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UNICEF Report says China, India Hold Key to Asia Sustaining Improved Child Survival Rates

A United Nations report says governments in the Asia and the Pacific need to step up spending on public health systems and lower income disparities to ensure child survival rates are sustained. As Ron Corben reports from Bangkok, the U.N. report says gains in China and India in reducing infant mortality hold the key to the Asia Pacific achieving key child survival goals by 2015.

The report, released by the United Nations Childrens Fund says Asia Pacific's buoyant economic growth of the past decade has been a key contributor to reducing infant and child mortality rates across the region.

Anupama Rao Singh, UNICEF regional director, says the report notes progress over the past two decades, although there are signs gains have slowed over recent years. In 1970 the annual number of under five deaths was 10.5 million. By 1990 this figure fell to 6.7 million. By 2006 this had declined to four million deaths.

"There has been good progress in the decline of infant and child mortality rates if you compare it from the 1970s to date," said Rao Singh. "Many countries are on track to achieving the millennium development goals of reducing infant and child mortality by two-thirds by 2015."

The report says China and India hold the key to the region achieving the millennium development goals in child survival. China, India and Pakistan are three of six countries which globally account for half of all deaths of children under five.

In China, two-thirds of the country's under five deaths were neonatal with almost 80 percent occurring in the first week of life.

But Rao Singh says China appears on target on achieving its infant and child mortality targets.

"China has made tremendous progress," she said. "As far as China is really addressing mortality and child deaths in the first four weeks of life; it's very, very closely linked. Clearly, China is in terms of national averages and norms clearly on a path of achieving the millennium development goal of two thirds reduction."

In India the report calls for major improvements in health, nutrition, water and sanitation, and education to achieve its millennium goals. India has 127 million children under five years. In 2006 it reported over two million under five years dying.

It also pointed to "extreme problems" faced by Afghanistan, which has the third highest rate of under five mortality in the world. In contrast, Sri Lanka has made major gains in reducing child mortality over recent years despite ongoing conflict.

A high burden of neonatal deaths occurs due to insufficient maternal health care services, and maternal under nutrition. Pneumonia and diarroeheal diseases as well as measles also claim many young lives.

Widening income disparities in South East Asia also put more children at risk despite gains against a backdrop of declines in public health spending that add to burdens on the poor. Rao Singh says it is vital Asia achieves its goals on improving child survival rates.

"If Asia does not achieve the Millennium Development Goals of reducing mortality by two thirds the world will not achieve them," she said. "Our estimates 9.7 million children under five died last year - more than four million were in Asia alone. So the achievement of these goals in Asia is going to be of global significance."

Urbanization and a shortage of skilled health workers are also having a "marked effect" on inequity affecting the lowest income groups. Governments need to increase and sustain budget spending over the next decade to ensure countries reach the goals on infant and child mortality.

The report says if the Asia Pacific fails to extend essential services to the poor and marginalized groups and narrow income disparities it may lead to one million child deaths in Asia Pacific in 2015 that would have otherwise been averted had the development goals been reached.