Six million children could be saved if $5.1 billion in
new resources for preventive and therapeutic interventions
were provided each year, according to researchers from the
Johns Hopkins Bloomberg
School of Public Health and other institutions.
Approximately 90 percent of all child deaths occur in 42
countries around the world. In those countries, the average
cost per child saved would be $887, or $1.23 per capita.
With the recent publication of the potential impact of
proven interventions that are feasible to deliver in
low-income settings to children younger than 5, this is the
first time the global cost of implementing child survival
programs could be estimated. The study is published in the
June 25 issue of The Lancet.
One of the United Nations-based Millennium Development
Goals is to reduce child mortality by two-thirds by
"Achieving the Millennium Development Goal for child
survival is clearly affordable," said Robert E. Black,
corresponding author of the study and chair of the
Department of International Health. "Protecting child
health should be the priority for countries with the
highest rates of child death and for international donors.
The biggest challenges are increasing the delivery of
health services and the lack of readily available funds,"
Past studies completed by Black and his colleagues
found that two-thirds of the almost 11 million child deaths
worldwide could be prevented with existing knowledge and
treatments. In order to decrease child death rates, the
authors say, adequate funding must be available to provide
comprehensive child survival interventions to the areas
that need them most.
The researchers compiled child survival interventions
previously shown to reduce mortality from the major causes
of death in children younger than 5. They focused on
preventive interventions that could be put in place during
18 visits with a primary care provider, from one month
before the child's birth until he or she reaches age 5. In
their cost analysis, the researchers ensured that treatment
for the major causes of child death were available to all
children who needed them. To obtain the average cost to
save a child's life, universal coverage levels from 2000
for drugs and other materials, delivery of treatment,
program management and support were calculated; the cost of
some of the interventions, such as vaccines to prevent
infection with Haemophilus influenzae type b, may drop
substantially as more extensive use reduces the price.
According to the study authors, full implementation of
preventive interventions would reduce the current annual
cost of treatment by more than 60 percent, due to the
projected reduction in child illnesses. Furthermore, the
delivery of integrated preventive and therapeutic services
would be far more efficient than parallel delivery of each
"The focus is on community-based resources, which
decrease costs since building hospitals and other fixed
resources isn't necessary. It is our hope that
policy-makers, donors and governments will use our price
estimates to strengthen their health systems. If they
don't, 16,000 children will continue to die each day as a
result," said Jennifer Bryce, lead author of the study.
This study follows a series of articles by Black,
Bryce and their colleagues published by The Lancet,
starting in June 2003, that examines the means to reduce
global child mortality. They found that at least 6 million
child deaths worldwide could be prevented with existing
interventions to prevent and treat pneumonia, diarrhea,
malaria, neonatal sepsis, preterm delivery and asphyxia at
birth, disorders that annually cause almost three-quarters
of child deaths worldwide. The researchers calculate that a
two-thirds reduction in child death can be accomplished by
new resources that are easily within the capability of
low-income countries and their international development
"Can the World Afford to Save the Lives of 6 Million
Children Each Year?" was co-authored by Bryce, Black, Neff
Walker, Zulfiqar A. Bhutta, Joy E. Lawn and Richard W.