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The early years: silent emergency or unique opportunity?

Dr. Margaret Chan, Director-General of WHO,
Anthony Lake, Executive Director, UNICEF, and
Keith Hansen, Vice President for Human Development, World Bank Group

Commentary
5 October 2016

Dr Margaret Chan
Dr Margaret Chan, the Director-General of WHO
WHO

Today's children will drive growth and development in the societies of tomorrow. We should be deeply concerned, therefore, that an estimated 250 million children (43%) younger than 5 years in low-income and middle-income countries are at risk of falling short of their potential because of adversities they face in their early, formative years.1

Helping these children reach that potential by investing in early childhood development—and developing their physical, cognitive, emotional, and social capacities—will benefit not only them but also all of us. Failing to make such investments will have profound implications for children, their families, and their societies, exacerbating inequalities and deepening societal divisions. When it comes to early childhood development, the cost of inaction is high.

The papers published in the Lancet Series, Advancing Early Childhood Development: from Science to Scale,1, 2, 3 quantify that cost, showing that children who are not nurtured properly in the early years may forfeit a quarter of their earning capacity as adults. The Series provides a roadmap to successful interventions in early childhood, along with evidence that such interventions contribute directly to ending extreme poverty, boosting shared prosperity, promoting healthy lives and learning, reducing inequalities, and maintaining peaceful societies.

New evidence is presented in the Series to support the concept of nurturing care as a basic right of every child, on the basis of the scientific advancements underscoring the importance of the early years.2 Thanks to those advancements, we know more than ever before about what works in early childhood when brain development is at its peak. All indications are that we must reach families from—or even before—the time of conception, and that support is vital in the first 1000 days of a child's life. The evidence shows that young children have the best chance of maximising their potential when they are well nourished, responsively cared for, with learning opportunities from birth onwards, and protected from disease, violence, and stress.1, 2, 3

Anthony Lake, Executive Director, UNICEF
Anthony Lake, Executive Director, UNICEF
UNICEF

The Series introduces evidence, as well, that successful policies for early childhood development focus on equipping families with the time, resources, knowledge, and skills they need to provide nurturing care.3 And it emphasises the importance of well coordinated efforts across sectors, including health, nutrition, education, welfare, social protection, environmental safety and conservation, agriculture, and water and sanitation.

But although we know what has to be done in the early years, our challenge is to provide the necessary resources and opportunities for the most disadvantaged young children and their families. Only with accessible support and services can we accelerate progress for the more than four in ten children worldwide who are seriously limited in accessing what they need for healthy growth, learning, and development.1, 3

"But although we know what has to be done in the early years, our challenge is to provide the necessary resources and opportunities for the most disadvantaged young children and their families."

Dr. Margaret Chan, Director-General of WHO,
Anthony Lake, Executive Director, UNICEF, and
Keith Hansen, Vice President for Human Development, World Bank Group

By advocating for interventions throughout the life course—starting with maternal health and prenatal care—we and our partners can make a positive difference in early childhood policies and programmes. If we succeed, more young children around the world will be able to survive and thrive, becoming developmentally ready to reap the full benefits of education when they reach school age.

We, therefore, have committed to making early childhood investments, policies, and programmes an essential part of our support to the countries in which we operate. To that end, we will work to create a continuum of care during the early years by engaging all relevant sectors. And we will help governments develop or strengthen national strategies and action plans aimed at giving every young child a fair chance to thrive. The UN Secretary-General's Global Strategy for Women's, Children's and Adolescents' Health 2016–2030 provides a foundation for such an intersectoral approach.4

The early childhood agenda is truly global, because the need is not limited to low-income countries. Children living in disadvantaged households in middle-income and wealthy countries are also at risk. In targeting our investments, we should give priority to populations in the greatest need, such as families and children in extreme poverty and those who require humanitarian assistance. In addition, we have to build more resilient systems in vulnerable communities to mitigate the disruptive influence of natural disasters, fragility, conflict, and violence.5

Keith Hansen, Vice President for Human Development, World Bank Group
Keith Hansen, Vice President for Human Development, World Bank Group
World Bank

Working together, we can help countries generate synergies and cost savings from well designed, integrated packages of early childhood services. But we must also continue learning from experience to strengthen the quality of programmes focused on the early years. Rigorous research into the delivery of interventions, and their short-term and long-term outcomes, is important for innovation. We need stronger measurement and a new consensus on robust, valid indicators to assess children's cognitive and socioemotional development. Intensified monitoring through nationwide population-based assessments, such as the Multiple Indicator Cluster Survey, among others, is essential for accountability and will help us stay the course.

Advancing early childhood development in this way will require the deliberate allocation of resources and coordination across countries and regions. Partnerships will, therefore, be key to our success. The Early Childhood Development Action Network, launched in April, 2016, is an important one.6 It brings together stakeholders from the public and private sectors, civil society, academia, professional associations, foundations, donor agencies, and local communities. The new network complements existing partnerships, providing a platform for joint advocacy, learning, action, measurement, and accountability.

We will also keep working to protect and invest in young children through the Global Financing Facility for the UN Secretary-General's Every Woman Every Child initiative, as well as alliances such as the Early Learning Partnership, the Global Partnership to End Violence Against Children, Scaling Up Nutrition, and the Power of Nutrition.

Ultimately, no matter what platforms or partnerships we use to get there, reaching children in the early years is a prerequisite for sustainable development. This Lancet Series shows why that is true, and points the way towards giving all young children the care and support they need to reach their potential. It is up to all of us to bring that aspiration closer to reality.



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