April 7 is World Health Day. It is shocking that government spending on health remains less than two per cent of the GDP in a country with some of the worst indices on health. For instance, India has the highest number of children dying in the world: approximately two million children under the age of five die every year in India of diseases and conditions that are easily preventable and easily treatable. This begs the question: why isn’t this a political and economic priority? A recent global survey by Save the Children found that nearly half of those questioned in 14 countries, including India, the US and the UK thought it cost nearly ten times the real amount to save children’s lives. The public assumed it would cost an additional $400bn when the reality is that globally it will cost an extra $40 billion – half the amount spent on bottled water a year. Adults surveyed across cities in India also thought it far more expensive to save millions of children’s lives than it really is, leaving the Government under little pressure to take action.

Young children are dying of diarrhoea and pneumonia in cities and towns across our country. If people really understood how affordable and feasible it is to prevent these deaths, they'd be shocked. But the pressure to push our leaders to act is simply not there, partly because of public perceptions that it’s too costly to do anything about it quickly. But child deaths can be stopped. We have seen it in a few States in India. We are also seeing it in Bangladesh and Sri Lanka – both countries putting us to shame in the progress they are making despite having an economic growth less remarkable than ours. We have no excuse not to act. We cannot even blame the global economic downturn. Given the high rate of inflation and economic difficulties that India faces, it would be easy to be pessimistic about the prospects of saving children’s lives.

Yet we know that a really dramatic reduction in the number of child deaths is achievable. Why? Because developed countries have already achieved huge reductions in child mortality in the course of the 20th century. In 1900, the infant mortality rate in the UK was double that of India. Child mortality rates then in the U.S. were worse than war-torn sub-Saharan Africa. More recently and more importantly, we know it’s possible to prevent children dying needlessly because many low- and middle-income countries have cut child mortality rates significantly over the last few decades, and many have done so more rapidly than today’s developed economies had managed in the last century. We now have the technology and knowledge and so since 1990, more than 60 countries have reduced their child mortality rate by 50 per cent.

Saving the lives of children is not rocket science. There are enough examples from within India where home-based low-cost interventions have proven effective. With relatively modest investments in basic training, supervision and support, female frontline health workers can promote and deliver low-cost, proven health interventions that can save the lives of thousands of mothers and their children each year. It is estimated that 63 per cent of children under 5 could be saved if all children were to receive a full package of essential health care that includes skilled birth attendance, immunisations and treatments for pneumonia, diarrhoea and malaria. These are not costly interventions but they do need to be prioritised.

We do not need a major technological breakthrough to crack this problem. But we do need to push the issue of health and nutrition of mothers and young children higher up national and state agendas and start to take this challenge seriously. If the moral case has not triggered us to act then perhaps economic common sense will inspire us. There is a strong economic case for keeping children alive and well. We all lose out when children are undernourished and vulnerable to sickness and early death, and we all benefit when they are healthier, better nourished and educated. Globally, the World Food Programme has estimated that the direct cost of child malnutrition is between $20 billion and $30 billion per annum.

The influential Commission on Macroeconomics and Health estimated the global impact of maternal and newborn deaths at $15 billion a year in lost productivity. They also looked at the longer-term economic benefits of better health. They argued that improved health outcomes should increase the life expectancy of low-income countries by one half of the existing 19-year gap with high-income countries – for example, from 59 to 68 years – and that this would boost economic growth rates. Their estimate was that the per capita income of low-income countries would be 10 per cent higher than otherwise after 20 years.

One World Bank Economic Review estimated that 30–50 per cent of Asia’s economic growth between 1965 and 1990 is attributable to demographic and health improvements, including reductions in infant and child mortality, better access to reproductive health services, and reductions in fertility rates. More recent research evidence shows that improvements in human development correlate with higher levels of economic growth, with a 5 percentage point reduction in child mortality rates associated with a one percentage point increase in economic growth over the subsequent decade. At a time when governments are looking to revive their economies, there is indeed a sound business case for investing in the future – our children.