By Dr. Hope Johnson

Children in Phalombe, Malawi

Children in Phalombe, Malawi. Photo by Matt Feldman / IVAC.

Understanding the major causes of child mortality is essential to establish health priorities and improve the health of children globally. Over the past decade, WHO and UNICEF’s Child Health Epidemiology Reference Group (CHERG) has strived to meet this need by publishing national, regional, and global estimates of the causes of child mortality. This information has been crucial to the development of child health interventions and long-term child survival strategies. 

Since CHERG’s first report, estimation methods and the quality and quantity of child mortality data reported by country vital registration systems have drastically improved. This week, a new CHERG report presents for the first time annual disease-specific time trends for causes of child mortality over the past decade. 

The new data, published in The Lancet, show that child mortality fell by 2 million deaths, from 9.6 million to 7.6 million between 2000 and 2010. According to CHERG, declines in mortality over this period are likely due to improving socioeconomic factors and the successful implementation of child survival interventions in developing countries, particularly those targeting nutrition.

But what continues to claim the lives 7.6 million children around the world every year? Infectious diseases are the main culprits–responsible for 64% of all deaths in children under five. And notorious killers, pneumonia and diarrhea, remain important causes and together were responsible for more than 2 million deaths in 2010. Sadly, a striking 40% succumb within the first month of life most often due to complications related to preterm birth.

Despite the historical drop in mortality seen between 2000 and 2010, the current rate of mortality reduction is insufficient to achieve the fourth UN Millennium Development Goal (MDG4): reduce the child mortality rate by two-thirds, before 2015.

Rapid introduction and scale-up of existing child survival strategies focused on infectious and neonatal causes, particularly in high burden areas of Africa and southeast Asia, is critical for achievement of MDG4. There’s reason to hope, however, with the continued rollout of life saving vaccines for pneumococcal disease and rotavirus by GAVI Alliance and its partners at an unprecedented pace, and at a price low-income countries can afford. But vaccines alone won’t stop pneumonia and diarrhea–other proven interventions such as improved nutrition, appropriate antibiotic treatment, and breastfeeding are also essential elements in this fight.

This newest CHERG report provides a valuable picture of the current state of child mortality worldwide. The data will allow policy makers to prioritize introduction and scale-up of effective interventions to reduce child mortality. CHERG’s job, however, is not over: monitoring the evolving causes of child deaths will continue to be a crucial part of global efforts to erase the 7.6 million child deaths that still occur each year.

Dr. Hope Johnson is an Epidemiologist at IVAC.