Child Deaths Fall Below 10 Million For First Time

Global child deaths have reached a record low, falling below 10 million per year to 9.7 million, down from almost 13 million in 1990, according to UNICEF.

"This is an historic moment," says UNICEF Executive Director Ann Veneman. "Now we must build on this public health success to push for the achievement of the Millennium Development Goals."

Among these goals, which range from halving extreme poverty to halting the spread of HIV/AIDS, is a commitment to a two-thirds reduction in child mortality between 1990 and 2015, a result which would save an additional 5.4 million children by 2015.

However, Veneman points out that there is no room for complacency. "The loss of 9.7 million young lives each year is unacceptable. Most of these deaths are preventable and, as recent progress shows, the solutions are tried and tested. We know that lives can be saved when children have access to integrated, community-based health services."

Twenty-five years ago, UNICEF envisioned and launched its "Child Survival and Development Revolution" aimed at sharply reducing childhood death, disease and disability in the developing world. UNICEF insisted that simple, low cost interventions such as immunization, exclusive breastfeeding and growth monitoring, when taken to mass scale, could yield dramatic gains for child survival.

This first-of-its-kind effort was highly controversial within and outside of the organization. Critics argued it was naive, impossible and too simplistic. UNICEF pushed ahead, enlisting the support of hundreds of NGOs, individuals, governments and others in the "revolution." As a result of these partnerships and years of quiet effort, children today are more than twice as likely to survive past the age of five than they were 40 years ago.

"Thanks in large part to many outstanding partnerships and the extraordinary compassion and support of the American public, more children are surviving today than ever before," says U.S. Fund for UNICEF President and CEO Caryl Stern. "UNICEF's relentless focus on saving children's lives will continue until we reach the day when no mother has to grieve the loss of her baby to malaria, diarrhea, measles, or pneumonia."

The new figures are drawn from a range of national data sources, including two sets of household surveys, the Multiple Indicator Cluster Surveys (MICS) and the Demographic Household Surveys (DHS). The current round of MICS surveys was conducted in over 50 countries in 2005-06 and, together with the USAID- supported Demographic and Health Surveys (DHS), are the largest single source of information of the Millennium Development Goals and form the basis of the assessment of progress in child survival.

Their findings reinforce reports of progress released earlier this year on measles mortality, with a 60 per cent fall in measles deaths since 1999, and a 75 per cent reduction in sub-Saharan Africa.

Rapid declines in under-five mortality have been seen in Latin America and the Caribbean, Central and Eastern Europe and the Commonwealth of Independent States (CEE/CIS) and East Asia and the Pacific.

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Heat-related Deaths In School Football Players Spikes in '06

Every year, Fred Mueller compiles a sports list, but unlike popular pre-season picks or a glamorous hot-recruit sheet, nobody envies him this task. Some years the list is longer than others, but, Mueller said, there’s no reason any kid should be on it.

It’s a list of boys who died playing or practicing football, kids whose body temperatures rose so high and so fast under the summer sun that their brains couldn’t keep up, couldn’t regulate their cores, and the boys died.

“When something is preventable ...,” Mueller says, shaking his head. “Those kids could be alive today.”

Five young athletes, from 11 to 17 years old, died of heat stroke in 2006. The trend was declining. The last time there were more than five was 1972, when there were seven. In five of the past 16 years there were none. But, Mueller said, there have been 31 since 1995, and all of them could have been avoided.

Seven other players died last year of “heart-related” deaths that might or night not have been related to heat or exertion. “And we don’t know the number of kids who had heat exhaustion,” Mueller said.

With summer practice about to swing into high gear, Mueller says it’s time to remember these kids, and to keep in mind how heat-related deaths can be prevented:

-- Require each athlete to have a physical and know if an athlete has a history of heat-related illness; these kids are more susceptible to heat stroke. Overweight players are also at higher risk.

-- Acclimatize players to the heat slowly; North Carolina mandates that the first three days of practice be done without uniforms.

-- Alter practice schedules to avoid long workouts in high-humidity.

-- Provide cold water before, during and after practice in unlimited quantities.

-- Provide shaded rest areas with circulating air; remove helmets and loosen or remove jerseys; some schools have plastic outdoor pools filled with ice for cool-downs after practice.

-- Know the symptoms of heat illness: nausea, incoherence, fatigue, weakness, vomiting, muscle cramps, weak rapid pulse, visual disturbance. Contrary to popular belief, heat stroke victims may sweat profusely.

-- Have an emergency plan in place; parents should inquire about emergency plans for their kids’ teams.

Heat-related deaths are compiled as part of the Annual Survey of Football Injuries, research that began in 1931; Mueller took the reins in 1980. The survey tracks major injuries and deaths in 1.8 million football players from sandlot (organized, non-school affiliated teams), middle school, high school, college and professional teams.

There were a total of 20 deaths in 2006; two sandlot players, three in college, 13 middle and high schoolers. Only one death was directly related to the game; a 17-year-old high school player who received a spinal cord injury when tackled in a practice drill.

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Caring For The Sick Now Public Health Priority For Developing Countries

Of the 57 million people dying worldwide each year, 6 million deaths are caused by cancer and 3 million from HIV/AIDS, with the majority of both occurring in developing countries. These figures indicate the large number of people experiencing incapacitation and pain through shortness of breath, constipation, diarrhoea, nausea as well as distress, depression and anxiety.

New research published in the Journal of Public Health Policy, prepared by research staff at The George Institute for International Health, the School of Public Health at the University of Sydney and the Department of Palliative Medicine at Calvary Hospital, highlights that a potential 100 million people in these poorer nations could benefit from palliative care services, including family members and close companions.

Lead author of the paper Ruth Webster, a research fellow at The George Institute, says that "The scale of this epidemic of death and dying requires acknowledgement and priority as a public health issue, with more than just an emphasis on prevention of these diseases and their cure. Around 100 countries around the world have palliative care services, however only 6% are located in Asia and Africa, where the highest demand for the services is."

"Palliative care is not on the health agenda of governments as a public health problem, which is extremely detrimental to the populations that most need these services. WHO has recommended that all countries have a policy to implement these types of services, but despite this, one only African country, has made this a priority, Uganda. South Africa has recently included palliative care in their new health policies." adds Webster.

The review found three specific barriers to implementing palliative care in developing countries - government commitment, opioid availability and education. While pain management is only part of the picture, the availability of opioids and morphine is extremely difficult for developing countries. Webster says that policy makers and health professionals need to understand that lifting unnecessary regulations is vital for the large number of ill people needing care.

The authors recommend training and education as a key part to developing palliative care programs. "Experience shows that training programs for health professionals is an essential and rewarding step to build capacity in developing countries. Educating family members and utilising volunteer caregivers, in conjunction with publicly raising the profile of palliative care services, is essential so that people know what options are available and what is the best option for a particular illness."


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Seat Belt Intervention Shows Many Lives Can Be Saved on China's Roads

China accounts for around 15% of the world’s total number of deaths from traffic accidents each year. Motor vehicle production has tripled since the 1990s and despite the availability of seat belts in almost all passenger cars in China and laws requiring restraint use, the habitual use of seat belts is low. With the human toll alone from road traffic injuries in China around 100,000 deaths per year, there is an urgency to implement such interventions in the major cities.

Lead investigator at The George Institute for International Health, Mark Stevenson says, “Research indicates that the risk of death is reduced by up to 60% in drivers using seat belts compared with those not using a seat belt. Prior to the intervention, around half of all drivers/passengers in Guangzhou used seat belts. Our study shows that, since implementation of the intervention, 62% of drivers and passengers in Guangzhou are wearing a seat belt (with an even greater improvement among taxi drivers - more than 20% increase in seat belt use). This translates into the equivalent of 530 Disability Adjusted Life Years (DALYs) saved as a result of the intervention.”

The seat belt intervention utilised a novel blend of scientific expertise with practical approaches including enhanced law-enforcement practices, extensive social marketing and health education.

According to Wu Guanghui of Guangzhou Municipal Bureau of Public Security, “Activities to increase seat belt use, awareness and compliance have been implemented with great success. We accomplished significant improvements in Guangzhou city with seat belt law enforcement training for traffic officers in conjunction with the intensive enforcement program. The results have shown that enhanced police enforcement and road safety communication strategies contributed to raising the prevalence of seat belt use in the city and reducing road traffic injuries."

World Health Organization (WHO) Representative in China, Dr Henk Bekedam notes that the results of the intervention set a good example for other cities in China. "Interventions such as this can save lives. Preventing road injury requires a sustained cross-sectoral effort and the China Seatbelt Intervention has been successful in bringing together a range of important Government, community and private sector partners committed to reducing death and injury on China's roads. WHO is proud to have been part of this effort. The next challenge is replicating these great results around China."
Zhang Li from the China Ministry of Health says, “Raising the use of seat belts will significantly reduce road traffic deaths and injuries. We are extremely pleased with the outcome of this project which involved strong collaborations of government, scientists, and industry.”

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