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Harvard panel to explore the path to ending child mortality

A panel at the Harvard School of Public Health, which will be live streamed here on Wednesday, examines what works and what doesn't in the fight to reduce under-5 deaths around the world.
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(Samuel De Leon/Photoshare/Courtesy)

BOSTON — The Forum at the Harvard School of Public Health will host a panel on Wednesday about the steps that can be taken to reduce child mortality around the world. The event is presented in collaboration with GlobalPost and will be live streamed here, on GlobalPost’s Pulse blog, starting at 12:30 p.m.

The panel discussion comes weeks after UNICEF released its 2013 progress report on child survival. The report announced that at the current rate of progress, as many as 35 million children could die between 2015 and 2028. The event also follows up on a Special Report published by GlobalPost titled "Step by Step: The path to ending child mortality."

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Opinion: Poliovirus makes a comeback, and Israel is prepared

The resurgence of poliovirus in Israel reminds us that the virus could make a resurgence anywhere. The world can’t rest until the virus has been eradicated, says Dr. Walter Orenstein.
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An Israeli child receives a vaccination against Polio at a clinic in Jerusalem on August 18, 2013. Israel took its polio vaccination campaign nationwide. (Menahem Kahana/AFP/Getty Images)

Over the last several months, wild poliovirus has been discovered circulating in Israel for the first time in 25 years. Although no paralytic polio cases have been reported, the presence of the virus – and the possibility of further spread within or beyond Israel – threatens the immense progress we’ve made toward global eradication.

Since the Global Polio Eradication Initiative (GPEI) first began its work, cases have dropped more than 99 percent to a record low of 223 in 2012. Down from 125 endemic countries in 1988, only three countries — Afghanistan, Nigeria and Pakistan — have never eliminated wild polioviruses, remaining capable of re-infecting other countries.

However, these countries have been stepping up efforts against the disease, resulting in 40 percent fewer cases as of September 11 of this year, compared to the same time last year.

The world’s progress toward eradicating polio is cause for celebration, but not complacency.

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Opinion: 'The moment of truth' for child survival

A pioneering doctor on child survival says now is the time to remember the highly successful Child Survival Revolution of the 1980s.
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World Health Organisation (WHO) and Oral Rehydration Salts (ORS) Goodwill Ambassador Smriti Irani (C) holds a child being fed an ORS solution. (Manan Vatsyayana /AFP/Getty Images)

In the 1970s, I joined the World Health Organization to help start and lead its new diarrheal diseases control program. The goal of the program was to reduce diarrheal mortality using a highly effective method of rehydrating patients by mouth using a solution composed primarily of salt, sugar and water.

In 1982, I wrote a paper with a colleague estimating that 4.6 million children under age 5 died each year from diarrhea — a shocking figure. Today, under-5 deaths caused by diarrhea have declined by 90 percent. Why? The treatment is inexpensive, easily administered at home, and it works.

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Millennium Development Goals: When failure means success

Global health advocates are calling for accelerated reductions in child mortality to meet the 2015 deadline, even though they know we won't reach the UN goal. Why many still consider MDG 4 a success story.
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Secretary General of the United Nations Ban Ki-moon speaks at the 68th United Nations General Assembly on September 24, 2013 in New York City. (Andrew Burton/AFP/Getty Images)

NEW YORK — Politicians in suits, entrepreneurs in jeans and philanthropists, aid workers and journalists dressed somewhere in between descended upon New York City this week for the annual meeting of the United Nations. 

And with about 800 days to go until the Millennium Development Goal deadline, conversation around 2015 cropped up everywhere, from cocktail receptions at UN headquarters in East Midtown to rapid-fire panel sessions at the Social Good Summit on the Upper East Side.

Two questions prevailed: What can we do to reach the MDGs by 2015? And what new development goals should come after 2015? That the president of the UN’s 68th General Assembly declared this year’s theme “The Post-2015 Development Agenda: Setting the Stage” only elevated the stakes for discussing the answers.

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Child mortality rates are falling, but Millennium Development Goal is still far off

A report released by UNICEF Thursday says the world will not meet the UN's Millennium Development Goal on child mortality until 2028.
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A mother with her 3-year-old daughter who suffers from chronic diarrhea and tuberculosis, at the District Hospital, Panna, Madhya Pradesh in Central India. (Harman Boparai/GlobalPost)

The number of children who die before their fifth birthday declined by nearly 50 percent between 1990 and 2012, from more than 12 million to 6.6 million, according to a new UNICEF report.

Despite the good news, the world is not on track to reach the United Nations' Millennium Development Goal (MDG) to cut the 1990 child mortality rates by two-thirds by 2015. Unless the world more than quadruples the annual rate of reduction in child death, it won’t meet the MDG until 2028.

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Counting the uncountable? Measuring progress in global child health

As the 2015 deadline to meet the Millennium Development Goals nears, United Nations statisticians say life's improved drastically for children in the developing world. How do they know?
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Leoncia Uwimbabazi and Lea Mukeshimana soothe their babies after vaccination at the Nyamata Health Center in the Bugasera District of Rwanda on September 3, 2010. With big strides made against both malaria and pneumococcal disease, Rwanda is on track to meet UN Millennium Development Goal no 4, the reduction of child mortality, officials say. 'Rwanda is one of the few countries in Africa that stands a chance of reaching the MDG targets if the current rhythm is maintained,' said Lamine Cisse Sarr, World Health Organisation representative to Rwanda. (Shanon Jensen/AFP/Getty Images)

The number of children who get measles vaccinations in Rwanda has been steadily climbing since 2001. But in June of last year, the United Nations reported a sudden drop in coverage from 97 percent to 80 percent.

When Rwandan Minister of Health Agnes Binagwaho saw the statistics show up online, she was certain it couldn’t be true. She posted an indignant Tweet calling out both UNICEF and the World Health Organization: “Why is #Rwanda’s DTP3 vaccine coverage shown as 80% on your sites?”

The vaccination reports, it turns out, said little about the health of Rwanda’s children. Rather, it illustrated the challenges of measuring child health in the developing world.

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Sierra Leone: Where water is foul, diarrhea is a killer

The people here endure the highest under-5 death rate in the world as local politicians and foreign NGOs fail to supply clean water.

FREETOWN, Sierra Leone — In Kroo Bay, a slum located in the heart of Freetown, mounds of raw sewage seep into pools of stagnant water. Children play on doorsteps, and neighbors bathe in the nearby Crocodile River, which feeds into the Atlantic Ocean.

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Malaria tests fate for children living in deadly climate zones

For 4-year-old Edwin, a Zambian, a piece of medical technology common in the West but rare in Zambia made all the difference.

KALENE HILL, Zambia – Edwin could have been my son.

When I first met him I was on assignment in Zambia. So much about Edwin reminded me of my youngest son, Konstantin. They were both 4 years old, and they both had a double set of dimples that pocked their cheeks when they smiled. The simple green t-shirt that Edwin wore looked as if it could have come right out of Konstantin’s drawer. And they both lived near the equator, as I was living with my family in Indonesia at that time.

Despite the similarities, fate for these two boys could not be more different for a specific and tragic reason: Konstantin had access to hospitals, mosquito nets, and a car. Edwin did not.

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India's malnourished children: It's not just about food

As India's government considers landmark legislation to address hunger, economists bicker about the root cause of the country's high malnutrition rates.
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A low wage earning Indian day laborer loads a 60 kg bags of rice on his back at a grains depot near New Delhi on August 27, 2013, one day after the Indian parliament passed a flagship program to provide subsidized food to the poor that is intended to 'wipe out' endemic hunger and malnutrition in the aspiring superpower. Despite decades of fast economic growth, India still struggles to feed its 1.2-billion population adequately with more than 40 percent of children under five malnourished, according to a major survey last year. (Roberto Schmidt/AFP/Getty Images)

India’s lower house of parliament Monday approved an ambitious proposal to address child malnutrition that would provide food at a subsidized rate to nearly two-thirds of the country’s 1.2 billion people.

Congress Party chief Sonia Gandhi told legislators that approving the bill, which aims to give 11 pounds of cheap grain to poor families monthly, was a “message” to the world that India was ready to eradicate malnutrition.

The country's malnutrition rates are among the worst in the world — even worse, the World Health Organization reports, than much more economically disadvantaged countries in sub-Saharan Africa. But is the problem that India’s children don’t have access to food? Or is there more at play?

Columbia University economist Arvind Panagariya recently ignited a passionate debate about the causes of India’s high malnutrition rate with the publication of a controversial paper arguing that Indian children may be smaller than the global average, not because of poor health, but because of genetics.

In the August 24 issue of Economic & Political Weekly, several researchers published papers refuting his claims, pointing instead to behavioral causes such as female disempowerment and the widespread practice of open defecation. One point of agreement in all the back and forth: it’s not just about food.

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Researchers isolate deadliest diarrhea strains — and find a surprise

In the largest study of diarrheal disease to date, researchers found that four pathogens are responsible for the majority of life-threatening diarrhea cases in developing countries. The second most common? The largely ignored parasite cryptosporidium.
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A worker from the NGO Doctors Without Borders examines a sick baby in Gao, in the north of Mali, on February 4, 2013. (Sia Kambou/AFP/Getty Images)

“What can you tell me about diarrhea in your country?”

It should have been a simple question for an official at Mali’s Ministry of Health, but when researchers backed by the Bill & Melinda Gates Foundation first asked it of Dr. Samba Sow a few years ago, his immediate thought, he said, was, “Not much.”

International organizations like UNICEF and the World Health Organization estimate diarrhea is the second most common cause of death for children under 5 in Mali. But, on a local level, the only hard data Sow had to work with at the time was an annual report of the number of children who checked into hospitals showing symptoms of diarrhea.

“If I was just looking at the numbers and considering nothing else, I didn’t know enough to say for sure that we even had a problem,” he said by phone.

The Ministry of Health agreed to make Mali one of seven sites in the Global Enterics Multi-center Study (GEMS), the largest and most in-depth research project examining diarrheal disease in the developing world to date. Sow used the resulting statistics to secure funding for a vaccine against diarrheal disease — among other things. But the findings, recently published in The Lancet, aren’t just helpful to Mali. They’re illuminating for the global health community as a whole.

Diarrhea is a tough problem to solve because it is caused by more than 40 different viruses, bacteria and parasites. GEMS found, though, that just four pathogens are responsible for the majority of moderate-to-severe diarrhea cases. The virus that topped the list — rotavirus — has long been regarded as a formidable foe. But the second most common contributor to diarrheal disease was a parasite called cryptosporidium, which has, up to this point, been considered more of a nuisance than a lethal threat to all but the severely immune compromised. While there is a vaccine for rotavirus, a weapon against cryptosporidium isn’t even in the pipeline.

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