Between 2000 and 2015, malaria mortality rate has fallen by 60% and the number of malaria cases has fallen by 37% globally. As result, 6.2 million lives saved over the last 15 years of which 5.7 million are children under five. Over the last 15 years, the delivery of core malaria interventions has undergone an unprecedented expansion. Since 2000, one billion insecticide-treated mosquito nets have been distributed in Africa. The introduction of rapid diagnostic tests has made it possible to distinguish more quickly between malarial and non malarial fevers – enabling more timely and appropriate treatment. Artemisinin-based combination therapies (ACTs) have been highly effective against Plasmodium falciparum, the most prevalent and lethal malaria parasite affecting humans. And as we have reached more communities and people at risk for malaria with these core interventions, many more lives have been saved.
Despite tremendous progress, malaria remains an acute public health problem in many regions. In 2015 alone, there were 214 million new cases of malaria reported, and approximately 438,000 people died of this preventable and treatable disease, 70 per cent of whom are children under five, still die from this preventable disease every year. 90% of malaria deaths occur in Sub-Saharan Africa. About 3.2 billion people – almost half of the world’s population – are at risk of malaria. The disease also contributes greatly to anemia among children — a major cause of poor growth and development.
Malaria infection during pregnancy is associated with severe anemia and other illness in the mother and contributes to low birth weight among newborn infants — one of the leading risk factors for infant mortality and sub-optimal growth and development. Malaria has serious economic impacts in Africa, slowing economic growth and development and perpetuating the vicious cycle of poverty. Malaria is truly a disease of poverty — afflicting primarily the poor who tend to live in malaria-prone rural areas in poorly-constructed dwellings that offer few, if any, barriers against mosquitoes.
The insecticide treated nets provide a physical barrier against mosquitoes; also, because they are impregnated with insecticide, they can reduce the lifespan of a mosquito, decreasing the chance of it transmitting malaria to another person. Thus, ITNs provide personal protection to those sleeping under them, and once a sufficient number of people are using ITNs, they can also provide a community wide protective effect by reducing the number of mosquitoes in a community. It is therefore desirable to achieve high rates of ITN use in a population.
Immunization saves up to 3 million children each year
Vaccines keep children alive and healthy by protecting them against disease. Immunization is especially important for the hardest to reach families as it can also be a bridge to other life-saving care for mothers and children in isolated communities – such as child nutritional screening, anti-malarial mosquito nets, vitamin A supplements and de-worming tablets. Immunization is one of the most successful and cost-effective public health investments we can make for future generations.
Vaccines are protecting more children than ever before. But, in 2015, nearly one in five infants –19.4 million children – missed out on the basic vaccines they need to stay healthy. Low immunization levels compromise gains in all other areas of health for mothers and children. The poorest, most vulnerable children who need immunization the most continue to be the least likely to get it.
Almost one third of deaths among children under 5 are preventable by vaccine. UNICEF and its partners are working to change these numbers and ensure that the lives of all children are successfully protected with vaccines. But, if immunization is not prioritized, the most marginalized children will not get vaccines, which could mean the difference between life and death.
Acute diarrhoea is still a major cause of child death
Diarrhoeal diseases account for roughly 530,000 deaths a year, 9% of total deaths among children under-five years of age, making them the second most common cause of child deaths worldwide. Over half of the deaths occur in just five countries: India, Nigeria, Afghanistan, Pakistan and Ethiopia. Despite this heavy toll, progress is being made. From 2000 to 2015, the total annual number of deaths from diarrhoea among children under 5 decreased by more than 50 per cent – from over 1.2 million to half a million.
Oral rehydration salts (ORS) and oral rehydration therapy (ORT), adopted by UNICEF and WHO in the late 1970s, have been successful in helping manage diarrhoea among children. It is estimated that in the 1990s, more than 1 million deaths related to diarrhoea may have been prevented each year, largely attributable to the promotion and use of these therapies. Today, however, there are indications that in some countries knowledge and use of appropriate home therapies to successfully manage diarrhoea, including ORT, may be declining. Zinc, in addition to ORS, has shown significant improvement in shortening a child’s current episode of diarrhoea, and helping prevent against subsequent episodes.
To prevent diarrhoea mothers and other caretakers should:
– Improve hygiene through hand washing with soap, increase use of improved sources of drinking water and sanitation facilities.
– Prevent dehydration through the early administration of increased amounts of appropriate fluids available in the home, and ORS solution, if on hand
– Provide children with 20 mg per day of zinc supplementation for 10-14 days as part of the diarrhoea treatment
– Promote exclusive breastfeeding and increase breastfeeding and all feeding during and after the episode of acute diarrhea
Recognize the signs of dehydration and take the child to a health care provider for ORS or intravenous electrolyte solutions and familiarize themselves with other symptoms requiring medical treatment (e.g. bloody diarrhoea)
Health care workers should:
UNICEF, WHO and other partners support these actions by:
Pneumonia is still a single leading cause of child death, killing 1 child every 35 seconds.
Pneumonia accounts for almost one million deaths every year, 922,000 in 2015 which is 16% of total deaths among children under-five years of age, 5% of which are neonatal. This makes it the single most common cause of child deaths worldwide. Despite having made some progress, a 51% decrease in pneumonia from 2000 to 2015, it is nowhere near the greater than 86% decrease in mortality from malaria-related under five mortality in the same time frame. There is still a significant road ahead to make a marked reduction in the preventable, treatable deaths due to pneumonia.
Pneumonia is the leading infectious disease killer of children worldwide; killing 2,500 children each day – more children than malaria, TB, measles, and AIDS combined. Despite causing 16% of all child deaths, pneumonia receives little attention and a tiny fraction of global public health investment – less than 2% of total global development funding for health. Despite the existence of effective tools to prevent, diagnose and treat pneumonia, most of the countries struggling with high rates of pneumonia-related deaths allocate a tiny portion of their health budgets to fighting child pneumonia. Mortality due to childhood pneumonia is strongly linked to poverty-related factors such as under nutrition, lack of safe water and sanitation, indoor air pollution and inadequate access to health care. An integrative approach to tackle this important public health issue is urgently needed.
Timely care seeking with an appropriate health care provider is one of the most important steps to saving the life of a child from pneumonia; yet, worldwide, only 3 in 5 children receive the necessary help and care. In sub-Saharan Africa, where most pneumonia deaths occur, only 2 in 5 children seek care.