The vast majority of Americans want to help children and their families in the developing world have a true start on a healthy and secure life. Children under 5 are the most vulnerable to early childhood diseases and conditions that contribute to more than 26,000 deaths each day, mainly due to preventable diseases and conditions.

Child Survival is a call to action to save the lives of children under 5 and promote healthy and productive families and communities. We already have the means and technology to save millions of children’s lives each year. The threats and solutions are well known to public health professionals, but we need to inform and educate a wider audience so that action can be taken.

Today, more than 26,000 children under age five will die from preventable or treatable causes, such as pneumonia or diarrhea. This loss of almost 9.7 million children each year – equivalent to every child living in the eastern half of the United States – is a global tragedy with humanitarian, economic, and political consequences. And nearly four million of these children die within the first month of life.

A majority of these child deaths are from preventable or treatable causes: pneumonia, diarrhea, malaria, and measles. Malnutrition, which weakens children's ability to ward off illness, contributes to more than one-third of all child deaths.

A large gap exists between the health of children in developing and developed countries; on the average the risk of death for children before reaching the age of five is nearly fourteen times greater in the developing world. Most of these deaths take place in the first year of life. Threats to health are exacerbated by the growing number of orphaned infants and children, generally due to the poor health conditions experienced by their parents-notably HIV/AIDS and mother's deaths in pregnancy and childbirth.

While child mortality rates have declined by about 1 percent every year for the past 20 years, millions of children (particularly in sub-Saharan Africa and parts of South and Southeast Asia) still die every year because they lack access to vaccines and other basic care.

Current programs are substantially improving child survival and health, but much more can and should be done. For example, vitamin A supplementation saves over a quarter of a million lives each year. Oral rehydration therapy prevents an estimated one million deaths. And immunization programs save the lives of almost four million children.

While we know what works, increased funding is needed. International health experts estimate that a minimum additional investment of $5.1 billion each year is necessary to save the lives of six million children in those countries with the highest rates of child mortality.

Six Million Children Every Year Can Be Saved

In 2000, the US pledged to work with 188 other members of the United Nations to achieve a two-thirds reduction in the number of child deaths by the year 2015. This goal can be achieved with enhanced global commitment to the following basic, cost-effective child health actions:

1. Expand Routine Immunization

Immunization has saved over 20 million lives in the last two decades. Immunization rates for the six major vaccine-preventable diseases - pertussis (also known as whooping cough, tuberculosis, tetanus, polio, measles, and diphtheria - have risen from under 10 percent in the 1970s to nearly 80 percent today.

More recently, however, coverage has leveled off. Worldwide, about 30 million children are still not reached each year with routine immunization. Rates in some African countries have dropped to less than 30 percent.

2. Promote Proper Child Feeding and Deliver Essential Micronutrients:

Although malnutrition has decreased 17% in the past decade, the rate of decline has been alarmingly slow in recent years, leaving 20 percent of children in the poorest countries to suffer serious developmental conditions. Promoting exclusive breastfeeding for the first six months of an infant's life, followed by the provision of nutritious, clean, mashed or semi-solid foods and breastfeeding thereafter, can reduce malnutrition, improve growth, and save lives.

Access to micronutrients is also critical for children to survival, develop, and grow. Deficiencies in vitamin A, zinc, iodine and iron, for example, can lead to blindness, severe infection, poor growth, mental retardation, and an increased risk of death. Given directly as supplements or through fortified food, micronutrients are an inexpensive and effective way to prevent these deficiencies.

3. Prevent, Diagnose and Treat Acute Respiratory Infections, Diarrhea, and Malaria:

Acute respiratory infections, usually in the form of pneumonia, contribute to more than two million deaths of children under 5 every year. Many of these deaths could be prevented through a five-day course of antibiotics, which costs as little as 30 cents.

Since 1990, childhood deaths from diarrhea have declined by 50 percent. Nevertheless, two million children still die every year from diarrhea. Key measures to reduce cases of diarrhea are to ensure access to safe drinking water and improved sanitation, good personal and food hygiene, and health education about how infections spread. Additional lives can be saved by giving children with diarrhea oral rehydration salts (ORS) - a simple solution of sugar, salt, and clean water that costs less than 50 cents to treat a single child.

Malaria kills a child every 30 seconds - about 800,000 children under 5 every year. The disease accounts for 1 in 5 of all childhood deaths in Africa. By increasing the number of children who sleep under insecticide-treated bed nets, and giving children effective drugs for treating malaria, more than a million lives could be saved.

4. Ensure Safe Pregnancy, Childbirth, and Newborn Care:

One woman dies each minute from complications of pregnancy and childbirth. Four million newborns die in their first month of life, mostly from infections (neonatal tetanus, sepsis, diarrhea, and pneumonia), birth asphyxia, premature birth, and unsafe delivery practices.

Proper care before, during, and after delivery could prevent most of these maternal and newborn deaths. Child survival could also be improved by providing access to skilled birth attendants; giving basic information on the importance of birth spacing and breastfeeding; warming and drying the newborn; and preventing and treating infections.