Philanthropists Bill and Melinda Gates are highlighting global gains in reducing child mortality, while advocating more work on vaccinating kids, addressing malnutrition and empowering women in society.
In an annual letter about the work done by their foundation released Tuesday, the couple said the efforts of their organization and many others with the same goals has helped save the lives of 122 million children since 1990.
"Virtually all advances in society - nutrition, education, access to contraceptives, gender equity, economic growth - show up as gains in the childhood mortality chart, and every gain in this chart shows up in gains for society," the letter says.
It identifies malnutrition as the cause for 45 percent of childhood deaths, and as a source of lifelong consequences from stunted growth to slower cognitive development, and a greater chance of contracting diseases such as pneumonia and diarrhea.
Bill and Melinda Gates say the simplest way to address malnutrition is for mothers to only breastfeed their children for the first six months.
Breastfeeding is also a key part of addressing the rate of newborn deaths, which they say does not improve as incomes rise in the same way that many health factors do. The letter points compares Rwanda and Mali, saying that despite having economies with similar growth levels, Rwanda has half the rate of newborn deaths. It credits Rwandan efforts to promote breastfeeding within the first hour, hygienic cutting of the umbilical cord, and a higher percentage of births attended by a skilled health care worker.
On vaccines, the letter says 86 percent of the world's kids now have coverage for a basic package of vaccines against diphtheria, tetanus and pertussis, the highest percentage ever.
"Vaccines are the biggest reason for the drop in childhood deaths."
But vaccination campaigns have left 19 million kids not fully immunized, with many of those living in either remote areas or places in conflict.
Access to contraceptives
Another future goal the Gates Foundation is working on with other global partners is to boost by 120 million the number of women who have access to contraceptives. The initiative has a particular focus on South Asia, where only one-third of women have access now, and Africa, where that number is less than one-fifth, according to the letter.
"When women are able to time and space their pregnancies, they are more likely to advance their education and earn an income -- and they're more likely to have healthy children."
The letter also says women are more likely to have only the number of children they can support, which lessens reliance on government programs and frees up more money for kids to be educated.
Bill and Melinda Gates write that overall, limiting the power of women "keeps everyone poor."
"When women have the same opportunities as men, families and societies thrive. Obviously, gender equity unleashes women's potential, but it also unleashes men's potential. It frees them to work as partners with women, so they can get the benefits of a woman's intelligence, toughness, and creativity instead of wasting their energy trying to suppress those gifts."
They close the letter by expressing an optimistic view, despite recognizing that certain goals, such as seeing the development of an HIV vaccine or more advances in combating tuberculosis, have not been met.
"Polio will soon be history. In our lifetimes, malaria will end. No one will die from AIDS. Few people will get TB. Children everywhere will be well nourished. And the death of a child in the developing world will be just as rare as the death of a child in the rich world. We can't put a date on these events, and we don't know the sequence, but we're confident of one thing: The future will surprise the pessimists."