BioEd Online

Simple, inexpensive treatments could prevent the deaths of three million babies every year, doctors and child advocates have announced.

According to studies published in the medical journal The Lancet¹-⁴, each year four million babies under a month old die, and three-quarters of them die in the first week of life. But the research shows that most could be saved through 16 basic interventions, such as encouraging mothers to breast-feed and providing antibiotics for sick babies.

The United Nations' 191 member countries have set the ambitious goal of reducing mother and child deaths by two-thirds by 2015. But most research on preventing infant deaths focuses on expensive medical technologies to save those who die in rich countries - only 1% of the total. About two-thirds of infant deaths occur in ten countries: Afghanistan, Bangladesh, China, the Democratic Republic of Congo, Ethiopia, India, Nigeria, Pakistan, Indonesia and the United Republic of Tanzania.

Doctors hope that this latest research will draw more attention to babies in poorer countries. "We believe the vast majority of deaths can be prevented by knowledge we have today, by tools we can afford," says Vinod Paul, a doctor at the All India Institute of Medical Sciences in New Delhi and a joint author of some of the Lancet research papers, which were presented at a press conference in Washington D.C. on Thursday 3 March. "The tragedy of four million newborn deaths must stop," he adds.

Cheap and simple

The research shows that the majority of these babies die from infections, premature birth, or problems during the birth itself, says Paul, and that most of the preventive measures are very cheap and simple. For instance, 500,000 babies die every year from tetanus infections. But these deaths could be prevented if their mothers received tetanus vaccinations, which only cost 20 US cents per shot. And most premature babies simply need extra warmth, feeding and prompt treatment of infections, which requires proper training of midwives, mothers-to-be and their families.

Anne Tinker, who works for the charity group Save the Children, says her programme has trained midwives in Bolivia to encourage mothers to hold and breast-feed their babies as soon as they are born. Traditionally, midwives there have advised mothers to feed babies tea made from anise or cocoa instead of breast milk. It is estimated that breast-feeding could prevent 1.3 million deaths worldwide each year. Other cheap interventions promoted by Save the Children include clean delivery kits, which contain soap, a clean razor blade and piece of string for cutting and tying the umbilical cord, and a plastic sheet to place on the ground under the baby. These measures aim to prevent babies from catching infections in the crucial minutes during and just after birth, Tinker says.

Some countries, such as Sri Lanka, Vietnam, Indonesia and Honduras, have begun to reduce infant deaths using inexpensive methods like these. Countries could fully address the problem by spending just 90 cents more per person than they do now, says Paul. He called upon both rich and poor countries to contribute this money, comparing the 4 million infant deaths a year to one Asian tsunami striking the world every two weeks. "Our responses are very different to these two tragedies," Paul says. "We must see the same response to the invisible tragedy that is happening today."