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Children: Development

Volume 749: debated on Tuesday 26 November 2013

Question for Short Debate

Asked by

To ask Her Majesty’s Government what steps they are taking to promote early childhood development in the post-2015 development framework.

My Lords, the millennium development goals, or MDGs, helped to channel political commitment and investment to bring about reductions in poverty and child mortality and improvements in health and education. They expire in 2015. This presents me with an opportunity to advocate today the inclusion of an integrated early childhood development target in the post-2015 agenda. In this debate, I hope to demonstrate that we need a measurable and actionable ECD goal to reduce by half the number of children under five who fail to reach their potential. This will not only strengthen progress towards the health and well-being of all children but also help reduce the intergenerational transmission of poverty and inequality.

My right honourable friend David Cameron, our Prime Minister, is one of three co-chairs of the high-level panel appointed by the United Nations. This panel is one of the elements which, working together with others, will craft the new goals. It is intended that the post-2015 goals will be more inclusive of various stakeholders than before and have an agenda that builds on the strengths of the MDGs but also addresses their shortfalls. They should be implemented by all countries, not just those in the developing world.

Why are we talking about early childhood development today? It is because focus on early childhood holds the long-term solutions to solving the economic and social problems of intergenerational poverty, and to achieving world peace and our environmental survival. That may sound like a very big claim, but mountains of evidence from almost every discipline come to one conclusion: the earliest years of life can give us the strongest foundation for individual, societal, national and global sustainable development. Research has shown that the key to the survival of our species is our long early childhood. This is the period of our lives when we are at our most vulnerable but, because we take so many years to develop to maturity, there is time for our brains to develop into much more complex organs, capable of more complex thought and action than any other species.

Evidence from neuroscience has shown that when a baby is born, its billions of brain cells are mostly unconnected. To function properly, these cells must be connected to each other, and these connections develop in response to the baby’s experiences. These early connections form the basis of personality and the lifelong capacity to learn, adapt to change and have resilience in case of unexpected circumstances, as well as physical and mental health. We develop these foundations at great speed in the first few years of life and we never again learn so fast. We also know that the quality of early care-giving can alter the brain’s chemistry and structure. That is why we need to pay attention to the early experiences of the world’s children, from before birth and right through childhood.

Economic studies have provided evidence that the largest returns on investment are realised in programmes for children prior to primary school. Therefore, although the MDGs have ensured that most children now attend primary school, we have to ask ourselves how well they are learning when they get there. Do they have the capacity to make the best use of that education and of the best instrument with which to learn—in other words, their brain? It is a bit like having all the parts of the engine of a very fast Formula 1 car. If you do not put it together in the right way and connect all the parts and tune them carefully, the car will not go very fast. It may limp along, but it will not beat Sebastian Vettel or Jenson Button.

Therefore, I should like to highlight something very rare: experts from many different disciplines are all coming to the conclusion that early childhood matters enormously. At a time like this, when money is scarce and needs are great, we must spend money smartly. The smart way is early, because it works in two ways. Not only does it produce better results, it will avoid the cost of putting things right when they go wrong. Therefore, I argue that an early childhood development target in the post-2015 goals will help us to achieve some of the other targets. The MDGs have achieved a lot, but the targets have not been fully achieved, so business as usual is no longer an option. Transformative and holistic solutions are required, addressing the root causes of problems rather than applying an Elastoplast to the symptoms.

Let us look at the role of early childhood programmes in achieving the UN’s aims. Let us take peace, for example. There is neurobiological evidence to show that in early childhood, we develop the capacity to love, empathise and show compassion. Through early childhood programmes, we teach children social skills and develop their decision-making capability. Those are carried forward into adulthood, resulting in better co-operation, aggression control and a reduction in violence. Wars are not instigated by armies; they are started by individuals who feel that aggression is the answer to their problems. It is not very clever. Wars contribute to poverty and environmental degradation, as well as suffering and death.

Let us take sustainability. In early life, we have an innate capacity to love nature. One has only to watch a young child with animals or in a garden. It is very clear: if we nurture that innate tendency, we can leave the world a generation of people who believe in sustainability and care for the environment.

Take the target of inclusive development. Here, again, when children are very young we have a window of opportunity to provide good nutrition and care in a responsive and safe environment. Early child development programmes promote an equitable start to a healthy life, especially if they start when babies are still in the womb. One of the greatest challenges for the next generation is the inexorable rise of non-communicable diseases, such as cardiovascular disease, diabetes, chronic lung disease and cancer. Although the symptoms of these diseases develop in adulthood, the foundations are laid in early childhood. That is when we need to lay the foundations for lifelong good health.

Let us look at gender equality. Early child development programmes improve outcomes for the girl child herself and often also for other female members of her family. Evidence shows that disadvantaged girl students are the ones making the most dramatic gains from such programmes. In Brazil, for example, girls from low-income families who attend pre-school are twice as likely to reach grade 5 and three times more likely to reach grade 8 as those who do not attend. In poor families, when the mother is at work, it is often older girls who have to look after the young children. If the toddlers are at pre-school, the older girls, too, can attend school.

However, the most obvious benefit of early years programmes is in the achievement of the target of learning for all. It has been said recently:

“A child born today must master skills and knowledge that were needed only by elites a century ago”.

I am sure that that is true. However, although progress has been made in school enrolment, great inequality occurs in actual learning.

Learning begins at birth. Does it not make sense for the UN to invest its efforts in the period when human beings learn fastest, thus also laying the foundations for a generation that eschews violence, cares for the natural environment and has developed the full capacity of its wonderful human brains? Learning is the result of a sequential and cumulative process of skills acquisition, with a hierarchy of achievement based on mastering early skills and then building on them, so early learning is vital for later achievement.

The UK, along with Nordic countries, is well positioned to be a beacon for early childhood development globally. We have already embraced the evidence of the benefits of early intervention and invested in the family nurse partnership, more health visitors and free early years provision for disadvantaged two year-olds. Now we need to become a global leader in championing early childhood abroad. The time to act is now, while the next set of goals is being developed. Will we be influenced by the mountain of scientific evidence? I hope so. I have a book full of evidence and solutions from the world’s experts. All we need now is the political will.

Will my noble friend pass on to her right honourable friend the Prime Minister our wish that he ensure that there is an integrated early child development goal in the next set of UN goals post-2015? Can she tell us how your Lordships’ House can influence the Prime Minister in his work with the UN? As the new goals will affect all countries, not just developing countries, will the UK Government take a lead by demonstrating the amount of economic and human capital that can be saved by investing in young children and their families?

Finally, I understand that there are to be multi-stakeholder consultations within countries on the post-2015 agenda to ensure a transparent process and meaningful participation from Governments. How is that being done in the UK? Can my noble friend assure me that the process will be comprehensive and that the Prime Minister will use its results when he works in his co-chair capacity?

My Lords, I begin by thanking my noble friend Lady Walmsley for raising this issue today, because it is one of the utmost importance. The millennium development goals were undoubtedly the single biggest push to combat world poverty in our history. Although they have succeeded in reducing poverty and child mortality, unfortunately, there is still much to do. In that respect, the post-2015 development agenda has a vital role to play.

Early childhood generally refers to the period of a child’s life between nought and eight when, as my noble friend Lady Walmsley mentioned, critical development occurs—physical, cognitive, linguistic and socio-emotional. I argue that this debate should have a broader scope, because what happens in utero is also critical.

Research into brain development and early childhood development has shown that in utero development and the first three to four years are critical for the development of sensory pathways for social and emotional development. During the early years, the brain develops most rapidly so that children can acquire the habits and skills needed for social and educational success and self-protection. If that development does not occur, children are at risk of mental health, learning and behavioural disorders. Thus, those children will fail to reach their full potential and may also become a challenge to their societies.

MDG 5 focuses on maternal health and is one of the MDGs on which more progress needs to be made. Although maternal mortality has nearly halved since 1990, an estimated 287,000 maternal deaths still occurred in 2010, with the maternal mortality ratio in developing regions being 15 times higher than in developed regions. Having a baby at a very young age also increases the risk and it is estimated that 70,000 adolescents in developing countries die each year from complications during pregnancy and childbirth. Thus, early forced marriage is a factor, and FGM also increases birth risk. In those maternal deaths, many of the babies will also die.

Although more women today receive antenatal care, only half of women in developing regions receive the recommended amount of healthcare that they need. Still, today, nearly 50 million babies are delivered without skilled care. The figures that are never produced are for those births which go wrong and result in live babies that are damaged. Very minor damage or slight oxygen deprivation can mean that a child will never reach his or her full potential.

According to UNICEF, in spite of four out of five children now getting vaccinated for a range of diseases and deaths from malaria having fallen by a quarter, around 29,000 children under the age of five still die each day, mainly from preventable causes. Although the death rate has nearly halved since 1990, these deaths mainly occur in developing countries. In sub-Saharan Africa, one in nine children die before the age of five, while an Ethiopian child is 30 times more likely to die before his fifth birthday than a child in western Europe. Children born into poverty are almost twice as likely to die before the age of five as those from wealthier families. The majority of those living in extreme poverty are female, and they are the ones who will struggle most to raise their children.

Nurture is essential to the development of a baby and very young child, and of course the mother plays a vital role. To provide good care to her child, the mother’s health and well-being are essential. It is estimated that one in seven women in the UK experiences some degree of depression after giving birth, but in developing countries there are simply no statistics about this. Yet we know that when mothers have depression, it can affect the bonding process and thus the child’s development, so postnatal care is extremely important. However, such healthcare may be scarce in many developing countries.

The events of a child’s early life are formative and play a critical role in shaping the way a child develops, and thus in building human capital and promoting economic productivity in later life. Yesterday was the International Day for the Elimination of Violence against Women. Nearly a third of women who have been in a relationship have experienced physical and/or sexual violence at the hands of a partner. For a young child, seeing his or her mother being beaten up is a terrifying experience and one which will affect them for the rest of their lives.

Freedom from conflict and violence is the most fundamental human entitlement. War tears children’s lives apart and has a devastating effect on their development. Young children who live in war zones or who are refugees will be severely affected by what they have seen and experienced. Today, it is said to more dangerous to be a woman or a child in war than a soldier. Not only is there imminent physical danger but, usually, a lack of food, an interruption of education and enormous stress. A UNICEF report estimates that during the past decade, through conflict: 2 million children have been killed; 4 million to 5 million have been disabled; 12 million left homeless; more than 1 million left orphaned or separated from their parents; and some 10 million have been psychologically traumatised.

In May this year, I visited Syrian refugees in Lebanon. Meeting some of the families camping in the Bekaa valley gave me some understanding on how hard it was to look after children in such circumstances. I met a woman trying to care for her eight children in a small tent. Having insufficient sanitation and very little clean water meant that maintaining hygiene was especially difficult in those conditions. Diarrhoea was already starting to spread through the camp, which can be fatal for very small and vulnerable children. While the women were trying to look after the children, the men who were there had nothing to do and were frustrated by their situation. We heard that domestic violence was rising. Trying to resolve conflict and promoting peace are also essential for ensuring good childhood development.

Today, in spite of relatively improved nutrition, it is estimated that more than 200 million under-fives in low and middle-income countries will not reach their developmental potential. Children are central to sustainable development. Current and future global development goals, including education goals, will be met only with attention to the overall development of young children, which will involve the rolling out of global and localised maternal and children’s healthcare. Dedicated political support is now required to ensure that there is a focus on guaranteeing that every child around the world is given the very best chance for the very best start in life.

My Lords, the inclusion of an early childhood development target in the post-2015 UN millennium development goals would be a hugely important action on behalf of children around the world. I agree with my noble friend Lady Walmsley—I congratulate her on securing this debate—that a global focus on early childhood development is essential as we move into a post-2015 global agenda. I also agree that the UK should be playing a leadership role in this crucial issue. However, if we are to take the lead on early childhood development we need to look long and hard at our own domestic policies to ensure that we truly are a world leader in our policies on early childhood. We must be seen to practise what we preach. That will be part of my focus today.

There is no escaping the unfortunate fact that of the children born around the UK today each will be born with different life chances. Sadly these chances will depend not on innate ability but, in large measure, upon the economic and social conditions into which these children are born. Of course, this inequality is magnified many times over for children living in countries with high levels of absolute poverty.

As policymakers, the natural question to ask ourselves is this: what can be done to improve the life chances of children, both in this country and around the world? To draw an analogy, last year the All-Party Group on Social Mobility, of which I am vice-chair, published a report entitled Seven Key Truths about Social Mobility. The first of those key truths—the one highlighted by my noble friend Lady Walmsley in her speech—is that the point of greatest leverage is what happens to a person between birth and the age of three. Basic cost-effective interventions in the first few years of life can pay big dividends later on in a person’s overall chances of a healthy and fulfilling life.

In the light of these conclusions, early childhood development emerges as one of the key issues for any policymaker or legislator who is seriously concerned about a fair chance in life for all our children. It is my hope that in the coming years the UK will lead the push, both internationally and at home, to put a strong emphasis on ensuring that all young children have that fair chance for a fulfilling life.

In addition to the benefits of early years intervention, the Seven Key Truths about Social Mobility report identified another key causal factor in improving life chances, and that is developing what is called character and resilience among children and young people. By that term “character and resilience”, I mean those habits of mind such as perseverance in the face of setbacks, sticking with it when the going gets really tough, high expectations, confidence, self-esteem and belief that your life is heading in a positive direction and that you can improve things by your own efforts. These habits of mind are even more crucial for children from far less privileged nations than our own. The inclusion of specific targets for early childhood development in the UN’s post-2015 millennium development goals should help to ensure that young children across the world are in an environment that will promote the development of these crucial characteristics that can make such a difference to their later life.

So what concrete interventions can Governments make in those early years that might lead to the development of the resilience that I was talking about? Given that most early-years development takes place in the home, the most important thing that Governments can do is to put policies in place that support parents during the first few years of their child’s life. Clearly a secure and nurturing home life during those early years is crucial for a child’s development. Of course, sadly, as we have already heard in the debate, in too many countries that simply is not possible because of the social and economic conditions, as well as war and conflict.

Many reports, in this country and abroad, have pointed to the fact that one of the most unhelpful assumptions is that people know instinctively how to parent. Of course, all parents want to provide a nurturing environment for their young children, but those from more privileged backgrounds tend to take for granted both the resources and the strong support networks that allow them to parent effectively. For those without those networks, the prospect of parenting on a low income can be extremely daunting. These challenges begin in the prenatal period and continue throughout early childhood and, of course, the quality of parenting varies hugely in both rich and poor households and rich and poor nations. However, clearly, having less time, fewer money worries and fewer resources makes the job of consistent and attentive parenting far harder. While what goes on in the home is, first and foremost, a matter for families, Governments can do more to provide the resources to ensure that mothers and fathers have the degree of physical and mental health, financial security and overall preparedness necessary for raising a child.

As the United Nations develops a plan for global action on early childhood development, we need to look around the world for examples of successful policies that really help parents. I believe that one model for these efforts can be found in Sweden, where expectant mothers and fathers are invited to join local groups run by a trained midwife to prepare them for the birthing process. These groups do not disband at birth but continue to meet throughout the first few years of the child’s life to offer advice and support throughout the parenting process. The data available so far suggest that parents find these programmes helpful, as more than half the parents who join prior to birth are still involved at the time of their child’s third birthday.

In addition to positive parenting, we know that education plays such a large role in enabling young children to develop into capable learners. Although the UK is above the average for OECD countries in overall participation in early-years education, a gap still exists between the more affluent and the less affluent in terms of both participation in and effectiveness of early-years education, particularly in preparing children to be ready to enter primary school. In its report entitled Greater Expectations: Raising Aspirations for our Children, the National Children’s Bureau—of which I am president—notes that, while two-thirds of children overall experience good development during early-years education, only half of children on free school meals in the UK experience that good development.

So what can be done? I suggest that there are three key components. First, we need a strategy for ensuring that success in early-years education, both in this country and elsewhere, is not tied to income. The first step must be to ensure that parents of underprivileged children have easy access to early-years education that is of good quality and promotes good child development, both intellectual and emotional.

Secondly, we need good practice guidance for early-years educators, which can be shared internationally, in order to ensure that early-years education is preparing young children to succeed when they enter school. This also means ensuring that early-years education facilities are staffed with qualified educational professionals, regardless of the affluence of the communities they serve. We need to think critically about the nature of the curriculum in the early years. In my view, early-years education should have a distinct emphasis on educating the whole person.

Finally, we need to understand and organise the way that we address the interests of children and young people at the level of public policy. This is what is so important about the specific inclusion of early childhood development in the UN’s post-2015 goals. Currently, in far too many countries the interests of children and young people are addressed in a decidedly fractured way. Some issues fall under the umbrella of education and others of health—physical, mental and so on. As Dr Nurper Ulkuer, formerly a senior adviser at UNICEF, remarked at a reception in Parliament on early childhood development earlier this month, a unified, holistic approach is needed in order to ensure that our children are physically healthy, mentally healthy, socially engaged, and ready to learn.

The importance of this holistic approach is at the core of the push to include specific benchmarks for early childhood development in the UN’s post-2015 development goals. However, this shift in how children’s issues are addressed can also happen at the national level. In the UK, the National Children’s Bureau makes two key recommendations in its report on how to organise policy-making, which I think are equally applicable in other countries. The first is the creation of a government children and young people’s board with full ministerial representation. This board can help set the agenda on policy that affects children across all levels and dimensions of government.

The second recommendation is to look—in this country it could be through the independent Office for Budget Responsibility—at the impact of each Budget on child poverty and inequality among children. Both these recommendations could help ensure that children’s issues are placed at the centre of all policy decisions and could be used as a model in other countries. Of course, that is ultimately the heart of the matter. Every Government around the world has to be held accountable for the way in which their actions promote the well-being and development of the youngest children. That is why I believe that the UK should use its international profile to push strongly for the inclusion of an early childhood development target in the post-2015 development goals to promote the interests of young children around the world.

My Lords, I, too, thank the noble Baroness, Lady Walmsley, for initiating this debate. She has a tremendous record in the field of child welfare.

The UN high-level panel report based its analysis on five transformative shifts, including the idea of leaving no one behind. I welcome many of the recommendations in the panel’s report, especially the objective to end extreme poverty by 2030 and the bringing together of the sustainability and poverty reduction agendas. The report is an important contribution to the debate about a new covenant for development, but there is still a lot of work to be done to ensure that the new goals and partnerships drive the radical change which is essential if we are to be the generation that ends poverty and safeguards scarce planetary resources.

Many questions still remain on content, financing and accountability, but the principles set out in the outcome document represent a good starting point. Having said that, my hope is that the more ambitious parts of the report, including its call for a stand-alone goal on gender equality and women’s empowerment, will be built on as the negotiations now move forward.

The five shifts I have described are only part of the equation. They help to build momentum to meet our aspirations. However, goals with effective monitoring will ensure that the international community moves in the same direction. As we have heard in this debate, the benefits of investment in early childhood development are strong, but the cost of inaction is also very clear.

Science has demonstrated that early childhood interventions are important because they help to mitigate the impact of adverse early experiences which, if not addressed, lead to poor health, poor educational attainment, economic dependency, increased violence and crime, all of which add to the costs and burdens on society. UNICEF and Save the Children operational research published in 2003 revealed the significant improvement in primary education grade promotion, repetition and drop-out rates attributable to school readiness and ECD programmes.

As the noble Baroness, Lady Walmsley, said, children are central to sustainable development. Decreased child mortality, relatively improved nutrition and school enrolment may give a picture that the world is on track on its promises for children. However, many of the children who are surviving now are not achieving their full developmental potential. According to an estimate, 200 million children around the world are not achieving their potential because they suffer from the negative consequences of poverty, nutritional deficiencies and inadequate learning opportunities. Moreover, 61 million children around the world are out of school and thus at risk. If one digs deeper, beyond national averages, one sees widening disparities among regions and countries and within countries based on wealth, gender and geographic location. In the face of increasing conflict, early childhood development is also considered an entry point for peacebuilding in communities. Furthermore, as we have heard, good early learning programmes can help to build the resilience of children and families in emergency and fragile situations.

Each year, about 19 million children in developing countries are born underweight because of poor growth in the womb. More than 200 million children below the age of five living in low and middle-income countries fail to reach their developmental potential. This failure to ensure that children have access to early childhood development has significant consequences for eradicating global poverty and achieving sustainable development. These twin objectives cannot be achieved when significant numbers of children start life at a disadvantage, one that continues to widen as they grow and develop, and becomes an intergenerational transfer of poverty. Eradicating poverty and achieving sustainable development therefore require that significant attention is paid to early childhood development and that strategies to ensure adequate health, nutrition, stimulation and early learning are part of all programmes to eradicate poverty and achieve sustainable development.

On 22 October in a supplementary Oral Question to the Minister, I referred to evidence that investing in children’s earliest years makes the biggest difference to their lives and to the country’s social and economic fortune. I asked the noble Baroness then whether she would support calls to put early childhood development at the heart of the new post-2015 development framework. In response, the Minister correctly pointed to the illustrative universal goals in the high-level panel report, which highlight the new emphasis on, for example, good nutrition, which is so important in the first 1,000 days of a child’s life, as well as education—not just primary education but a wider scope of education. The noble Baroness suggested that, as concerns for young children are built into a number of the goals, the early childhood development approach can be assumed to be there.

The goals to provide quality education and to ensure a healthy life, food security and good nutrition are strong component parts of a comprehensive approach to early childhood development. However, as the noble Baroness, Lady Tyler, said, policies and programmes need to be fully comprehensive if the approach is to be carried through. They must also include parenting support, developmental monitoring with early intervention, and childcare.

It is important that we do not let up on making a strong case for these important points of principle at events and debates in the General Assembly throughout 2014. These will set the scene for member state negotiations, which will culminate in the summit in 2015. Will the noble Baroness give us some indication of how the Government plan to highlight these issues leading up to 2015? I, too, would like to see the good examples being highlighted. Can the noble Baroness highlight some of the programmes that the department is currently engaged in to support the provision of a comprehensive approach to early childhood development?

Children are key stakeholders in the future. The evidence shows clearly that investing in children’s earliest years makes the biggest difference to their lives and to a country’s social and economic fortunes. Straying slightly off my remit, I am only sorry that since 2010 many of the Sure Start centres in this country have been closed.

My Lords, I thank my noble friend Lady Walmsley for securing this important debate and for introducing it, as ever, so cogently.

As the 2015 deadline for the MDGs approaches, it is very important that we seek to ensure that we build on what has already been achieved and move forward in seeking the MDGs’ replacements, having learnt from what worked in the current set and where we need to head in the future. The MDGs seek the relief of poverty internationally and they use various means to do that. As my noble friend Lady Hodgson emphasised, much has been achieved but much still needs to be done.

In the proposed new goals, there is the aim to eradicate extreme poverty and to ensure that no one is left behind, and that clearly includes children. I welcome the opportunity to explore the core issues surrounding progress on early child development globally and how those issues can best be reflected in the post-2015 development framework.

As my noble friend Lady Walmsley stated, the case for a major global effort on early childhood development is compelling. As she indicated, evidence from multiple disciplines, including neuroscience and epigenetics, and across the social sciences tells a similar story: that early childhood matters. When everyone gets a good start in life, we are more likely to see better education and health outcomes, and higher earnings with more inclusive economic and sustainable development for all.

We know that we need to emphasise child development, support for parents and education in the United Kingdom, as my noble friend Lady Tyler noted. Internationally, we are some way off our aims. Of those children who survive birth, globally it is estimated that in low and middle-income countries more than 200 million under-fives are failing to reach their true cognitive development potential and that 165 million are stunted. However, of course, millions never even reach their first birthday. Four overlapping constraints are at the root of these challenges, and noble Lords have referred to them: poverty, nutritional deficiencies, poor healthcare and inadequate learning opportunities. The noble Lord, Lord Collins, crossed over all those.

The UK Government have a long-standing tradition of engagement in development and they work hard to improve early childhood outcomes globally. The noble Lord, Lord Collins, and others have shown how desperate is the situation of many children around the world, and he rightly emphasised the significance of intergenerational poverty.

To achieve their full potential, it is essential that children have a healthy and nutritious start to life, as my noble friend Lady Hodgson and the noble Lord, Lord Collins, emphasised, and that they should be supported by mothers who are in good health themselves. DfID funding for family planning is helping to avert 2.6 million unwanted pregnancies and prevent 70,000 deaths during pregnancy, childbirth and infancy. The benefits of family planning go well beyond the health sector. Evidence shows that when families are able to choose the number of children they have, they choose to have fewer children and do more for them. They particularly choose to invest in their children’s education. As my noble friend Lady Hodgson pointed out, paternal health is critical before, during and after birth.

My noble friend also pointed out the importance of good nutrition, as did the noble Lord, Lord Collins. We recognise that good nutrition is essential, particularly in a child’s first 1,000 days—from conception to their second birthday—to ensure that they reach their full physical and cognitive potential. Noble Lords will no doubt remember the Nutrition for Growth event that we held on 8 June. That brought together partner Governments, civil society, business and science to try to address the neglect of undernutrition. DfID also supports efforts here to increase vaccine coverage and reduce avoidable child deaths, illness and disability. Between 2011 and 2015, UK funding for GAVI—formerly the Global Alliance for Vaccines and Immunisation—will help to vaccinate more than 80 million children.

It is estimated that diarrhoeal diseases are now a leading cause of child deaths in Africa and the second leading cause of child deaths globally. After pneumonia, they are the biggest killer of children under five in the world. DfID is committed to reaching 60 million people with improved water, sanitation and hygiene—WASH—by December 2015. Through partnership with UNICEF, this includes WASH in schools and WASH in health units. Globally, DfID is assisting pre-primary education through core support to UNICEF—an organisation that I know my noble friend Lady Walmsley strongly supports—the World Bank and international NGOs, such as Save the Children, and through our work directly with partner Governments. Ensuring quality early-years provision for all when education budgets are already stretched is key.

While the evidence base on the impact of early childhood development on life chances for all is strong, the capacity and resources needed to implement cost-effective, sustainable and quality programmes that reach the poorest, which is what noble Lords have been emphasising, remain a cause for concern. I hope I can reassure the noble Lord, Lord Collins, and my noble friend Lady Tyler that this is why DfID is stepping up efforts with its partners, such as the World Bank, UNICEF and the Children’s Investment Fund Foundation, to scale up programming in this area. We are working with these partners to explore ways to improve the cross-sectoral links between health, education, water and sanitation and social protection, which is key here, in the provision of services that target children from birth to eight years old. I can tell the noble Lord, Lord Collins, that innovative cross-sectoral programmes have already been developed in Zimbabwe and Bangladesh.

The UK is also currently engaged in a range of research activities to fill gaps in our knowledge of the impacts of early interventions and how they can best be delivered. For example, DfID currently supports the young lives study of childhood poverty, involving 12,000 children in Ethiopia, India, Peru and Vietnam over 15 years. We also recently commissioned a multi-disciplinary team to undertake a rigorous literature review on early childhood development and cognitive development. That report will be published soon and used to inform future research and policy direction. I hope my noble friends are pleased to hear that.

My noble friend Lady Tyler spoke of confidence and self-esteem. I think she should stay and participate in the following debate in the name of the noble Baroness, Lady Grey-Thompson, which addresses such issues and which I shall also be answering. I reassure my noble friend that in the UK we recognise the importance of early years development. There is an overwhelming evidence base from the UK and around the world that shows that high-quality early education has long-lasting benefits for children. By the time that children reach the age of five, there is already a 12% achievement gap between those from lower-income households and the rest. That is unacceptable to us, as a Government who believe in opportunities for all children. The evidence shows that there are social and cognitive benefits for children who receive good quality pre-school provision between the ages of two and two and a half, compared with children who started at the age of three or more. My noble friend will know the details of the provision that the United Kingdom Government are putting in place.

My noble friend Lady Walmsley asked how the UK Government can lead on the post-2015 development settlement. She referred to my right honourable friend the Prime Minister’s role in co-chairing the high-level panel. Through that, we were able to ensure that a commitment to leave no one behind is at the heart of the final report. That is the key to all this. The report, published in May 2013, recognises the importance of early childhood development with illustrative targets on the provision of pre-primary schooling, reduced stunting and wasting among the under-fives and ending preventable infant and under-five deaths.

The high-level panel gave us an excellent starting point for the next two years of discussions on the framework to replace the MDGs. It is extremely important that we focus hard on trying to deliver something that is as comprehensive and deep-rooted as the proposals before us at the moment. We will continue to work hard and actively with others to highlight the important issues raised on early childhood development as part of the ongoing dialogue on a post-2015 development framework. I can assure my noble friend that outreach to civil society, businesses and other key stakeholders, both in the UK and internationally, will continue to be a key part of the UK Government’s work on post-2015. I am pretty sure that my honourable friend the Minister of State in DfID is having a meeting with parliamentarians in the CPA as part of that. It was during the Prime Minister’s tenure as co-chair of the high-level panel reports that those issues were brought forward.

As noble Lords have made abundantly clear, our children are our future. Noble Lords are right to focus on children and their development. I assure noble Lords that we share that view. This has been a wide-ranging debate covering life, death, war and peace among women, men, children and adults, and many other things. It is to ensure that the children of the future survive and thrive and that none are left behind that the new MDGs are needed.