May 11,2007 00:00
the St. Louis Post-Dispatch
Every year more than 10 million children around the world - about 28,000 a day - die before they reach their fifth birthdays. Many could be saved by things that cost little or nothing: breast-feeding, immunization for measles, clean drinking water, mosquito nets.
What stands in the way? The lack of resources is a factor to be sure. But ignorance, war and politics reap their own grim harvest of precious young lives.
While many countries have made progress over the last 15 years in reducing death rates among children aged 5 and under, mortality rates have plateaued or risen in others, according to a report released this week by Save the Children, a U.S.-based international humanitarian organization. The report was based on data compiled from various sources, including the World Health Organization and UNICEF.
Twenty of the 60 developing countries that collectively accounted for 94 percent of child deaths either have made no progress over the last 15 years or have seen their child death rates worsen, according to the report. Among those sliding backward the most are Iraq, Botswana, Zimbabwe and Swaziland. Child death rates doubled in Iraq and Botswana over the last 15 years.
The vast majority of child deaths - 99 percent - take place in the developing world, with the highest rates found in Africa and South Asia. Just 10 countries account for the greatest number of them, including China, India, Angola and Democratic Republic of Congo. The highest mortality rates are in countries undergoing armed conflict such as Afghanistan, Liberia, Sierra Leone and Somalia.
However, even in developed countries such as the United States, death rates among some groups are unacceptably high. The United States tied for 26th place with Croatia, Estonia and Poland. Given our nation's wealth and resources, we should place at the top of the list. But that won't happen until impoverished mothers and infants, especially African-Americans, have better access to prenatal and pediatric health care.
The problem of child deaths may seem intractable, but experts say the solutions sometimes are simple. The leading causes of death among children under the age of 5 - newborn disorders, pneumonia and diarrhea - can be prevented or treated with low-cost interventions such as breast-feeding, birthing attendants, immunization for measles and treating diarrhea with oral rehydration therapy.
Warming and drying newborns immediately after birth, distributing insecticide-treated mosquito nets and providing clean drinking water also can save thousands of infants. Access to contraceptives and family planning allow mothers to space their babies at healthy intervals and avoid pregnancy when they are too young or too old to give birth safely.
Countries with limited financial resources such as Egypt, Indonesia, Bangladesh, Nepal and the Philippines have drastically reduced their childhood death rates by using some of those interventions. Among the developing countries, Egypt has made the most progress, with an impressive 68 percent decline in deaths over the last 15 years. Bangladesh has more than halved its child death rate.
The United States can help children around the world, but global social and health programs are mired in ideology. The Bush administration limits family planning funds to abstinence-only sex education.
Some things are beyond politics. Saving children's lives should be one of them.
Reprinted from the St. Louis Post-Dispatch.