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Experts: Simple Measures Can Avert Millions of Infant Deaths a Year


Public health experts say most of the four million newborn babies who die each year in developing nations could be saved by simple, inexpensive interventions. They appeal to rich countries, international organizations, and charitable foundations to increase their funding to promote infant survival.

The number of newborn deaths worldwide is colossal in the view of one medical adviser to the Indian government. Vinod Paul, of the All India Institute of Medical Services, says the number of infants who die in the first month of life is about 10,000 every day, 99 percent of them in developing nations. But he notes that most of the concern and resources are focused on the other one percent in industrial countries.

"It's as if one Asian tsunami is hitting the world every two weeks, year-after-year. And yet, the responses are very different - to that kind of an event and to this invisible tragedy that is happening," Dr. Paul says.

Dr. Paul is a co-author of one of four articles appearing in the medical journal Lancet that point out the worsening plight of newborns worldwide, and what should be done. The contributors are scholars and health economists from several countries, United Nations agencies, and the World Bank. Their research was funded by the U.S. government and the Bill and Melinda Gates Foundation of Seattle, Washington.

Lancet Senior Editor Faith McLellan told a Washington, D.C., audience that the disaster of newborn mortality must end.

"The Lancet is publishing this series to inform the world about this appalling situation, and to call upon the global community to reform it," Ms. McLellan says.

The Lancet papers say two-thirds of all newborn mortality takes place in just 10 countries - Afghanistan, Bangladesh, China, Democratic Republic of Congo, Ethiopia, India, Nigeria, Pakistan, Indonesia and Tanzania. The major causes are infections, premature birth, delivery complications, diarrhea and lack of oxygen.

Dr. Paul says common, low-cost measures can prevent 75 percent of the newborn deaths, and can be offered within existing maternal care and child survival programs. They include tetanus shots for pregnant mothers, promoting clean delivery, extra care for low birth weight babies, inexpensive antibiotics, and breast-feeding. The Indian physician says the extra cost for assuring such safety is about $6 billion annually, or just one dollar a year for every person in the world.

"There are not many health paradigms where such a low cost would save such a large chunk of deaths," Dr. Paul says. "We would like to plea, the time has come to bring these resources to save the babies."

The Lancet outlines actions nations can take to address the crisis, including setting targets for reducing newborn mortality by 2015. It calls on the international community to demonstrate political commitment to increased resources, and to coordinate country support to turn what is known about saving newborn babies into action.

A private group addressing such needs is Save The Children-USA. The head of its newborn survival program, Anne Tinker, says boosting resources includes reversing the shortage of trained health workers in developing countries.

"Nurses and midwives, as well as doctors, are unbelievably in short supply. Many locally trained midwives and nurses are being lured away for better jobs in the United States and UK," Ms. Tinker says.

Lancet editor Richard Horton says continuing to fail children under threat would deliver a verdict of wanton inhumanity against ourselves.

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