Infections cause two-thirds of child deaths

According to a new study, preventable infectious diseases cause two-thirds of child deaths.

Published in The Lancet, experts from the World Health Organization (WHO) and UNICEF’s Child Health Epidemiology Reference Group (CHERG) assessed data from 193 countries to produce estimates by country, region and the world.

“With less than five years to reach the United Nations Millennium Development Goal 4—to reduce child deaths by two-thirds from 1990 levels—it is vital for governments, public health organizations, and donors to have accurate country-level estimates so they can target their efforts effectively,” said lead author Dr. Robert Black, chair of the Department of International Health at the Johns Hopkins Bloomberg School of Public Health.

“These findings have important implications for national programs,” said UNICEF Chief of Health, Dr. Mickey Chopra. “The persistence of diarrhea, pneumonia and malaria, all of which are easily preventable and curable but which nonetheless remain the leading single causes of death worldwide, should spur us to do more to control these diseases.”

The study’s country and regional estimates, however, underscore how global efforts must be targeted to have maximum impact. Malaria, for instance, is responsible for approximately 16 percent of deaths in Africa, but is a comparatively minor disease in the rest of the world. The study did reveal successes in fighting some infectious diseases, such as measles and tetanus—each now only accounts for 1 percent of child deaths worldwide.

Newborn deaths—those within the first month of life—increased as a proportion of all child deaths globally from 37 percent in 2000 to 41 percent in 2008.

The two greatest single causes of death among neonates are pre-term birth complications and birth-related asphyxia.

“These new data make the compelling case that for countries to get on track for Millennium Development Goal 4, they need to scale up low-cost, effective newborn health interventions,” said co-author Dr. Joy Lawn, director of Global Policy and Evidence for Save the Children’s Saving Newborn Lives program.

From TOI

New children’s medicine guide released by UNICEF and WHO

29 APRIL 2010 | GENEVA — A new publication that lists medicines formulated for children is being made available online by UNICEF and the World Health Organization, to help doctors and organizations obtain some of the 240 essential medicines that can save the lives of children.

“An estimated 9 million children die each year from preventable and treatable causes. Improved availability and access to safe child-specific medicines is still far from reality for many children in poor countries. This one-of-its-kind publication will be useful for organizations and personnel involved in procurement to identify where medicines may be found and what they cost,” said Hans Hogerzeil, Director Essential Medicines and Pharmaceutical Policies at WHO. More than half of these deaths are caused by diseases which could be treated with safe essential child-specific medicines: acute respiratory infections – pneumonia (17%), diarrhoeal diseases (17%), neonatal severe infections (9%), malaria (7%), and HIV/AIDS (2%).

Sources and prices of selected medicines for children

The second edition of Sources and prices of selected medicines for children offers current details on 612 different paediatric formulations of 240 medicines selected from the ‘WHO Model List of Essential Medicines for Children’, as well as therapeutic food, and vitamin and mineral supplements, to treat major childhood illnesses and diseases. The information is vital for development and health partners who procure and supply essential medicines for children.
Challenges to obtain child-specific medicines

The guide notes that the number of sources is limited for the paediatric treatment of diarrhoea and HIV/AIDS, and there is still a serious challenge to obtain child-specific medicines to treat tropical infections endemic in Africa and Asia. The guide ranks the availability of the identified medicines, and notes that 75% of the formulations included are available for purchase. There are several sources for children’s medicines and treatments to address opportunistic infections, palliative care, pain and pneumonia. Availability of paediatric formulations for treatments of malaria, maternal and newborn care, and tuberculosis was fair.

Newborn care is often lacking in poor countries, particularly in hard to reach communities. At the time of publication, there was no information from manufacturers for respiratory stimulants and pulmonary surfactants for the treatment of apnoea and respiratory distress syndrome in newborns.

Although diseases such as schistosomiasis, filariasis, and parasites transmitted through soil, are endemic in some parts of Africa and Asia, there are few manufacturers who produce child-specific medicines to treat these neglected diseases. Broadening the market search for essential medicines in this category is a serious challenge.

“While effective medicines exist to fight disease and treat life-threatening conditions like malnutrition, formulations suitable for children are often difficult to source,” said Francisco Blanco, Chief of Medicines & Nutrition, UNICEF Supply Division. “The data in this edition confirms that much more research and effort needs to be made to make medicines for children more available and accessible for those who need them most.”

As an alternative to missing paediatric medicines, health-care workers and parents often use fractions of adult dosage forms or prepare makeshift prescriptions of medicines by crushing tablets or dissolving portions of capsules in water. This is not always safe or effective as the dose will not be accurate. Other challenges include the need for more clinical trials and research to be carried out on paediatric medicines.

WHO recommendation

WHO recommends that wherever possible, medicines for children should be provided as flexible, solid, oral dosage forms that can be administered in a liquid when it is given to the sick child. Liquid formulations are more expensive to purchase compared with dispersible tablets and are also more costly to store, package, and transport safely.

Sources and prices of selected medicines for children is part of UNICEF/WHO work to make essential medicines for children more universally available. Since the launch of the campaign “make medicines child size” in 2007, WHO and UNICEF have been working in partnership to raise awareness and accelerate action to address the serious gaps that contribute to nine million preventable child deaths every year.

About WHO

WHO is the directing and coordinating authority for health within the United Nations system. It is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends. The Essential Medicines and Pharmaceutical Policies department’s vision is that people everywhere have access to the essential medicines they need; that the medicines are safe, effective and of assured quality; and that they are prescribed and used rationally.


UNICEF is on the ground in over 150 countries and territories to help children survive and thrive, from early childhood through adolescence. The world’s largest provider of vaccines for developing countries, UNICEF supports child health and nutrition, good water and sanitation, quality basic education for all boys and girls, and the protection of children from violence, exploitation, and AIDS. UNICEF is funded entirely by voluntary contributions.
For more information contact:

Liz Finney
Communications Officer, World Health Organization
Geneva, Switzerland
Telephone: +41 22 791 1866

Joan Howe
Communications Specialist, UNICEF Supply Division
Copenhagen, Denmark
Mobile: +45 29 65 71 94
From WHO

Four lakh children die from pneumonia every year in India: WHO

NEW DELHI: Nearly four lakh children below five years of age die every year in the country due to pneumonia, a lung infection which can be prevented by taking proper care, according to World Health Organisation and United Nations Children’s Fund (UNICEF).

Several global agencies including Indian Academy of Paediatrics, Public Health Foundation of India, WHO, UNICEF, USAID, Indian Clinical Epidemiology Network and AIIMS will come together to observe the first ever World Pneumonia Day on November 2 with an aim to prevent the "avoidable" two million deaths that happen worldwide due to the disease.

"In India, every minute nearly 82 children below the age of five are affected by pneumonia, every hour 45 children die due to it and the infection claims almost four lakh lives every year. It is India’s number one killer among children," a WHO official said.

According to WHO, 25 per cent of the total global toll of pneumonia takes place in India alone," he said.

Dr Panna Choudhary, president of Indian Academy of Paediatrics said, "There is very less awareness about it among the masses and the government too is not taking proper steps to prevent the disease. We wish to bring it to the notice of the people and the government especially to focus on pneumonia as a public health issue and to prevent millions of avoidable deaths from pneumonia that occur each year."


Unicef-UN: Vaccines, hygiene could stop diarrhea deaths

LONDON – Diarrhea causes one in five child deaths across the world but getting important vaccines to Africa and Asia could help save many lives, two U.N. agencies said on Wednesday.

Some 1.5 million children die each year from diarrhea, — more than AIDS, malaria, and measles combined — yet only 39 percent of children with diarrhea in developing countries get the right treatment, the World Health Organization and the United Nations children’s fund UNICEF said in a report.

Vaccinations against rotavirus, the leading cause of severe gastroenteritis with vomiting and diarrhea in babies and children, as well as better sanitation and proper rehydration treatment would help solve the problem, they said.

Vaccines, hygiene could stop diarrhea deaths: U.N - Reuters

Vaccines, hygiene could stop diarrhea deaths: U.N - Reuters

Rotavirus causes around 40 percent of hospital admissions from diarrhea in children under five worldwide, according to the report, and vaccination against it has recently been recommended for all national immunization programs.

Only a few, mostly developed and richer nations include rotavirus vaccine in routine childhood immunization programs, but the WHO has been working to make two vaccines — Rotateq from Merck & Co and Rotarix from GlaxoSmithKline — more widely available in developing countries.

“Accelerating its introduction in Africa and Asia, where the rotavirus burden is greatest, needs to become an international priority,” said the report.

It also said two mainstays of diarrhea treatment — zinc supplements and low-osmolarity oral rehydration salts — are still hard to come by in many poorer countries.

“We know what works to reduce child deaths from diarrhea and what actions will make a lasting reduction in the burden of diarrhea,” Tessa Wardlaw of UNICEF and Elizabeth Mason of the WHO said in a commentary in The Lancet medical journal.

“We need to make the prevention and treatment of diarrhea everybody’s business, from families and communities to government leaders to the global community.”

More than 80 percent of child deaths due to diarrhea occur in Africa and South Asia and just 15 countries account for almost three quarters of all deaths from diarrhea among children under five each year. India has the highest number of annual deaths at 386,600.

The report set an action plan to try prevent more childhood deaths from diarrhea. It stressed that simple steps like encouraging hand washing, promoting breastfeeding for small babies, and discouraging open defecation were crucial.

“Nearly one in four people in developing countries practice open defecation,” the authors said. “And despite some recent progress, only 37 percent of infants in developing countries are exclusively breastfed for the first six months.”

An estimated 88 per cent of diarrheal deaths worldwide are due to unsafe water and poor sanitation or hygiene, they added.

By Kate Kelland – Reuters

Water – Firms role in protecting water

The basic elements (based on those developed by the World Health Organization and UN) of protecting the right to water are:

    * Safety: Ensure that operations preserve the quality of the water resources in the communities in which you do business;
    * Sufficiency: Ensure that use of water will not diminish the availability of community water resources to the individuals or the communities in the areas in which you operate;
    * Acceptability: Involve communities in  plans to develop water resources, and  assure transparency of any risks or challenges to the local governments and community members in an on-going manner;
    * Physical Accessibility: Ensure operations will not adversely impact physical accessibility of community members to community water resources and will address community concerns in a cooperative manner;
    * Affordability: Appropriately advocate to applicable government bodies that safe water supplies should be available in a fair and equitable manner to members of the community. Such water should be safe and of consistent and adequate supply and affordable within local practices.

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