THURSDAY, March 24, 2005 (HealthDayNews) -- Six easy-to-treat infectious diseases account for the majority of deaths in young children in the developing world, according to a new report by researchers for the World Health Organization (WHO).

What's so tragic, experts say, is that all of these illnesses are easily treated.

Of the 10.6 million children under 5 years of age who die each year around the world, most succumb to pneumonia (19 percent), chronic diarrhea (18 percent), malaria (8 percent), newborn blood infection or pneumonia (10 percent), preterm delivery (10 percent) and asphyxia at birth (8 percent), according to the results of a study appearing in the March 26 issue of The Lancet.

Sadly, these grim statistics are largely unnecessary since each of these conditions "are largely amenable to simple intervention," according to study co-author Dr. Robert E. Black, a professor and chairman of the Department of International Health at the Bloomberg School of Public Health at Johns Hopkins University.

Some 98 percent of these deaths occur in developing countries, Black said. Among deaths in children, 42 percent occur in Africa while another 29 percent occur in southeast Asia.

Despite continuing high childhood mortality from killers such as pneumonia and diarrhea, most Americans are unaware that these illnesses take such a tragic toll. Black said that, in the United States, the perception is that the primary causes of death among children around the world are HIV/AIDS and malnutrition.

Malnutrition is an underlying cause of 53 percent of the deaths, according to the report, since it renders children vulnerable to disease. On the other hand, HIV/AIDS -- while a serious problem -- isn't the worst threat facing children in developing countries.

"There are clearly major infectious disease causes that are the predominate ones, and they are not AIDS," Black said. "AIDS in children under 5 accounts for only 3 percent of child deaths."

Black stressed that most of these deaths are avoidable. "We have the opportunity to reduce these deaths very drastically with very affordable, easily delivered means," he said. "And we're not doing it." He estimates that if these diseases were treated, deaths among young children could be reduced by two-thirds.

Better treatment would require political action that's just not there right now, however. "There is not yet the global conscience and political will to make it happen," Black said.

One key factor would be a targeted strengthening of existing health-care systems in poorer countries. "There is no need to build fancy hospitals," Black said. "What we need is a delivery system that reaches communities."

He believes U.S. resources devoted to health care in the developing world often miss the mark. "We are not rationally targeting our foreign aid," he said. "We target only a small amount to health and social sector issues, in proportion to military aid."

Within health care, too much is being spent on AIDS at the expense of these other infectious diseases, Black argued. "The amount of money going to AIDS is a high priority," he said. "But it should not be dominating the funding."

Moreover, Black noted that "the U.S. is among the worst countries in the world in terms of contributions to foreign assistance."

According to Black, the rich countries have pledged that they will each give 0.7 percent of their gross national product to foreign assistance. "The U.S. is currently at 0.17 percent, while other European countries have reached 0.7 percent," Black said. "So the U.S. goes to conferences and pledges additional aid, and doesn't deliver."

The Johns Hopkins expert also puts the blame on international organizations like UNICEF and WHO. "Until recently, these groups have not focused on child survival as a major international issue -- a major right of children in the world to survive."

In an accompanying commentary in the journal, Peter Byass from Umea University in Sweden writes: "Counting the world's children is not all that is involved in making the world's children count. It is important to look at the single most important determinant of childhood death, which has to be poverty. Childhood mortality is strongly inversely correlated with per-capita health expenditure. In today's world, an Ethiopian child is over 30 times more likely than a western European to die before his or her fifth birthday."

Dr. David L. Katz, an associate clinical professor of public health and director of the Prevention Research Center at Yale University School of Medicine, said "the goal of reducing mortality among the global population of children under age 5 by 2015, cited in the United Nations Millenium Declaration, is laudable. But without the means to reach these noble ends, the declaration is just so much ink."

Children know nothing of political boundaries, or ideology, Katz said. "If the plight of these innocents helps us see that there is only one world for public health, we will begin to make progress toward the Millenium Declaration goal."

Katz believes that if every parent stopped to consider, "What if it was my child?" all the world's children could receive the best public health we can provide. "We have both ends, and means, but miles to go before we sleep in confidence of success," he said.

Research is offering the world's most vulnerable children hope, however: Another study in the same issue of The Lancet reports on the successful trial of a new children's pneumonia vaccine, which the researchers believe could be particularly useful in developing countries.

Results of the trial conducted in Gambia found that the vaccine reduced the first episode of pneumonia by 37 percent and reduced admissions to hospital by 15 percent. Moreover, pneumonia caused by the types of bacteria targeted in the vaccine was reduced 77 percent, while overall child mortality was reduced by 16 percent.

"The trial results are highly promising, and provide us with a clearer picture of the pneumococcal disease burden in Africa," researcher Felicity Cutts from the Medical Research Council in the U.K. and WHO, said in a prepared statement.

More information

The World Health Organization can tell you more about childhood diseases in developing countries.

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