When governments gathered last September at the United Nations General Assembly, the talk was of a “decade of delivery” for the Sustainable Development Goals (SDGs)—the targets for eradicating extreme deprivation, expanding opportunities, and turning the tide on climate change. That was then. Now the world is teetering on the brink of unprecedented reversals in development. Can we stop the 2020s becoming a lost decade?
The answer to that question will have a profound bearing on a constituency often absent from the COVID-19 response debate. Children have not borne the brunt of the immediate health threats posed by the coronavirus pandemic. But as the pandemic mutates into a global economic crisis, millions of children could be left carrying disadvantages that will limit opportunities for the rest of their lives.
Poverty is one driver of the impending great reversal. The world was not on track for the 2030 goal of eradicating extreme poverty before COVID-19, and progress was slowing. We are now heading in the wrong direction. Based on national poverty lines, UNICEF and Save the Children estimate that the global downturn in economic growth could leave another 117 million children in destitution.
That figure is almost certainly an underestimate. Derived from economic growth projections, it takes no account of lockdown policies that have pushed millions of the near poor into poverty. Narendra Modi, India’s Prime Minister, apologized for the botched lockdown, which left millions of migrant workers and poor households without safety nets, food, or income; sadly, apologies don’t lift people out of poverty.
Snapshot numbers on poverty don’t tell the full story. Malnutrition, a close cousin of poverty, has devastating consequences in the first 1,000 days of a child’s life—in utero through to their second birthday—increasing the risk of low birth weight and health problems, compromising the immune system, and damaging cognitive development. These early health problems lead to reduced educational performance and lost income in adulthood. The International Labor Organization has rightly warned that rising household poverty could force millions more children out of school and into child labor.
Progress on child survival, perhaps the greatest development success story of the 21st century, could now stall—or even reverse. Health systems have been hit by lockdowns, the disruption of supply chains, and the diversion of budget and aid resources to the pandemic response. Research at Johns Hopkins University has sounded a powerful early warning alarm by looking at three scenarios for reduced health service utilization. The least severe of these scenarios (a reduction of 10-18 percent) results in 253,000 additional child deaths over six months.
This is not a theoretical risk played out in a modeling exercise. While the world fixates on ventilators for treating COVID-19, over 800,000 children lose their lives each year to pneumonia for want of basic diagnosis, simple antibiotics, and medical oxygen. Disruption of health services will add to that number.
Vaccination is one of the most cost-effective ways of protecting young lives, but of the 68 new immunization programs planned by Gavi for this year, 39 have confirmed delays. Visits to health centers for immunization in Karachi, Pakistan fell by half during lockdown, and recovery since then has been partial. The worst-affected areas are slums and squatter settlements, which have formed hotspots for vaccine-preventable diseases such as measles and polio.
When it comes to education, COVID-19 has layered a global emergency on a preexisting crisis. Even before the pandemic, progress in reducing the number of children out of school had stalled. Half of the children in school were finishing primary education unable to read a simple sentence. Now the deadly combination of a lockdown that has left 1.3 billion children out of school—many with no access to remote learning—rising child poverty, and cuts to education budgets threatens outright catastrophe. Adolescent girls face particularly grave threats of school dropout.
Research provides insights into the looming threats. One recent paper by Jishnu Das and colleagues looks at the impact on learning of the school closures that followed the 2005 earthquake in northern Pakistan. Enrollment recovered quickly. But children located closest to the fault line and aged between 3-15 at the time of the earthquake lost the equivalent of 1.5 years of schooling in terms of learning outcomes.
On July 13, Save the Children is launching a global campaign to “Save our Education,” backed by an agenda for action—because if we don’t act, millions of children will be trapped in a self-reinforcing downward spiral of diminished opportunity. Preventing that spiral is a better public policy option than reversing it once it has gathered momentum.
Many of the most effective prevention measures are both well-known and long overdue. The most effective antidote to the monetary poverty now threatening so many children is more money. National solidarity demands that governments strengthen social protection safety nets by increasing conditional and unconditional cash transfers, with specific benefits for children. One concrete idea with far wider potential application is the Inclusive Growth Dividend proposed for India—in effect, a universal monthly supplement with allowances for children paid to mothers.
Protecting children against the collateral damage caused by COVID-19 will take increased investment in community health. It is critical that governments maintain immunization programs and strengthen the integrated health approaches needed to combat malnutrition, pneumonia, malaria, and other infectious diseases.
The COVID-19 crisis presents education planners, perhaps more than any other sector, with an opportunity to build back better. Far too much learning potential is destroyed by subjecting children to inappropriate curricula and rote teaching, with weak support for remedial programs. Tackling this core problem is now more urgent than ever. Every child returning to school should undergo a learning assessment, with governments then investing in accelerated learning programs of the type successfully operated by Pratham and BRAC to support catch-up.
Without effective international cooperation, many of the world’s poorest countries will be unable to prevent development reversals. Having entered the crisis with limited fiscal space, they have now been buffeted by recession, capital flight, and deteriorating export prospects. As the IMF has recently reminded us, this is “a crisis like no other.”
Unfortunately, the international response has been an all-too-familiar rehearsal of moves from the 2008 crisis playbook. To its credit, the IMF has marshaled its emergency credit lines and increased provisions for its Poverty Reduction and Growth facility. The World Bank has front-loaded $50 billion in International Development Association (IDA) resources for the poorest countries. Both agencies prevailed upon the G-20 to agree the Debt Service Suspension Initiative—an agreement to freeze repayments to official bilateral creditors.
So far, not enough. Agreeing a new issue of Special Drawing Rights (an IMF international reserve asset) with a reallocation in favor of poorer countries would help create the liquidity needed to support recovery in developing countries—but the U.S. is opposed and European governments are half-hearted in circumventing its veto. Front-loading IDA resources is right, but it’s not a substitute for a supplementary IDA budget, or for leveraging the World Bank’s balance sheet through loan guarantees—an approach Gordon Brown has rightly championed for education. The World Bank should also be championing the case for a global safety net in the poorest countries.
The G-20 debt initiative is a step in the right direction, but it has the hallmark “too little, too late” stamped all over it. The private creditors and Chinese agencies who account for the bulk of debt repayments have shown no inclination to participate. That is indefensible. Surely this is an opportunity to convert debt liabilities into investments in children.
We are living today with a pandemic that could have been prevented through international cooperation and competent political leadership. There has been enough suffering. Let’s not allow a generation of children to pay for a great reversal in development we can still prevent.