The auditorium of the high school in the heart of Quito, Ecuador, was sparse. Beyond a regal painting of Simon Bolivar displayed prominently on stage and a few posters, the room was unadorned, belying the incredible scene we were about to witness. We were there on a visit to learn more about UNICEF-supported programs in Ecuador. The eight of us sat in a row at the front of the room, facing dozens of students—mostly 18 years and older—who had previously dropped out of school and were now returning to finish their education. They were participating in a UNICEF-supported Fast Track Initiative, where they were able to complete three years of school in only one rigorous year, helping them catch up to their peers.

Malaria is the single most important cause of illness in the Democratic Republic of Congo (DRC). Out of the country’s population of 72 million – nearly all are at risk of contracting the disease. Malaria here is responsible for nearly 200,000 deaths every year – the equivalent of 366 plane (747) crashes. You would think that providing this simple, cost-effective and lifesaving solution over the beds of those who need it most would be pretty straightforward. Yet, given the complex terrain of areas where the transmission of malaria is highest, the distribution of millions of needed bednets is one of the most challenging tasks faced by UNICEF as well as other humanitarian organizations working on the ground to stop this deadly disease. Back in 2009, UNICEF helped organize a historic campaign where 5.5 million nets were distributed at a cost of about US $32 million to protect at least 11 million people living in DRC’s provinces of Orientale and Maniema. These nets were transported by barge, bicycle, canoe, trucks and sheer human effort. This year, we’re at it again with another extraordinary series of campaigns! Our goal for 2012 is to distribute 13.7 million mosquito nets in four provinces across the country.

Mosquito-borne illnesses are a life-and-death matter, and since World Malaria Day is right around the corner on April 25, it’s a good time to stop and take a look at the status of the fight against this ancient and often deadly disease.
On the surface, remarkable progress has been made. Over the last decade, the malaria mortality rate has decreased by over one-quarter globally, and by a full third in Africa. Some countries in particular have made spectacular gains in malaria control, and an effective malaria vaccine may finally be on the horizon. On closer inspection, however, the situation is less inspiring.

Walking through the door into the intensive care ward, I am struck by sensory overload – children’s cries come seemingly from every direction; medical staff buzzing around me, inserting a feeding tube here, testing for malaria there; and an oppressive 104 degree heat from which there is no escape. This is the Intensive Nutritional Rehabilitation Center (CRENI) in the village of Madarounfa, south-eastern Niger, a hospital where children under age 5 are treated for severe acute malnutrition with complicating medical conditions. I have been here before, but somehow it has been transformed. Apart from the building structure itself and the familiar faces of the doctors and nurses, it is a different place entirely, almost unrecognizable. As I adjust to the scene around me, I realize what has changed. When I was here three months ago, there were only six children undergoing treatment for severe acute malnutrition. Today, all 28 hospital beds are occupied.

It is a microcosm of the worsening crisis across the Sahel region of Africa, where drought, poor harvests and rising food prices have left an estimated 1 million children at risk of death from malnutrition.

In more than 30 countries maternal and neonatal tetanus (MNT) remains a risk. U.S. Fund for UNICEF staff and a team from Kiwanis International will travel to the Philippines to witness firsthand UNICEF programs to eliminate MNT there.

The children of the Sahel are closer than you think. We are not hundreds but thousands of miles away from the unraveling crisis threatening the survival of 1 million children in the Sahel! I can feel the pain and the impossible choices that families thousands of miles away continue to face each passing day and the urgent assistance they need. Colleagues and partners in each of the eight country offices in the region diligently collate and share updates of the situation on the ground. UNICEF offices across the world receive Situation Reports or as we say in internal speak SitReps describing in great detail the first-hand on-ground realities and needs. The situation reports are our information lifeline.

These internal reports continue to be delivered to our inboxes and continue to warn us of the worsening situation and the need for urgent immediate aid to save 1 million children.

To really give you a sense of what’s happening on the ground I wanted to share a SitRep covering all the eight countries and the overall situation.

We thank you for helping us sound the alarm but our work is far from done. We need your support to continue to raise awareness for the crisis and to help ensure the survival of the 1 million children standing on the brink of death and disease as a result of the food and nutrition crisis.