I was interested to read this statement from Bill Gates. A response from me below.
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By Bill Gates | September 6, 2022
https://www.gatesnotes.com/Health/Why-do-children-die
I want to let you know about the new package of content I’ve just published on Gates Notes.
It’s about a heartbreaking subject: child mortality. I know it’s not an easy topic to read about. But I think it’s incredibly important, because it tells us so much about the state of the world at a given moment. And what it tells us today is actually quite positive.
I first became aware of the shocking truth about child mortality in the late 1990s, when I learned that 3.1 million children were dying every year of diarrhea. I could hardly believe it was true. Yet the more I learned, the worse the picture looked. At the time, 10 million children under the age of 5 were dying every year.
But I also learned two encouraging facts. One was that the percentage of children who died each year had fallen by half since the 1950s. The other was that more than 80 percent of those deaths were considered preventable. In fact, many of the health problems that caused them already had solutions - and with the right set of partners and funding, the solutionns that didn’t exist yet could be invented and delivered to the people who needed them most. This became the core of the Gates Foundation’s health work.
In the Life and Death package that I just published, I take you through the top causes of child mortality and explain why I’m optimistic about each one. You may be surprised that problems associated with childbirth and the first 30 days of life - things like premature birth and biirth asphyxia - are the top cause. After that comes pneumonia, where there is incredible innovation going on to save lives. (I published a separate post and video about some amazing work on a new pneumonia vaccine being done by a company near Seattle.) There’s also good news about malaria and mind-blowing news about measles.
Organizations around the world deserve the credit for all the progress in saving children’s lives - including leaders in countrries with high disease burdens, as well as the leaders of wealthy countries that have stepped up with lifesaving health aid...
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RESPONSE (NPW): Children die because they receive poor quality care. Poor quality care in the home, poor quality care in the community, poor quality care in the health facility. Poor quality care represents a failure to access and apply reliable healthcare information. You give the example of child deaths from diarrhoea.
In 1987 I was working as a volunteer doctor in rural Peru. A distraught young woman came to my health post with a bundle in her arms. In the bundle was a small dead girl. She had died just half an hour before, on the way from their village to the health post. The medical cause of death was dehydration from acute diarrhoea. But this death was entirely preventable: The girl died because her parents believed they should *withhold* fluids to a child with diarrhoea - the exact opposite of what one should do. I subsequently learned that this false belief is common worldwide, especially in LMICs. Other false beliefs contribute to unnecessary child deaths from pneumonia, malaria, child cancers… Lack of reliable healthcare information is also a major cause of avoidable deaths in adults, right across the disease spectrum. And it affects health workers too.
More than 20,000 people are interacting on the HIFA forums with the common vision to improve the availability and use of reliable healthcare information for individual, families, health workers. Sadly, the combination of lack of reliable healthcare information and spread of misinformation continues, and in some respects it is getting worse, fuelled paradoxically by information technology and social media.
Child diarrhoea: The District Health Surveys for India between 2005 and 2016 found no evidence of improvement in basic knowledge. The 2005/2006 survey suggest that 4 in 10 children with diarrhoea are given less fluid than usual, when they should be given more. Ten years later the District Survey (2015/2016) found that '57 percent of children with diarrhoea were given [by caregivers/parents] less to drink and 5 percent were not given anything to drink'. It also found that one in five children with diarrhoea were inappropriately given antibiotics by health workers.
More political and financial investment is needed to address the complex challenge of meeting people's healthcare information needs. As three global health leaders wrote in The Lancet back in 2006, the year HIFA was launched: "The Gates Foundation identified fourteen challenges but a fifteenth challenge stares us plainly in the face: The 15th challenge is to ensure that everyone in the world can have access to clean, clear, knowledge - a basic human right, and a public health need as important as access to clean, clear, water, and much more easily achievable."
Tikki Pang (WHO), Muir Gray (NHS, UK), and Tim Evans (WHO): 'A 15th grand challenge for global public health.' The Lancet 2006; 367:284-286.
http://www.thelancet.com/journals/lancet/article/PIIS0140673606680501/fu...
Best wishes, Neil
Let's build a future where every person has access to reliable healthcare information and is protected from misinformation - Join HIFA: www.hifa.org
HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health movement (Healthcare Information For All - www.hifa.org ), a global community with more than 20,000 members in 180 countries, interacting on six global forums in four languages in collaboration with WHO. HIFA brings stakeholders together to accelerate progress towards universal access to reliable healthcare information. HIFA is administered by Global Healthcare Information Network, a UK based non-profit in official relations with the World Health Organization.
Twitter: @hifa_org neil@hifa.org
