04/01/2017 08:27 GMT | Updated 05/01/2018 05:12 GMT

Zero Possibility Of 'Getting To Zero' On Child Mortality?

Every other minute, a child drowns.

It's time to talk about the fact that, a year on from the Global Goals launch, the key child survival target - of ensuring that every baby born in 2030 will live to celebrate their fifth birthday - has zero chance of being achieved ... without action on drowning.

In every region of the world, drowning is a top cause of child death. As with most epidemics it affects the poorest and most vulnerable first and worst; over 90% of deaths are in developing countries, and children make up the majority of lives lost.

Africa has the highest drowning rates, but in Asia, where the majority of the world's children live, drowning decimates communities. From Viet Nam to Thailand and Indonesia to Bangladesh, drowning is the leading killer of children.

In Bangladesh alone, 43% of all 1-5 year old deaths are drownings. Here, more children are killed by drowning than by malnutrition, diarrhoea and pneumonia combined. So, for a country like Bangladesh, there is, truly, zero possibility of 'getting to zero' on child mortality without addressing drowning.

I don't doubt that we can be the generation to end preventable child deaths. But I have grave doubts that we can deliver by focusing on historic - and increasingly minor - causes of mortality. Despite, indeed because of, dramatic progress, it's time for the resource and the debate to shift.

The closer you get to a goal, the more concentrated the challenge and the more intractable the inequity. So, to reach our shared child survival target, we'll have to look to issues that don't feature in the Global Goal framework and are silent in sector discussions.

We'll need to recognise drowning prevention as an enabler of child survival.

And here's the good news; Drowning is preventable. Simple, scale-able solutions could save hundreds of thousands of lives every year. Survival swim lessons, lifeguarding, community crèches and flood response can be delivered at large-scale and low-cost. For example, an $8 swim skills course in Bangladesh resulted in a 90% increase in child survival rate.

If the moral imperative alone isn't enough to act, perhaps the financial imperative is. Every donor dollar spent on education, immunisation and nutrition is nullified by each life lost to the water. So, drowning prevention has the potential to be a low-cost, high-impact insurance for Global Goal progress and hard-won and child survival successes since 1990.

The case should be compelling. Wasted lives and preventable deaths on an epidemic scale. But, as the WHO recognises, drowning is a 'silent epidemic'. Not a single political or public initiative exists to dramatically reduce the global drowning death toll.

It is time to recognise drowning for what it is - a leading, preventable cause of child mortality. And it's time to resource it accordingly.

If the global community is serious about 'getting to zero' on under-five child deaths, it needs to be equally serious about drowning, positioning prevention as a priority; a forgotten, but fundamental, Global Goal enabler.