[health-vn] Donors urged to tackle leading killer of under-fives - reports [two news items]

[Vern Weitzel]

"Fatal Neglect" may be downloaded at:
http://www.wateraid.org/documents/plugin_documents/wateraid_fatal_neglect.pdf

"Diarrheal Disease: Solutions to Defeat a Global Killer" may be downloaded at:
http://www.eddcontrol.org/files/Solutions_to_Defeat_a_Global_Killer.pdf

Donors urged to tackle leading killer of under-fives - reports

14 May 2009 15:19:00 GMT
Written by: Natasha Elkington


REUTERS/Natasha Elkington

Outside Kenya's biggest slum, one-year-old Michelle Wabuira sits silently in her 
mother's arms, her eyes sunken and struggling to keep her head up. She has 
diarrhoea, the second biggest killer of children under five.

Michelle is one of millions of children who will get diarrhoea this year, nearly 
a fifth of whom will die. That's 1.6 million children killed every year by what 
aid workers say is an entirely preventable disease.

Two major aid agency reports published this week say millions of children's 
lives are being put at risk because governments and the international aid 
community are not responding appropriately to diseases such as diarrhoea.
"Diarrhoea kills more children than HIV/AIDS, malaria and TB combined, yet 
compared to these diseases receives little financing and is not prioritised by 
governments in donor and developing country governments alike," said Oliver 
Cumming, co-author of a report by Water Aid.

The report shows that between 2004 and 2006 only $1.5 billion was spent globally 
on improving sanitation. In the same period, $10.8 billion was spent on 
interventions for HIV/AIDS - responsible for 315,000 child deaths in that 
period, and $3.5 billion on interventions for malaria - responsible for 840,000 
child deaths.

Kenya's Red Cross emergency health manager James Mwangi says outbreaks of 
diarrhoeal diseases are due to lack of access to safe water, poor sanitation and 
unhygienic practices.

"The same community are using the water for livestock drinking, for washing 
clothes and some community members also bathe in the same rivers. It is a full 
cycle with problems related to water sanitation, hygiene and of course 
knowledge," added Mwangi.

HEALTHCARE

A health worker in the only government-run clinic in Kibera said diarrhoea was a 
major problem in the slum, which is home to over one million of Kenya's poor. 
It's easy to see why - toilets are holes in the ground and many are overflowing.
"There are a lot of cases of children dying of diarrhoea because the health 
service in a slum setting such as this is not so well distributed," added the 
health worker who asked to remain anonymous.

She said most clinics in the slum were private and the majority of people could 
not afford the fees. The lack of roads, lighting and poor security also made it 
difficult to reach a doctor, particularly if a child fell sick in the middle of 
the night.

"By the time this child is brought to hospital maybe it is too late, the 
intervention of what could have saved the child is overtaken by time and events 
and we lose that child," she added.
Michelle Wabuira's mother Rosla said she arrived in Kibera last week from her 
home in Busia, in Kenya's Western Province. She believes her daughter fell sick 
after drinking water from a tank.
"I don't know if the water is clean, we don't even have Water Guard (a brand of 
water purifier)," Rosla said. "Because of diarrhoea I have decided to go back to 
Busia because here, hygienically, I don't feel safe."

BURDEN

Another report "Diarrheal Disease: Solutions to Defeat a Global Killer" by 
health advocacy group PATH, speculates that in the 1970s and 1980s 
awareness-raising and fund-raising for tackling the problem were so successful 
that the mortality rate fell by almost 50 percent. It says many donors, 
governments and aid agencies may have considered the problem solved.

But the issue is far from solved. Water Aid says that when taking into account 
adult deaths, funding for HIV/AIDS is balanced, but when considering child 
deaths, the large resources for fighting the disease are disproportionate.
Both reports highlight that relatively cheap fixes can be effective - for 
example educating people to wash their hands, using water purifiers and 
disinfectants and taking rehydration salts for diarrhoea.

But the aid community is not devoting sufficient funds or attention to the 
problem, the reports say.

The Kenyan government is working with aid groups to educate the public on good 
hygiene, improve water chlorination and provide communities with water purifiers 
and disinfectants. But the financial burden is high, says Kenya's Health 
Minister Shahnaaz Sharif.

"A lot of donor agencies are not concentrating on diarrhoea and then it is left 
up to the individual governments to handle those programmes and most governments 
cannot cope," Sharif told AlertNet.

The Kibera health worker said she believed some funding for HIV, TB and malaria 
would do more good if it was diverted to treating diarrhoeal diseases in young 
children.

"If I was offered a wish list, I would say we channel a lot of funds (to) 
healthcare for children under five with an emphasis on diarrhoea and 
malnutrition," she added.

Reuters AlertNet is not responsible for the content of external websites.

----

http://www.wateraid.org/uk/about_us/newsroom/7655.asp

Second biggest killer of under-fives being ignored

The report argues that a major cause of child mortality is being neglected.
Credit: WaterAid / Layton Thompson
12 May 2009

The international health agenda is failing to save the lives of millions of 
children by not responding appropriately to causes of child deaths, according to 
a new WaterAid report released today.

Read the report here ( PDF 1Mb)

Hard-hitting figures published in the report reveal that the aid system is not 
responding rationally to disease burden. Despite diarrhoea being the second 
biggest killer of children, critical interventions to prevent these deaths 
attract a dismal amount of international aid.

In 2004, diarrhoea killed 1.8 million children, yet between 2004-2006 only $1.5 
billion was spent globally on improved sanitation – vital in the fight to 
protect children from diarrhoea.

In the same period, $10.8 billion was spent on interventions for HIV/AIDS 
(responsible for 315,000 child deaths), and $3.5 billion on those for malaria 
(responsible for 840,000 child deaths). [see graph below]

The report stresses that the aid system must continue to tackle diseases such as 
malaria and HIV/AIDS but calls for a comparable effort to address diarrhoea.

'Fatal neglect: How health systems are failing to comprehensively address child 
mortality' argues that to reduce under-five deaths by two-thirds and therefore 
meet Millennium Development Goal Four, the aid system must target its resources 
to diseases that are killing the most children – such as diarrhoea – and focus 
on providing cost-effective interventions such as improved sanitation that can 
prevent these diseases.

"The aid system's response to the global child health crisis is not rational – 
put simply, a major cause of child mortality is being neglected," said Oliver 
Cumming, report co-author and WaterAid Sanitation Policy Officer. "Diarrhoea 
kills more children than HIV/AIDS, malaria and TB combined, yet compared to 
these diseases receives little financing and is not prioritised by governments 
in donor and developing country governments alike."

Fatal Neglect shows that the global imbalance of aid allocations is matched at 
the national level in developing countries. The report calls for national health 
challenges, rather than international campaigns to determine the allocation of aid:

In Zambia, the Ministry of Health notes that "over 80% of the health conditions 
presented at health institutions are diseases related to poor environmental 
sanitation." Yet environmental health receives just one eighth of the funding 
provided for malaria, a disease which kills a similar number of children to 
diarrhoea.
In Madagascar, UNAIDS (The Joint United Nations Programme on HIV/AIDS) found the 
number of deaths from HIV/AIDS was too small to estimate, whereas diarrhoeal 
diseases kill 14,000 children every year. Yet HIV/AIDS received five times more 
aid than sanitation between 2004-6.
Rwanda has a 3% AIDS infection rate, but in 2005 almost 75% of donor assistance 
for health was for HIV/AIDS and only 2% for health care services for childhood 
illnesses.
"Disease burden is not informing aid decisions," said Cumming. "Donors need to 
take a long hard look at their financing and priorities and see if it actually 
matches the reality on the ground."

"It is not a matter of choosing between one disease or another," said Cumming. 
"Developing countries could provide a balanced response to child mortality if 
the 2005 G8 commitments to increase aid volumes were met."

The report also warns that by neglecting sanitation, the effectiveness of 
current health systems is being reduced.

"There is no doubt that diarrhoea is one of the biggest child killers. The aid 
system is failing to respond to the evidence, and this is contributing to 
millions of preventable child deaths."

Download 'Fatal neglect: How health systems are failing to comprehensively 
address child mortality' ( PDF 1Mb)

What do you think?

Is sanitation being neglected and, if so, what can be done about it? Respond to 
the report on our blog here.


Available for interview:

WaterAid Policy Officer, Report co-author Oliver Cumming
WaterAid Executive Director, Barbara Frost
WaterAid Programme Manager, Advocacy and Communications, Zambia, Nancy Mukumbuta
For all media enquiries/interviews please contact:

Chloe Irvine, Media Officer - Policy
Tel +44 (0)207 793 4909
Mobile +44 (0)751 494 1577
chloeirvine at wateraid.org