The Nelson Mandela Children’s Hospital (NMCH) is the tangible result of the Nelson Mandela Children’s Hospital Trust (NMCHT) mandate: raise R1 billion to build a specialist paediatric hospital providing tertiary care to the Southern African region. Thanks to generous donors around the world, ranging from corporations to ordinary citizens and children, as well as various key strategic partners, we were able to begin construction on 22 April 2014. • In South Africa: There are 54 deaths per 1 000 children born each year. • In comparison: The USA, UK and Germany’s rate is 8 per 1 000 or less. • Under-five deaths are increasingly concentrated in Sub-Saharan Africa, while the share in the rest of the world dropped from 31% in 1990 to 17% in 2011. (Unicef, 2012) • Sub-Saharan Africa has the highest risk of death in the first month of life and is among the regions showing the least progress. (Unicef, 2012) • Millennium Development Goal No. 4: To reduce under-five child mortality by two-thirds between 1990 and 2015.