U.N. Calls Many Child Deaths Preventable

Pneumonia is now the biggest killer of children in the world, resulting in 3.6 million deaths annually, but in most cases the cure is a five-day course of antibiotics that costs only 25 cents, according to a United Nations report released today.

The means of stopping pneumonia and dozens of other childhood diseases are now “available and affordable,” the report said, but countries are not making the necessary investments in basic medical care, sanitation and education.

“The present neglect,” the report said, “is a scandal of which the public is largely unaware.”

Each week, the report found, a quarter of a million children die of malnutrition and diseases that are either curable or preventable.

“No famine, no flood, no earthquake, no war has ever claimed the lives of 250,000 children in a single week,” said James P. Grant, executive director of the United Nations Children’s Fund. “Yet malnutrition and disease claim that number of child victims every week. “

To bring an end to the “age-old evils” of disease, malnutrition and illiteracy and to save as many as 4 million young lives a year would require an extra investment of $25 billion a year--which is less than Americans spend on beer and half what Europeans spend yearly on cigarettes, the report said.

For the past 10 years, UNICEF has been monitoring the condition of children throughout the world. Today, the report said, less than 10% of the $40 billion spent annually on international aid is devoted to basic human needs--rudimentary health care, nutrition, water and sanitation, primary education and family planning. The bulk of aid is now financing national debts and military expenditures in developing countries.

Yet when even minimal efforts are made to address basic problems plaguing children, “remarkable progress” can be charted, the report said.

Ten years ago, for example, diarrheal disease was the biggest killer of the world’s children, claiming almost 4 million young lives each year. Now, there are 1 million fewer deaths each year associated with dysentery and other intestinal ailments, thanks largely to the promotion of a simple, low-cost home remedy known as oral rehydration therapy. The method, largely unknown outside of medical circles until recently, helps assure that children and babies who have severe diarrhea will not die of dehydration.

Perhaps the most spectacular progress in caring for children over the past decade has been made in the prevention of polio, the report said.

As the result of a 10-year effort by the World Health Organization and other medical groups, polio immunizations have leaped to 85% worldwide. “A decade ago, when only about 20% of children were immunized, polio struck at the lives of more than a half million children a year,” the report said.

Polio still paralyzes more than 100,000 children each year, but there has not been a single case of paralytic polio recorded in the Western Hemisphere for more than a year. If current trends continue, the report said, polio may become the second major disease (after smallpox, in 1977) “to be eradicated from the face of the Earth.”

Overall, the decade-long immunization campaign has resulted in a dramatic increase in all childhood vaccinations for diseases such as whooping cough and diphtheria, from 20% in the early 1980s to 80% in the 1990s. UNICEF estimates that these immunizations have saved more than 3 million lives.

Still, the report said, “diseases that vaccines can prevent continue to kill nearly 6,000 children every day in the developing world.”

Hundreds of thousands of children, for example, succumb to pneumonia, which frequently follows an attack of measles. In fact, the report said, 50% of pneumonia deaths in babies under 9 months would be prevented by ensuring that all youngsters had measles vaccinations.

Malnutrition is another devastating and potentially deadly problem that could be prevented at very low cost, the report said.

Vitamin A deficiency, which threatens up to 10 million children with blindness and early death, could be controlled for about 10 cents per child per year, the report said.

Similarly, the report said, iodine deficiencies, the world’s single biggest cause of mental retardation, could be eliminated for about $100 million--”less than the cost of two fighter planes.”

Poverty is one of the principal reasons so many children throughout the world are ill and malnourished, but it is not the only reason, the report said.

Girls as a whole tend to fare far worse than boys throughout the world. “In many countries, boys get better care and better food than girls. As a result, an estimated 1 million girls die each year because they are born female,” the report said.

Females also continue to be less well-educated. While 90% of the developing world’s children start school, half drop out before even learning to read. Two-thirds of the dropouts are girls, the report said.

While children in developing countries face the most serious health problems, children in industrialized countries are not immune. In the United States, for example, vaccine-preventable childhood diseases, once thought to be on the verge of eradication, are now on an upsurge.

Requirements that children in the United States have up-to-date immunizations to enter kindergarten or licensed day care have resulted in a 95% immunization rate for school-age children, but health officials believe that preschoolers are now at very high risk for communicable diseases.

In Los Angeles County, health officials have reported that only 42% of 2-year-olds are fully immunized against measles and other childhood diseases. In Orange County, 50% are. (In an annual report to be released today, the Children’s Defense Fund is expected to report similar trends in other states.)

One reason that children are not vaccinated at an early age, according to health experts, is there is not enough money allocated to basic health care. Also, many parents do not remember polio or diphtheria outbreaks and thus do not appreciate the importance of vaccinations.

BACKGROUND

The General Assembly of the United Nations established the Children’s Fund, UNICEF, in 1946 to provide food, clothing and medical supplies for child victims of World War II. After the war effort ended, UNICEF began concentrating on the reduction of infant mortality rates. For the past 10 years, UNICEF has been monitoring the health, nutritional and educational needs of children throughout the world. Its latest report, “The State of the World’s Children 1993,” found that about two-thirds of the 12.9 million child deaths each year are caused by only three diseases--pneumonia, diarrheal disease and measles--all of which are either preventable or curable.

Child Deaths

More than 65% of the 12.9 million child deaths in the world each year are caused by pneumonia, diarrheal diseases, vaccine-preventable diseases or some combination of the three. Here are the main causes of deaths under age 5 in developing countries in 1990. Pneumonia: 28% Diarrheal diseases: 23% Vaccine-preventable diseases: 16% Other: 33% Measles: 880,000 Whooping cough: 360,000 Tuberculosis: 300,000 Neonatal tetanus: 560,000 Source: WHO and UNICEF