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The Independent (London), September 14, 2007

World child mortality at 'historic' low level, says Unicef

By Anne Penketh Diplomatic Editor

Child mortality has passed a "historic" milestone, according to the UN, which claimed the number of children dying before they reach the age of five has dropped below 10 million for the first time.

The UN children's agency Unicef attributed the progress to such measures as immunisation campaigns, which it said reduced measles deaths in Africa by 75 per cent, breast-feeding, the use of mosquito nets, and vitamin A supplements to boost children's immune systems.

It based its conclusions on data provided by governments in more than 50 countries in 2005-2006. Child deaths worldwide fell to 9.7 million in 2005, down from nearly 13 million in 1990 - but nearly half were in Sub-Saharan Africa, which has been ravaged by Aids and conflict.

"More children are surviving than ever before," said Unicef executive director Ann M Veneman. "[But] the loss of 9.7 million young lives each year is unacceptable. Most of these deaths are preventable and, as recent progress shows, the solutions are tried and tested."

Some of the main causes of the death of young children are pneumonia, premature births and birth defects, diarrhoea, malaria, Aids and measles. But malnutrition is also blamed as a major factor in the deaths of under-fives.

According to Unicef, every region has made progress in reducing the under-five mortality rate. The most rapid declines between 1990 and 2006 were in Latin America, the Caribbean, central and eastern Europe, the former Soviet republics, east Asia and the Pacific region.. In Morocco, Vietnam and the Dominican Republic, Unicef reported that child death rates dropped by more than a third.

The British charity Save the Children said that the data was borne out by its own research. "It's not a surprise, it's true that the decline in child mortality has been slowing up since 1960. But 10 million children are losing their lives every year, which is still unacceptable," said campaigns director Adrian Lovett.

In the past, most child deaths occurred in Asia, and the falling under-five mortality in that region has helped to improve the overall picture. China's under-five mortality rate has fallen from 45 deaths for every 1,000 live births in 1990 to 24 per 1,000 in 2006, a reduction of 47 per cent. India's rate has fallen from 115 to 76 per 1,000 in the same period, a reduction of 34 per cent. This compares to six deaths for every 1,000 live births in the developed world. "China and India combined have a third of the world's population. So the fact that both are making progress in terms of child mortality is going to contribute significantly to the overall result," Ms Veneman said.

But in a country such as Afghanistan, where one child in five does not live beyond the age of five, the figures continue to be bleak, despite an overall improvement in health provisions.

"There's no doubt about it, there have been obvious improvements in the last few years. Vaccines are reaching people in isolated communities," said Matt Waldman, the Kabul-based policy adviser for Oxfam.

But he added that a country like Afghanistan was "starting from a very low base" comparable to Sub-Saharan Africa. He said he had spent time in a typical village in the northern Afghan province of Badakhshan, where 265 families lived, which lost 45 children last winter to preventable diseases.

Some experts questioned the reliability of the Unicef data, noting that it had been provided by government-conducted surveys, although there was general agreement that child mortality rates were slowing down.

"Considering all the tools we have for child survival, we are not doing better at reducing child mortality now than we were three decades ago," Dr Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington told the Associated Press. He is lead author of a paper to be published in two weeks in The Lancet which casts doubt on data collection methods used by Unicef and the World Health Organization.

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