Intended for healthcare professionals


Scaling up oral rehydration salts and zinc for the treatment of diarrhoea

BMJ 2012; 344 doi: (Published 10 February 2012) Cite this as: BMJ 2012;344:e940
  1. Oliver Sabot, executive vice president for global programs1,
  2. Kate Schroder, director of essential medicines initiative1,
  3. Gavin Yamey, lead, evidence to policy initiative 2,
  4. Dominic Montagu, lead, health systems initiative2
  1. 1Clinton Health Access Initiative, Boston, MA, USA
  2. 2Global Health Group, University of California San Francisco, San Francisco, CA 94105, USA
  1. yameyg{at}

Is cheap and effective and could accelerate reductions in child mortality

In the years after the launch of the millennium development goals, the health economist Jeffrey Sachs emphasised investment in malaria control as the “lowest hanging fruit” in the battle to reduce child mortality.1 Such investment is paying off: cases of malaria and deaths from the disease, which mostly occur in young children, have fallen by more than 50% in nine African countries since 2000 through scaling up of malaria control tools.2 Yet despite this progress in controlling malaria and in scaling up other interventions such as vaccines, most countries are still not on track to achieve millennium development goal 4—that of reducing child mortality by two thirds from 1990 to 2015. With only four years until the deadline, we must now pursue other “low hanging fruit” that can rapidly reduce child mortality in developing countries.

Investment in the treatment of diarrhoea with oral rehydration salts (ORS) plus zinc is one of the best opportunities to achieve such rapid impact.3 Acute diarrhoea is the second biggest cause of death in children worldwide, causing 1.2 million deaths each year.4 Rotavirus vaccines, clean water, sanitation, and other preventive measures are important in reducing this burden. However, vaccines are only partially …

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