Millions of children die needlessly

Nearly 11 million under age 5 succumb each year, largely to easily
preventable illnesses, health experts say.


By EMMA ROSS
The Associated Press

LONDON – The lives of 6 million children under 5 could be saved every year
if flu shots and other low-cost measures to prevent or treat disease were
more widely used, global health experts say.

Every year, nearly 11 million children worldwide die before their fifth
birthdays, most from preventable causes such as diarrhea, pneumonia,
neonatal problems and malaria. Malnutrition is a major factor in more than
half those deaths, researchers estimate.

In a series of articles this week in The Lancet medical journal, experts
say inexpensive lifesaving measures - such as breast feeding,
insecticide-treated bed nets, flu shots, antibiotics, newborn
resuscitation and clean childbirth - are not reaching the mothers and
children who need them most.

Scaling up those interventions to a level that would save 6 million lives
a year would cost about $7.5 billion annually, the experts say.

In the 1980s, the world made great progress in reducing unnecessary child
deaths through a UNICEF campaign called the child-survival revolution. But
the momentum was lost in the 1990s.

"We have dropped the ball," said one of the experts, Cesar Victora,
professor of epidemiology at the Federal University of Pelotas in Brazil.
"Child survival has fallen off the international agenda. We need now a
second revolution to finish this job."

The number of deaths among children under 5 fell from 117 per 1,000 live
births in 1980 to 93 per 1,000 in 1990. Today, the death rate is still
declining but not as quickly - in 2000, it was 83 per 1,000.

Experts stressed two main reasons why progress appears to have stalled.

In the 1990s that HIV/AIDS shifted the world's attention and resources
toward fighting that specific diseases.

"I'm not saying that it was wrong, but child health lost out in that,"
said Hans Troedsson, director of child and adolescent health and
development at the World Health Organization.

The experts noted that the total number of child deaths each year is
greater than deaths due to HIV, malaria and tuberculosis combined.

The other major factor was complacency, experts say.

"We were doing really well," Troedsson said. "There was a kind of attitude
that the job was more or less finished. That kind of perception meant that
a lot of investments and commitments to keep the steam in child survival
was actually lost."

Other experts said the death of former UNICEF leader Jim Grant, who
spearheaded the child-survival revolution of the 1980s, left a void in
global leadership as UNICEF's focus shifted toward children's rights and
education.

The U.N. children's agency said it still spends most of its money on
child-survival programs and that many of its newer strategies addressing
children's rights and education translate in the long term to better child
survival.

"The easy gains have been made," said UNICEF spokeswoman Marjorie
Newman-Williams. "We have now plateaued because the strategies we have to
put in place are more difficult."

Whereas earlier strategies were focused on delivering vaccines and
medicines to clinics, future progress does not necessarily depend on that,
she said. The benefits of that approach have been mostly mined, she said.

Many of the actions that will reduce the deaths now are those that have to
be taken into the home, such as breast-feeding, bed nets and proper infant
nutrition after weaning.

"Those three heavily depend on women's time, women's knowledge and
availability," Newman-Williams said. "And to reduce neonatal mortality,
you have to focus on women's health. This is not a child health
intervention."

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