The Questionable Power of the Millennium Development Goal to Reduce Child Mortality

Despite almost a quarter of a century during which the global community pursued the goal of child survival, together with targets for improving child health and nutrition, Millennium Development Goal 4 (MDG4) had but one target: the reduction of child mortality by two-thirds between 1990 and 2015. MDG4 was untethered from the Millennium Declaration and from the Convention on the Rights of the Child. This paper analyzes the unintended consequences of framing MDG4 in this reductive manner, showing that doing so shrunk the child health agenda, and ignored earlier incipient efforts to embed human rights principles in the pursuit of child survival. The paper also analyzes the evidence of whether the remarkable 47% decline in child mortality since 1990 was a consequence of the mobilizing Power of MDG4's numbers. Change seems due to veterans of the child-survival revolution of the late twentieth century coalescing to overcome MDG4's limitations. By 2010, the coalition began to address the distortions that flowed from disconnecting MDG4 from a human rights framework. The paper concludes with recommendations of selection criteria for indicators to monitor child survival in the post-2015 agenda.