Challenge for children

from The Fiji Times

Every year, some 9.7 million children die before their fifth birthday. Most of these children live in developing countries and die from a disease or a combination of diseases that could be easily prevented or treated antibiotics for pneumonia, for example, or a simple mix of salts and sugars for diarrhoea.

Malnutrition contributes to around half of these deaths.

Child mortality is closely linked to poverty.

Advances in infant and child survival are more slow in poor countries and to the poorest people in wealthier countries.

Improvements in public health services are key, including safe water and better sanitation.

Education, especially for girls and mothers, will also save children's lives. Raising incomes can help, but little will be achieved unless a greater effort is made to ensure that services reach those who need them most.

According to the Pacific Islands Regional Millennium Development Goals Report 2004, prepared by the Secretariat of the Pacific Community, children's health status in the Pacific region has improved significantly from the 1960s, by establishing and/or improving health programmes, focusing on maternal and child health as well as social and economic developments.

Pacific regional achievements include:

1. Eradication of polio (the WHO Western Pacific Region was declared polio-free in 2000);

2. Indigenous measles transmission (outside of PNG) interrupted since 1998 (the most recent outbreak in Marshall Islands in 2003 but controlled through a vaccination campaign); and

3. High reported routine immunisation coverage (greater than 90%) for most Pacific countries. Currently, leading causes of death in children under five years of age include chest infections, diarrhoea, malaria (in PNG, Solomon Islands and Vanuatu only), and newborn complications and injuries.

UNICEF is calling on Pacific leaders and communities to step up to the challenge of further reducing child mortality (MDG 4).

Former and current leaders around the Pacific have pledged towards achieving the Millennium Development Goals (MDGs):

"The government's village focus will be meaningless without serious investment in the Millennium Development Goals. The government will endeavour to deliver in villages: clean piped running water and sanitation by 2010; an adequately supplied health post within an hour's walk of every Solomon Islander by 2010; and basic education to year 9 for all Solomon Island children ..." __ Major Policy Address by Prime Minister of Solomon Islands David Derek Sikua on January 18, at the launch of the CNURA Government Policy Document.

"While all of our Pacific Island countries have endorsed the MDGs, we are at different stages in implementing them. This underscores the importance of in-country efforts in formulating appropriate strategies that will raise the quality of life of the Pacific community," said Prime Minister of Samoa, Tuilaepa Sailele Malielegaoi, Chair Pacific Islands Forum, Preface for Pacific Islands Regional MDG Report, 2004.

"It is now time to update the 2003 Priorities and Action Agenda and this new Priorities and Action Agenda (for Vanuatu 2006 - 2015) builds on the experience since the first was developed. It also builds in the Millennium Development Goals." __ Prime Minister of Vanuatu, Ham Lini Vanuaroroa, Foreward of Priorities and Action Agenda for Vanuatu 2006 - 2015, June 2006.

These are encouraging commitments. But there is still much to be done to reduce child mortality. UNICEF calls for combined action to reach the thousands of Pacific children still excluded from health interventions.

Reducing child mortality (MDG 4) requires the achievement of the health-related MDGs - reducing poverty and hunger (MDG 1), improving maternal health (MDG 5), combating HIV and AIDS, malaria and other major diseases (MDG 6) and improving water and sanitation (MDG 7). Reaching MDG 4 - which requires two-thirds reduction in the under-five mortality rate between 1990 and 2015 - is still possible, but the challenge is not easy.

It is clear that meeting all of these goals in the Pacific requires political will, community mobilization and investment in simple yet effective interventions such as water, sanitation, vaccination, education and accessible health services.