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Gates Package, p.1079 · gates:exh:00489

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Vaccines
the age of five. And I could cite dozens of statistics to show you the extent to which disparities in health have shrunk over the years. But I'm going to narrow it down to just one: child mortality. From a clinical point of view, there's a good reason for using child mortality as a measuring stick for the health of the world. Improving child survival requires some interventions such as maternity care for their mothers, childhood vaccines, better education for women, and better diets. When more children survive, it's an indication that a country is getting better at doing these things. But there's also another reason I use this statistic: When you look at health through the lens of child mortality, you can't help realizing just how high the stakes are. It is gut-wrenching to think about the death of a child. As a parent, I can't imagine anything worse, and I would give my life to protect my kids. For every child saved, there is a family that does not have to live through the worst anguish imaginable. So let's look at how the world is doing on this fundamental measure of the human condition. In 1960, nearly 19 percent of children died before their fifth birthday. Think about that for a moment: Almost one in every five children on earth did not live to see the age of five. And the disparity was enormous: In North America, the rate was 3 percent, while it was 21 percent in Asia and 27 percent in Africa. If you lived in Africa and had four children, you probably had to bury one of them. Thirty years later, in 1990, the worldwide child mortality rate had dropped by half, to just under 10 percent. In Asia it was under 9 percent. Africa saw a similar but less dramatic improvement.