Improving the Lot of the Children

New goals for the immunization and improved health care of children around the world are being developed by the international Task Force for Child Survival after a meeting in France at which remarkable progress was reported. These are encouraging developments, evidence of the importance of coordination and cooperation and of the need to maintain the momentum.

More than half the world’s children now have been immunized against at least some of the diseases that most affect them. Fewer than 20% had been protected when the program was initiated four years ago. There is optimism among public-health officials that the immunization programs will have been extended to 80% of the children by the end of 1990. And there is renewed hope that polio may be eradicated from the Western Hemisphere by 1992, and from the world by the end of the century.

There has been slow but steady progress in fighting the effects of diarrheal diseases, the principal killers of young children in the developing nations. This campaign has focused on educating families and improving the distribution of kits for the oral-rehydration therapy that prevents death by dehydration. The supply of kits has increased threefold since 1983; it is estimated that one-third or more of the affected families now have accessto the therapy.

Progress has been slower in the area of family planning. The emphasis has been placed on the appropriate spacing of children, improving in that way maternal health, with the understanding that a healthy mother is the key to healthy children. But in many cultures there remains an unfulfilled need to improve the care of mothers.

Looking ahead, officials are now talking of a 90% reduction in measles, which alone kills 2 million children a year, and of reducing infant mortality, now 78 per 1,000 in developing nations, to a rate below 50 per 1,000 in the next few years. But significant resources will be required. Continuing and expanded programs in Africa alone will cost an estimated $170 million a year.

The meeting of the international task force symbolized the global commitment that is being made to realize these goals. The task force is made up of the World Health Organization, UNICEF,the United Nations Development Program, the World Bank and the Rockefeller Foundation;the leaders of each of these were present for the summit meeting in France. Also attending were officials of the governments that provide most of the aid, including the administrator of the U.S. Agency for International Development, and leaders of 11 developing nations, among them China and India, representing about 80% of Third World populations.

“In a little over a decade a public-health revolution has quietly taken place,” Dr. Ralph H. Henderson, director of the expanded WHO immunization program, said, outlining the achievements in the world immunization program. The program has targeted whooping cough, tuberculosis, diphtheria and tetanus in addition to measles and polio.

This was the third meeting since the Task Force fort Child Survival was convened in 1984. At the first meeting the question was “Can we do it?” according to Dr. Terrel Hill of UNICEF. At the second meeting in 1985 the question was “How can we do it?” Now, he said, the question is “How can we sustain these achievements?”

“There is,” Hill added, “a consensus that it is do-able.”