Seven Million Lives Saved: Under-5 Mortality Since the Launch of the Millennium Development Goals

Abstract

To what extent have developing countries’ patterns in reducing under-5 mortality rates (U5MR) changed since the advent of the Millennium Development Goals (MDGs)? This paper investigates that question across multiple time horizons, with attention to the fact that countries’ progress had already begun to accelerate during the late 1990s compared to the early 1990s. The paper gives special consideration to countries the MDGs were primarily intended to support, including initially “Off Track” and low-income countries. Although only 21 percent of originally Off Track countries and 34 percent of originally low-income countries are now on a path to achieve the MDG target by 2015, at least 80 percent of each group has seen accelerated progress since 2001. Approximately 90 percent of countries in sub-Saharan Africa have accelerated. Most importantly, regression analysis indicates that cross-country trends since 2000 differ considerably from previous decades. The years since the launch of the MDGs include the first extended period in at least four decades during which rates of U5MR decline have not been negatively correlated with U5MR levels. Compared to a conservative counterfactual trend from 1996 to 2001, at least 7.5 million additional children’s lives are estimated to have been saved between 2002 and 2013. The results suggest that much of the greatest structural progress has been achieved by countries not likely to achieve the formal MDG targets, even if their progress might be linked to the pursuit of those targets. Implications are considered for setting U5MR targets through to 2030.