UNICEF said last week global efforts to promote childhood immunization, breast-feeding and anti-malaria measures had helped cut the death rate of children under age 5 by nearly a quarter since 1990 and more than 60 percent since 1960.
Helped, yes. But by how much?
This reminds me of boasts, years ago, from the United States Agency for International Development's program on child survival, when they pointed out that child mortality rates were declining in most of the countries in which they were working. Well, yes, but that was because there has been a steady worldwide decline in child mortality rates in recent decades that has been occurring independently of any specific interventions. Child mortality rates decline just about everywhere if there are no extraordinary events such as widespread armed conflict or a massive HIV/AIDS epidemic.
Some of these agencies seem to want to take credit for improvements that probably would have taken place just about as well in their absence.
Take a close look at the so-called progress reports relating to the Millennium Development Project. They cite improvements in various indicators, but they do not offer any evidence that these improvements were related in any significant way to the activities of that project.
The question that these agencies need to address is not simply whether there has been some improvement in key indicators, but whether the improvements were significantly greater as a result of their activities. The evidence on this is not clear and strong.
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George Kent
mailto:kent@hawaii.edu