UNICEF and WHO call for an urgent plan to control diarrheal disease

The United Nations Children’s Fund (UNICEF) and World Health Organization (WHO) released a joint report today demonstrating the urgent need to focus attention on diarrheal disease, a neglected illness responsible for the deaths of about 1.5 million children under 5 each year. This unacceptable loss of life can be stopped. But as the report indicates, diarrheal disease is often overlooked, and children in developing nations, where the burden is greatest, do not have access to the lifesaving interventions they need.

The UNICEF–WHO report Diarrhoea: Why Children Are Still Dying and What Can Be Done highlights the proven diarrheal disease prevention and treatment solutions already available today. Many children in the developing world cannot access urgent medical care for severe illnesses, making prevention methods—including improved hygiene, sanitation, safe drinking water, exclusive breastfeeding, and vaccines preventing rotavirus—critical components of diarrheal disease control. When diarrhea occurs, it can be effectively treated with simple solutions, including oral rehydration therapy/oral rehydration solution, zinc and other micronutrients, and continued feeding.

“We can save the lives of millions of children with a coordinated approach to combating diarrheal disease that includes prevention and treatment methods available today,” said Dr. Christopher J. Elias, president and CEO, PATH. “We need increased awareness of the toll of diarrheal disease and the simple and cost-effective interventions we have today, along with the political will to make those solutions available to those who need them most.”

Key findings in the report indicate:

• More than 2 billion cases of diarrhea occur among children under 5 each year. More than 50 percent of these cases are in South Asia and sub-Saharan Africa, where incidences of diarrhea are more likely to be fatal.
• Only 39 percent of children in developing nations receive the recommended treatment for diarrheal disease.
• Pneumonia and diarrhea, the most common causes of death for children under 5, are responsible for an estimated 40 percent of deaths in this age group around the world each year.
• Significant reductions were made in diarrheal disease fatality rates in the 1970s and 1980s. But momentum has slowed and, today, diarrheal disease is the second leading killer of children under 5 worldwide.

Handwashing with soap is one of the most cost-efficient and effective methods for preventing diarrheal disease, reducing incidence up to an estimated 40 percent. Global Handwashing Day 2009 will take place tomorrow, October 15; a coalition of U.S.-based public and private organizations, including AED, Global Water Challenge, the Institute for OneWorld Health, method, Millennium Water Alliance, PATH, PSI, the U.S. Coalition for Child Survival, U.S. Fund for UNICEF, WaterAid America, and Water Advocates have come together to raise awareness around the benefits of handwashing in preventing diarrheal disease.

“Now is the time to renew efforts to fight diarrheal disease and with so many simple and low-cost interventions like handwashing with soap, we can save millions of children’s lives,” said Andrew E. Barrer, executive director, U.S. Coalition for Child Survival. “We will continue to raise awareness about the diarrheal disease burden and proven prevention and treatment interventions that exist, like improved sanitation, and we encourage others to get involved in these efforts.”

The report calls for a 7-point plan to control diarrheal disease and ultimately improve child survival:

• Ensure wide availability of low-osmolarity oral rehydration solution and zinc.
• Include rotavirus vaccines in national immunization programs worldwide, which was recently recommended by the WHO.

• Develop and implement behavior-change interventions and communication programs to encourage exclusive breastfeeding.
• Ensure sustained high levels of vitamin A supplementation, combining its delivery, where possible, with other high-impact health and nutrition interventions.
• Apply results of existing consumer research on how to motivate people to wash their hands with soap to increase this highly effective and cost-effective health practice.
• Adopt household water treatment and safe storage systems, such as chlorination and filtration, in both development and emergency situations to support major reductions in the number of diarrhea cases.
• Implement demand-led approaches to stop community-wide open defecation.

Recently, more than 100 organizations worldwide signed onto a Call to Action, encouraging decision-makers to commit political will and funding to defeat deaths from diarrheal disease. At the same time, world leaders have committed to child survival and improving conditions around the world for future generations by 2015 through the Millennium Development Goals. Without aggressive efforts to control diarrheal disease, Millennium Development Goal 4 will remain out of reach.