Fragile Futures

The Fragile Futures report reveals that the current United Nations’ projections: that infant mortality rates will continue to decline this century are inaccurate.

Recent evidence suggests that infant mortality is already increasing in several different countries: the United States, France, India, Madagascar, Cambodia, Nepal, and the Philippines.  

The evidence in the  Fragile Futures report reveals that climate change and population dynamics will cause a deterioration in the health and wellbeing of all children, disproportionately impacting children in low to middle-income countries.

Infant mortality rate is the probability of a child born in a specific year or period dying before reaching the age of one.

Population dynamics refers to the changes in population size and distribution over time. In the context of children’s health, population dynamics shape resource availability, living conditions, and exposure to risks such as climate change, disease, and food insecurity.

United Nations’ projections on infant mortality rates are based on estimates that trends of past demographic data will continue. The United Nation’s data does not account for the effects of climate change or population dynamics. The United Nations methodology for its infant mortality projections is to take its own Medium fertility variant for population growth and fit a smoothed line to previous data on infant mortality for each country, extrapolated to 2100. The Fragile Futures report reveals new evidence that demonstrates infant mortality rates will be higher than currently predicted and children’s overall health will decline.

Current population dynamics reveal that the majority of the world’s children will be born in the most climate-vulnerable regions. This includes Sub-Saharan Africa, which contains 22 of the world’s poorest countries, experiencing the world’s highest fertility rates, with the fewest resources to adapt or shield increasing numbers of children from a deteriorating climate. Exposure to hotter temperatures is linked to several factors that can increase infant mortality.

The evidence in the Fragile Futures report also identifies that high population density, both within households and in rapidly urbanizing cities, increases exposure to infectious diseases and polluted air, which will contribute to higher infant mortality and cause children’s overall health to decline.

Climate change will have a myriad of effects on children’s health from the short to the long-term – rising temperatures are linked to a 60% increase in preterm births, a major contributor to higher rates of infant mortality. The effects of a preterm birth can result in long-term health problems that can shape a child’s entire life, causing delayed development and stunted growth.

The risk of preterm birth is already higher in low- and middle-income countries, Sub-Saharan Africa and Southern Asia accounted for 65% of all preterm births globally in 2020. More frequent and severe heatwaves in these regions will increase the already high burden of preterm births, putting both women and children’s health at risk. 

Climate change also causes more air pollution exposure, increasing cases of asthma, eczema, and allergies in young children. In Africa alone, air pollution was linked to 449,000 additional infant deaths in 2015, underscoring the growing climate health crisis facing the world’s most vulnerable populations. 

The majority of the world’s children this century will be born in the regions at highest risk of climate breakdown.  The risk to these populations is compounded further because of the inequalities they have historically and will continue to face in accessing healthcare and fundamental human rights, such as the right to education. 

Sub-Saharan Africa, a region where 3 to 5 billion children are projected to be born, is also representative of the largest number of people living in poverty, are the least resilient countries, where child malnutrition is already high and the capacity to increase food supply is strained.

Climate change is already impacting children’s health, and children based in the global south face the highest risks to child mortality.

Due to the lack of global investment required in climate change mitigation, high risk regions have the least level of resources to protect increasing numbers of children from deteriorating climate related risks and mortalities. Current United Nations’ projections on infant mortality fail to take these considerations into account.  

Access to reproductive healthcare is critical for both women and children, healthy women ensure a greater chance of them giving birth to healthy children. Ensuring women have access to healthcare services and information to decide the number and spacing of their pregnancies is their reproductive right. This includes women being able to access quality post-partum recovery, which improves both maternal health and survival rates for newborns and young children.

Neonatal deaths account for nearly half (47%) of all child deaths under the age of 5, yet receives the lowest investment in care. In 2020, 287,000 women died from preventable pregnancy-related complications. Investment in sexual and reproductive healthcare saves lives.

But sexual and reproductive healthcare is under attack, cuts to UK overseas aid, the dismantling of USAID, and the expansion of the Global Gag Rule²² are rolling back essential sexual reproductive health care services, with progress being reversed.

UNFPA warned that between 2025 and 2028 the absence of USAID support will likely result in 1,200 additional preventable maternal deaths in Afghanistan alone. The total impact on women and children’s survival rates on a global scale from the loss of international aid is not yet fully known but it will  to be catastrophic, unless urgent action is taken by partners in the third sector.