Rajesh Kumar Singh  /  AP
A newborn baby is kept under observation at the Intensive Care Unit of the Childrens Hospital in Allahabad, India. In India's Uttar Pradesh province, the newborn mortality rate was reduced by about 40 percent by teaching mothers how to better care for their babies.
updated 9/13/2007 7:59:43 AM ET 2007-09-13T11:59:43

The number of children dying worldwide has dropped below 10 million a year for the first time, UNICEF said Thursday.

“More children are surviving today than ever before,” said Ann Veneman, UNICEF’s executive director.

New data from the U.N. Children’s Fund suggests that life-saving measures like vitamin A supplementation, insect nets and vaccines are reaching more children than ever in poor countries. Global child deaths fell to 9.7 million in 2005, down from nearly 13 million in 1990.

In Morocco, Vietnam and the Dominican Republic, UNICEF reported that child death rates dropped by more than a third. In Africa, increased vaccination coverage reduced measles deaths by 75 percent.

“We are very encouraged by this progress,” Veneman said. “If we can maintain the sense of urgency, then real progress can be made.”

UNICEF’s data is based on government-conducted surveys in more than 50 countries in 2005-2006.

Questioning data
But some experts questioned UNICEF’S interpretation of the data.

“Considering all the tools we have for child survival, we are not doing better at reducing child mortality now than we were three decades ago,” said Dr. Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington.

Murray is the lead author of a paper to be published in two weeks in the medical journal The Lancet. The paper casts doubt on the data collection methods used by UNICEF and the World Health Organization.

Many information sources for child mortality are either out of date or missing from the U.N.’s database, according to the paper. And because U.N. organizations are required to use data provided by governments, there are limits on how credible such information is.

Based on current projections, Murray said the child mortality rate is expected to drop by 27 percent by 2015. That represents an annual decrease of 1.3 percent, which is far slower than the worldwide 2.2 rate decline between 1970 and 1985.

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“The difference between our paper and UNICEF’s announcement may be a matter of interpretation,” Murray said.

“But for all the rhetoric the world has heard about child survival, the rate of decline in child mortality is not speeding up,” Murray said. “It’s slowing down.”

WHO agreed that the progress in reducing child mortality has stalled. In a press statement released earlier this week, its Asia office said that the decline in child mortality is slower today than it was two decades ago.

'At the tipping point'
Health experts agree more needs to be done. “We are not saying we’re there yet,” said Dr. Peter Salama, UNICEF’s health chief. “But we’re at the tipping point and we need much more investment to succeed,” he said. Salama estimated that the global community would need another $5 billion if the U.N. was to achieve its goal of cutting childhood mortality by two thirds by 2015.

Still, millions of children could be saved without expensive medicines and vaccines, simply by changing their parents’ behavior.

“There are lots of things we can do that don’t really cost much money at all,” said David Oot, associate vice president of health at Save the Children.

For instance, in India’s Uttar Pradesh province, Oot said that the newborn mortality rate was reduced by about 40 percent by teaching mothers how to better care for their babies, including advice about breastfeeding and keeping them warm.

Oot also said that countries could save many more children by investing in training village health workers rather than building new hospitals. “We need to reach children where they are, and most of them are not coming to hospitals,” he said.

UNICEF said that their survey results showed that many child deaths could be prevented relatively easily, even in developing countries. In Ethiopia, Veneman said that child mortality dropped by about 40 percent after the country trained an army of 30,000 paid health workers to treat people in their own villages.

“We are not yet where we want to be,” Veneman said. “But with the things that work, we can make a big difference.”

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