Nearly two million children die each yearfrom diarrheal diseases, which account for nearly 20 percent of the deaths of childrenunder five. Development advocates say much more can be done to bring those numbers down. But there's one problem: governments are focusing instead on other diseases that, while serious,kill fewer children than diarrheal illnesses.
In May, two development organizations,WaterAid and PATH, both issuedreports outlining the problem and calling for change. They want governments and donors torecognize the seriousness of diarrheal diseases and to increase financialsupport for fighting the problem.
They say between 2004 and 2006, only $1.5billion was spent on sanitation, while 10 times as much went to HIV/AIDStreatment. But experts say that many more children die of diarrheal diseasesthan from AIDS.
National governments spent three times as much on fighting malaria than they did on improving contaminated water sources and poor sanitation, which kills twice as many children by causing diarrhea and other illnesses.
WaterAid and PATH cite figures showing that Rwanda has a 3% rate of HIV/AIDSinfection. However, the latest numbers show that almost 75 % of donor assistance for health went towardfighting HIV/AIDS, while only two percent targeted childhood illnesses.
WaterAid and PATHhave several recommendations. They say the international aid system anddeveloping governments must respond to evidence showing diarrheal diseases as oneof the leading causes of child mortality, and they must target resourcesappropriately. That means taking a number of steps to curb the spread of cholera and other water-borne diseases and to treat diarrhea in young children. Solutions include campaigns to encourage breastfeeding over untreated water, and oralrehydration therapy. WaterAid and PATHalso suggest widespread use of vaccines against the most common and lethal form ofdiarrheal disease called rotavirus.
Nancy Bwalya-Mukumbuta, WaterAid's programmanager in Zambia, says much of thegovernment's funding for anti-diarrheal measures is funneled to departments that the illnesses. But she says more money should go to the Environmental HealthDepartment which works to them.
Bwalya-Mukumbuta says it should teach thepublic better hygiene and other sanitation practices that can help prevent pneumoniaincluding regular hand washing. Instead, she says department health technicians are being used to diagnose disease and dispense medicines at health centers.
Bwalya-Mukumbuta would also like to see funding made available for thepurchase of vehicles that technicians can use to travel deep into rural areas.
And, she'd like to see improved coordination between various departments of the government.
"Thereis a need to coordinate across different sectors," she says. "We have a Ministry of Local Government andHousing, which is responsible for providing water and sanitation. They are notworking closely with the Ministry of Health, which is responsible for diseaseprevention and treatment."
She says Zambia has a good health information system, and she'd like to see more of its material used for planning national and local budgets.
WaterAid and PATH say neglecting sanitation undermines the effectivenessof current health systems. Meanwhile, health specialists warn that it sets backefforts by Africa to meet the UN DevelopmentGoals, which include cutting child mortality rates in half by 2015.