What JPG’s Child Survival Revolution can teach us about dealing with Covid-19

We seem to know more about the bad things and people in the world than we do the good. Perhaps there are too many bad things and people. But it is in times like this that it is all the more important to remember people like James P Grant (JPG) and his "child survival revolution (CSR)" that probably saved more lives than were destroyed by Hitler, Mao, and Stalin combined".

James P Grant as the executive director of Unicef from 1979 to 1995 almost single-handedly launched the child survival revolution promoting vaccinations and diarrhoea treatments across the world. The significance of his approach was not in any ground-breaking invention but in his leadership; in mobilising people, resources, and leaders and to bring about positive change in the world for children to survive. Here's how he did it and how we can apply them actionably in these times: 

i) Synergy: Grant grasped early on that it was the synergy that came through a package of interventions that would allow children to survive. So CSR was the concept of GOBI which later became GOBI-FFF:

G for growth monitoring to detect undernutrition in small children.

O for oral rehydration therapy [ORT] to treat childhood diarrhoea.

B to encourage breastfeeding.

I for immunisation against the six basic childhood diseases; tuberculosis, polio, diphtheria, tetanus, whooping cough, and measles.

And three Fs: food supplements, family planning and female education.

In this pandemic, the discovery of a vaccine alone will not solve the problem, the collective effort in promoting hygiene practices that ensures limited scope of transmission of diseases must take centre stage in the world. Teaching people how to wash their hands should be revisited and re-taught to people all over the world, preventing the spread of communicable diseases by isolating when ill, social distancing in public spaces and wearing masks should become the focus for prevention not only during non-holiday seasons as done by advanced economies like UK, USA and many European nations.

ii) United under a common goal: Recognising that only supporting some countries would not produce the result needed, JPG drove the United Nations "World Summit for Children" held in the UN Headquarters in September 1990. It then had the-largest-ever gathering of heads of state and government to commit to a set of goals to improve the well-being of children worldwide by the year 2000. It was the first time a UN conference had set a broad agenda for a wide range of goals in health, education, nutrition and human rights.

In recent times WHO director-general, Dr Tedros Adhanom Ghebreyesus', "no one is safe until everyone is safe" is a similar call for united efforts which can work if we keep in mind it worked with CSR. So instead of Vaccine Nationalism going for or "vaccine multilateralism—protecting at-risk populations in all countries and keeping economies working" as the focus. A popular home-grown collaborative effort is Dr Younus' pledge declaring the "Covid-19 vaccine to be a common good" to ensure that it will be available once discovered, to everyone even those who cannot afford it.

iii) Credible Leadership: JPG utilised his position at the helm of a powerful institution to get other leaders and institution onboard the CSR, he worked with dictators and rebel leaders. Unicef, at the time having won the Nobel Peace Prize, was uncomfortable to collaborate with corrupt and insensitive regimes to promote immunisation of children. One of his colleague Peter Adamson wrote, "we worried about the lending of UNICEF's good name to corrupt and inhuman regimes. But Jim's answer was always the same. 'We don't like the President, so the kids don't get immunised?' 'You want to wait to launch the campaign until all governments are respectable?'"

The UN and all other world leaders; people and institutions, are failing this test of leadership putting themselves first and picking sides from like-minded or allied leaders in the midst of pandemic is only creating division and confusion among the masses. In 1975 WHO and Unicef agreed on the procurement and distribution of ORS regardless of patent age. A combined effort would make for a better campaign.

iv) Finding new ways to work together: JPG convinced rebels, religious leaders in El Salvador to halt civil war; agreeing to "Days of Tranquillity" so that children could get their immunisation vaccines, adopted later by Lebanon, Sri Lanka and Congo. He convinced countries to put their money and skin in the game, through "Corridors of Peace", facilitating humanitarian supplies to reach war ravaged Iraq, Uganda and Sudan. Better still, he convinced Islamic leaders in Egypt to recommend and commit to promoting education of girls.

The world today is divided and there are many reasons today multi-lateral organisations like the UN and even collaborative nations like the EU to become protectionist and selfish. Multi-laterals must not shy away from engaging because of conflicting values and reluctance but insist on bringing conflicting nations together. If institutions using these types of methods can work with conflicting nations to ensure that solutions to the pandemic is provided apolitically, then we can make a lot of progress, especially given the multiple wars going on in the world at the moment.

v) Social Mobilisation: To bring change at a population level it is necessary to get everyone involved. Everywhere he went, JPG called for "social mobilisation" enlisting every possible outreach resource in society—the teachers, religious leaders, the media, the business community, the army, the police force, the NGOs, the youth movements, the women's organisations and the community groups.

Healthcare systems that need immediate attention with not just regulatory policies, but funds resources and commitments must have these social supports. Both the public and private healthcare system must be revamped to work towards preventive measures that can be adopted by people so that they do not have to heavily rely on limited hospitals and medicines for survival.

vi) Consistent-efforts: JPG was always ready to pitch for the CSR, he carried with him a sachet of iodine salt or saline whichever one was needed to be discussed and he never shied away from creating a platform to pitch his ideas backing them with hard facts.

We must all consistently promote and demonstrate preventive measures such as hand washing and wearing of masks and keeping our environment clean. Political propaganda cannot deter scientific facts and that is what we should continue to promote. Many economies are opening up; they are trying to "go back" to normal but we need to move forward and not backward.

vii) Time bound specific action: JPG in 1994 called for a major global push to achieve 80 percent oral rehydration therapy (ORT) use rates against diarrhoea by the end of 1995. He was not willing to wait and he was not willing to take no for an answer, by means of a collaborative, focused effort to make sure low-cost techniques like immunisation and ORT was available to almost every child in every developing country.

We have long discussed the arrival of the 4th Industrial Revolution, that of the Internet of Things (IoT), but adoption of modern technology has not happened at the same pace and many economies have been left out. In the times of Covid, we must ensure the use of technology involving everyone.  

Sharmin Ahmed is consultant at IFC.