The highest rate of return in early childhood development comes from investing as early as possible, from birth through age five, in disadvantaged families. Starting at age three or four is too little too late, as it fails to recognize that skills beget skills in a complementary and dynamic way. Efforts should focus on the first years for the greatest efficiency and effectiveness. The best investment is in quality early childhood development from birth to five for disadvantaged children and their families.

The first 1,000 days of a child’s life set the stage for future success. Yet an estimated 200 million children worldwide do not get a healthy start because of poverty, poor nutrition, and other challenges. Health services are particularly well placed to reach children early with services that support families to deliver nurturing care and facilitate early childhood development. However, the time has come for the health sector to expand its vision of health beyond prevention and treatment of disease to include the promotion of nurturing care for young children as crucial factor in the realization of the human potential of all people.

The brain architecture starts very early following conception, starting prenatally and extending through adolescence. If you look at what’s happening in terms of brain development during the first thousand days, it’s an incredibly active time. It’s a time of both vulnerability and opportunity. If we think about the environment preconception, during pregnancy, and during early infancy, what we have are opportunities to influence the genetic blueprint that wind up influencing health, learning, and behavior throughout life.

If a child is exposed to adverse experiences during a critical period of development or deprived of expectable experiences, brain development can be undermined. These effects can be biologically embedded and persist across the entire lifespan. This, in turn, can impact not only the child, but also the family and ultimately, all members of society.

In our world of plenty, no one should live in hunger. No child should have his growth stunted by malnutrition. No child should have her opportunity for a better life curtailed even before she is born, because her mother was undernourished.

Programs that help families meet the nutritional, health, and psychosocial needs of young children will substantially improve human capital. For this reason, early child development programs, should be viewed as long term economic development strategies. Because poverty compounds the effects of deficient nutrition and psychosocial deprivation, the programs are needed most desperately in developing nationals and underprivileged sectors of society. Compelling scientific findings and considerable programmatic experience indicate the need to promote widespread and energetic support for early child development programs.