As the world rallies behind the soon-to-be finalized Sustainable Development Goals, the Bill & Melinda Gates Foundation continues to stay focused on our bottom line – saving lives. We are especially focused on increasing access to proven interventions that save children’s lives – a lot of lives. And interventions that have the potential to save thousands more every year.
Thanks to increased investments in global health in the last 25 years, we have seen dramatic improvements in child health – the number of children dying has been cut in half since 1990. It is unconscionable that children are still dying by the hundreds of thousands every year from diseases that are preventable and curable. The fact is that one in five children dies before the age of five from preventable diseases.
Governments – rich and poor alike – must prioritize child health so that young people can grow and unlock their full potential. Closing the gap on preventable deaths, which disproportionately affect the poorest communities, should be the first order of business. Affordable and effective interventions like vaccines, oral rehydration solution (ORS), zinc, hand-washing and breastfeeding have proven track records and yield immediate impacts.
We can’t afford to wait any longer to prevent these senseless deaths – countries need to step up and provide all children with vaccines and the other lifesaving tools they need to survive and thrive.
Diarrhea: A top childhood killer in South Asia and sub-Saharan Africa
A mere inconvenience for people in wealthy parts of the world, diarrheal disease is the most common cause of childhood illness and the second-leading infectious killer among children worldwide. Approximately 90 percent of childhood deaths from diarrheal disease are in South Asia and sub-Saharan Africa, where access to safe water, sanitation, and urgent medical care can be limited.
When children experience serious bouts of diarrhea, they lose an excessive amount of fluids and can become severely dehydrated. These infections play a role in compromising health more broadly and can lead to a vicious cycle of infection, stunted growth, cognitive impairment, and poor immune response to vaccines, preventing children from reaching their full potential.
Proven, lifesaving interventions to prevent and treat diarrheal diseases exist. In the last three decades, millions of children’s lives have been saved thanks to access to improved sanitation and simple hydration treatments, and more recently, with new vaccines.
Low-cost sugar and salt mixture saves lives
One critically important intervention the health community has used for decades is a low-cost sugar and salt mixture called oral rehydration solution (ORS) which helps rehydrate children in a matter of hours. Recently it has been used in new situations and with new diseases.
If you are familiar with ORS, you may have heard of it being used in response to cholera outbreaks following natural disasters, such as the major earthquakes in Haiti in 2010 or Nepal earlier this year. Cholera and other diseases that cause severe diarrhea have the potential to kill thousands during an outbreak, but ORS is a low-cost and effective tool that can stand in harm’s way.
ORS has also proven adept in the face of new challenges. When little else was working to help people suffering from Ebola in West Africa, ORS helped relieve symptoms stemming from severe dehydration and was even credited with saving lives. The CDC recognized the power of ORS and recommends administering it immediately to patients who show signs of the Ebola virus.
ORS was also instrumental recently in Pakistan, where a record-breaking heatwave killed more than 1,200 people died in a week. Patients arrived in hospital emergency rooms with extreme dehydration, showing signs of confusion, dizziness and weak pulse after enduring temperatures up to 113 degrees Fahrenheit. Many healthcare providers and members of the public turned to ORS to prevent dehydration and the loss of essential body salts during this trying time, likely preventing many more deaths.
ORS is affordable almost anywhere, costing as little as $0.10/packet. It is typically given free-of-charge to children in poor countries who are sick with diarrhea and at risk of dehydration. The benefits of ORS are so great that they outweigh the risks of using contaminated water to mix the solution.
There is no doubt that this simple solution is a magical elixir, and many people have worked hard to promote its continued and increased use.
Bangladesh is one example of a country that has achieved consistent improvement in ORS coverage and uptake over the last 30 years. Bangladesh is an impoverished country that has nonetheless made steady gains in improving health and child survival. The supportive collaborations between the government of Bangladesh, the private sector, and organizations like BRAC are leading to improvements in infrastructure and successful scale-up campaigns.
The campaign for the treatment of dehydration due to diarrhea using ORS began in 1979. Through the 1980s, the primary form of treatment was homemade solutions. Use of pre-packaged oral rehydration salts (ORS) gained momentum in the 1990s and continues to expand. The campaigns are seen as a sustained success.
ORS use remains low where it is most needed
ORS is most certainly a lifesaver, but use of this essential intervention remains low where it is needed most. The Gates Foundations’ treatment strategy for diarrheal disease focuses on ensuring the availability of proven treatments in the highest-burden countries. We invest in research to improve diarrheal treatment and case management and ways to increase care-seeking and use of appropriate therapies. We collaborate with a network of partners to use the research findings to advocate for policy changes related to child health and increased funding to expand the availability of key treatment commodities and delivery systems.
We must continue to work to promote the use of ORS wherever people may benefit from it – from heat waves in Pakistan, to Ebola patients in Sierra Leone, Guinea and Liberia, to parents throughout the world with young children experiencing diarrhea. Lives depend upon it.
This article was originally published on Skoll World Forum.