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preventable diseases
Approximately 6 million five-year-old and younger children die each year, mostly from preventable diseases such as pneumonia, diarrhea and malaria. The majority of these deaths are based in the world’s low- and middle-income countries where healthcare is limitedly available.

The Bill and Melinda Gates Foundation helped launch the Child Health and Mortality Prevention Surveillance (CHAMPS) Network in an attempt to clearly understand the causes of illness and deaths due to preventable diseases for children in these areas.

Even though reducing mortality rates for children under the age of five is a key objective for global development initiatives, major gaps in health surveillance, research and cause-of-death determination still exist throughout the world.

Southern Asia and Sub-Saharan Africa account for over 82 percent of these deaths, with children in Sub-Saharan Africa being 15 times more likely to die before reaching age five than children in high-income countries.

CHAMPS – made up of the Emory Global Health Institute, the U.S. Centers for Disease Control and Prevention (CDC), the International Association for National Public Health Institutes (IANPHI), the Public Health Informatics Institute at the Task Force for Global Health and the Barcelona Institute for Global Health (ISGlobal) – will focus on these two regions in order to gather better data about how, where and why children are becoming sick and dying.

After an intensive selection process and with the high percentage of under-five deaths in Southern Asia and Sub-Saharan Africa in mind, CHAMPS announced its first three sites on June 14:

  • Soweto, South Africa
  • Manhiça, Mozambique
  • Bamako, Mali

CHAMPS will help each of these sites build surveillance infrastructure and train local site staff. The data collected from each location will then be shared with scientists, health officials and others around the world in an attempt to stimulate advocacy and research.

Results from the data-driven surveillance networks will also, in turn, inform treatment and research decisions for numerous childhood diseases, attract more funding for vaccine- and drug-related research and inform healthcare policy decisions for local and national governments.

“The data from CHAMPS will provide new tools to better protect children from preventable diseases. Six million preventable deaths each year is a reality none of us can accept. CDC is proud to work with Emory and the governments of South Africa, Mozambique and Mali on this important effort that will change that reality and provide healthier futures for millions of children and their families,” said Dr. Rebecca Martin, the director of CDC’s Center for Global Health.

With an initial commitment of up to $75 million by the Gates Foundation, CHAMPS is envisioned as a long-term, 20-year initiative that will eventually reach up to 20 sites. As it expands, the network will provide capacity and training for situations such as the event of an epidemic (for instance, Ebola) in various sites, thus helping make the world a much safer place.

Alice Gottesman

Photo: Flickr

Child_Poverty
Every day, the effects of poverty take the lives of thousands, with children suffering the most. Chronic poverty makes children more susceptible to disease, hunger, and developmental problems. Here are the most concerning facts about child poverty:

  1. According to the World Bank, more than 400 million children are living in extreme poverty (less than $1.25 a day).
  2. Roughly 16,000 children die each day—mostly due to preventable or treatable conditions.
  3. UNICEF estimates that over 2 million children ages 10-19 have HIV.
  4. Roughly half of all deaths of children under the age of five are caused by malnutrition.
  5. The International Labor Organization reports that 168 million children are child laborers; many of them in dangerous lines of work, such as factory jobs.

The question then arises, what can be done about child poverty? The good news is that, despite the previous data, progress is being made every day combating this issue. Here are four facts on the fight against child poverty:

  1. According to UNICEF, the mortality rate for children under age 5 has decreased by 53 percent since 1990.
  2. The World Health Organization says the most important element in reducing the mortality rate for children is increasing access to healthcare worldwide, particularly in preventative measures such as vaccines.
  3. Global programs, such as the Meningitis Vaccine Project (MVP), are working to achieve WHO’s goal of increasing access to preventative care. Started in 2010, more than 235 million Africans have been vaccinated against meningitis through MVP.
  4. Ending child poverty can start with an individual. You can donate to an organization working to combat child poverty, and you can do things like contact congress to voice support for increasing foreign aid to causes like this.

The global community has made strides in combatting child poverty, but there is still work to be done to ensure sustainable futures for the world’s youth.

Emily Milakovic

Photo: U.N. Multimedia

Tuberculosis_Policy
Released in March of 2016, a USAID’s report concerning Tuberculosis Policy entitled, “The Policy and Practice Divide for Childhood Tuberculosis in Africa: A Landscape Analysis” provides an in depth look at how to tackle the huge problem that is TB. The report states “Childhood tuberculosis (TB) is a serious, yet historically neglected epidemic affecting children globally.”

In 2014, TB took the lives of 1.5 million people. Of those, 890,000 were men, 480,000 women, and 140,000 children. However, we can easily add more to those numbers because the World Health Organization approximates that 34 percent of TB cases go unidentified, undiagnosed and untreated. It is quite evident that the challenge of reducing these numbers will take clear and practical tuberculosis policy implementation.

USAID identifies a gap between current tuberculosis policy implementation at the national level by African countries and the practical realties of treatment “providers lack the capacity to diagnose and treat TB; pediatric formulations are often not available at the point of care; contact tracing and preventive therapy are not consistently implemented; and gaps in data quality preclude their use for decision-making.”

To close the gap between tuberculosis policy and practice the report makes three key points: prioritize high impact interventions through strengthened partnerships, strengthen systems for improved diagnostic capacity, and conducting operational research to improve service delivery.

What does all this mean in laymen’s terms? Countries need to think more strategically. An early diagnosis of TB is crucial for a child’s survival. Where health care is slim, this can be a major obstacle. Establishing a steady stream of health care services close to home is vital. Health care professionals must be provided adequate diagnostic tools to ensure children don’t go untreated.

Systematic steps should be taken to identify children that have been diagnosed with the disease. Tuberculosis relief is entirely possible; the disease is curable. The WHO’s Global Tuberculosis Report of 2015 states, “In all, effective diagnosis and treatment of TB saved an estimated 43 million lives between 2000 and 2014.”

Michael A. Clark

Photo: Flickr

malnutrition_in_south_sudan
UNICEF and the World Food Programme announced recently that volunteers will go door to door over the next 12 months in an effort to screen 250,000 children for acute malnutrition in South Sudan.

The initiative will target households in the state of Warrap in Buhr el Ghazi, where an estimated 26,000 children are thought to suffer from life-threatening cases. Volunteers have been chosen from local communities and trained by the state Ministry of Health with support from UNICEF and WFP.

“Visiting every single home will help ensure that children who are malnourished or sick will be referred for treatment and will receive life-saving care,” said Vilma Tyler, Chief of Nutrition for UNICEF in South Sudan.

The announcement comes just as the recent Integrated Food Security Phase Classification warns that the situation in some areas of the country could escalate to famine levels if humanitarian assistance isn’t delivered by December. Nearly 238,000 children in South Sudan are currently experiencing Severe Acute Malnutrition (SAM).

Widespread food insecurity in the newly formed country has been the result of ongoing conflict between various rebel groups and the fledgling South Sudanese governing body.

Civil war came to a head in Juba in 2013 amidst ethnically motivated attacks, civilian massacres, and the displacement of over 750,000 children as people fled their homes to escape the violence.

Record food prices caused by the resulting economic downturn and unreliable rainy seasons have exacerbated an already dire problem; the number of children facing SAM doubled from the previous year.

With time running out, volunteers are working quickly to triage those in need. Children at risk of starvation will receive treatment at UNICEF-supported health facilities and outpatient therapeutic programs while caregivers will be offered guidance on how to keep children healthy through nutrition, hygiene and sanitation practices.

For children with SAM, initial treatment often means utilizing Ready-to-Use Therapeutic Food (RUTF) – 500kcal spreads containing essential amino acids, lipids, and minerals – as their sole nutritional intake.malnutrition_in_South_Sudan

UNICEF is hoping to build on the progress it made in 2014 by prioritizing three strategic objectives: continuing humanitarian intervention in UN Protection of Civilian (PoC) and Internally Displaced Person (IDP) sites, scaling up its Rapid Response Mechanism (RRM) in hard to reach locations and supporting capacity building by engaging community-based organizations.

Until March 2014, UNICEF primarily operated within United Nations’ PoC and IDP sites, which sheltered only a fraction of the 800,000 people displaced by conflict. Ethnic and gender-based harassment and shifting security situations prevented volunteers and specialists from reaching 90 percent of at-risk individuals across the country.

Still, for 90,000 people, life-saving treatment and sustainable training came just in time. In addition to nutrition services, children benefited from guidance on sanitation and hygiene and were enrolled in school.

The development of RRM revolutionized UNICEF’s reach in the country. Mobile teams of specialists are now equipped to deploy to locations previously inaccessible because of deteriorated security.

During the 34 missions these teams conducted last year, more than 500,000 additional people were screened, and the number of children receiving life-saving treatment for SAM climbed to 93,000.

These teams are also equipped to collect more extensive data on the ground and to implement warning systems, which will alert them to return to communities when progress begins to reverse. UNICEF is hopeful that by ramping up RRM capabilities, they will continue to see more patients.

To prevent recurring cases, UNICEF will step up engagement with community-based organizations with a focus on capacity building. Last year, the organization worked with 88 local organizations to train around 1,900 partners on SAM treatment, infant and young child feeding, and nutrition surveys.

It also supported local working groups seeking to maintain progress in affected areas and engaged the government of South Sudan on water sanitation and national planning.

These efforts will be critical to ensuring that sustainable development continues even after these next 12 months, and UNICEF is hopeful that, for children in South Sudan, it will.

Ron Minard

Sources: IpcInfo 1, IpcInfo 2, UNICEF 1, UNICEF 2
Photo: Flickr, Wikipedia

global_immunization_target
Great news from the world of life-saving vaccinations! According to UNICEF and the World Health Organization (WHO), the number of countries with 90 percent coverage of children receiving routine life-saving vaccinations has doubled between 2000 and 2014.

In 2012, 194 WHO Member States endorsed the Global Vaccine Action Plan (GVAP) and committed to delivering vital vaccinations, with the goal of 90 percent diphtheria-tetanus-pertussis (DTP3) vaccination coverage in all countries by 2015. GVAP sought to prevent millions of deaths by 2020 by expanding the access of vaccines. The plan resulted from DoV collaboration, which brought together development, health and immunization experts and stakeholders. It was also made possible with the leadership of organizations such as the Bill & Melinda Gates Foundation and with partnerships in all levels of government, across various segments of society.

The global immunization target has seen an incredible push forward, with 90 percent of children receiving the required three doses of DTP3 vaccines, in 129 countries as of 2014. Currently, DTP3 immunization coverage stands at 86 percent for all 3 doses, and at 91 percent for infants receiving at least one dose. This is a great improvement from 2000, when 21 million children did not receive the first dose of DTP3, which is now up to 12 million.

Another great improvement is India’s current immunization rate. India has the largest number of unvaccinated children and is now at 80 percent of DTP3 coverage. According to the WHO, India is one of the three countries where almost half of the world’s unvaccinated children live. The other two countries are Indonesia and Nigeria.

Improvements in meeting other immunization targets have been made. Hepatitis B, which is common in East Asia and sub-Saharan Africa, has seen an increase in vaccinations from 2000 to 2014, from 30 percent receiving 3 doses to 82 percent. The number of children protected from Hepatitis B is high and increasing.

Another improvement in meeting immunizations targets have occurred with the rotavirus, which is the most common cause of severe diarrhea in children and infants, and is widespread in developing and under-developed countries in East Asia and sub-Saharan Africa. More countries are using vaccines against the rotavirus and pneumococcal conjugate vaccine.

Despite these incredible improvements, there is still more room for improvement. According to the WHO, 65 countries need to improve their strategies for meeting the GVAP goal. These include six countries with less than 50 percent coverage with DTP3: Central African Republic, Chad, Equatorial Guinea, Somalia, South Sudan and the Syrian Arab Republic.

We’re on the right path to meeting the global immunization targets considering it has doubled, we just need to develop better strategies to speed up the process to make sure we can get to 100 percent of all children receiving routine life-saving vaccinations.

Paula Acevedo

Sources: International Business Times, World Health Organization
Photo: International Business Times

Measles
The Nuba Mountains in Sudan were once seen as a sanctuary but because of their remoteness and ongoing military struggle in the area, the largest measles crisis in years is currently sweeping across Sudan. Due to the power struggle between the government and rebels, children have been denied access to immunization.

The measles virus is spread by respiratory transmission and is highly contagious. Up to 90 percent of people without immunity who are sharing a house with an infected person will catch it.

According to UNICEF, Sudan has already seen 2,700 cases of measles this year. “Of these roughly one in 10 will die. The fear now is that, with around 150,000 children under 5 in the Nuba Mountains who have had no reliable access to immunization since 2011, the situation could explode.”

Without immunization, there is a real potential that more lives will be lost to measles than to the recent Ebola outbreak in West Africa. However in this case, the majority of lives lost will be children.

Sudan’s recent outbreak of measles is not caused by lack of immunization efforts. In April 2015, UNICEF launched an immunization campaign to first vaccinate children in the highest risk states, and then expanding into other areas identified to be at risk.

Geert Cappelaere, UNICEF Representative in Sudan said, “Measles is a life threatening disease but on that can easily be prevented with timely immunization. Every girl and boy must be reached no matter where they live. There are no excuses and no child can be left out.”

Children are the most at risk for contracting measles; children who are malnourished are even more vulnerable. For malnourished children, measles can cause serious health complications including blindness, ear infections, pneumonia, and severe diarrhea.

“In Sudan, some 36 percent of children are stunted and the country has one of the highest levels of malnutrition in Africa. Of the total number of reported measles cases in Sudan 69 percent are below 15 years of age, including 52 percent under the age of five.” A large portion of the children in Sudan is at risk to contract measles.
With the dispute over border territory around the South Kordofan region, the region has struggled to see vital humanitarian aid that is a crucial lifeline. Since 2011, the region has not seen food and medical supplies.

For the partners of Gavi, the Vaccine Alliance, there are few options left to deliver the much-needed vaccines. UNICEF and the World Health Organization have put their support behind the efforts of the Ministry of Health.

Another option is to try to get vaccines delivered by partner organizations that are still working in the area. These organizations include Doctors Without Borders and faith based organization such as Caritas. However, these organizations are not given immunity and vaccines cannot be promised to be delivered.

In light of this situation, it is also a learning opportunity. Governments must be more proactive about not just responding to humanitarian disasters but by also preventing them. The warning signs need to be recognized. “After all, for any country to have a future it must protect its children.”

Kerri Szulak

Sources: CNN, UNICEF
Photo: Flickr

alwaleed_philanthropies
On July 13, 2015, Alwaleed Philanthropies announced their commitment to protecting the lives of children through immunization programs. They have signed an agreement with Gavi, the Vaccine Alliance, worth $1 million.

According to their website, “Alwaleed Philanthropies supports and initiates projects around the world, regardless of gender, race, or religion. [They] collaborate with a range of philanthropic, governmental and education organizations to combat poverty, empower women and the youth, develop communities, provide disaster relief and create cultural understanding through education.”

Alwaleed Philanthropies has supported thousands of projects in over 90 countries and served millions of people across the globe for over 35 years.

The agreement with Gavi, the Vaccine Alliance was negotiated in January at the Gavi Pledging Conference. This is the first time Alwaleed Philanthropies has provided support to Gavi.

The contribution from Alwaleed Philanthropies is multiple projects to support the vaccine needs in Timor Leste, Kiribati, Armenia, Azerbaijan, Moldova and Guyana for the 2016 to 2020 period.

Gavi’s Resource Mobilization and Private Sector Partnerships Managing Director Marie-Ange Sarakao-Yao says, “We are very pleased that His Royal Highness Prince Alwaleed Bin Talal has decided to support Gavi through Alwaleed Philanthropies. Immunisation is one of the most effective ways of reducing preventable deaths in the poorest countries and thanks to this contribution, Gavi will be able to support developing countries with vaccines that protect children against preventable diseases.”

Every year, nearly 22 million children do not receive a full course of even the most basic vaccines. These children are mainly in poor countries. More than one in five of all children who die before the age of five lose their lives to vaccine preventable diseases.

Since 2000, Gavi has invested more than $3.8 billion to introduce vaccines to the members of the Organization of Islamic Cooperation (OIC). For the 2016 to 2020 period, Gavi predicts that 60% of its funding will support immunization programs in OIC who are eligible for Gavi support.

Since its introduction in 2000, Gavi has helped developing countries immunize over a billion children, saving seven million lives. World leaders joined German Chancellor Angela Merkel in January to raise $7.5 billion to ensure Gavi supported programs anticipated for the 2016 to 2020 time period

With this contribution, Gavi will be able to support an additional 300 million children with vaccines. Because of the funding it is receiving, Gavi is taking the steps to ensure all children will survive vaccine preventable diseases. Because not all families can afford vaccines, Gavi is the bridge between healthy children and the future of vaccinated children.

Kerri Szulak

Sources: Alwaleed Bin Talal Bin Abdulazaz Al Saud, Gavi, the Vaccine Alliance
Photo: Alwaleed Philanthropies

Foreign_Aid_Investments
The Institute of Health Metrics and Evaluation, or IHME, the top international agency for global health data collection and analysis, has provided a new report which scores the impact of foreign aid investments made over the past fifteen years.

The study, recently published in the Lancet Medical Journal, determined that between 2000 and 2014, low and middle-income nations invested $133 billion US into child health initiatives. These investments are estimated to have saved the lives of 20 million infants and children.

An additional $73.6 billion US of foreign aid investments provided by donors, both governmental and privatized, accounted for the saving of an additional 14 million infant and child lives, the IHME estimates.

In total, an estimated 34 million children’s lives have been saved in the past 15 years. The report estimates that US foreign aid investments saved the largest number of children under-five, with 3.3 million lives saved. The UK was also noted as a significant factor in this progress, and is estimated to have saved 1.7 million lives through their own development funding. The Bill and Melinda Gates Foundation proved to be the largest privatized donor, having saved an estimated 1.5 million lives.

Ray Chambers, the UN Secretary General’s Special Envoy for Financing the Health Millennium Development Goals and Malaria, collaborated with the IHME to produce this report and hopes to use this form of analysis in the future to track the success of the Sustainable Development Goals.

Chambers stated in an interview about the new score, “We know that despite the efforts of governments and donors to improve health in low-income and middle-income countries, too many children die before the age of five. Without a way to monitor and publicly share progress regularly, we will miss the opportunity to build on the momentum we have seen since the millennium declaration.”

The IHME estimates that within the most impoverished nations, the cost to save a child’s life is about $4,000 US. The organization stated in its report that within countries such as Tanzania and Haiti, the costs are $4,205. They estimate within nations such as Botswana and Thailand, where economies are more developed, that the costs to save a child’s life are above $10,000 US due to high health care costs.

The Director of the IHME, Dr. Christopher Murray, stated in a recent interview, “You can spend $4,000 on many different things, but there are very few places where the money would deliver the kind of impact you get by investing it in child health.” He continued in reasoning, “If you invest in the poorest countries, you will see the biggest impact in child health because the costs of things like nutrition programmes, vaccines and primary care are lower.”

The report analyzed both governmental and privatized donors, and included internationally renowned agencies such the Global Fund, World Bank, UNICEF, USAid, and Gavi. The study concluded that the efforts and financial support of Gavi, a global non-profit organization focused on vaccination, has saved over 2.2 million lives.

Looking towards future development initiatives such as the Sustainable Development Goals, Dr. Murray has stressed, “We have seen such incredible success in saving children’s lives over the past 15 years. We need to take what we have learned from that experience and push for more progress and more accountability as we enter the era of the Global Goals for Sustainable Development.” The Sustainable Development Goals were developed at the UN Rio+20 Conference in 2012, and are designed to build upon the progress of the Millennium Development Goals in the coming years.

James Thornton

Sources: The Guardian, News Medical
Photo: Flickr

School_Lunch_Program
The World Food Program began a massive school lunch program this past May across the Central African Republic. This week, they began a campaign that aims to battle common intestinal worm infections in children in cooperation with the school lunch program.

Many children in the Central African Republic suffer from intestinal worm infections that affect their health, ability to intake nutrition, mental development and ability to study in school. The program that collaborates with UNICEF and the Ministry of Education aims to improve the health of 250,000 children across the Republic.

One deworming pill is effective for six months. When children are healthy and worm-free, they can both focus in school and study at home more effectively.

The school lunch program that began in early May of 2015 has been very effective so far. Over 155,000 metric tons of food have been distributed. Ninety schools, over 70,000 primary school children and 4,300 elementary school children across the capital of the Central African Republic are currently receiving school lunches.

The meal includes rice, beans, oil and salt. In many cases, this school lunch is the only food children will consume in a day. The food encourages families to value attendance and enrollment in school. It also improves the efficacy of the children’s schooling experience, enabling concentration and enthusiasm.

The school lunch and deworming campaign in the Central African Republic follows political violence, armed conflict and chaos that began in December of 2014. Thousands of people have been killed and almost 1 million have left their homes due to political violence.

The instability and violence caused the majority of schools in the Central African Republic to close, leaving children without access to education. The few schools that remained open were too unsafe for children to attend. According to the U.N. Office for the Coordination of Humanitarian Affairs, about 45 percent of schools are currently still closed in the Central African Republic and 35 percent of the population is food insecure.

According to the U.N., 3,500 to 6,000 children have been recruited as child soldiers in armed groups in the Central African Republic. Parents and many organizations like World Vision are encouraging school attendance in an effort to diminish children’s vulnerability to recruitment.

According to World Vision, Claudia Geraldine, a teacher from Bangui that educates boys and girls from age 5 to age 14 said, “I’m encouraging parents to send children to school now because it is safe.”

The school lunch and deworming programs have so far been successful due to the tenacious, determined, collaborative efforts of local community members along with large organizations. “Everybody plays a part in the process. The head of the school organizes the logistics and mobilizes parents to help. Local women volunteer to prepare the food, and the children fetch water. This is making a real difference in the lives of children in Bangui,” said Fikru Gebeyehu, a World Vision food assistance expert.

– Margaret Anderson

Sources: World Food Programme, World Vision USAID
Photo: World Food Programme,

Child_mortality
One out of every 20 children dies before the age of 5, and the Bill and Melinda Gates Foundation wants to know why.

That’s according to the foundation’s announcement in early June 2015 of a $75 million investment in a new program named the Child Health and Mortality Prevention Surveillance Network, or CHAMPS.

The network will utilize ground teams in Africa and Asia to gather information about recent childhood deaths. Teams will be positioned in key areas and will collect samples to be analyzed in advanced laboratories. In doing so, the foundation hopes to replace the current practice of conducting “verbal autopsies”—asking questions of parents following a child’s death—with something more comprehensive.

“The world needs better, more timely public health data not only to prepare for the next epidemic, but to save children’s lives now,” said Bill Gates, co-chair of the foundation, in announcing the investment.

As part of the new program, teams will utilize minimally invasive needle biopsies to take samples from certain deceased children after obtaining permission from parents. The samples will then be analyzed at labs throughout the world to determine the cause of death. Key partners in this effort will include the U.S. Centers for Disease Control and Prevention, as well as the Global Health Institute at Emory University.

While these teams will mostly be focused on monitoring childhood deaths, they will also be able to respond to global health crises, should the need arise. In an interview with The Atlantic, Gates stated the program would help detect epidemics sooner and deploy key resources faster. Gates believes this will improve upon the reaction time seen in the Ebola crisis.

The Ebola epidemic, still ongoing, is responsible for at least 26,000 reported cases and 11,000 deaths; the World Health Organization estimates many more cases have gone unreported. According to The New York Times, the WHO believes the first Ebola victim was a one-year-old boy. As the epidemic worsened, 12 weeks passed before the virus was properly diagnosed.

The new program may make a difference in some of the world’s poorest regions. High child mortality is a common symptom of poverty and is an indicator of poor access to medical services. It often causes overpopulation, as families are forced to consider that not all of their children will survive to adolescence.

The United Nations has made the reduction of childhood mortality a centerpiece of its development policy, naming it as one of the eight Millennium Development Goals. Since 1990, childhood mortality has been reduced by 50 percent. With new efforts and innovative technology, the Bill and Melinda Gates Foundation hopes to cut the rate in half once more.

– Kevin Mclaughlin

Sources: The Atlantic, Bill and Melinda Gates Foundation 1, Bill and Melinda Gates Foundation 2, New York Times 1, New York Times 2, United Nations, World Health Organization
Photo: Lagos Daily News