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WORLD HEALTH DAY: There’s Nothing Natural About These Deaths

Katherine Stapp

NEW YORK, Apr 7 2005 (IPS) - Although pregnancy-related complications kill 500,000 women each year, and nearly 11 million children never reach their fifth birthday, U.N. experts say this largely preventable tragedy is just not a high enough priority for many governments or the international community.

”Simple measures will make a huge difference,” said Dr. Ian Smith, adviser to Dr. Lee Jong Wook, the director-general of the World Health Organisation (WHO), in an interview.

For example, ”better care for newborns, whose first five minutes of life are the most dangerous,” would easily reduce infant mortality.

Launched Thursday, the WHO report, ”Make Every Mother and Child Count”, says that almost 90 percent of all deaths among children under five are attributable to just six conditions: preterm birth, birth asphyxia and infections, which account for 37 percent of the total; lower respiratory infections, mostly pneumonia (19 percent); diarrhoea (18 percent); malaria (8 percent); measles (4 percent); and HIV/AIDS (3 percent).

To reduce the death toll, experts are calling for a ”continuum of care” approach that begins before pregnancy and extends through birth and childhood. This means a massive investment in health systems, particularly the deployment of more doctors, midwives and nurses, since millions of women are giving birth at home without professional medical care.

”There is a huge need for more resources,” Smith said, ”about 90 billion dollars over the next 10 years. It becomes a question of what does the world want to commit to doing? Where are our priorities?”

Two key targets of the U.N. Millennium Development Goals (MDGs) to improve the living standards of billions of people in developing countries are a reduction of child mortality by two-thirds and maternal mortality by three-quarters.

While 93 countries are on track to meet these goals, 43 others – representing 12 percent of the world’s population – are in stagnation or decline, Smith said.

Most of this last group are found in sub-Saharan Africa, and are struggling with the triple threat of armed conflict, extreme poverty and soaring HIV/AIDS rates.

”One of the key words in the report is ‘exclusion’,” Smith said. ”Women are being excluded from essential services, and governments have a responsibility to do something about it. This is the first year we’ve combined World Health Day and the World Health Report, as a way to make sure the message comes across loud and clear.”

Meanwhile, controversy has again erupted over the issues of birth control and abortion, with the George W. Bush administration spearheading an unpopular campaign to amend the landmark Programme of Action unanimously adopted at the 1994 International Conference on Population and Development in Cairo.

At a United Nations meeting this week focused on HIV/AIDS prevention strategies, the U.S. delegation introduced another amendment stressing that HIV prevention should emphasise abstinence and monogamy, and that condoms should only be offered to those ”whose behaviour places them at risk for transmitting or becoming infected with HIV.”

But since four-fifths of women living with HIV were infected by their husbands or primary partners, some argue this approach is irrelevant and dangerously short-sighted.

Thoraya Ahmed Obaid, executive director of the U.N. Population Fund, said in a statement Thursday, ”One sure way to make every mother and child count, as the slogan for World Health Day urges us to do, is to guarantee universal access to reproductive health, as was agreed at the International Conference on Population and Development.”

Noting that pregnancy would be a death sentence for half a million women this year, Obaid stressed that more than 200 million others have an unmet need for safe and effective contraception.

”This is a public health crisis and a moral outrage,” she said. ”If these needs were met, unwanted pregnancies and unsafe abortions would plunge.”

The WHO report also notes that 68,000 women a year die from botched abortions, and Smith agreed that family planning is an integral part of women’s overall health.

”What the report focuses on is making sure that each pregnancy is safe and desired,” he said.

While the picture remains bleak in many areas of the world, there have also been some real success stories.

Last month, an international campaign launched four years ago by UNICEF and WHO announced that it was on target to slash measles deaths in half by the end of 2005.

A leading vaccine-preventable killer, measles claimed 530,000 lives in 2003, compared to 873,000 in 1999. Since 2001, the campaign has inoculated 150 million children throughout the world.

”Almost every country has seen a dramatic improvement,” said Dr. Jeff McFarland, the WHO’s measles guru. ”I can say confidently that the goal of a 50 percent reduction will be achieved.”

”Anecdotal evidence from Malawi, for example, indicates that that about 10 years ago, there were measles wards in almost every hospital – now they’re gone,” he told IPS. ”We’re all very happy, but that is not to say we are satisfied with 400,000 preventable child deaths a year.”

Governments are now starting to combine the measles vaccination campaign with other critical interventions. In December 2004, Togo conducted the first-ever nationwide initiative to target all children nine months through five years of age with four life-saving measures – measles and polio vaccines, insecticide-treated nets to prevent malaria, and de-worming tablets.

The campaign has successfully reached more than 95 percent of the children in that age group.

”Over next 12 months, we will have a very good sense of the impact in Togo,” McFarland said. ”The key is that we need to look at things we already have tools to prevent.”