2023: Best Year Ever

Charities often use urgency or news events to pressure donors into immediate giving. Despite this focus on negativity, many great things also happened in 2023 around the world that did not make headlines. In his New York Times article, Nicholas Kristof reminds us that recognizing the world's progress can inspire us to keep doing good.

Kristof highlights three areas of improvement. First, child mortality decreased to its lowest level ever in the history of humanity at 3.6%. Second, the percent of people living in extreme poverty reached its lowest rate ever at 8.6%. Finally, polio and other neglected tropical diseases are closer than ever to eradication.

1) 3.6% Global Child Mortality. 

The rate of child mortality decreased from 3.69% to 3.62% from 2022 to 2023. For comparison, Canada's child mortality rate is only 0.4%. In 2023, an estimated 4.865 million children under the age of five died, which is 101,000 fewer than in 2022. Child deaths went from 9.1 million in 2003 to 4.9 million in 2023, saving 4.2 million lives despite population growth. 

The UN's Sustainable Development Goal 3.2 (SDG) is to reduce the rate to 2.5% by 2030. Despite overall improvements in child mortality, the world is not on track to meet the UN's goal by 2030.

Why are children dying? According to the World Health Organization, the leading causes of death in children are birth defects, birth trauma, pneumonia, diarrhea, and malaria. For babies that die in the first month of life, the main cause of death is prematurity. For children who die from ages one month to five years old, the main cause of death is malaria. Malnutrition can make death from these causes more likely. The World Health Organization estimates that malnutrition contributes to 45% of deaths in kids under five. To prevent these deaths, it is important to provide sufficient nutrition, care for expectant mothers, vaccinate children, and ensure access to clean water and sanitation.

Where are kids dying? In 2023, only five countries had over 100,00 deaths in children under five: Nigeria (870,000), India (705,000), Pakistan (402,000), The Democratic Republic of Congo (DRC) (304,000) and Ethiopia (162,000).

In 2021, the leading causes of death in these countries by age group were: 

In these countries with the most deaths in children under five, only Nigeria has a higher proportion of children dying between 1 month old and 5 years old. In Nigeria, of kids who die before age 5, two-thirds die between 1 month old and 5 years old. For comparison, in Canada two-thirds of kids who die before age 5 die before they are one month old. Only one-third die between 1 month and 5 years old. In India, Pakistan, DRC, and Ethiopia, most kids who die before age 5 die before they are 1 month old.

2) Record Low Extreme Poverty: 8.6%

In 2023, only 8.6% of the world’s population, or an estimated 691 million people below the extreme poverty line of $2.15 per person per day. The UN’s SDG goal is to eliminate all extreme poverty below by 2030. Although progress slowed due to covid-19, the world has now fallen below the pre-pandemic levels of extreme poverty, which affected 700 million people in 2019. This is an amazing improvement from just ten years ago when 846 million people lived in poverty; however, not all areas of the world are improving equally. Low-income countries still have poverty rates above pre-pandemic levels. The extreme poverty rates in the Middle East and North Africa have been increasing annually since 2019.

From 2016 to 2022, the number of people living in extreme poverty fell from 788 million people to 704 million people. That is 84 million people lifted out of extreme poverty. Specifically, Indonesia and Bangladesh made remarkable progress: these two countries account for 9% of people lifted out of extreme poverty during this period, a total of 8 million people.  

In Bangladesh, the number of people living in extreme poverty went from 21.5 million people to 16.4 million people (a 5.1 million decrease). 9.7 million people in Indonesia lived in extreme poverty in 2016. By 2022, that number went down to 6.8 million people (a 2.9 million decrease).

3) Health and Disease Improvements.

Polio is nearly eradicated. This contagious illness mainly affects children under the age of five. One in every 200 cases leads to paralysis, which may result in death. In 1988, polio paralyzed an estimated 350,000 individuals per year. The world eradicated two types of polio in the past decade: Type 2 in 2015 and Type 3 in 2019, leaving only Type 1 behind. In 2023, there were only wild 12 Polio cases: 6 in Afghanistan and 6 in Pakistan. These two countries are the only places where polio remains endemic. In 2022, there were 20 cases in Pakistan, 8 in Mozambique, and 2 in Afghanistan. This significant accomplishment is partly due to the increase in polio vaccinations. In Pakistan, polio vaccine coverage was 85% in 2022 compared to 65% in 2013. In Afghanistan, polio vaccine coverage in 2022 was 76%, up from 64% in 2013. 

Guinea worm disease is nearly eradicated. This is a parasitic infection that leaves people disabled. Vaccines cannot prevent and medications cannot treat this disease. It is most common in remote areas without access to clean drinking water. In 2023, there were only 11 cases of the disease: 8 in Chad, 2 in South Sudan, and one in Cameroon. In 2013, there were 148 cases and 1993 had 229,773 cases. The Carter Center in the US leads the international campaign to end Guinea worm disease. It works with ministries of health to stop the spread of the disease. It also helps communities stop the spread of the disease by teaching people to filter drinking water. Guinea worm disease can spread through animals. The Carter Center works with partners in Chad, Ethiopia, Mali, South Sudan, and Angola to encourage people to report infected animals and bury them away from water sources.

Trachoma rates are declining. This bacterial infection can cause vision loss and blindness. It is prevalent in poor areas especially where there isn’t access to clean water and sanitation. Benin, Mali, and Iraq eliminated blinding trachoma in 2023. In total, 18 countries have eliminated the disease. It is estimated that in 2023, 1.5 million people have the type of trachoma that can cause blindness, down from 1.7 million in 2022. It is also estimated that 116 million people around the world need interventions to prevent trachoma, such as antibiotics and improved hygiene. This is a decrease from 132 million in 2022. Ethiopia has the most people that need interventions at 64 million, followed by the DRC (9 million) and Brazil (5 million).

If you are feeling overwhelmed by donor fatigue (see this 2016 Charity Intelligence piece), remember there have been astounding improvements in the state of the world during 2023. Things are improving in part due to the work of some excellent charities across the globe. Reflecting on the things that went well during 2023 may help us keep the momentum to tackle these issues in 2024.

Beat the January Blahs, dive into more details on the good news stories, and be inspired by high-impact giving.

(Sources)

Bruce Y. Lee, 2023: World On the Verge Of Major Global Polio Eradication Milestone, Forbes, 19 November 2023.

Child and Adolescent Causes of Death project, UN Inter-agency Group for Child Mortality Estimation, 2023.

Child mortality (under 5 years), World Health Organization, 28 January 2022. 

Concepcion F. Estivariz, Ruth Link-Gelles, and Tom Shimabukuro, The Pink Book: Poliomyelitis, Centers for Disease Control and Prevention, August 2021.

Global Health Observatory data repository: Polio (Pol3) Immunization coverage estimates by country, World Health Organization, 11 July 2023.

Global Wild Polio Virus 2017-2023, The Polio Eradication Initiative, December 2023.

Guinea Worm Case Totals, The Carter Center, 8 January 2024.

Guinea Worm Eradication Program, The Carter Center, Accessed on 17 January 2024.

Nicholas Kristof, This Was a Terrible Year, and Also Maybe the Best One Yet for Humanity, The New York Times, 30 December 2023. 

Nishant Yonzan, Daniel Gerson Mahler, and Chistoph Lakner, Poverty is back to pre-COVID levels globally, but not for low-income countries, World Bank Blogs, 3 October 2023. 

Poverty and Inequality Platform (data set), World Bank, Accessed on 17 January 2024.

WHO Alliance for the Global Elimination of Trachoma: progress report on elimination of trachoma, 2022, World Health Organization, 14 July 2023.

World Population Prospects: The 2022 Revision, United Nations Department of Economic and Social Affairs, Population Division, 2022.