drops in Child Mortality Ever Seen, Anywhere in the World

The Economist has an article titled "The Best Story in Development" about a recent World Bank study finding that 16 of the 20 African countries that have had detailed surveys of living conditions since 2005 reported declines in their child-mortality rates (deaths of children under five per 1,000 live births).  Twelve countries had decreases of more than 4.4% a year (see vertical blue line in chart above), the rate of decline needed to meet the millennium development goal (MDG) of cutting child-mortality rates by two-thirds between 1990 and 2015. The top three countries in the group - Senegal, Rwanda and Kenya - have achieved declines of more than 8% a year, almost twice the MDG rate and enough to  cut child mortality by one-half in the next decade.

It is, says Gabriel Demombynes, of the World Bank’s Nairobi office, “a tremendous success story that has only barely been recognized." Michael Clemens of the Center for Global Development calls it simply “the biggest, best story in development.” It is the huge decline in child mortality now gathering pace across Africa.

The decline in African child mortality is speeding up. In most countries it now falling about twice as fast as during the early 2000s and 1990s. More striking, the average fall is faster than it was in China in the early 1980s, when child mortality was declining around 3% a year, admittedly from a lower base.

What are the factors responsible for some of the "biggest falls in child mortality ever seen, anywhere?"

What makes a big difference, Mr. Demombynes argues, is some combination of broad economic growth and specific public-health policies, notably the increase in the use of insecticide-treated bednets (ITNs) which discourage mosquitoes, which cause malaria.

Bednets are often taken as classic examples of the benefits of aid, since in the past they were pioneered by foreign charities. Consistent with the view that aid is vital, Jeffrey Sachs, an American economist, recently claimed that a big drop in child mortality in his Millennium Villages project (a group of African villages that his Earth Institute of Columbia University, New York, is helping) is the result of large increases in aid to villagers. In fact, argues Mr. Demombynes, the mortality decline in these villages was no better than in the countries as a whole.

The broad moral of the story is different: aid does not seem to have been the decisive factor in cutting child mortality. No single thing was. But better policies, better government, new technology and other benefits are starting to bear fruit. “This will be startling news for anyone who still thinks Africa is mired in unending poverty and death,” says Mr. Clemens. But “that Africa is slipping quickly away.”

MP: Another amazing success story of a significant improvement in a key health metric that contributes to a consistent increase in living standards around the world.  And the key factor in Africa's reduction in child mortality wasn't the standard solution of foreign aid, but more likely a combination of accelerating economic growth, advances in technology and more sensible government policies.  In other words, it seems like factors internal to Africa were more important than external factors like foreign aid.