Earlier this month I was in Washington for the launch of Save the Children’s new report: Follow the Money: Equitably financing child survival. The title might evoke memories of Jerry Maguire, but the message is serious – if world leaders don’t prioritise those children who are furthest behind, we’ll have no chance of achieving the Sustainable Development Goals (SDGs). The report focuses on child survival, by which we mean not just the SDG target to end preventable child deaths (target 3.2), but also those on ensuring universal health coverage (3.8) and ending malnutrition for all (2.2). Not delivering on the Leave No One Behind principle means accepting that in 2030 there will still be 119 million stunted children and 4 million children under five will die.
We will never accept that projection. Follow the Money puts the pledge to Leave No One Behind to the test. Are countries really putting those furthest behind first? Our research found that a lack of accessible and transparent budget data makes this a hard question to answer. In some countries where data is available we found that there isn’t a strong correlation between allocation of resources and need. Indeed, in some cases the reality is even worse – some Kenyan districts with the highest child mortality rate are receiving lower than average health and nutrition spending. In Indonesia the picture is marginally more encouraging, yet health and nutrition allocations in Central Sulawesi and North Maluku are similar to those in Bangka Belitung and Jakarta, despite the former pair having child mortality rates 2.5 times higher than the latter.
The primary problem remains that child survival is underfinanced. For nutrition particularly, there is a funding cliff-edge in a year’s time when the Nutrition4Growth commitments made in 2013 expire. The Tokyo 2020 Nutrition Summit is therefore absolutely vital in the fight to end malnutrition for all. We’re working alongside the Japanese government, UK Department for International Development, the Gates Foundation, Scaling Up Nutrition and other civil society partners to ensure it is a success.
However, what Follow the Money shows is that it is not just about quantity of financing, but also about the people we prioritise in the allocation of those funds. Leaving no one behind requires specific, tailored interventions by governments to ensure that a disproportionately large share of resources is channelled to those who need it the most. Without that, and the accelerated action that comes with it, we will not achieve the targets on child survival, nutrition or universal health coverage. We won’t stop following the money until it gets to where it needs to be. I’m pretty sure that’s a principle Cuba Gooding Jr would support us on!