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We are here today

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because [the] United Nations

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have defined goals

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for the progress of countries.

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They're called Millennium Development Goals.

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And the reason I really like these goals

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is that there are eight of them.

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And by specifying eight different goals,

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the United Nations has said

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that there are so many things needed

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to change in a country

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in order to get the good life for people.

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Look here -- you have to end poverty,

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education, gender,

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child and maternal health,

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control infections, protect the environment

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and get the good global links between nations

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in every aspect

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from aid to trade.

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There's a second reason I like these development goals,

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and that is because each and every one is measured.

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Take child mortality;

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the aim here is to reduce child mortality

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by two-thirds,

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from 1990 to 2015.

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That's a four percent reduction per year --

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and this, with measuring.

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That's what makes the difference

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between political talking like this

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and really going for the important thing,

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a better life for people.

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And what I'm so happy about with this

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is that we have already documented

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that there are many countries

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in Asia, in the Middle East,

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in Latin America and East Europe

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that [are] reducing with this rate.

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And even mighty Brazil is going down with five percent per year,

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and Turkey with seven percent per year.

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So there's good news.

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But then I hear people saying, "There is no progress in Africa.

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And there's not even statistics on Africa

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to know what is happening."

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I'll prove them wrong on both points.

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Come with me to the wonderful world of statistics.

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I bring you to the webpage, ChildMortality.org,

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where you can take deaths in children

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below five years of age for all countries --

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it's done by U.N. specialists.

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And I will take Kenya as an example.

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Here you see the data.

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Don't panic -- don't panic now, I'll help you through this.

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It looks nasty, like in college

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when you didn't like statistics.

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But first thing, when you see dots like this,

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you have to ask yourself:

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from where do the data come?

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What is the origin of the data?

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Is it so that in Kenya,

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there are doctors and other specialists

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who write the death certificate at the death of the child

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and it's sent to the statistical office?

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No -- low-income countries like Kenya

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still don't have that level of organization.

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It exists, but it's not complete

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because so many deaths occur in the home

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with the family,

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and it's not registered.

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What we rely on is not an incomplete system.

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We have interviews, we have surveys.

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And this is highly professional

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female interviewers

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who sit down for one hour with a woman

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and ask her about [her] birth history.

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How many children did you have?

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Are they alive?

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If they died, at what age and what year?

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And then this is done in a representative sample

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of thousands of women in the country

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and put together in what used to be called

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a demographic health survey report.

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But these surveys are costly,

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so they can only be done [in] three- to five-year intervals.

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But they have good quality.

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So this is a limitation.

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And all these colored lines here are results;

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each color is one survey.

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But that's too complicated for today, so I'll simplify it for you,

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and I give you one average point for each survey.

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This was 1977, 1988,

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1992, '97

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and 2002.

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And when the experts in the U.N.

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have got these surveys in place in their database,

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then they use advanced mathematical formulas

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to produce a trend line, and the trend line looks like this.

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See here -- it's the best fit they can get of this point.

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But watch out --

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they continue the line

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beyond the last point

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out into nothing.

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And they estimated that in 2008,

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Kenya had per child mortality of 128.

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And I was sad,

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because we could see

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this reversal in Kenya

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with an increased child mortality in the 90s.

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It was so tragic.

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But in June, I got a mail in my inbox

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from Demographic Health Surveys,

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and it showed good news from Kenya.

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I was so happy.

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This was the estimate of the new survey.

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Then it just took another three months

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for [the] U.N. to get it into their server,

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and on Friday we got the new trend line --

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it was down here.

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Isn't it nice -- isn't it nice, yeah?

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I was actually, on Friday, sitting in front of my computer,

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and I saw the death rate fall

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from 128 to 84 just that morning.

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So we celebrated.

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But now, when you have this trend line,

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how do we measure progress?

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I'm going into some details here,

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because [the] U.N. do it like this.

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They start [in] 1990 -- they measure to 2009.

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They say, "0.9 percent, no progress."

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That's unfair.

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As a professor, I think I have the right to propose something differently.

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I would say, at least do this --

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10 years is enough to follow the trend.

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It's two surveys, and you can see what's happening now.

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They have 2.4 percent.

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Had I been in the Ministry of Health in Kenya,

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I may have joined these two points.

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So what I'm telling you

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is that we know the child mortality.

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We have a decent trend.

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It's coming into some tricky things then

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when we are measuring MDGs.

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And the reason here for Africa is especially important,

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because '90s was a bad decade,

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not only in Kenya, but across Africa.

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The HIV epidemic peaked.

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There was resistance for the old malaria drugs, until we got the new drugs.

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We got, later, the mosquito netting.

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And there was socio-economic problems,

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which are now being solved at a much better scale.

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So look at the average here --

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this is the average for all of sub-Saharan Africa.

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And [the] U.N. says

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it's a reduction with 1.8 percent.

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Now this sounds a little theoretical,

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but it's not so theoretical.

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You know, these economists,

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they love money, they want more and more of it, they want it to grow.

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So they calculate the percent annual growth rate of [the] economy.

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We in public health, we hate child death,

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so we want less and less and less of child deaths.

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So we calculate the percent reduction per year,

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but it's sort of the same percentage.

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If your economy grows with four percent,

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you ought to reduce child mortality four percent;

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if it's used well and people are really involved

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and can get the use of the resources in the way they want it.

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So is this fair now to measure this over 19 years?

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An economist would never do that.

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I have just divided it into two periods.

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In the 90s, only 1.2 percent,

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only 1.2 percent.

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Whereas now, second gear --

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it's like Africa had first gear,

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now they go into second gear.

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But even this

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is not a fair representation of Africa,

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because it's an average,

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it's an average speed of reduction in Africa.

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And look here when I take you into my bubble graphs.

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Still here,

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child death per 1,000 on that axis.

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Here we have [the] year.

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And I'm now giving you a wider picture than the MDG.

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I start 50 years ago

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when Africa celebrated independence in most countries.

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I give you Congo, which was high,

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Ghana -- lower. And Kenya -- even lower.

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And what has happened over the years since then? Here we go.

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You can see, with independence, literacy improved

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and vaccinations started, smallpox was eradicated,

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hygiene was improved, and things got better.

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But then, in the '80s, watch out here.

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Congo got into civil war,

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and they leveled off here.

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Ghana got very ahead, fast.

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This was the backlash in Kenya, and Ghana bypassed,

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but then Kenya and Ghana go down together --

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still a standstill in Congo.

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That's where we are today.

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You can see it doesn't make sense

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to make an average of this zero improvement

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and this very fast improvement.

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Time has come

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to stop thinking about sub-Saharan Africa as one place.

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Their countries are so different,

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and they merit to be recognized in the same way,

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as we don't talk about Europe as one place.

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I can tell you that the economy in Greece and Sweden are very different --

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everyone knows that.

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And they are judged, each country, on how they are doing.

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So let me show the wider picture.

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My country, Sweden:

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1800, we were up there.

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What a strange personality disorder we must have,

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counting the children so meticulously in spite of a high child death rate.

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It's very strange. It's sort of embarrassing.

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But we had that habit in Sweden, you know,

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that we counted all the child deaths,

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even if we didn't do anything about it.

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And then, you see, these were famine years.

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These were bad years, and people got fed up with Sweden.

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My ancestors moved to the United States.

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And eventually, soon they started to get better and better here.

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And here we got better education, and we got health service,

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and child mortality came down.

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We never had a war; Sweden was in peace all this time.

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But look, the rate of lowering

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in Sweden

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was not fast.

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Sweden achieved a low child mortality

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because we started early.

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We had primary school actually

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started in 1842.

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And then you get that wonderful effect

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when we got female literacy

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one generation later.

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You have to realize that the investments we do in progress

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are long-term investments.

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It's not about just five years --

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it's long-term investments.

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And Sweden never reached [the] Millennium Development Goal rate,

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3.1 percent when I calculated.

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So we are off track -- that's what Sweden is.

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But you don't talk about it so much.

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We want others to be better than we were, and indeed, others have been better.

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Let me show you Thailand,

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see what a success story, Thailand from the 1960s --

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how they went down here

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and reached almost the same child mortality levels as Sweden.

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And I'll give you another story -- Egypt,

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the most hidden, glorious success in public health.

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Egypt was up here in 1960,

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higher than Congo.

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The Nile Delta was a misery for children

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with diarrheal disease

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and malaria and a lot of problems.

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And then they got the Aswan Dam. They got electricity in their homes,

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they increased education

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and they got primary health care.

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And down they went, you know.

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And they got safer water, they eradicated malaria.

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And isn't it a success story.

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Millennium Development Goal rates for child mortality

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is fully possible.

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And the good thing is

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that Ghana today is going with the same rate

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as Egypt did at its fastest.

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Kenya is now speeding up.

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Here we have a problem.

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We have a severe problem in countries which are at a standstill.

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Now, let me now bring you to a wider picture,

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a wider picture of child mortality.

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I'm going to show you the relationship

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between child mortality on this axis here --

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this axis here is child mortality --

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and here I have the family size.

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The relationship between child mortality and family size.

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One, two, three, four children per woman:

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six, seven, eight children per woman.

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This is, once again, 1960 --

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50 years ago.

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Each bubble is a country --

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the color, you can see, a continent.

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The dark blue here is sub-Saharan Africa.

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And the size of the bubble is the population.

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And these are

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the so-called "developing" countries.

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They had high, or very high, child mortality

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and family size, six to eight.

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And the ones over there,

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they were so-called Western countries.

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They had low child mortality

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and small families.

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What has happened?

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What I want you [to do] now is to see with your own eyes

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the relation between fall in child mortality

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and decrease in family size.

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I just want not to have any room for doubt --

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you have to see that for yourself.

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This is what happened. Now I start the world.

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Here we come down with the eradication of

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smallpox, better education,

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health service.

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It got down there -- China comes into the Western box here.

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And here Brazil is in the Western Box.

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India is approaching. The first African countries coming into the Western box,

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and we get a lot a new neighbors.

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Welcome to a decent life.

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Come on. We want everyone down there.

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This is the vision we have, isn't it.

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And look now, the first African countries here are coming in.

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There we are today.

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There is no such thing

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as a "Western world" and "developing world."

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This is the report from [the] U.N.,

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which came out on Friday.

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It's very good -- "Levels and Trends in Child Mortality" --

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except this page.

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This page is very bad;

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it's a categorization of countries.

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It labels "developing countries," -- I can read from the list here --

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developing countries: Republic of Korea -- South Korea.

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Huh?

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They get Samsung, how can they be [a] developing country?

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They have here Singapore.

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They have the lowest child mortality in the world, Singapore.

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They bypassed Sweden five years ago,

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and they are labeled a developing country.

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They have here Qatar.

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It's the richest country in the world with Al Jazeera.

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How the heck could they be [a] developing country?

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This is crap.

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(Applause)

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The rest here is good -- the rest is good.

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We have to have a modern concept,

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which fits to the data.

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And we have to realize

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that we are all going to into this, down to here.

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What is the importance now with the relations here.

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Look -- even if we look in Africa --

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these are the African countries.

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You can clearly see the relation with falling child mortality

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00:13:37,000 --> 00:13:39,000
and decreasing family size,

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even within Africa.

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It's very clear that this is what happens.

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And a very important piece of research came out on Friday

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from the Institute of Health Metrics and Evaluation in Seattle

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showing that almost 50 percent

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of the fall in child mortality

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can be attributed to female education.

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That is, when we get girls in school,

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we'll get an impact 15 to 20 years later,

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which is a secular trend which is very strong.

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That's why we must have that long-term perspective,

355
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but we must measure the impact

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over 10-year periods.

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It's fully possible

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to get child mortality down in all of these countries

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and to get them down in the corner

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where we all would like to live together.

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And of course, lowering child mortality

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is a matter of utmost importance

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from humanitarian aspects.

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It's a decent life for children,

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we are talking about.

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But it is also a strategic investment

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in the future of all mankind,

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because it's about the environment.

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We will not be able to manage the environment

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and avoid the terrible climate crisis

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if we don't stabilize the world population.

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Let's be clear about that.

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And the way to do that,

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that is to get child mortality down, get access to family planning

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and behind that drive female education.

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And that is fully possible. Let's do it.

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Thank you very much.

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(Applause)