* Focusing on neediest is more cost-effective - UNICEF
* Changing aid distribution could save millions of lives
By Louis Charbonneau
UNITED NATIONS, Sept. 7 (Reuters) - The U.N. children's foundation UNICEF plans to make the poorest and most remote regions of needy nations top priority for aid, an approach it said on Tuesday is not only morally but economically sound.
"It's not often that the right thing to do is also the most cost-effective thing," UNICEF chief Anthony Lake told Reuters in an interview.
Lake, who was former U.S. President Bill Clinton's National Security Adviser, said a new study on aid distribution undertaken by UNICEF showed aid agencies could save millions of lives by going first to the most disadvantaged mothers and children and their communities.
Traditionally aid programs have focused first on a country's capital and major cities, where underprivileged populations are relatively accessible, only later moving to difficult-to-reach pockets of poverty and disease.
But the new study, Lake said, found that the economic and developmental impact of going straight to the neediest and hardest to reach communities, and then working back to the central cities, was significantly greater than the traditional approach.
One reason for that approach is that remote poverty-stricken areas lack infrastructure and personnel. But Lake said it was possible to work with a minimum of infrastructure and provide locals with sufficient expertise to supply routine medical services.
UNICEF, he said, would be focusing its future humanitarian and developmental aid in line with the results of the study.
NOT WITHOUT RISKS
A report on the UNICEF study released on Tuesday said it showed that by comparing the effectiveness of different strategies for aid delivery, targeting the poorest and neediest children could save more lives per $1 million spent than the current path.
Among the advantages of what UNICEF describes as an "equity-based approach" to aid delivery would be the ability to avert many more child and maternal deaths and episodes of stunted growth than the current approach.
A $1 million investment in reducing the deaths of children younger than five years in a low-income high-mortality country would avert an estimated 60 percent more deaths than the current approach, UNICEF said.
Because disease, ill health and illiteracy are concentrated in the most impoverished child populations, focusing on such areas could also improve poor nations' progress towards meeting the Millennium Development Goals aimed at slashing poverty by 2015 and reduce disparities within countries.
The approach is not without risks, Lake said. Sometimes the remotest and poorest communities are in areas where the central government has little authority and insurgents are in control, making the distribution a very risky business.
This is the case in countries like the Democratic Republic of the Congo, Afghanistan or Somalia. But Lake said UNICEF has proven capable of getting into and operating in unstable regions because it is apolitical and focuses on children.
"If you're a local militant, you wouldn't want the mothers saying that you weren't letting in UNICEF," he said. (Editing by Jerry Norton)
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