Millions of the world's poorest children die each year, because international efforts designed to improve their health never reach them.  That is the finding in a report in this week's issue of The Lancet.

Researchers at Federal University in Brazil looked at the distribution of supplies such as safe water, Vitamin A supplements, and vaccines to mothers and children under the age of five in nine mostly low-income countries. 

Vitamin A is used to combat blindness; safe drinking water is crucial to prevent diarrheal diseases, a leading cause of death among young children; and vaccines guard against a host of deadly diseases that are prevalent in poor nations.

Investigators studied data in Bangladesh, Benin, Cambodia, Eritrea, Malawi, and Nepal, among other nations.  They uncovered widespread inequity in the distribution of these and other medical supplies. 

For example, the survey found the percentage of children who did not receive a single intervention, such as a vaccine or a nutritional supplement, ranged from only 0.3 percent in Nicaragua, which fared the best in the survey, to almost 19 percent in Cambodia.  The percentages of children receiving all available interventions varied from 0.8 percent in Cambodia to just more than 13 percent in Nicaragua.

In general, researchers found the greatest inequities in countries where services, like prenatal care and vaccination, were concentrated in urban centers. 

Nils Daulaire of the Global Health Council says the problem of child health in the developing world is one that rarely gets attention in the media.  But he says diseases of poverty are taking the life of an estimated 11 million children each year.

"They are dying from easily treatable, easily preventable, cheap infectious diseases," he said.  "They are dying from inadequate reproductive health care for their newborns."

Mr. Daulaire estimates it would cost $5 billion a year to provide a range of interventions, from full vaccination to oral rehydration therapy to antibiotics to fight pneumonia, to six million children.

But the authors of the Lancet article write that unless new strategies are developed for increasing the coverage areas, the same children who are already receiving services would continue to get any increase in interventions.