Abstract

By the 1990s, global interest in the health of mothers and children had waned. HIV, malaria and non-communicable diseases were at centre stage in the global agenda. Yet, over 10 million under-five children and half a million mothers died every year. Attempting to reverse this situation, a group of concerned scientists and policymakers joined efforts to produce the Lancet Child Survival Series in 2003, and to set up the Countdown to 2015 Initiative 2 years later. The global Countdown conferences and reports are aimed at monitoring progress towards the Millennium Development Goals, and at holding governments and international actors accountable for insufficient performance. Sound epidemiological research laid the foundation for selecting a handful of cost-effective interventions and advocating for their incorporation into national and international policies. Epidemiology then contributed to measuring coverage with these interventions, assessing which population groups are lagging behind, feeding back this information to policymakers on a continuous basis, and evaluating large-scale programmes. Breastfeeding promotion and community case-management of pneumonia are used as examples of how rigorous research data can influence policy. Growing emphasis on accountability, results-based financing and real-time mortality monitoring in low-income countries will bring additional measurement needs, which require greater involvement of epidemiologists in global initiatives.