Unicef doctor says investment now could help meet millennium development goals on tackling child and maternal mortality

An intense focus on countries with the highest levels of child mortality combined with the availability of cheaper vaccines and medicines can lead to a development breakthrough, according to a senior U.N. health expert.

Dr Mickey Chopra, chief health officer at Unicef, the U.N. children’s agency, said investment now would lead to massive strides in meeting the millennium development goals of reducing maternal deaths by three-quarters (MDG4) and the deaths of children under five by two-thirds (MDG5), both by 2015.

“If we make the kind of investment we need now, which is not huge, we could achieve a ‘man on the moon’ moment,” said Chopra. “We have a clearer idea why and where children are dying. Twenty-four countries account for 80 per cent of the deaths. We know where they are dying within those countries. Combined with effective interventions such as vaccines and breastfeeding, we have the potential to reach kids in the most cost-effective manner.” Since 1990, annual maternal deaths have declined by almost half and the deaths of young children have fallen from 12 million to 7.6 million in 2010. Some of the world’s poorest countries have achieved impressive progress in reducing child deaths. Rates of child mortality in many African countries have been dropping twice as fast in recent years as during the 1990s.

The group Countdown said analysis for 2010 showed that 64 per cent of child deaths were attributable to infectious disease and 40 per cent occurred during the neo-natal period. Over the course of the decade, global malaria deaths have dropped by an estimated 38 per cent, with 43 countries (11 of them in Africa) cutting cases or deaths by 50 per cent or more. This is down to more effective drugs (artemisin combination therapies) — although there are reports of growing resistance to the new drugs, rapid diagnostic tests, long-lasting insecticidal nets (developed since 2000), better policies, and increased resources (human and financial), including distribution of enough bednets to cover nearly 80 per cent of the population at risk in sub-Saharan Africa.

Handwashing

Other means of reducing child mortality, such as handwashing and breastfeeding, come down to education rather than money. Modifying behaviour can be difficult, but not impossible. Chopra pointed to Uganda, where education has led to a significant increase in breastfeeding. “It is possible to change behaviour and it is being done and can be done in a short period of time,” he said.

Still, money will be needed to help achieve MDGs on child and maternal mortality, but official development assistance for maternal and child health appears to have plateaued in 2009 after increasingly steadily over the past decade, according to Countdown. In 2009, total official development assistance for maternal, infant and child health increased by 14.1 per cent to $4.5bn from 2008. This compared with increases of 17.1 per cent from 2006 to 2007 and 21.2 per cent from 2007 to 2008. — © Guardian Newspapers Limited, 2012

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