Saving the Children


London -- When President Carter decided to throw his weight behind, and thus determine, the nomination of James Grant to be executive director of UNICEF, there were many voices, both inside the U.S. and out, who admired the nominee's energy but were wary of his tendency to shoot from the hip.

Fifteen years later, we can see that Mr. Grant shoots from the shoulder, and usually with unerring accuracy. He is revolutionizing the life chances of millions of children the world over. Not even his battle with cancer appears to slow the rapid fire of this gunslinger of good fortune.

Mr. Grant's doubters liked to rubbish his great invention, the PQLI, the Physical Quality of Life Index. Its purpose was to undermine the obsession with income as a measure of the progress of nations. For Mr. Grant, who came to UNICEF from heading the Overseas Development Council, a Washington think tank, comparisons of aggregate national income masked enormous disparities that often hid desperate truths.

In contrast, his measuring rod of well-being looked at things like infant mortality, life expectancy and the education of girls. He showed that societies generally considered successful, like the U.S., Oman or Brazil, were, in critical areas of human development, doing less than countries considered much "poorer."

Once you dare to tread on the sacred cows of the economics profession a lynch mob forms. Jim Grant and all his works were ridiculed for simplicity, naivete and lack of intellectual rigor. Yet a decade and a half later, his idea is widely accepted -- and imitated.

At UNICEF, Mr. Grant used his telescopic lens to target the most easily remedied causes of child mortality -- immunization, iodine deficiency, diarrhea, bottle instead of breast feeding.

We can now see Mr. Grant's bullseyes: child deaths from measles cut from 2.5 million a year to about 1 million today; the death toll from diarrhea down from 4 million to under 3 million a year; whooping cough cases down from 700,000 a year to 400,000; tetanus deaths dropping from a million a year to half that; and those children crippled by polio falling from half a million a year to about 140,000.

Mr. Grant's technique is to select a target, rush around the globe and personally lobby heads of state to agree to it, then use his organization to marshal every resource at hand, both domestic and international. His good-guy American charm and energy, combined with his earthy understanding of the elementary basics of life -- he was the child of missionary parents in pre-revolutionary China -- appear to give him a special ability to sell his ideas equally to left and right. And where left and right are locked in stalemate, as they were during the civil war in El Salvador, he was able to persuade both army and guerrillas to stop fighting for one day a week so that children could be immunized.

For 1995 his targets, according to his latest "State of the World's Children," published Tuesday, are a 95 percent reduction in measle deaths; an 80 percent use rate for the dirt-cheap oral rehydration technique that can prevent diarrhea deaths, and an end to disabilities caused by micronutrient deficiencies.

For the year 2000, he wants to see 90 percent of all children immunized, a goal already being met in 18 Third World countries, including China, Indonesia, Mexico and the Philippines. (Compare this with the 10 percent rate in some of America's inner-city areas, below even Haiti.)

It's a fight not just for resources and concentrated attention but also, he adds, against "the pharmaceutical industry that doesn't often have its priorities right. Costly, useless drugs continue to be marketed in every village and neighborhood in the Third World. Yet the cheap antibiotics required to attack pneumonia, the biggest single killer of the world's children, are not being made available to those who need them."

The world has listened to Jim Grant for 15 years. Just because he's getting older and fighting a difficult illness, it is no time to unplug our earphones. We should go on doing what he says.

Jonathan Power writes a column on the Third World.

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