A New Year's Resolution: A Child Survival Revolution

Over the next two and half years, 10 million children will be born in the United States, most of them healthy and with an excellent chance of living a long life. Now imagine that, suddenly, every single one of them died before age five. Such an unspeakable tragedy would surely shock our nation into a rapid response to ensure that it would never happen again. Yet almost without notice, 10 million children do, in fact, die each year before age five—but most of them don’t die in the United States.

They die beyond the gaze of the developed world from preventable diseases such as pneumonia, diarrhea, malaria, measles and HIV/AIDS. A majority of these children’s lives could have been saved if we committed the political will and the resources to deliver low cost, effective public health interventions that are often take for granted in our country: vaccines, antibiotics and other medications, vitamins and micronutrients, rehydration solutions and mosquito bite prevention. Knowing that the solutions are so simple, how can America ignore this global health crisis? In this season of giving, everyone can make a difference.

During the 20th century, the triumph of public health interventions significantly improved the health and well being of people living in the United States. In 1900, the average life expectancy for Americans was just 48 years and the major causes of death were infectious diseases. Since then, food and water safety, improved hygiene and sanitation, vaccines and antibiotics, better nutrition and improved access to health care extended Americans’ average lifespan by more than 30 years. Such historic progress was made in improving public health that in 1969 the Surgeon General of the United States declared that it was “time to close the book on infectious diseases.” Sadly, he was wrong.

Since 1972, more than 32 new or re-emergent diseases such as AIDS, Ebola virus, Lyme’s disease, SARS, West Nile virus, and H5N1 avian influenza have appeared. Tuberculosis, malaria and other old diseases are resurfacing in new places and in dangerous strains resistant to modern medicines. In an interconnected global society, where one in four deaths every year are due to infectious diseases worldwide, not even the wealthiest countries can immunize themselves from the threat of infectious diseases that have tremendous humanitarian, economic, and national security implications. With international trade and travel, the spread of an infectious illness from a local outbreak to a global one is just a jet plane away and the safety of our food and water supply do not respect national borders.

Consider these statistics for the world’s children. Annually:

• 4 million newborns die—three quarters during the first week of life. Almost 40% of deaths of children under the age of five occur during the first 28 days of life. 75% of these children’s lives could have been saved by low cost interventions including improved hygiene practices, breastfeeding, antibiotics and the use of safe birthing kits.
• 1.4 million children die as a result of not receiving vaccinations to prevent common childhood diseases such as measles, tetanus, rotovirus and pertussis.
• 2.1 million children die from pneumonia that could have been cured with antibiotics.
• 1 million children die from malaria, a mosquito-borne disease, which can be prevented with insecticide-treated netting or treated with drugs.
• At least 2 million children –5000 every day--die from diarrhea caused by a lack of clean water. Many of their lives could have been saved with simple oral rehydration solutions.
• An estimated 700,000 childhood deaths could be averted with vitamin A supplementation and another 394,000 deaths through zinc treatment for diarrhea. Iodine deficiency is the primary cause of preventable mental retardation and brain damage. It is estimated that 30% of households in the developing world that are not consuming iodized salt include 41 million newborns and infants. Millions of children lack other vital nutrients necessary for healthy development.
• Over 2 million children under the age of 15 are infected with HIV/AIDS. Most of them were infected as a result of mother-to-child transmission of the disease that could have been prevented by education and medications.

These startling statistics underscore the pressing need to move global health to the forefront of our national agenda and our social consciousness. The good news is that solutions cross national borders too. Simple, affordable interventions currently exist to prevent over 60 percent of these children’s deaths and dramatically improve the quality of life and life expectancy for people around the world. We must share the benefits and advances of 20th century public health and medicine with the 21st century’s most vulnerable populations in the most impoverished countries.

Americans have an enormous capacity to respond with empathy and action to fellow humans in crisis, as we saw in response to the Southeast Asia tsunami last year and to Hurricane Katrina this year. At least one-third of American households were said to have donated funds to aid people in Southeast Asian tsunami-hit nations and to help fellow citizens in the Gulf Coast region of our country. Are we capable of mobilizing the same concern and action for slower, larger waves of infectious disease deaths that crash on tens of thousands of communities around the world?

We must. We are the first generation that can look health disparities and disease in the eye and put an end to needless suffering and deaths worldwide. Simple, life-saving public health and medical interventions to prevent and treat disease are very inexpensive and are being provided to children in developing countries through programs such as Rx for Child Survival and its partner organizations -- Save the Children, CARE and UNICEF. Anyone who can find a way to contribute just $25—an amount many of us spend on a single meal—can offer real hope to a vulnerable child. A new year and a new prescription of commitment and resources will help us reach the time when future generations can turn to the history books to learn that 10 million children died every year from preventable causes and that we accomplished the mission of a better future for all here on earth.

So let’s make a new year’s resolution to open our hearts and our wallets by supporting organizations that deliver these critical interventions and give millions of the world’s children the gift of a healthier life in 2006.

Rear Admiral Susan J. Blumenthal, M.D., M.P.A. served as Assistant Surgeon General of the United States. She is a Clinical Professor at Georgetown and Tufts Schools of Medicine and a member of the Board of Directors of Save the Children.