ASSORTED NEWS ITEMS

[New York Times, May 8, 2007]

The rate at which young children perish has worsened most disastrously over the past 15 years in Iraq, hard hit by both sanctions and war, and in Botswana, Zimbabwe and Swaziland, devastated by AIDS, according to a report released yesterday by Save the Children. But researchers also found against-the-odds progress in some of the world’s poorest nations.

Bangladesh has profoundly improved the chances that a child would survive by promoting family planning, a strategy that has enabled women to have fewer children, space births and strengthen their own health and that of their babies.

Nepal, despite a decade-long Maoist insurgency, has halved the death rate of children under age 5. It has enlisted the help of 50,000 mothers, most of them illiterate, who have squeezed vitamin A drops into the mouths of every child, hauled laggards in for vaccinations and even diagnosed pneumonia and dispensed medicines to combat it.

And Malawi, with an extreme shortage of doctors and nurses, has made surprising gains by taking simple steps that require no professional skills, for example distributing nets that protect children from malarial mosquitoes.

“In 2007, when we know what to do and how little it costs, that 28,000 kids are still dying each day is just plain wrong,” said David Oot, a public health expert on the team that produced the Save the Children report, “State of the World’s Mothers: Saving the Lives of Children Under 5.”

Despite many hopeful stories, broad progress against infant and child mortality has flagged since international health agencies began a campaign to reduce deaths 25 years ago, the researchers concluded. By the end of the 1980’s, global rates of child mortality had fallen 20 percent, and the lives of 12 million children were saved. “Much of the momentum behind the child survival revolution has now been lost, and gains achieved in the 1980s and early 1990s have slowed or reversed,” the report says. “Under-5 mortality declined by only 10 percent from the early 1990s to 2000.” Among the 60 developing countries where 94 percent of the child deaths occurred, 20 have either made no progress or have regressed, while 24 have cut death rates of children under 5 by at least 20 percent.

Iraq experienced the most staggering rise in under-age-5 mortality — 150 percent over 15 years. Since the war began in 2003, deteriorating health services, rising inflation and electricity shortages have worsened living conditions, the report said. In 2005, about 122,000 Iraqi children died before their fifth birthdays.

In countries that progressed, a focus on family planning was central to progress, the report said. In the five countries that made the greatest strides in reducing child deaths — Egypt, Indonesia, Bangladesh, Nepal and the Philippines — women’s use of contraceptives rose and fertility rates declined. In those countries, mothers were less likely to be physically depleted by having too many babies in too short a time. With fewer children, families were also able to invest more in the care of each child.

Political will was also an essential ingredient of success — and in Malawi, Tanzania, Nepal and Bangladesh was even more important than national wealth, the report found. Egypt, which has cut the death rate of children under age 5 by 68 percent since 1990, more than any other country, has shown a particular commitment to children’s health, said the researchers at Save the Children, a non-profit group, and other experts.

“In words and deed, Egypt has put children more at the center of their social agenda than most other countries,” said Ruth Levine, author of “Millions Saved: Proven Successes in Global Health (Center for Global Development, 2004).

Egypt has carried out a comprehensive effort to improve the health of mothers and children. It invested in clean water and public health campaigns to teach the importance of hand-washing in disease prevention. It built roads that sped access to hospitals. It renovated dilapidated clinics. It made sure most mothers had midwives or other skilled workers to attend births. It strove to perfect immunization campaign strategies.

“There is a way to do a blanket of public health interventions that is very effective,” said Dr. Ayman El-Mohandes, a pediatrician and chairman of the Department of Prevention and Community Health at George Washington University’s School of Public Health, who served as a consultant on a United States-financed maternal and child health program in Egypt.

World Bank-IMF (International Monetary Fund) Report

[WASHINGTON, April 13, 2007]

To reach key development objectives by 2015, women's equality and fragile states need to receive concerted attention and the international community must scale up strategies for reaching the eight Millennium Development Goals. While progress on the first goal of halving poverty is on track everywhere except in Sub-Saharan Africa, efforts to attain goals related to child mortality, disease reduction, and environmental sustainability are falling short.

The 2007 Global Monitoring Report: Confronting the Challenges of Gender Equality and Fragile States on the Millennium Development Goals (MDGs) assesses the contributions of developing countries, developed countries, and international financial institutions (IFIs) toward meeting universally agreed development commitments. The goals, which call for halving between 1990 and 2015 the proportion of the people living on less than US$1 a day, achieving universal primary education, reducing infant and maternal mortality, and ensuring environmental sustainability, among others, were approved by 189 world leaders in 2000.

Due to strong growth performance and better policies, over 34 million more children in poor countries gained the chance to attend and complete primary school since 2000; over 550 million children were vaccinated against measles, and the number of HIV positive people with access to anti-retroviral treatment rose nearly sevenfold from 2001. Nevertheless, there are regions -- Sub-Saharan Africa and South Asia in particular -- where a number of countries are seriously off track to meet the millennium goals, and many people are being left behind.

"Many poor countries are making the difficult decisions needed to get their policies aimed at poverty reduction and growth. But they cannot accomplish this task alone. They need to have reliable, predictable and efficiently delivered aid from their partners," said Rodrigo de Rato, IMF Managing Director.

This year's report focuses on gender equality and the lack of opportunities for women as well as the vulnerability of fragile states. The authors stress that MDG 3-the promotion of gender equality and empowerment of women-is important for reasons of fairness and is also essential to economic well-being and the advancement of such other goals as halving poverty, achieving universal primary education, and lowering the under-five mortality rate.

"Persistent poverty and unequal opportunities for women slow development and block attainment of the MDGs. Likewise, fragile states need urgent attention if the goals are to be met," said World Bank Group President Paul Wolfowitz, "We face the dual challenge of focusing on those most in need while also pushing ahead in strong performing nations that are close to reaching their goals."

Due largely to strong growth in developing regions, an estimated 135 million people were lifted out of extreme poverty between 1999 and 2004. South Asia is expected to surpass the first MDG target—to reduce poverty by half by 2015. The share of people living in extreme poverty in South Asia is expected to fall to 18 percent, well below the targeted 21.5 percent. The total number of poor people living on less than $1 a day in the region as of 2004 was 462 million.

Progress in gender equality and women's empowerment has been uneven. Concerted country efforts have helped raise girls' enrolments significantly in the past decade, reaching gender parity in primary school enrolments in most (83 of 106) developing countries. In South Asia, the gender literacy ratio remains low. In 2002, 82 percent of males aged 15-24 were literate, but only 65 percent of females. Globally, the lowest ratio was in Afghanistan—just 36 literate young women for every 100 literate young men.

In the same period, the increase in women's participation in the economy and in political decision-making has been modest at best. The report recommends a stronger role for donors and IFIs in monitoring gender equality and in scaling-up women's access to opportunities, rights, and voice. Investing in gender equality is smart economics, the report stresses.

For more information about the World Bank in South Asia, visit WORLD BANK IN SOUTH ASIA

[kaisernetwork.org, April 17, 2007]

The number of HIV-positive people in developing countries with access to antiretroviral therapy increased 54% to two million people in 2006, but hundreds of thousands of children died of AIDS-related illnesses due to a lack of access to the drugs, according to a report released on Tuesday by UNAIDS, UNICEF and the World Health Organization.

The report found that five million people remain without access to antiretrovirals and that 15% of the 780,000 children in need of antiretroviral drugs had access to treatment by the end of last year. Only 4% of HIV-positive children received the antibiotic co-trimoxazole, recommended by WHO for HIV-positive children and infants who contracted the virus from their mothers during birth.

About 380,000 children last year in developing countries died of AIDS-related illnesses, most of which were preventable, according to the report. Mother-to-child transmission rates remain "particularly aggressive" in developing countries, compared with high-income countries, where rates have dropped to below 2%, the report said.

According to the report, 11% of HIV-positive pregnant women in low- and middle-income countries have access to antiretrovirals to prevent mother-to-child transmission, and many infants born HIV-positive go undiagnosed and are subsequently untreated. Sub-Saharan Africa, where about 25 million people with HIV/AIDS and 85% of all HIV-positive pregnant women live, showed the most severe treatment access problems. Children account for 14% of those in need of antiretroviral treatment in the region but only 6% are on such treatment regimens.

RECOMMENDATIONS, REACTION

The report said that a "greater effort should be made to follow up HIV-exposed children and to determine the HIV status of all children born to mothers living with HIV/AIDS so that appropriate care and support can be provided." The United Nations agencies called for increased investment in tests to detect HIV in infants and in fixed-dosed pediatric drug formulations that could raise survival rates of HIV-positive infants and children.

The agencies also recommended more screening for other sexually transmitted infections and tuberculosis to help reduce the spread of HIV "The significant progress outlined in this report in scaling up access to treatment is a positive step forward for many countries in achieving their ambitious goals of universal access to HIV prevention, treatment, care and support," Peter Piot, executive director of UNAIDS, said, adding, "However, new data in the report also sho[w] that there is still a long way to go, particularly in the widespread provision of treatment to prevent mother-to-child transmission of HIV, which remains one of the simplest and cheapest proven prevention methods available."

[April 20, 200] During a day of heavy fighting in Somalia's capital city, four shells exploded in the SOS Children's Village Mogadishu. The SOS Children's Village Mogadishu was under siege yesterday when four missile shells exploded in the project grounds during heavy fighting around the village. Two of the shells landed on the deserted football pitch, a third destroyed part of the wall between the school and the football pitch and a fourth landed in the teachers' houses. Fortunately the school is closed for the holidays and the teachers are away. Thus no one was injured.

During the fighting, children and staff of the village retreated to a safe haven: an unused building that is now heavily reinforced with concrete. According to project director Claudio Croce, stray bullets from nearby gunfire also landed in the compound. Because of the fighting, staff who live outside the compound are not able to come to work. This is also affecting the hospital, which is still open, but due to a shortage of medical personnel is not fully functional.

Croce added that the situation in Mogadishu is chaotic. Besides the fighting between the transitional government, backed by Ethiopian forces and former elements of the Islamic Courts, clan warfare has also broken out and many of the people from these clans live in the vicinity of the village. He likened the situation to the beginnings of a guerrilla war.

Meanwhile, the SOS Children's Village is fully operational and contingency plans remain in place to protect the 82 children, 13 youth and approximately 30 co-workers who live in the village.

SOS CHILDRENS’ VILLAGES