Everyone deserves a fifth birthday

Young girl wearing a white dress looks up at the camera while another girl behind her looks down.

We’ve set an ambitious goal: end preventable child deaths. Photo: PATH/Teresa Guillien.

Two years ago, PATH joined the governments of Ethiopia, India, and the United States as well as thousands of our colleagues in global health and development in an unusually straightforward effort: to end the preventable deaths of young children by 2035.

Portrait of Rachel Wilson.

Rachel Wilson. Photo: PATH.

Let me restate that for those of you who aren’t used to such directness from usually cautious, evidence-fixated organizations like PATH: we’re no longer proposing to decrease preventable deaths among children younger than 5, which stood last year stood at 6.3 million infants, toddlers, and preschoolers. We’re proposing to stop them altogether.

We can stop preventable child deaths

On June 25, we’re convening with colleagues, legislators, health ministers, partners, and others at 5th Birthday and Beyond, an event in Washington, DC. We’ll meet to mark the remarkable progress made on child survival in the last 24 months and to commit ourselves to the next step—a world where every child lives to celebrate his or her fifth birthday.

We’re confident that together, we will reach our goal. A fascinating new analysis (11.3 MB PDF) by the Institute for Health Metrics and Evaluation published in The Lancet shows why we’re so optimistic.

Infographic of several data showing declines in child deaths since 1990, including the combination of diagnostics, procedures, vaccines, new drugs, and public health campaigns equaling 4.2 million fewer child deaths.

Declines in child deaths have accelerated rapidly, especially between 1990 and 2013, as this infographic from the Institute for Health Metrics and Evaluation shows.

Remarkable progress—so far

The study’s authors point out that, since 1970, the world has made remarkable progress in saving the lives of young children. Over the past 44 years, under-five child mortality rates dropped by a walloping 64 percent—which is even more impressive if you recall that those years encompass the beginning of the HIV/AIDS crisis.

What’s more, most countries the authors analyzed—including 43 of 48 in sub-Saharan Africa—experienced faster decreases in child mortality from 2000 to 2013 than they did during 1990 to 2000—an encouraging sign that progress may be accelerating.

The study’s authors single out three factors behind the decrease in child mortality: rising income per person, maternal education, and the availability of  new drugs, vaccines, and other health innovations. This last category, which includes many of the health innovations PATH focuses on, led to the greatest impact: 4.2 million fewer child deaths in 2013 compared to 1990.

Innovation is our sweet spot

PATH has long been known for accelerating innovations that address the leading causes of illness and death for women and children. We’ve designed, developed, and adapted more than 100 technologies, from vaccine vial monitors that alert health workers to heat damage to neonatal resuscitators that can help a baby take her first breath. And we’ve worked hard to strengthen and improve the health systems to deliver those technologies.

One of our unique strengths is breaking down barriers that keep health solutions from achieving impact at scale. We develop targeted solutions, test and refine them, gain regulatory approval, foster supportive policies, develop markets, commercialize products, and work with partners to scale them up where they are needed.

We’re more convinced than ever that these types of innovation are crucial to establishing a world in which no child dies of a preventable cause. And we’re encouraged that data published in The Lancet points firmly in the direction we’ve been headed for almost 40 years.

What’s your number?

But why zero deaths? Why not pick a more “realistic” goal? This is not the time to back down. Though we’ve made impressive progress, it’s hard to celebrate that progress when last year 6.3 million young children died of preventable causes. If 6.3 million are too many, what number can we live with—4 million? 2 million?

I know the number I can live with—it’s zero. And I’m confident we can get there.

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Stop the flow of diarrhea

Seven women holding young children on their laps sit in chairs lined along a white wall.

Mothers and their children await care at a health clinic in Bangladesh. Photo: Jonathan Torgovnik©.

Guest contributor Eugenio de Hostos is director of research and preclinical development for PATH’s Drug Development program. His post was first published on our Drug Development program blog.

When you walk into a diarrheal disease health clinic in a place like Bangladesh, the reality of the disease strikes you immediately. It’s the rows of bright orange bed covers drying in the sun, the long lines of women with children waiting to be seen, and the patients—most of them too young and vulnerable to be fighting for their lives.

Young woman holds a tiny white cup up to a young child's mouth.

Oral rehydration solution, administered spoonful by spoonful, can be a lifesaver for young children with severe diarrhea. Photo: Jonathan Torgovnik©.

The onslaught of diarrhea is sudden and the loss of fluids is copious. Mere inconvenience quickly turns to a daily struggle for life, fighting off the dehydration that diarrhea causes. A child is rushed to a hospital where lifesaving oral rehydration solution (ORS) is administered, usually by a mother or a care provider. Spoon by spoon, lost fluids are slowly restored, though weakness can persist for several weeks and repeated bouts of diarrhea are common.

The reality is that despite rapid progress in reducing child deaths from diarrhea over the last decade—a decrease of more than 50 percent from almost 1.3 million in 2000 to approximately 600,000 in 2012—there is a lot more to be done. And as long as diarrhea continues to take the lives of more than 1,600 children every day before they can grow to see their fifth birthday, there is no time we can allow ourselves to waste. Continue reading »

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Eight signs life is improving for African children

Children in many African countries have a better shot at a healthy life than ever before. We’re marking the International Day of the African Child on June 16 by taking stock of the encouraging if uneven progress Africa has made in the past two decades in improving the odds of survival for children.

There is still a long way to go. But the overall picture for Africa’s children includes bright spots, promising trends, and the prospect of a future when all children have an equal chance to live full and healthy lives.

1. Africa is making strides against the top killers of children.

Group of children standing next to a blue building.

Photo: PATH/Eric Becker.

A half-million fewer African children under age five died between 1990 and 2010 from diarrheal disease and lower respiratory infections such as pneumonia, two of the leading child killers. Premature death and disability from diarrheal diseases fell 34 percent in that period, and death and disability from lower respiratory infections dropped 22 percent, according to the Institute for Health Metrics and Evaluation (IHME). Continue reading »

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What Africa’s children need to succeed

Five young children in green school uniforms smile up at the camera.

Schoolchildren in Zambia pair health and hygiene through lessons in sanitation. The country is pursuing an integrated strategy to overcome childhood diarrheal disease with education, proven interventions, and new tools. Photo: PATH/Gareth Bentley.

Dr. Ayo Ajayi is PATH’s vice president of International Development.This post originally appeared on The Guardian‘s Global Development Professionals Network partner zone.

Portrait of Ayo Ajayi.

Dr. Ayo Ajayi. Photo: PATH/Mike Wang.

When a child is educated, a community can prosper. On the International Day of the African Child, commemorated on June 16 each year, we celebrate school enrollment and educational improvements. But when a child is not healthy, he cannot attend school. If he is vulnerable to resilient diseases that target poor, rural communities, he may not even reach school age.

Each year, we celebrate the growing number of African children who thrive beyond their first years, young lives spared from preventable diseases. Often, we can credit innovation: new tools that help conquer old threats. The African Rotavirus Symposium, which begins this week, will celebrate rotavirus vaccines’ steady march across the continent—expanding access to an innovative tool to conquer the most common and deadly cause of childhood diarrhea. Continue reading »

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Senator Patty Murray visits PATH

Mike speaks to the senator, surrounded by equipment in PATH's shop.

PATH’s Mike Eisenstein welcomes Senator Patty Murray to our product development shop and provides an overview of our user-centered design process. Photo: PATH/Patrick McKern.

Recently, PATH was privileged to host Patty Murray, US senator from Washington State, at our Seattle headquarters. Senator Murray met with PATH president and CEO Steve Davis and chief strategy officer Amie Batson and toured our product development shop and laboratory.

In PATH’s shop, the group discussed PATH’s work on a low-cost electrochlorinator for water purification. Originally developed by Seattle-based Cascade Designs, Inc., the device requires only a power source—usually a battery—along with salt and water to create a concentrated chlorine solution. Chlorine added to water inactivates bacteria, viruses, and some protozoa, making it safer to drink.

Jesse shows electrocholorinator device to Senator Murray.

PATH staff member Jesse Schubert shows the senator elements of a prototype electrochlorinator, which has been field tested in Korogocho, Kenya, and redesigned based on that feedback. Photo: PATH/Patrick McKern.

This technology was originally developed by Cascade, and improved with support from congressional appropriations championed by Senator Murray, in a project that outfitted 20,000 US Marines with an effective on-the-move water purification system. The PATH collaboration is focused on reducing the unit cost and increasing the capacity of the device, for use in low-resource settings where poor water quality has a huge impact on health.

Faster diagnosis, faster treatment

After donning lab coats, the group toured PATH’s laboratory, where they learned about progress on several next-generation health innovations, including a project funded by the US National Institutes of Health to develop a rapid assay to diagnose infants infected by HIV.

Amie Batson, Patty Murray, and Steve Davis stand in front of PATH signage.

PATH’s Amie Batson and Steve Davis (left and right) host Senator Patty Murray (center) at PATH’s Seattle headquarters. Photo: PATH/Patrick McKern.

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Packed with nutrients, but how does it taste?

Girl with smile and face cosmetics eating a spoonful of rice.

A girl in Myanmar, her cheeks and nose covered with a traditional cosmetic, takes part in our taste test comparing unfortified rice with a fortified blend. Photo: PATH/Seema Kapoor.

Guest contributor Kate Bagshaw is a member of our staff in the Mekong region of Vietnam, Cambodia, and Myanmar.

Early one recent Saturday morning, a group of volunteers gathered near the busy 56 Wards Market in Yangon, Myanmar, to conduct a study. With the help of staff from PATH and the Burnet Institute, the volunteers readied their equipment to test 30 participants carefully chosen to represent a cross-section of the community.

Their goal: to determine if consumers could tell the difference between three bowls of seemingly identical rice.

Two women, one opening a bag containing a stack of cups and the other bending toward a tray of cups. Three electric rice cookers sit on tables between the women.

Volunteers set up three rice cookers to prepare samples of fortified and unfortified rice. Photo: PATH/Seema Kapoor.

The difference: micronutrients

The study volunteers, from the Myanmar Red Cross and the country’s Maternal and Child Welfare Association, were conducting a taste test pitting two kinds of  unfortified rice against a blend of grains fortified using the Ultra Rice® technology.

The fortified grains are designed to deliver essential micronutrients—including iron, folic acid, vitamin A, thiamine, and zinc—that otherwise might be missing from local diets. At a ratio of 99 traditional grains of rice for every 1 grain of fortified rice, the idea is to produce a nutrient-rich blend that looks, feels, smells, and tastes nearly identical to unfortified rice.

Fortified rice is already making a difference for millions of people in India, Brazil, Cambodia, Colombia, Mali, and Vietnam. Along with groups at two other markets in Myanmar, the volunteers in Yangon were helping us determine not only whether the taste testers could pick out the fortified rice, but also if local consumers are likely to buy and eat the rice blend if it becomes available in their local markets, which could happen as soon as the end of the year. Continue reading »

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An overview of PATH in 5 short videos

PATH logo on film strip.Can we sum up everything PATH does in five short videos? Not even close. Our recent annual report gives a broader picture, but even that barely captures the breadth and depth of our work across the spectrum from development to delivery of innovations. Still, in the last few months we have released several great videos, so we’re gathering them here. Together, they create a nice overview of our work.

1. Imagine a New Day

Our work spans five platforms that, together, have the potential to solve challenges that stand in the way of better health and greater development for women and children.

2. Defeat Diarrheal Disease? Together, We’ve Got it Covered

If there was a way to save half a million children’s lives every year, wouldn’t you join that movement?

Continue reading »

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Four key global health wins from the World Health Assembly

Young mother with a baby swaddled on her back.

The health of mothers and their young children took center stage at last week’s World Health Assembly. Photo: PATH/Deborah Atherly.

Guest contributor Heather Ignatius is senior policy and advocacy officer at PATH.

Portrait of Heather Ignatius.

Heather Ignatius. Photo: PATH/Doug Palm.

The global health community is buzzing about the 67th World Health Assembly (WHA), which took place in Geneva last week. The WHA is the decision-making body of the World Health Organization (WHO) and is composed of health ministers from 194 member countries. Here are four messages we heard loud and clear at this year’s WHA:

“Health has an obligatory place on any post-2015 development agenda.” —Dr. Margaret Chan, director-general of WHO

Over the past year, policymakers have heatedly debated which development goals to put in place after the Millennium Development Goals reach their 2015 target date. At the assembly, delegates approved a resolution that prioritizes several health topics for inclusion in the post-2015 development agenda. They include newborn health, noncommunicable diseases, mental health, neglected tropical diseases, and completion of the existing Millennium Development Goals that address HIV, tuberculosis, and malaria; child health; and maternal health. Continue reading »

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Why do girls need sanitary pads to stay in school?

Three nozzles above three sanitary pads emit red fluid.

If girls had access to sanitary pads, would they be more likely to stay in school? Here, we test pads in PATH’s product development shop. Photo: PATH/Patrick McKern.

Nancy Muller is continually impressed by the grace and ingenuity of girls dealing with their menstrual periods. “Every month, all around the world,” she says, “there are girls who don’t know what’s happening when they suddenly get their menstrual period, who face shame and embarrassment and taboos around the subject, and on top of all that, who don’t have easily available means to absorb the blood.”

Menstruation, says Nancy, program officer with our Technology Solutions program, is a complex subject with repercussions for public health, global development, women’s empowerment, and beyond. To commemorate the first global Menstrual Hygiene Day May 28, we asked Nancy to help us understand the issues by answering one seemingly simple question:

Why do girls need sanitary pads to stay in school?

Nancy Muller: You start to see a real difference in rates of school attendance for boys and girls as they move from primary school to secondary school. Rates for girls can be 8 to 10 percent lower than for boys. There are a lot of reasons for this. If there’s a need for help in the home, for example, often a girl may be held back.

Nancy explains why girls need more options for menstrual hygiene and offers some alternatives in this video from Ignite Seattle.

Now, if a girl doesn’t have access to sanitary pads or a safe and clean place at school to change them, that becomes another reason to keep her home. She starts missing a few days every month, she falls behind, and she may eventually drop out. In fact, some small studies in Ghana and Uganda found that if you provide a girl with underwear and sanitary pads, her chances of staying in school are 30 to 50 percent higher.

Keeping girls in school is important to health and development—not only for the girls but for their communities and countries. When girls stay in school, they are less likely to get HIV infection, wages go up, teenage pregnancy rates go down, and the children they have are healthier. You educate a girl and you change the world.

Five colorful sanitary pads, one with absorbant substance that looks like cotton balls pulled out.

Early examples of our work to develop hybrid sanitary pads. Photo: PATH.

So, why  not make sanitary pads more widely available? There are challenges, and one of the biggest is the ongoing cost. Another is that most sanitary pads are disposable. In countries that don’t have a good sanitation or waste disposal system, that can be big problem.

At PATH, we’re exploring potential solutions that are appropriate and affordable. For example, we’ve been looking at ways to make a hybrid reusable pad less expensive, easier to wash, and quicker to dry. Maybe we could even package those with a booklet so girls could learn what’s happening when they start to menstruate.

And another option that I’m excited about right now is the menstrual cup. These cups catch blood and can last for a decade. And they can be used for 10 to 12 hours at a stretch—a full school day. Think of what that could mean to a girl!

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Gugu Xaba: making the most of a child’s first 1,000 days

Close-up of a newborn wrapped in a red blanket.

The first 1,000 days of life determine a child’s health and development, says Gugu Xaba. She leads our Window of Opportunity project to make sure kids get the best start. Photo: PATH.

Early in Gugu Xaba’s career, when she was still a community health nurse, she realized the difference she could make in the lives of her fellow South Africans. It was the early 1990s, and HIV was devastating people’s lives. Treatment was not yet available, and a solution seemed impossible.

Portrait of Gugu Xaba.

Gugu Xaba. Photo: PATH/Patrick McKern.

“I remember well the amount of counseling we had to do with people who were infected,” says Gugu, who now works with PATH’s program in South Africa. “The need to give hope when there was nothing.”

She knew she had succeeded when she saw a change in people’s eyes. “They came in with eyes that were despairing, but their eyes were calm when they left. They could see the reason to go on in life.”

A baby named Bokang

Eventually, the impossible became possible. Thanks to the efforts of the South African government and many organizations, including PATH, South Africans today are receiving treatment and living longer.

Gugu’s career took a turn, too. She earned a master’s degree in public health and worked at institutions including South Africa’s Department of Health, the Elizabeth Glaser Pediatric AIDS Foundation, and the US Centers for Disease Control. In 2012, she came to PATH to lead our Window of Opportunity project, which focuses on improving the health of children under the age of two.

These children often face dire health risks. South Africa has one of the highest rates of newborn mortality in the world—43,000 infants die every year. More than half of them are HIV-positive or exposed to HIV.

And 3.7 million children have been orphaned, including a little boy called Baby Bokang.

Watch this video to learn more about PATH’s Window of Opportunity project in South Africa.

Opening windows of opportunity

Both of Bokang’s parents were HIV-positive. Within a month of his birth, Bokang was abandoned by his mother, and his father died of HIV-related infections. He, too, is HIV-positive.

To help children like Bokang, the Window of Opportunity project is strengthening care over the course of the first 1,000 days of life—from a woman’s pregnancy to her child’s second birthday. Continue reading »

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