Save the Children is partnering with GlaxoSmithKline to reformulate an antiseptic to clean newborns' umbilical cords, a simple intervention that researchers in South Asia have found can prevent one out of every six newborn deaths in the developing world. Save the Children, in its State of the World’s Mothers report this week, identified this intervention as a key strategy to saving as many as one million babies worldwide who die each year on their first day of life.
Umbilical cord infections are one of the leading causes of newborn deaths, particularly in the developing world where babies are often born under poor hygienic conditions.
Save the Children says that the 14 countries with the highest first-day death rates are all in sub-Saharan Africa. And the group notes that of the one million babies worldwide each year who die on their first day of life, 40 percent are born in West and Central Africa.
Infections such as sepsis, meningitis and tetanus account for approximately 15 percent of all newborn deaths. They are caused by bacteria that enter the bloodstream after the umbilical cord is cut.
Preventing these infections is key because antibiotics are not always available - either the health center does not have them or a family can’t afford them.
Research shows that chlorhexidine, an inexpensive, easy-to-use antiseptic that is commonly found in mouthwash, can also be used to cleanse the umbilical cord stumps of newborn babies and prevent such infections.
Simon Wright is the head of child survival at Save the Children.
“There are tubes of chlorhexidine that are available. What is not available is a formulation which is suitable for delivery when you can’t refrigerate the product, that maybe needs to be used in the home by new mothers and used every day for the first seven days of the baby's life," said Wright.
Save the Children says that one seven-day treatment cycle of the liquid antiseptic costs about 25 U.S. cents.
It can be administered even by minimally trained health workers or by family members.
Trial studies in Nepal, Bangladesh and Pakistan show that applying liquid chlorhexidine to the umbilical cord stump after birth can reduce the risk of newborn death by up to 23 percent.
Wright said Save the Children is now working with the British multinational pharmaceutical company GlaxoSmithKline, (GSK) to create a new gel form of the antiseptic adapted for use in health centers with minimal resources.
Doctor Pauline Williams is leading the chlorhexidine project at GSK.
“What we’re going for is a gel, which seems to have a lot of user preference on the mother’s side, but also has practicalities of when she squirts it on the umbilical it will stay on. There’s been a central study non-inferiority showing that it’s as good, if not better than the liquid. You can also put it in a sachet, so that means we have the opportunity to put it in or bundle with a clean delivery kit," said Williams.
Williams said GSK and Save the Children plan to provide training materials for midwives and health workers and provide picture instructions to make it user-friendly even for illiterate mothers.
She said they are hoping to keep the cost at about 25 cents per baby treated.
Dr. Williams said that it will take at least one year to develop the optimum formulation and stability of the gel. The formula will then have to be approved by regulators before it will made available to the public.