The Cost of Inaction for Young Children Globally: Workshop Summary (2014)

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Linking Children’s Developmental Potential to a Nation’s Developmental Potential¹

Peter Singer began his keynote address by challenging the audience to consider its failures. In particular, he argued that the primary failure of the early childhood development (ECD) community is its inability to translate emerging evidence into commensurate action by policy makers. ECD research results are not reflected in global policies and accountability frameworks that will guide action in the next 15–20 years. Singer referred to this failure as “lost in translation.” He emphasized that this statement was not a critique of individual efforts, but rather a collective acknowledgement that the community is not where it wants to be.

Suggesting that ECD is one of the world’s grandest challenges in terms of scope, scale, and impact, Singer proposed that failure to provide optimal early environments for children leads to lower income and national gross domestic product (GDP), higher rates of disease and depression, and increased crime rates (Naudeau et al., 2011). Without ECD, children are already behind at school age. Singer posited that inattention to ECD is locking countries in a condition of poverty. Specifically, ECD will provide the first skills needed to build a nation’s workforce.

One particularly salient political issue for the field is the presence of ECD in the post-2015 agenda, and more specifically, the United Nations’ Open Working Group (OWG) on sustainable development goals. The

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¹ This section summarizes information presented by Peter Singer, Grand Challenges Canada.

OWG proposed a list of 19 focus areas.² Singer stated that no one area explicitly cites ECD initiatives, though ECD is included in the next level of detail for many of the 19 areas. As a result, ECD is not considered in a holistic manner and is not seen as the grand challenge that it truly is.

Singer also described the Countdown to 2015 framework, which is the outcome of the United Nations’ Commission on Information and Accountability for Women’s and Children’s Health.³ The main indicators of the Countdown to 2015 framework are stunting and survival; these are related to child development, but emphasize biology and nutrition more strongly. Survival is a necessary and critical element to child welfare, but alone it is insufficient, he said. Mothers do not merely want their children to survive; they want them to thrive. Singer suggested pivoting the discussion in women and children’s health from a focus on survival to a focus on thriving—a more aspirational message.

Framing the absence of a holistic view on ECD as a “lost in translation” failure, Singer pointed out that a compelling story focused on thriving children is not being told. He listed a number of reasons contributing to this failure, including

• Fragmented risks—Singer noted that the risk factors in child development are complex and manifold, including such elements as nutrition, vaccines, and early education. He argued that, instead of focusing on risks, the community should adopt a holistic, integrated view of risk in order to have an integrated response.
• Siloed outcomes—There are many different outcomes, including economic (such as GDP), social (such as violence), or health-related (such as depression). By focusing on only a single element of the burden, the effect of interventions on outcomes appears diminished.
• Metrics—Singer listed several concerns with metrics. First, he posited that good metrics do not exist for the early years (ages 0 to 2). Singer noted that The Bill & Melinda Gates Foundation recently joined the Grand Challenge on Saving Brains, launching an Explorations call for proposals on measuring early child development (fetal/infant stage) (Grand Challenges Canada, 2014). On the other hand, Singer argued that there are many organizations, each with many different metrics, and referred to this as

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² See http://sustainabledevelopment.un.org/owg.html for more information (accessed April 27, 2014).

³ See http://www.countdown2015mnch.org/about-countdown/accountability for more information (accessed April 27, 2014).

• “starvation in the midst of plenty.” He challenged the audience to develop six metrics that could fit onto a “dashboard” that could be tracked by a policy maker. He argued that these metrics should be harmonized across health, economics, and other fields, and that the community should be cognizant of context when metrics are used. Singer stated that metrics are the gateway to accountability, which drives global policy.

• Political economy—Singer stated that many people consider investment in global child development to be “big government” or “big spending,” which adds the challenge of politics to the ECD discussion. He proposed that the community take a fiscally conservative approach, noting that many basic improvements (such as safe spaces and enhanced play) are not expensive. He also proposed the use of innovative financing mechanisms for situations in which additional money is needed. For instance, corporations benefit from workforce development and might be willing to support programs if the benefits to them are well understood. Singer emphasized the importance of developing programs that are financially neutral or net positive, whether for a nation or for a corporation.
• Lack of global linkages—Singer argued that the U.S. war on poverty, including initiatives in ECD, is not appropriately linked to the global challenges of ECD, international development, and human capital infrastructure. This nation has an opportunity to link domestic problems with the problems of global poverty.

Singer also challenged the audience to better synthesize science and data. He stated that economic data on child development could provide translational evidence that is compelling to policy makers. He suggested addressing such questions as the total cost of inattention, the cost of neglecting ECD on an individual country’s GDP, and the cost of neglecting a particular set of risk factors.

Singer noted that the OWG framework cannot be implemented unless change first takes place. He offered two possibilities for how that change could be implemented. Under one possibility, a single actor will appear who will shape the goals and the community will follow. Under the second possibility, a narrative will develop that unifies the goals and provides a coherent story. Singer suggested that the narrative be integrated under a single theme, such as “reaching potential” or “human promise.” Such a theme embraces all the goals in a coherent manner.

A workshop participant pointed out that individual pieces of a larger problem are easier to sell to policy makers than a large, holistic perspective. Singer countered that both elements are necessary: a holistic frame-

work that unifies all the goals and a tactical use of individual programs or elements appealing to an individual policy maker. The unifying framework could serve to align and unify the community and better enable partnerships.

In response to a question about how to translate the science to policy, Singer stated that translation must be considered from the beginning. He pointed out that, in today’s model, policy focuses on domestic economic development (investment, infrastructure, and stimulus) to spur domestic prosperity. Foreign aid is considered charity and a drain on scarce resources. The community instead needs to reframe global investment in ECD as a key to domestic prosperity. For example, South Africa made development of its workforce a priority and quickly realized ECD would support that effort. Such an idea should be put in an international framework. Participants also discussed the importance of synthesizing the evidence and linking it to real challenges and programs in countries.