世界の子どもの死亡率が低下

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画像 世界中の子どもの死亡率が更に低下し、1960年に記録を取り始めて以来初めて1000万人を割ったとUnicef が発表した。はしか、マラリア、授乳のキャンペーンと、アフリカ以外の経済好転による。5才以下の死亡が970万人に低下したことは歴史的な出来事とし、1990年から2015年までに2/3に減らす国連の目標への一里塚としたが、自慢できるものではなく、ほとんどは防げ得る死である。これは、2005年時点での推計であり、その後の数年で AIDSや結核マラリアへのグローバルファンドや、Gates 資金、ブッシュのAIDSとマラリアへの2つのプログラムに莫大な資金が投入されている。そのため今後5年で更なる死亡率の低下が起こるだろう。
 ワクチン接種により麻疹はしかによる死亡は1999年から60%低下、母乳の薦めで感染が減少、子どもを蚊帳の中で寝かせる、ビタミンA摂取、といったことが大きく寄与した。しかし、先進国では平均5であるが、西中央アフリカでは5才未満の死亡率が150以上(出生1000対)ある。南部アフリカはAIDSのため、コンゴやシエラレオネは戦争のため、この2つの地域では死亡率は悪化した。インドや中国の経済発展も大きく改善に影響。子どもの死亡の53%に栄養失調が基礎的な原因としてある。ドミニカ、ベトナム、モロッコなどは急激な発展で死亡率は1/3となった。地方で、高価な治療ではなく安価な予防という簡単な方法が効果を出している。単に資金の問題ではなく、優先順位の設定が重要だ。

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Last Updated: Thursday, 13 September 2007, 09:19 GMT 10:19 UK
Child mortality 'at record low'
http://news.bbc.co.uk/2/hi/health/6992401.stm
Fewer children under the age of five are dying thanks to immunisation programmes and anti-malaria measures, the UN children's agency, Unicef, says.

Children being immunised
Millions of lives have been saved by immunisation, Unicef says

Worldwide, the number of young children who died in 2006 dropped below 10 million for the first time, it said.
Measles vaccinations, mosquito nets and increased rates of breast-feeding were said to have contributed to the fall.
However, experts said most of the deaths were preventable and that more needed to be done.
The Unicef figures are based on government-conducted surveys in more than 50 countries in 2005 and 2006.
'Historic moment'
Unicef said 9.7 million children under five died in 2006, down from almost 13 million in 1990.
The decline was particularly marked in Morocco, Vietnam and the Dominican Republic, where the number of children dying dropped by a third, Unicef said.
The Latin American and Caribbean region is on course to achieve the millennium development goal of reducing child mortality by two-thirds by 2015 - it registered 27 deaths on average for every 1,000 live births in 2006, compared with 55 in 1990.

MORTALITY RATE FACTS
Worldwide: 72 per 1,000 live births
Developed world: 6
China: 24
India: 74
Latin America and Caribbean: 27
West and central Africa: 186
Source: Unicef

The majority of deaths occurred in sub-Saharan Africa (4.8 million) and south Asia (3.1 million).
Rates were highest in west and central Africa, where HIV and Aids are prevalent.
Ann Veneman, Unicef's executive director, said that dropping below 10 million was an historic moment, but warned that most of the deaths were preventable.
"We know that lives can be saved when children have access to integrated, community-based health services, backed by a strong referral system," she said.
Peter Salama, Unicef's head of global health, called on the global community to invest another $5bn (£2.4bn) to help the UN achieve its millennium development goals.
Millions of deaths could be prevented using currently available health measures, Mr Salama said.
Among these were campaigns to increase childhood immunisations, the distribution of vitamin A supplements and mosquito nets treated with insecticides, drug treatments for children infected with HIV.
In sub-Saharan Africa, deaths from measles have been reduced by 75% due to increased vaccination coverage.
In Vietnam, child mortality dropped by about 40% after 30,000 people were trained as health workers and paid to treat people in their own villages, Unicef said.
Convincing mothers to exclusively breastfeed their children for the first six months of life was also important, the agency said.

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Child Mortality at Record Low; Further Drop Seen
By DONALD G. McNEIL Jr.
Published: September 13, 2007
http://www.nytimes.com/2007/09/13/world/13child.html?ref=health

Ahmad/Agence France-Presse ― Getty Images
Vaccination campaigns, as in Indonesia, cut childhood deaths.

For the first time since record keeping began in 1960, the number of deaths of young children around the world has fallen below 10 million a year, according to figures from the United Nations Children’s Fund being released today.

Child Mortality DeclinesGraphic
Child Mortality Declines
Enlarge This Image
Scott Eells for The New York Times

Children in Lo Manthang, near Nepal's border with Tibet, receive measles vaccinations at a local temple.
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Joao Silva for The New York Times

A municipal worker sprayed a house on the outskirts of Maputo, Mozambique, with insecticide.
This public health triumph has arisen, Unicef officials said, partly from campaigns against measles, malaria and bottle-feeding, and partly from improvements in the economies of most of the world outside Africa.
The estimated drop, to 9.7 million deaths of children under 5, “is a historic moment,” said Ann M. Veneman, Unicef’s executive director, noting that it shows progress toward the United Nations Millennium Development Goal of cutting the rate of infant mortality in 1990 by two-thirds by 2015. “But there is no room for complacency. Most of these deaths are preventable, and the solutions are tried and tested.”
Interestingly, Unicef officials said, the new estimate comes from household surveys done in 2005 or earlier, so they barely reflect the huge influx of money that has poured into third world health in the last few years from the Global Fund to Fight AIDS, Tuberculosis and Malaria; the Gates Foundation; and the Bush administration’s twin programs to fight AIDS and malaria. For that reason, the next five-year survey should show even greater improvement, they said.
“We feel we’re at a tipping point now,” said Dr. Peter Salama, Unicef’s chief medical officer. “In a few years’ time, it will all translate into a very exciting drop.”
The most important advances, Unicef said, included these:
¶Measles deaths have dropped 60 percent since 1999, thanks to vaccination drives.
¶More women are breast-feeding rather than mixing formula or cereal with dirty water.
¶More babies are sleeping under mosquito nets.
¶More are getting Vitamin A drops.
In 1960, about 20 million children died annually, but the drop since then has been steeper than 50 percent because the world population has grown. If babies were still dying at 1960 rates, 25 million would die this year.
There are still wide disparities. The highest rates of child mortality are found in West and Central Africa, where more than 150 of every 1,000 children born will die before age 5. In the wealthy countries of North America, Western Europe and Japan, the average is about six.
The most rapid progress has been made in Latin America and the Caribbean, in Central and Eastern Europe, and in East Asia and the Pacific.
Despite the improvement, two sets of countries have worsened, Unicef said: those in southern Africa that have been hit hardest by AIDS, and those that have been at war recently, like Congo and Sierra Leone.
The improving economies of India and China have helped pull world figures upward. More girls are getting education and jobs, they marry later and they have fewer children, more of whom survive.
Also, because malnutrition is an underlying factor in 53 percent of all child deaths, anything that feeds children ― whether that means large-scale aid during famines or simply better seeds and fertilizer ― reduces deaths.
Among countries that made particularly rapid progress since 2000 are the Dominican Republic, Vietnam and Morocco, which all cut child deaths by more than one-third.
Madagascar cut its deaths by 41 percent despite going to the brink of civil war in 2002, and São Tomé and Principe managed to cut its deaths by 48 percent.
Domingos Ferreira, a minister counselor at São Tomé and Principe’s mission to the United Nations, was pleasantly surprised to learn that his country ― two islands in the crook of West Africa ― had bested the world.
He guessed that credit was due to a national antimalaria campaign that had drained swamps, sprayed houses and provided mosquito nets. “Malaria used to be the first source of killing in our lives,” he said. “And now I hear that the hospital beds on Principe are empty for the first time.”
In Madagascar, Dr. Salama said, the difference was Vitamin A drops, which drastically reduce the chances that a child will die of measles, diarrhea or malaria.
In general, Ms. Veneman said, the countries that did best concentrated on extending simple measures to rural areas, and focusing on inexpensive prevention rather than expensive care.
Ethiopia, many of whose doctors and nurses emigrate, trained 30,000 community health workers for tasks like weighing babies, advising on breast-feeding, giving shots, testing for malaria and handing out mosquito nets.
Success, Ms. Veneman said, “is not just linked to money, it’s linked to setting priorities.”

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  • ゲイツ財団

    Excerpt: 世界の子どもの死亡率が低下 http://kurie.at.webry.info/200709/article_27.html に出てきたゲイツ財団についての記事。莫大な資金を寄付している。今後5.. Weblog: 医師の一分 racked: 2007-09-14 22:54