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India sees 230,000 measles deaths annually, reveals UNICEF report

Despite the tremendous strides made over the past two decades in immunisation of infants against the ''big six'' diseases, measles remains the number one vaccine-preventable killer of children under five years of age and India alone accounts for 230,000 of the over 800,000 deaths from the disease every year.

Measles continues to thrive in the cities of Africa and Asia, especially in deprived neighbourhoods and just 20 countries in this region account for 85 per cent of measles deaths of children under five years, says the just released ''The Progress of Nations, 1998'', a report of United Nations International Children's Education Fund.

In addition, measles immunisation coverage has remained static or slipped in 32 of the 44 poorest countries since 1990, it says.

The scenario with regard to neonatal tetanus deaths is somewhat better and India is among the 20 countries successful in reducing the death toll from this disease. Neonatal tetanus deaths in India were brought down from 77,700 in 1990 to 59,100 in 1997, says the report.

Immunisation of infants against measles, tetanus, whooping cough, tuberculosis, polio and diphtheria is duly recognised by the report as the greatest public health success story in history with 80 per cent coverage in developing countries today from a mere five per cent two decades ago. But despite this, two million children continue to die each year from vaccine-preventable diseases, it says.

Deaths from these six diseases have drastically reduced by three million a year and at least 750,000 fewer children are left blind, paralysed or mentally disabled as a result of improved vaccination coverage. Yet notwithstanding the low cost of the existing immunisation package, 26 million infants worldwide annually do not receive their three DPT shots.

Malaria kills over one million children under the age of five every year -- a child every 30 seconds -- in about 100 malaria-endemic countries around the world, says the report.

Treated bednets are a vital protection against malaria-carrying mosquitoes as the disease is increasingly resistant to drug treatment and the development of an effective vaccine is proving difficult. But families at risk in at least 14 countries have to pay more to protect themselves from the disease as their governments impose stiff tariffs on imported bednets.

According to the report, UNICEF has adopted three related goals to combat malaria -- to have 20 per cent of children under five in high-risk areas sleeping under bednets by the year 2000, 50 per cent by 2005 and universal access to bednets by 2010. Steps to cut the costs of bednets including the removal of import tariffs will be crucial to the success of the campaign to eliminate malaria.

Diarrhoeal dehydration is another of the world's great child killers, claiming over two million children under the age of five in developing countries. Up to 90 per cent of these deaths could be prevented by replacing lost body fluids with oral rehydration salts. In this context, the report names Bangladesh, Brazil, India and Nigeria (home to over 160 million children under five) among 32 countries and territories which have reported an increase in production of ORS.

The success of the immunisation programme depends on building the capacity of local and national systems so they can vaccinate one year's generation of 130 million babies on five separate occasions and repeat the process each year. Also, families and communities have to be convinced of the importance of starting and continuing immunisation of their children, says the report.

By 1996, 25 per cent of the poorest countries were meeting their minimum targets for vaccine self-sufficiency compared with only two per cent in 1990. Another encouraging indicator is that developing countries now produce more than half the vaccines used for national immunisation programmes.

UNI

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