EDITORIAL

A focus on child development

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Science  11 Jul 2014:
Vol. 345, Issue 6193, pp. 121
DOI: 10.1126/science.1257424
PHOTO: GRAND CHALLENGES CANADA
PHOTO: MICHAEL PEAKE

By September 2014, the United Nations (UN) Open Working Group will present its final report on the Sustainable Development Goals to the UN Secretary General and President of the General Assembly, who will finalize these goals by September 2015. Because these goals (the successors to the Millennium Development Goals) will guide global action through 2030, it is unfortunate that early child development is not yet effectively addressed in this framework. Investing in child development is the foundation for improved health, economic, and social outcomes. Not getting the early years “right” is linked to violent behavior, depression, higher rates of noncommunicable disease, and lower wages, and it negatively affects a nation's gross domestic product. Unless early child development is addressed effectively in the UN Sustainable Development Goals, countries will be locked into poverty, and sustainable development will not be achieved.

Emphasis on child development is needed

“Unless early child development is addressed effectively … countries will be locked into poverty…”

PHOTO: HAN LANS/GETTY IMAGES

Child development is reflected in the post-2015 goals but in an implicit and fragmented way. Relevant targets appear under various goals: under health as ending preventable newborn and child mortality; under hunger and nutrition as ending child stunting and wasting; under education as providing access to quality early childhood care and pre-primary education; under sanitation as achieving adequate sanitation for all; and under peaceful and inclusive societies as ending abuse, exploitation, and violence against children. However, these actions would be executed more effectively and efficiently if they were considered together, under a single goal. This would put the focus where it belongs: on the end beneficiary, the child, and her or his potential for development. It would also provide an integrated approach and suggest a common means of implementation: Eliminating one risk will not allow children to thrive if they face multiple adversities, which is often the case for children growing up in poverty. This reframing would also highlight the fundamental importance of early child development to overall sustainable development, a message that is currently lost in the UN Sustainable Development Goals.

These targets could be combined with those on ending preventable maternal, newborn, and child deaths under a single integrated goal that focuses on women and children. Such a goal would build on the progress on maternal and child survival (the focus of two of the original Millennium Development Goals) and extend it to ensuring that children who survive reach their full potential. Recent advances in neuroscience indicate the importance of healthy brain development in the early years to human capital formation. Many of the same interventions (nutrition, vaccines, sanitation, and newborn resuscitation) that save children's lives also save children's brains. A society only reaps the full benefits of a child's survival if that child becomes a productive individual as an adult. Moreover, such a goal would respond to recent calls, such as that by Canadian Prime Minister Stephen Harper,* to place maternal, newborn, and child health at the heart of the post-2015 agenda.

Given the advanced state of the draft UN Sustainable Development Goals, an alternative is to better link early child development to ending poverty and inequality, the leitmotif of the post-2015 agenda, with an explicit target of reducing by 50% the number of children who fail to reach their full economic and social potential later in life. But either way, progress on healthy brain development in the early years could be directly tracked by a composite indicator of age-appropriate development that includes self-regulation, language, and responsive parenting (for infants) or social interaction (for children 3 to 5 years old). An increase in thriving children over the next 15 years would lay a stronger foundation for healthy, prosperous, and peaceful societies. It is difficult to see how the world could end poverty and inequality without addressing early child development.

A key challenge for the UN is finding focus and coherence in the Sustainable Development Goals. A more effective emphasis on early child development could also generate an overarching aspirational narrative for the Sustainable Development Goals: fulfilling human potential.

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