Children under 5 dying from preventable diseases, says UN

BMJ 2016; 353 doi: (Published 30 June 2016) Cite this as: BMJ 2016;353:i3653
  1. Anne Gulland
  1. London

Almost 70 million children will die before they reach their fifth birthday if progress to reach the sustainable development goals by 2030 continues at today’s pace, the charity Unicef has warned.

In its annual report on the health, education, and life chances of children around the world, Unicef said that, by 2030, 69 million children under 5 will have died from preventable causes, 167 million children will live in poverty, and 750 million women will have married while still children.1

Unicef urged governments, donors, businesses, and international organisations to speed up efforts to address these problems.

The goals aim for a reduction in neonatal mortality to 12 deaths or fewer per 1000 live births, and for under 5 mortality to be reduced to 25 deaths or fewer per 1000 live births in every country of the world by 2030. On current trends 33 countries will miss the under 5 mortality target. Angola, Somalia, Chad, and the Central African Republic will miss the target by more than five times.

Anthony Lake, Unicef executive director, said, “Denying hundreds of millions of children a fair chance in life does more than threaten their futures—by fuelling intergenerational cycles of disadvantage, it imperils the future of their societies.” He added, “We have a choice: invest in these children now or allow our world to become still more unequal and divided.”

Of the 5.9 million deaths of children under 5 in 2015, almost half were caused by infectious diseases such as pneumonia, diarrhoea, malaria, meningitis, tetanus, measles, sepsis, and AIDS, the report said. Pneumonia and diarrhoea remained the leading causes of death in the three regions with the highest under 5 mortality rate: eastern and southern Africa, South Asia, and west and central Africa.

However, while infectious diseases are still a large factor in child mortality, efforts to tackle them through vaccination and prevention programmes have been largely responsible for the fall in the global child mortality rate from 91 in 1990 to 43 in 2015, said Unicef.

The annual number of under 5 deaths from a range of infectious diseases fell from 5.4 million to 2.5 million between 2000 and 2015.

However, the gaps between rich and poor countries remain the same, said the report. “Children born in sub-Saharan Africa are 12 times more likely than their counterparts in high income countries to die before their fifth birthday, just as they were in 1990,” the report said.

The country with the highest under 5mortality rate in the world was Angola, which in 2015 saw 157 deaths per 1000 live births—a substantial improvement on its 1990 rate of 226 deaths per 1000 live births.

The countries with the second and third highest under 5 mortality rates were Chad, with a rate of 139 per 1000 live births, and Somalia with a rate of 137. Luxembourg, Finland, and Iceland had the lowest rates, with two deaths per 1000 live births. The UK had a rate of four, like other western European countries including France, Germany, Spain, and Italy.

The report said that some of the reductions in mortality could be attributed to a rise in living conditions. It added, however, that, “Some countries in the fast lane for global economic growth—including India and Nigeria—have been in the slower lane for child mortality reduction. The policy lesson: economic growth can help but does not guarantee improved child survival, and a country’s income need not hinder progress.”

The report also warned of the health of children in countries experiencing conflict —among the 20 countries with the highest child mortality rates 10 were in the World Bank’s list of fragile states, such as Afghanistan, Chad, and Somalia.


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