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WHO Leader Backs Call To Action For Child Survival Programmes (p 323)

July 23, 2003

The new Director-General of WHO is calling for global collaboration to tackle the crisis identified by The Lancet's Child Survival Series, which concludes in this week's issue.

The series has highlighted a global public-health disaster: over 10 million children under five years dead every year; the majority from easily preventable causes. In a Commentary in this week's issue, Dr JW Lee highlights three key priorities for action. He comments:
"First, the health of children and mothers must be reinstated as an important focus of organisational agendas. Monitoring child and maternal mortality is a key measure of progress, reflected in the Millennium Development Goals. The underlying causes of disease must also be monitored. Undernutrition, for example, is estimated to account for over half the child deaths annually, and improved nutrition must be an integral part of child and maternal health programmes. An integrated approach to the causes of under-nutrition and over-nutrition, which often coexist in the same family, will also contribute to reducing the future burden of obesity, diabetes, and other non-communicable diseases."

"Second, more of the children and mothers who are dying must be reached, by scaling up the delivery of effective interventions and achieving and maintaining high coverage rates, especially among vulnerable populations. This will require a two-pronged strategy. The efficiency of integrated health systems, based on the foundation of strong primary health-care, needs to be increased to provide preventive and curative services of adequate quality to a greater number of children. Mechanisms need to be put into place to better engage and support families and communities in preventing disease and caring for their sick children."

"Third, and most important in the longer term, there must be a commitment to building capacity for public-health programmes at the district level. As shown in the first paper in the series, epidemiological profiles vary across countries, even within regions. More reliable and timely health data are needed at country and district level to inform policy choices and assess the effectiveness of programmes. Capacity must be built to collect, analyse, interpret, and act on these data. Reductions in child mortality are needed at district level to achieve the ambitious Millennium Development Goal of reducing child mortality worldwide by two-thirds by 2015."

Dr Lee concludes: "WHO cannot take on this challenge alone. Collaborative partnerships for child survival are needed. These will build on the complementary strengths of ministries of health and education, UNICEF, other UN organisations, the World Bank, bilateral aid agencies, non-governmental organisations, paediatricians, nurses, and other technical experts, professional associations, and the private sector. One important part of leadership is setting the direction, mobilising the forces, and monitoring progress. WHO will play its leadership role and use the opportunity of regular meetings on child survival to monitor progress and hold the broader public health and development community accountable for reducing child and maternal mortality."

Lancet