The Lottery of Birth – Executive Summary

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Key Messages

  • A child’s chances of survival should not depend on where they are born, how wealthy their parents are, or their ethnic identity. Yet across the world, these factors continue to determine whether a child lives to celebrate his or her fifth birthday – factors which, for the child, are purely a matter of chance. This unfair lottery of birth violates every child’s right to an equal start in life.
  • While we have seen important progress on reducing under-five child mortality across the world over the past 15 years, in too many countries inequality is actually worsening. Progress in reducing child mortality is slower among some groups of children who are falling even further behind their more fortunate peers. Ending this lottery is a defining challenge for our generation, and one that we must tackle head-on.
  • Thankfully, inequality is not rising in all countries. Some have managed not only to reduce child mortality at a fast rate, but to do so equitably – meaning that progress for excluded groups has been faster than the national average. In fact, contrary to popular belief, our research finds that pursuing an equitable pathway to reducing child mortality is associated with 6% faster progress over the course of ten years, on average.
  • A range of policies make equitable progress more likely, including steps towards the progressive realisation of Universal Health Coverage to ensure that poor and marginalised groups have access to quality services that meet their needs and that they are protected from financial hardship. • Governments should ensure that the successor framework to the Millennium Development Goals (MDGs), to be agreed in September 2015, shifts the world onto a more equitable pathway of progress. By 2030 no target should be considered met unless it is met for all social and economic groups. This is the only way to achieve Save the Children’s ultimate vision – a world in which no child dies from preventable causes, no matter where

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