Deaths of children aged under five years have dropped by 27% globally since 1990, according to the latest World Health Organization (WHO) estimates. But in WHO’s first progress report on the health Millennium Development Goals (MDGs) released on Thursday in the World Health Statistics 2009, other results are mixed. An estimated 9 million children aged under five years died in 2007, significantly fewer than the 12.5 million estimated to have died in 1990, the baseline year against which progress towards the goals is measured. However, in many African countries and in low-income countries generally, progress has been insufficient to reach the MDG target, that aims for a two thirds reduction in child mortality by the year 2015. "The decline in the death toll of children under five illustrates what can be achieved by strengthening health systems and scaling up interventions, such as insecticide-treated mosquito nets for malaria and oral rehydration therapy for diarrhoea, increased access to vaccines and improved water and sanitation in developing countries,” said Dr Ties Boerma, Director of WHO’s Department of Health Statistics and Informatics. The MDGs were initiated by the United Nations and its partners to achieve significant improvements in eight health and development areas by 2015. "At the mid-way point, the analysis shows encouraging signs of progress," said Dr Boerma. "But there needs to be more effort to strengthen health systems in countries affected by high levels of HIV/AIDS, economic hardship or conflict. Moreover, there is a need to pay greater attention to the poorest groups within countries where progress is often the slowest and child mortality rates remain high." "Areas where there has been little or no movement are notably maternal and newborn health. An estimated 37% of deaths among children aged under five occurs in the first month of life, and most of them in the first week of life," said Dr Boerma. "While the data are patchy and incomplete, it appears that the regions with the least progress are those where levels of maternal mortality are highest." "The challenges ahead are those presented by weak health systems, those associated with noncommunicable chronic conditions, and emerging health threats such as pandemics and climate change," said Dr Boerma. World Health Statistics 2009 is an annual report based on more than 100 health indicators collected from WHO's 193 Member States. These indicators provide a snapshot of global health trends. However, the data have some limitations. Among other findings, the report reveals:

• An estimated 1.2 billion people are affected by neglected tropical diseases. In 2007, 546 million people were treated to prevent the parasitic disease lymphatic filariasis (also known as elephantiasis), which causes enlargement of parts of the body.
• The availability of essential medicines at public health facilities is often poor and prices remain high, even for generic medicine.
• There are now more than 3 million people in developing countries receiving antiretroviral therapy, which proves that complex treatment for chronic disease is possible in low-income settings.
• Adolescent pregnancy rates remain high. Globally, there were 48 births for every 1000 women aged 15–19 years in 2006, a small decline from 51 per 1000 in 2000.
• Out of every 100 deaths worldwide, 51 are due to noncommunicable conditions; 34 to communicable, maternal or nutritional conditions; and 14 to injuries. Changes in population age structures, risk factors and disease patterns are resulting in increases in the proportion of deaths due to noncommunicable diseases such as heart disease, stroke, cancers and road traffic accidents. Many developing countries have to cope with a double burden of both infectious and noncommunicable diseases that is overwhelming their health care systems. Action needs to be taken now to implement preventive interventions including reductions in tobacco use, overweight and obesity, and high blood pressure.

Source: WHO