New tools offer new hope for saving almost a million kids a year

Children shouldn’t die of anything as commonplace as diarrhea, yet it kills an estimated 800,000 under five a year. Most of these deaths occur in the developing world, where families face a double jeopardy: first they are at high risk for diarrheal disease from unsanitary conditions and unsafe water, and then they lack access to life-saving treatment.

It doesn’t have to be—both prevention and treatment options are available. PATH is working to focus a spotlight on a new vaccine and new treatments for diarrhea that, combined with the tools we already have in hand, can further improve on the gains made in diarrhea control over the last couple of decades.

Early strides

In the 1980s and 1990s, UNICEF and the World Health Organization led a global effort to reduce diarrhea deaths by promoting preventive measures—such as exclusive breastfeeding and improved access to clean water—and use of oral rehydration solution to counter dehydration. Millions of lives were saved.

But it’s hard for overburdened health systems to maintain focus on stubborn health problems using the same old methods, even as new prevention and treatment options are in development. Research indicated that efforts to control diarrhea in many developing countries were waning.

New tools, new hope

Just in time, the innovation pipeline produced new tools to control diarrhea: vaccines against rotavirus, the most common cause of severe diarrhea; a new formulation of oral rehydration solution; and zinc treatment that shortens the duration of diarrheal episodes. When used with the existing health interventions, these tools strengthen diarrhea control in the poorest countries, where diarrheal disease was once considered insurmountable.

To move the new tools from the pipeline to widespread use, PATH provides policymakers in developing countries with the information they need when considering their investment in control of diarrheal disease. We developed the DefeatDD website to provide tools for advocates, key documents for program officers, and links to information on these simple, lifesaving interventions.

A comprehensive approach using proven interventions and the new tools has been widely adopted in several countries, and we help others find and implement the strategies that are right for them:

• We work with the ministry of health in Vietnam to update diarrheal disease control guidelines for provincial health workers. In Binh Dinh Province, we helped bring zinc treatment to the country’s children for the first time. The use of new clinical guidelines in Binh Dinh helps inform nationwide expansion.
• In Cambodia, we assisted the government in work to integrate diarrhea and pneumonia control, specifically targeting rural communities where child deaths due to these two illnesses are the highest in the country.
• In Kenya, we helped the government develop a new, integrated policy for diarrhea management. We support the establishment and expansion of oral rehydration therapy (ORT) corners, where mothers with dangerously dehydrated children can immediately access lifesaving treatment while receiving education on nutrition, hygiene, and home care. Read more about the ORT corners on the DefeatDD website.
• Our work in Nicaragua helped foster a partnership between vaccine manufacturer Merck, local nongovernmental organization NicaSalud, and the Nicaraguan ministry of health that resulted in a three-year demonstration project introducing rotavirus vaccine, starting in October 2006. After becoming the first developing country to introduce the vaccine, Nicaragua saw a dramatic drop in childhood rotavirus hospitalizations. This historic milestone brings greater momentum to our work to accelerate global access to rotavirus vaccines.

A winning combination

Together with existing, tried and true methods, new interventions such as rotavirus vaccines and zinc treatment can reduce the burden of diarrhea in the poorest countries. This convergence of common knowledge and innovation means that the day will sooner come when kids can avoid, or at least recover from, debilitating diarrhea—no matter where they were born.

Photos, from top: PATH/Janie Hayes, Robin Biellik.