With 7.7M child deaths expected this year, study finds global child deaths falling faster than expected

May 25 2010

Researchers estimate that 7.7 million children under the age of 5 will die this year, an indication that global child deaths "seem to have fallen faster than officials thought," according to a study, published online Monday in the Lancet, the Associated Press reports (Cheng, 5/23).

"Using a new method of calculating mortality that they say is more complete and accurate than previous methods," scientists from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington said deaths among children under 5 has dropped "from 11.9 million in 1990 to 7.7 million in 2010," Reuters reports. The 2010 deaths include 3.1 million newborns, 2.3 million infants and 2.3 million children between the ages of 1 and 4 (Fox, 5/23). According to an IHME press release, the worldwide "decline during the past 20 years is 2.1% per year for overall under-5 mortality and for neonatal mortality, 2.3% for postneonatal mortality, and 2.2% for mortality in children aged 1 year to 4 years" (5/24).

The New York Times writes that "in many regions, even some of the poorest in Africa, the declines have started to accelerate, according to the report." The study used data from "official birth and death records, census data and information from detailed surveys in many countries" and was funded by the Bill & Melinda Gates Foundation. Researchers found that one-third "of all deaths in children occur in south Asia, and half in sub-Saharan Africa. Newborns account for 41 percent of those who die," according to the newspaper (Grady, 5/23). The study shows that mortality for children under 5 "is falling in every region of the world with increases in only Swaziland, Lesotho, Equatorial Guinea and Antigua and Barbuda," Reuters writes (5/23).

Despite the overall reduction, the 2 percent rate of decline of child deaths "still doesn't match the annual 4.4% decline needed to meet" the Millennium Development Goal (MDG) "to reduce deaths in children under age five by two-thirds between 1990 and 2015," the Wall Street Journal writes. "But it appears to reflect a scale-up of funding in recent years for efforts to combat malaria, mother-to-child transmission of HIV, and to immunize more children, resulting in greater progress than previously known against childhood diseases, the researchers said" (McKay, 5/24).

"Previous estimates had shown child deaths falling slowly and neonatal deaths nearly at a standstill," according to Julie Knoll Rajaratnam, who led the study. "We were able to double the amount of data and improve the accuracy of our estimates to find that children are doing better today than at any time in recent history, especially in the first month of life," Reuters writes (5/23).

"The very slow progress in Africa has led some people in global health to argue there should be more emphasis on tackling child mortality outside of Africa, especially India," said Christopher Murray, an author of the report and the director of the Institute for Health Metrics and Evaluation, according to the New York Times. "We think it's important to call out this accelerated progress. The last thing we'd like to see, when at last something is happening, is to pull the plug and move elsewhere" (5/23). 

Mickey Chopra, UNICEF's director of health, said the new study "reinforces our belief that the scale-up of interventions such as (malaria) bed nets, vaccines and vitamin A (pills) are starting to show an impact," the AP writes, noting that "UNICEF was not linked to the study."

According to the news service, "given the fluctuating figures common in global health, not everyone was swayed by the new research. There was also no evidence to show U.N. programs are responsible for the drop in child deaths. Murray said the reduction could be because the AIDS epidemic peaked several years ago and is now hitting fewer kids." The article includes reactions from a former WHO official who said "patchy surveillance" in some countries makes the data uncertain (5/23).

Kaiser Family Foundation Forum Examines Progress On Maternal And Child Health, U.S. Role

Murray joined an expert panel on Monday morning at the Kaiser Family Foundation which addressed progress on meeting Millennium Development Goals for improving maternal and child health worldwide and examined the U.S. role in helping meet these targets. Kaiser Executive Vice President Diane Rowland introduced and moderated the panel, which also included: Flavia Bustreo, director of the Partnership for Maternal, Newborn and Child Health; Jen Kates, vice president and director of Global Health Policy and HIV at Kaiser; Jennifer Klein, senior advisor on global women's issues at the State Department; Ana Langer, president of EngenderHealth. 

In prepared remarks, Klein discussed the high priority the Obama administration has placed on women's issues in foreign policy. She went on to highlight five key principles of President Barack Obama's Global Health Initiative, which include: a women- and girl-centered approach to global health, the need for coordination and collaboration between U.S. agencies and with partner countries; a focus on stronger relationships with multilateral organizations, nonprofits, the private sector and other groups; country ownership of programs that are aligned with national priorities; and a requirement of increased accountability in countries that receive aid.

Murray discussed data from his studies on child deaths and maternal mortality. "The high level message here is lots of progress," he said, noting that the improvements in reducing child deaths were greater than those to decrease maternal mortality. Among several implications for policy resulting from the data, Murray said there was a need for more understanding of why some countries do better than others. He called for additional investment in research to measure progress on child and maternal health and for policy makers to strike a balance between approaches that favor countries that produce good results and those that are worse off when it comes to reducing death rates.

During remarks, Bustreo echoed the other panelists' sentiments that the upcoming G8 meeting, the MDG summit in September and other planned events present an "unprecedented" opportunity for progress on maternal and child health. She outlined the areas that need more attention from donors, such as increased investment in family planning and additional support at the country level to focus on national priorities.

Langer focused on how the GHI would work with developing countries and said the perspective of local experts in developing nations is critical for the success of the initiative.

Ahead of the discussion, Kates highlighted data from the Kaiser's new report and fact sheet on U.S. policy on global maternal, newborn and child health.  A fact sheet on the U.S. role in international family planning and reproductive health was also released today. A webcast of the panel discussion will be available online later today (Schiff, 5/24).