As leaders from across sectors gather this week at the World Economic Forum to tackle global challenges, all solutions and priorities should be assessed first with a view to dismantling entrenched inequities. 

One urgent disparity that demands attention is child survival in Africa. A child born in sub-Saharan Africa is 14 times more likely to die before their fifth birthday than a child born in Europe and North America, reflecting inequities in access to essential healthcare services.

Achieving health equity is not just a goal but a necessity for sustainable development. In 2025, efforts to ensure that all children have a fair chance at survival must be a priority for policymakers and practitioners alike.

Distribution of common antibiotic

Resiliency through Azithromycin for Children (REACH) is a regional and international network of researchers, policy makers and public health actors dedicated to reducing child mortality. 

The REACH network offers a practical, collaborative approach to reducing child mortality through biannual distribution of the common antibiotic, azithromycin, to children under five in high-mortality settings. 

More than a health intervention, it emphasizes Africa’s collective commitment, as articulated in the recent Abuja Declaration, to achieving health equity, sustainable progress, and a future where no child is left behind.

For us, as co-chairs, this work is deeply personal. We grew up in communities much like those REACH now serves, where access to basic healthcare was limited, and preventable illness took countless young lives.

REACH is equity in action – here’s why:

The program is most impactful in places with the least access to health care and the highest rates of child mortality. A randomized control trial with 200,000 children in Niger, Tanzania, and Malawi found that the average mortality reduction was 13.5% and the impact was highest in areas with the most significant under-5 mortality at 18.1%. To date, over one million children across six countries have been treated for as little as $1–$3 per dose, proving that health equity is within reach.

 Health equity

REACH is owned and led by countries. We know firsthand that health equity can only be achieved when the countries themselves take ownership, driving solutions that address their people’s unique needs.

 This model of national leadership is vital, and through REACH, we are laying the groundwork for lasting change by empowering African nations to adapt, scale, and collaborate on solutions that transcend borders.

We must acknowledge the critical role played by governments and local communities across Burkina Faso, Côte d’Ivoire, Mali, Niger, Nigeria, and Sierra Leone, whose commitment and support make this progress possible.

The REACH Network is also strengthening primary healthcare systems and building capacity to tackle wide-ranging needs and challenges that often go unmet.

In addition to reducing preventable child deaths, REACH has the potential to support iron supplementation for pregnant women, nutritional aid for at-risk populations, ivermectin for parasitic infections, and increased vaccination efforts in zero-dose areas. 

Lifeline approach

This “lifeline approach” ensures that each intervention is strategically woven together, creating a safety net that addresses the complex health needs of our communities. Through targeted training and capacity-building, REACH also empowers local healthcare workers to deliver consistent, community-based care.

By prioritizing local capacity-building, we ensure that our progress is sustainable, building community trust and resilience within healthcare systems that are prepared to endure.

REACH supports families to drive economic growth. By focusing on the hardest-to-reach populations, REACH becomes a lifeline for mothers, children, and families in dire need of care.

This approach does not stop at health—it is also a foundation for economic empowerment. Healthier children lead to stronger communities and accelerate demographic transitions. By reducing child mortality, REACH strengthens Africa’s workforce of tomorrow, driving the continent closer to sustained economic growth and prosperity.

The program is implemented responsibly, to ensure its longevity and continued impact. Through robust frameworks, we continually assess our strategies to make certain they are scalable, adaptable, and responsive to the needs of those who need them most. 

AMR surveillance

Antimicrobial resistance (AMR) surveillance is a key pillar, ensuring that the immediate survival benefits of azithromycin do not compromise long-term sustainability. As health ministers from REACH countries come together to share challenges and successes, we are creating a unified roadmap for addressing shared priorities, and this network-wide collaboration strengthens our collective commitment to measurable, lasting change.

Imagine a future where no African child is left behind—a future where a child born in the remotest village has the same chance at survival as one born in the most advanced urban center. Where no child or mother is denied essential healthcare services. With REACH, this is not just a vision; it is a possibility within our grasp.

Sustaining the REACH Network requires broad support and new partnerships. With over one million children treated already, imagine the exponential impact if REACH could reach two million or more, supported by enhanced infrastructure, data collection systems, and local workforce capacity.

With continued collaboration and dedicated resources, this lifeline will reach every child in need, ensuring that each can thrive and contribute to the Africa of tomorrow.

We call on all who believe in a future where every African child has the chance to live a healthy, fulfilled life to join us on this journey and to embrace these principles of equity to transform lives across the continent.

Dr Muhammad Ali Pate is the Minister of Health in Nigeria and co-chair of the REACH Network

Professor Samba Sow is Director-General of the Center for Vaccine Development in Mali and co-chair of the REACH Network

Image Credits: The Global Alliance to end AIDS in children, WFP/Ala Kheir.