New data show child mortality rates falling
New data released 16 September 2014 by the United Nations show that
under-five mortality rates have dropped by 49% between 1990 and 2013.
The average annual reduction has accelerated – in some countries it has
even tripled – but overall progress is still short of meeting the global
target of a two-thirds decrease in underfive
mortality by 2015.
New estimates in the ‘Levels and Trends
in Child Mortality 2014’ report show that in
2013, 6.3 million children under five died
from mostly preventable causes, around
200,000 fewer than in 2012, but still equal
to nearly 17,000 child deaths each day.
“There has been dramatic and accelerating
progress in reducing mortality
among children, and the data prove
that success is possible even for poorly
resourced countries,” said Mickey Chopra,
head UNICEF’s of global health programmes.
“There is now a gathering
momentum from countries in every part
of the world to make sure proven, costeffective
interventions are applied where
they will save the most lives.”
In 2013, 2.8 million babies died within the
first month of life, which represents about
44% of all under-five deaths. About two-thirds
of these deaths occurred in just 10 countries.
While the number of neo-natal deaths have
declined, progress has been slower than for the
overall under-five mortality rate.
In June this year, WHO, UNICEF and
partners issued the first-ever global plan
to end preventable newborn deaths and
stillbirths by 2035. The Every Newborn
Action Plan calls for all countries to take
steps to provide basic, cost-effective health
services – in particular around the time of
childbirth, as well as for small and sick babies
– and to improve the quality of care.
“The global community is poised to end
preventable maternal, newborn and child
deaths within a generation,” said Dr Flavia
Bustreo, Assistant Director General at WHO.
“We know what to do and we know how to do
it. The challenge now is to move from plan to
action – we are pleased to see countries like India beginning to lead the way.”
Among the report’s other major findings:
- Eight of the 60 countries identified
as ‘high mortality countries’ – with at
least 40 under-five deaths for every 1000
live births – have already reached or surpassed
the MDG target (67% reduction).
The countries are Malawi (72%), Bangladesh
(71%), Liberia (71%), Tanzania
(69%), Ethiopia (69%), Timor-Leste
(68%), Niger (68%) and Eritrea (67%).
- Eastern Asia, Latin America and the
Caribbean and Northern Africa, have already
reduced the under-five mortality rate
by more than two-thirds since 1990.
- Two countries, India (21%) and Nigeria
(13%), together account for more
than one-third of deaths among children
below 5 years of age.
- While Sub-Saharan Africa has cut under-
five mortality rates by 48% since 1990,
it still has the world’s highest rate – 92
deaths per 1000 live births – nearly 15 times
the average in high-income countries.
The leading causes of under-five deaths
are pre-term birth complications (17%);
pneumonia (15%); complications during labour and delivery (11%); diarrhoea (9%);
and malaria (7%). Under-nutrition contributes
to nearly half of all under-five deaths.
“For continued progress, it is essential to
invest more in health systems that deliver
high-quality, affordable services to all women
and children who need them,” said Olusoji
Adeyi, Director of Health, Nutrition
and Population at the World Bank Group.
The report notes that major improvements
in child survival are in part due to
affordable, evidence-based interventions
against the leading infectious diseases, such
as immunization, insecticide-treated mosquito
nets, rehydration treatment for diarrhoea,
nutritional supplements and therapeutic
foods. The major causes of neonatal
mortality – pre-term birth complications
(35%) or problems during delivery or birth
(24%) – require health interventions closely
linked with protecting maternal health.
GAVI introduces Inactivated Polio
Vaccine for Endgame Strategic Plan
Nepal has becomes the first country in the world to use support from Gavi, the
Vaccine Alliance to begin protecting its
children with Inactivated Polio Vaccine
(IPV). The introduction is part of a plan
to ensure that IPV will be available to millions
of children in Gavi-supported countries
through the introduction of the vaccine
into routine immunisation systems.
Inactivated Polio Vaccine (IPV) was licensed
in 1955 and underwent early reformulations
to enhance potency and ensure
safety in standalone and combination vaccines.
According to the WHO, IPV is one
of the safest vaccines in humans, whether
used alone or in combination vaccines. No
serious adverse events have been reported.
While the oral polio vaccine has successfully
reduced polio cases by 99%
worldwide, adding IPV to routine immunisation
programmes will improve
immunity and help prevent new vaccineassociated
outbreaks from emerging. In
May 2013, the World Health Assembly
endorsed the Polio Eradication & Endgame
Strategic Plan 2013-2018, calling
on countries to strengthen routine immunisation
programmes and introduce at
least one dose of IPV as a lead up to the
phased removal of oral polio vaccines.
Children in Afghanistan and Pakistan –
two of the final three countries where polio
remains endemic – are also set to begin receiving
inactivated polio vaccine (IPV) by
the end of next year as part of the planned
‘endgame’ for eradicating the crippling disease.
Nigeria, the third country where polio
remains endemic, has also applied to introduce
IPV, with approval expected shortly.
Afghanistan, Nepal and Pakistan are
among 25 countries who have received
approval to begin using IPV with support
from Gavi, while gradually phasing out the
oral polio vaccine (OPV) which is currently
used in most developing countries.
“Nepal’s introduction of IPV with Gavi
support marks an important moment in the
global effort to secure a polio-free future,”
said Dr Seth Berkley, CEO of Gavi, the Vaccine
Alliance. “Gavi is working with partners
to ensure that millions of children in
the world’s poorest countries are protected
with IPV through routine immunisation as an important step towards achieving
global polio eradication.”
Last year more than 400 cases of wild polio virus were recorded,
mostly in endemic countries and since the beginning of this year
more than 150 cases have been reported, mainly in Pakistan but also
in non-endemic countries such as Equatorial Guinea, Iraq, Cameroon,
Syria and Ethiopia.
Ban Ki-moon says improving health of
women, children a ‘moral imperative’
Lauding the gains made in improving the health of women and
children worldwide, UN Secretary-General Ban Ki-moon called for
renewed commitment and action to sustain the unprecedented progress
made in this area in partnership with governments, civil society,
the private sector, philanthropists and international organizations.
“For the first time ever, we have the opportunity to end all preventable
deaths of women and children within a generation,” Ban
said at the ‘Every Woman Every Child’ event held 25 September
2014 at UN Headquarters on the margins of the General Assembly’s
“Let us seize this historic opportunity as a moral imperative. It is
also one of the smartest investments we can make.”
Launched by the Secretary-General in September 2010, Every
Woman Every Child aims to save the lives of 16 million women
and children by 2015.
The initiative has catalysed unprecedented progress in reducing
maternal and child mortality, doing so through a pioneering
model of multi-stakeholder partnership involving governments,
civil society, the private sector, philanthropists and international
To date, over 400 partners have made commitments
under Every Woman Every Child.
Ban noted that efforts have led to the reduction in deaths of
children under the age of five faster than at any time in the past
Each day, some 17,000 more children survive. Deaths
of mothers have been cut by almost half since 1990.
“These are impressive numbers in conference rooms in New
York. They are even more meaningful in hospitals, health posts
and homes,” he noted.
“In today’s troubled world, our progress in this area shines brightly.
It demonstrates what can be achieved when we come together
as a community in partnership.
“As we advance, we will have to protect these fragile gains – and
cope with emerging challenges. Climate change, water, education,
sanitation, nutrition and human rights all affect women and children’s
“I call on all of you to renew your commitments, boost financing,
keep insisting on accountability for resources and results,
and reach every woman and every child,” said the Secretary-
“Together, we can make history.”
IBA, Philips join forces to advance
diagnosis, treatment of cancer
IBA (Ion Beam Applications S.A.), a leading provider of proton therapy and
radiopharmacy solutions, and Royal Philips have
signed of a global collaboration agreement to provide advanced
diagnostic and therapeutic solutions for the treatment of cancer.
The collaboration covers sales, marketing, research and development
(R&D) of imaging and therapy solutions in oncology.
In a joint statement, the companies said that leveraging high
quality imaging and proton therapy offers the potential to increase
confidence in the diagnosis and treatment of cancer, reduce shortand
long-term side-effects and potentially enhance the quality of
life of the patient before, during and after treatment, while reducing
the cost of treatment for the healthcare system.
IBA will benefit from Philips diagnostic imaging products offered
to oncology care centres, while Philips will leverage IBA
proton therapy solutions within its offering for customers in select
markets around the world. The commercial collaboration
also includes an integrated offering for Molecular Imaging Centres,
combining IBA’s expertise in PET radioisotope production
centres with Philips imaging and diagnostics expertise.
Commenting on the
collaboration, Olivier Legrain, Chief Executive Officer of
IBA, said: “This is an exciting and important
step for IBA. A closer collaboration
with a company of Philips’ caliber and
global reach, where we are able to combine
both companies’ expertise and excellence
in oncology care, will accelerate innovation
and provide more efficient and effective
solutions in molecular imaging and
treatment solutions. This collaboration is
an important step toward adaptive treatment
of cancer and a personalized treatment
approach to enable the best possible
result for cancer patients across the globe.”
Gene Saragnese, Executive Vice President
and CEO, Imaging Systems, Philips
added: “Proton therapy is one of the most
exciting technological advancements in the
oncology field. We look forward to collaborating
with IBA to enhance access to bestin-
class technology for both Proton Centres
and Molecular Imaging Centres, as well as to
accelerate the development of our informed
therapy guidance vision in ways that can
change the future of care, and improve the
quality of life for patients.”
IBA’s Proton Therapy Specific Cone Beam
CT successfully used for the first time
IBA (Ion Beam Applications SA), a leading
provider of proton therapy solutions
for the treatment of cancer, and Université
Catholique de Louvain announced September
15 that the first patient treatment
with IBA’s Proton Therapy Specific Cone
Beam CT (CBCT) was successfully completed
at Penn Medicine’s Roberts Proton
As a component of IBA’s Image Guided
Proton Therapy (IGPT) solution, CBCT
provides 3D imaging for increased accuracy
in patient treatment. It is fully integrated
with IBA’s imaging platform adaPTinsight,
developed in partnership with the Université
catholique de Louvain (UCL), to offer
fast 6D corrections of patient positioning
for IBA’s ProteusPLUS and ProteusONE
proton therapy solutions.
Dr. James M. Metz, MD, Professor and
Vice Chair, Radiation Oncology, Penn
Medicine commented: “CBCT is a great
tool for highly accurate patient positioning. It also enables the clinicians to
the patient anatomical change over the
treatment course regularly and to adapt
the treatment plan whenever needed.
The end results significantly benefit the
patients, with enhanced precision and accuracy
of the proton therapy delivery. We
believe that this is another significant step
in improving our ability to help patients
achieve their goals of beating their cancer
with as few side effects as possible.”
Frederic Genin, Executive VP Product
Management at IBA added: “IBA’s significant
experience and successful collaborations
with key users make it possible to
achieve this important milestone in the
development of specific imaging solutions
for proton therapy. The applications of image
guidance and image monitoring are of
paramount importance to benefit from the
superior dose distribution of proton therapy.
By adding Cone Beam CT as one of
IBA’s Image Guided Proton Therapy solutions,
we are accelerating the development
of Adaptive Proton Therapy.”
WHO calls on countries to implement
salt reduction measures
On World Heart Day, 29 September,
the World Health Organization (WHO)
called on countries to implement population
salt reduction measures, on communities
to support public health efforts to
reduce salt intake, and on individuals to
consume less salt to avoid high blood pressure
and heart disease.
High salt intake is a key contributor
to the increase in noncommunicable diseases
(NCDs) worldwide. NCDs account
for over 2.2 million deaths, or over 57%
of mortality, in the Eastern Mediterranean
Region annually. Cardiovascular diseases
alone, in which high salt intake plays a major
role, cause almost half of these deaths.
The scientific evidence linking high
blood pressure to high salt intake, and
conversely reduced salt intake to improve
health outcomes, is conclusive. In
countries where salt intake was reduced
by 1 gram per person per day, deaths from
stroke and heart attack are expected to be
reduced by more than 7%.
“Data from the Eastern Mediterranean Region shows that the average salt
in most countries is around 10
grams per person per day,” said Dr Ala Alwan,
the WHO Regional Director for the
Eastern Mediterranean. “This is double the
amount recommended by WHO.”
Dr Alwan added: “Reducing salt intake
to less than 5 grams per person per day can
prevent cardiovascular disease, which is
the number one killer in the Eastern Mediterranean
Region and in the world.
“Salt reduction is one of the strategic
interventions in the regional framework
for action on noncommunicable diseases
, endorsed by ministers of health in this
region,” explained Dr Alwan. “Implementing
salt reduction programmes can help
countries achieve the global target for salt
reduction,” he said, referring to the global
voluntary target, endorsed by the World
Health Assembly in May 2013, to reduce
salt intake by 30% by the year 2025.
Salt reduction is a proven measure “best
buy” for combating noncommunicable diseases,
with a cost of about US$ 0.40-0.50
per person per year. Best buys are interventions
that are very cost-effective, cheap,
culturally acceptable and feasible to implement
in all countries.
This World Heart Day, governments,
the food industry, civil society groups,
families and individuals are urged to take
action to reduce salt intake and improve
In consultation with Member States
and international experts, WHO has
developed policy guidance and recommended
actions to reduce salt intake;
several countries are in the process of
implementing this guidance. A key measure
is setting national standards for the
amount of salt in various food items.
Bread is the first priority for action since
more than 25% of people’s salt intake
in the region comes from salt in bread.
Cheese, processed tomato products and
meats, and the salt added during cooking
or at the table are the next targets.
WHO calls for stronger action
on climate-related health risks
“The evidence is overwhelming: climate
change endangers human health. Solutions exist and we need to act decisively
to change this trajectory,” Dr Margaret
Chan, WHO Director-General said at the
first-ever global conference on health and
climate, held late August in Geneva.
Previously unrecognized health benefits
could be realized from fast action to reduce
climate change and its consequences. For
example, changes in energy and transport
policies could save millions of lives annually
from diseases caused by high levels of
air pollution. The right energy and transport
policies could also reduce the burden
of disease associated with physical inactivity
and traffic injury.
Measures to adapt to climate change could
also save lives around the world by ensuring
that communities are better prepared to deal
with the impact of heat, extreme weather,
infectious disease and food insecurity.
These are two key messages discussed at
The health sector needs to act quickly and
assertively to promote climate-smart strategies,
climate and health experts warned.
WHO and its partners highlighted the
importance of acting now to help protect
health in the present as well as the future.
The health community is working hard to
improve its capacity for surveillance and
control of infectious diseases such as cholera,
malaria and dengue, which are highly
sensitive to weather and climate.
Climate change is already causing tens of
thousands of deaths every year from shifting
patterns of disease, from extreme weather
events, such as heat-waves and floods, and
from the degradation of water supplies, sanitation,
and impacts on agriculture, according
to the most recent WHO data.
“Vulnerable populations, the poor, the
disadvantaged and children are among
those suffering the greatest burden of climate-
related impacts and consequent diseases,
such as malaria, diarrhoea and malnutrition,
which already kill millions every
year,” noted Dr Flavia Bustreo, WHO Assistant Director-General, Family, Women’s
and Children’s Health.
“Without effective action to mitigate and adapt
to the adverse effects of climate change on health, society will face
one of its most serious health challenges,” she said.