Preventable Childhood Deaths Remain a Global Challenge

The UN estimates as many as 35 million children could die between 2015 and 2028 if the global community doesn't take immediate action to curb child mortality

Jon Hrusa/Swaziland

Last year, 6.6 million children younger than 5—18,000 each day—died mainly of preventable causes, including HIV.

Without faster progress to reduce preventable diseases in children, the world will not meet its child survival goal under the Millennium Development Goals until 2028 – 13 years after the 2015 deadline. This stark warning was made by the United Nations Children’s Fund (UNICEF) in its annual child survival report that details the progress made on global commitments toward achieving Millennium Development Goal 4 (MDG 4), which aims to cut the rate of mortality for children younger than 5 by two-thirds.

In fact, the UN agency warned that as many as 35 million children could die between 2015 and 2028 if the global community does not take immediate action to drastically cut the rate of mortality for young children. The 2013 Progress Report on Committing to Child Survival: A Promise Renewed found that, in 2012, 44 percent of childhood deaths occurred during the first 28 days of life and many of these children were already weakened by under-nutrition.

The report also noted that approximately 1.5 million HIV-positive women were pregnant in 2011, with more than 90 percent living in sub-Saharan Africa. In the absence of any interventions to prevent mother-to-child transmission of HIV (PMTCT), about half of these women will pass the infection on to their children during pregnancy, delivery, or breastfeeding. Without antiretroviral therapy (ART), 80 percent of HIV-positive children will die before their fifth birthday. Despite this, treatment coverage for children living with HIV was less than half the coverage for adults in 2012, according to UNAIDS.

But there is some good news—since 1990 childhood deaths worldwide have been reduced by half.  From 2009 to 2012, the number of children newly infected by HIV globally declined by 35 percent. Thanks to the UN-supported Global Plan Towards the Elimination of New HIV Infections among Children by 2015 and Keeping their Mothers Alive, we have seen rapid reductions in new HIV infections among children in 21 priority countries in sub-Saharan Africa.

But, despite this progress, approximately 700 children are born HIV-positive each day. Children born to women living with HIV (whether they become infected or not) are at increased risk of morbidity and mortality, and must be identified early so that they can receive the right treatment and follow-up care. The report also notes that even uninfected children born to women living with HIV must be monitored, as they have slower early growth rates and a higher risk of morbidity and mortality from childhood diseases like diarrhea and pneumonia, compared to children born to HIV-negative women.

UNICEF recommends integrating this care with other child survival interventions such as immunization, nutrition, and community involvement activities. New technologies for early infant HIV diagnosis and HIV viral load monitoring at the point of care will further simplify testing and linkage to treatment for children and their families. Together, these will improve outcomes and support child survival, growth, and development.

At the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), we know that our work is far from finished, despite some recent progress to eliminate pediatric HIV and improve overall child survival rates. To achieve a generation free of AIDS, we must ensure that both nationally and internationally the political will, resources, and science are available to create healthy outcomes for children and their families. The survival, growth, and development of future generations depends on it.

Eliane Drakopoulos is Public Policy and Advocacy Officer for EGPAF, based in Geneva, Switzerland.