World Bank Press
Review for March 25, 2005
Poverty Leads 10 Million Children To An Early Grave
About 10.6 million
children under five die each year, most from
preventable causes, World Health Organization advisers estimate. Almost
four in 10 die within 28 days of birth and more than four in 10 deaths
in southern and western Africa, writes The Guardian (UK).
The figures, published
soon after Tony Blair's Commission for Africa
called for huge injections of aid to improve health on the continent,
confirm the size of the global public health disaster international bodies
such as the G8, the WHO and Unicef are trying to tackle.
their latest estimates, based on an analysis of death
registrations, long-term research and improved models for calculating
mortality rates between 2000 and 2003, are the most accurate yet. The
deaths are mainly from pneumonia (19 percent), diarrhea (17 percent),
malaria (8 percent), measles (4 percent), HIV/Aids (3 percent) and
injuries (3 percent). Premature birth (28 percent), sepsis or pneumonia
(26 percent), and asphyxia (23 percent) are the most common causes of
early death. Poor nutrition is an underlying factor in more than half
all the deaths under five, according to the figures, published in the
Lancet medical journal today.
The statistics are
still imperfect, the advisers admit, but will act as
the benchmark against which progress on WHO initiatives can be measured.
WHO's Africa region, which covers all but the north-east corner of the
continent, has the biggest disease burden, with 4.4 million deaths each
year - accounting for 94 percent of the global total linked to malaria,
percent to HIV/AIDS, 46 percent to pneumonia and 40 percent to diarrhea.
Nearly 3.1 million under-fives die in south-east Asia.
Robert Black, of
the Johns Hopkins Bloomberg School of public health,
Baltimore, Maryland, head of the independent advisers, said the main
causes could be tackled "through existing, available and affordable
interventions". In an accompanying commentary, Peter Byass of Umea
University, Sweden, said: "It is important to look at the single
important determinant of childhood death, which has to be poverty.
"Childhood mortality is strongly inversely correlated with per capita
health expenditure. In today's world, an Ethiopian child is over 30 times
more likely than a western European to die before his or her fifth
In related news,
The New York Times reports that a new vaccine tested in
West Africa could save the lives of thousands of poor rural children who
die each year from bacterial infections, a team of scientists reported
yesterday. The vaccine is a strengthened version of Prevnar, which has
been given widely to American infants since 2000 and prevents rare but
serious infections with the Streptococcus pneumonia bacterium. In the
third world, the same germ is a major killer, and the new vaccine, tested
in Gambia, "exceeded our expectations," said Orin Levine, head
pneumonia vaccine program at the Global Alliance for Vaccines and
Immunization, which backed the trial. The results are to be published
today in The Lancet, a British medical publication.
How cheaply it can
be made remains to be seen, but experts were optimistic
yesterday that poor countries would eventually get regular supplies. Lisa
Jacobs, a spokeswoman for the alliance, known as GAVI, said: "This
exactly the kind of opportunity GAVI is looking for. I can't say
definitely that GAVI will fund this - the board has to make that decision.
But given that this data is so promising, we'll definitely look at this."
Separately, The Guardian
also reports that a proposed relaxation in
international ethics for human trials in developing countries could lead
to patients losing access to drugs that they have helped to test,
according to an article in medical journal The Lancet. The authors accuse
US regulators of trying to limit the rights of trial subjects in
developing countries. A number of pharmaceutical firms, such as Novartis
and GlaxoSmithKline, are moving significant numbers of trials to India
other low-cost countries. The US's Food and Drug Administration has
proposed that some of the trials required for a drug's approval in the
will not have to be conducted under the Declaration of Helsinki guidance
drawn up in 1964. The article says rules to prevent conflicts of interest
in trials are at risk, as well as the access of trial subjects to a
successful drug once tests are over, which would not be present under
proposals from the FDA.