Dramatic Gains Against Child Diseases Told

The U.N. Children’s Fund, heralding dramatic progress in the last decade, reported today that it is in the final offensive “against some of the oldest and most common enemies of the world’s children”--five diseases that kill more than 8 million children a year and malnutrition that retards the growth of one of three children in the developing world.

“The war on the age-old diseases of childhood . . . is being won,” said UNICEF Executive Director James P. Grant, commenting on his agency’s report. “Many of the great diseases of the world are for the first time being overcome.”

But warning that the progress is endangered by the deteriorating environment, enormous population growth and absolute poverty of the developing world, Grant said that “the need is to maintain the momentum” of progress.

Grant spoke at a luncheon Monday in advance of the release of UNICEF’s annual report on the state of the world’s children. The report will be presented to President Clinton at a White House ceremony today.

Though generally optimistic about the developing world, the report had some sobering statistics about the United States. In the mortality rate for children under 5 years of age, the United States ranked only 22nd in the world, far behind Ireland and Japan, which had the best rates, and even lower than poorer nations like South Korea, Greece and Spain.

“One of five youngsters now lives below the poverty line--a rate twice that of any other industrialized country,” the report said about the United States. “Child immunization has fallen as low as 10% in certain urban areas; in the Western Hemisphere, only Bolivia and Haiti had lower overall rates.”

Commenting on the American record, J. Brian Atwood, administrator of the U.S. Agency for International Development, said that his foreign aid specialists intend to “go around to the cities of this country, teaching them all our techniques.” On immunization, he said, “we have been able to do much better overseas than here.”

The report said that health officials had managed to increase the level of immunization throughout the world from 20% to 80% during the last 10 years--”undoubtedly one of the greatest public health achievements of this or any other century.”

Surveying the killer diseases of childhood, the report said that measles deaths have dropped in a decade from 2.5 million to 1.1 million, diarrhea deaths from 4 million to 2.9 million, whooping cough deaths from 700,000 to 400,000, and tetanus deaths among newborns from 1.1 million to 600,000. Pneumonia deaths, however, only dropped from 3.3 million to 3.1 million during the past decade.

Many of these gains were attributed to the high rate of immunization. This, according to the report, also contributed to battling the malnutrition that stunts physical and mental growth throughout the developing world. Frequent illnesses reduce the appetite of children, use up calories and drain away nutrients in vomiting and diarrhea. “When such illnesses strike frequently,” the report said, “the child is steadily pushed into a downward spiral of malnutrition and ill health.”

Immunization cannot prevent pneumonia, which the report said is “now the biggest single killer of the world’s children.” UNICEF said that the deaths could be cut in half “if parents are informed of the early danger signs and if community health workers are trained in the appropriate use of antibiotics.” Yet, the report went on, the failure of governments to ensure the adequate distribution of these antibiotics has encouraged parents to buy useless and harmful drugs sold in village markets.

UNICEF said that many of the vaccines and health techniques used in the past decade have been known since at least the 1960s. But it took two social changes to ensure their use in the last 10 years. Roads and communications are now developed enough for health workers to reach almost every community. “This is an historic and much underestimated change,” the report said.

On top of this, UNICEF said, people throughout the developing world are now aware of scientific advances, and it is therefore “no longer acceptable for millions of families to endure preventable disease and malnutrition and for millions of their children to suffer frequent illness, poor growth and easy death.”

The success in immunization, UNICEF went on, should galvanize governments to push other programs in aid of children.

But there are still problems of distribution to the most impoverished people. A quarter of a century has passed since the extraordinary discovery that an inexpensive mixture of sugars and salts can prevent the killing dehydration caused by diarrhea. Yet nearly 3 million children still die from diarrheal disease every year.

“If those children were the sons and daughters of better-off or more influential parents,” the report said, “then it is difficult to imagine them dying at such a rate 25 years after the discovery of an effective and low-cost remedy.”

UNICEF said that the goals set for the year 2000 by the World Summit for Children in 1990including a one-third reduction in child mortality rates, primary school education for 80% of children, safe water and sanitation for every community and family planning services for all--can be met for $25 billion a year.

“It is a price which could be easily afforded if even 20% of present government spending in the developing world, and 20% of overseas budgets, were to be allocated to long-term investment in meeting basic human needs for adequate nutrition, primary health care, basic education, safe water supply and family planning,” UNICEF said.