Researchers outline strategy and benchmarks to curb childhood preventable deaths

Preventable childhood deaths caused by illnesses such as pneumonia and diarrhea can be nearly eliminated in 10 years according to researchers from the Johns Hopkins Bloomberg School of Public Health and the National Institutes of Health. In a new commentary featured in the June issue of the Journal of the American Medical Association, researchers outline a strategy and benchmarks for curbing childhood preventable deaths and recommend a new common vision for a global commitment to end all preventable child deaths.

Developed in 2000 by the United Nations, eight Millennium Development Goals (MGD) were created to meet the needs of the world's poorest and most vulnerable populations. Guidelines for achieving the goals were established and agreed upon by all countries including a number of the world's leading development institutions. The goals range from halting the spread of HIV/AIDS to reducing preventable deaths among children to providing universal primary education by 2015.

"Preventable deaths remain the leading cause of deaths among children under 5," said Robert Black, MD, MPH, senior author of the commentary and the Edgar Berman Professor and chair in the Bloomberg School's Department of International Health. "Recent studies suggest a decline in the total number of deaths between 2000 and 2010, however the decline is not sufficient enough to reach Millennium Development Goal number 4, which seeks to reduce child mortality by two-thirds in 2015. During the last 20 years, global health efforts have saved over 50 million child lives-half of them from pneumonia, diarrhea, and measles. Success in bending the curve of child mortality is predicated on renewed commitment and political will, as well as continued innovation in health technology and implementation."

To reduce child mortality and improve maternal health, as outlined in Millennium Development Goals 4 and 5, government officials from the Unites States, India and Ethiopia, in collaboration with UNICEF and other partners, will convene a Child Survival Call to Action in Washington, D.C., June 14-15. Maternal and child health experts will and discuss building on significant global achievements and create a coordinated strategy to support the MDG goals beyond the 2015 deadline. Researchers believe if the world's average under-five mortality rate can be reduced to that of industrialized countries today, the global total this year would be two million deaths or less. The Lives Saved Tool developed at Johns Hopkins, predicts improvements in mortality rates that can be achieved in 2035 by scaling up current interventions to provide full and equitable coverage. This modeling tool could provide insights into the individual value of each intervention.

"Such a vision will not be compelling unless it can be tied to concrete and measurable benchmarks at global and country levels that are both ambitious and plausible," note the authors.

"In this commentary we endorse one proposed benchmark: that all countries achieve a national under-5 mortality rate of 20 deaths per 1,000 live births by 2035 and that the global average under-5 mortality rate be 15 per 1,000 in 2035. Of 195 countries, 102 are already at 20 deaths per 1,000 or below, 39 would reach the goal by 2035 at current annual rates of reduction and 54 would have to accelerate the progress above the 2000-2010 annual rates of reduction," said Black.