June 25, 2012

Plan to end preventable child deaths in a generation outlined

Preventable childhood deaths caused by illnesses such as pneumonia and diarrhea can be nearly eliminated in 10 years, according to researchers from the Johns Hopkins Bloomberg School of Public Health and the National Institutes of Health. In a commentary featured in the June issue of the Journal of the American Medical Association, the researchers outline a strategy and benchmarks for curbing childhood preventable deaths and recommend a new common vision for a global commitment to end all preventable child deaths.

Eight Millennium Development Goals, or MDGs, were developed in 2000 by the United Nations to meet the needs of the world’s poorest and most vulnerable populations. Guidelines for achieving the goals were established and agreed upon by all countries and a number of the world’s leading development institutions. The goals range from halting the spread of HIV/AIDS to reducing preventable deaths among children to providing universal primary education by 2015.

“Preventable deaths remain the leading cause of deaths among children under 5,” said Robert Black, senior author of the commentary and the Edgar Berman Professor in International Health and chair of the Bloomberg School’s Department of International Health. “Recent studies suggest a decline in the total number of deaths between 2000 and 2010; however, the decline is not sufficient enough to reach Millennium Development Goal number 4, which seeks to reduce child mortality by two-thirds in 2015. During the last 20 years, global health efforts have saved over 50 million child lives—half of them from pneumonia, diarrhea and measles. Success in bending the curve of child mortality is predicated on renewed commitment and political will, as well as continued innovation in health technology and implementation.”

To reduce child mortality and improve maternal health, as outlined in Millennium Development Goals 4 and 5, government officials from the United States, India and Ethiopia, in collaboration with UNICEF and other partners, convened a Child Survival Call to Action this month in Washington, D.C. Maternal and child health experts discussed building on significant global achievements and creating a coordinated strategy to support the MDGs beyond the 2015 deadline. Researchers say they believe if the world’s average under-5 mortality rate can be reduced to that of industrialized countries today, the global total this year would be 2 million deaths or less. The Lives Saved Tool, developed at Johns Hopkins, predicts improvements in mortality rates that can be achieved in 2035 by scaling up current interventions to provide full and equitable coverage. This modeling tool could provide insights into the individual value of each intervention.

“Such a vision will not be compelling unless it can be tied to concrete and measurable benchmarks at global and country levels that are both ambitious and plausible,” note the authors of the JAMA piece.

“In this commentary,” Black said, “we endorse one proposed benchmark: that all countries achieve a national under-5 mortality rate of 20 deaths per 1,000 live births by 2035 and the global average under-5 mortality rate be 15 per 1,000 in 2035. Of 195 countries, 102 are already at 20 deaths per 1,000 or below, 39 would reach the goal by 2035 at current annual rates of reduction, and 54 would have to accelerate the progress above the 2000–2010 annual rates of reduction.”