New tools offer new hope for saving almost a million kids a year

Children shouldn’t die of anything as commonplace as diarrhea, yet it kills about 1.6 million a year, claiming the lives of more kids under five than AIDS and malaria combined. Most of these deaths occur in the developing world, where families face a double jeopardy: first they are at high risk for diarrheal disease from unsanitary conditions and unsafe water, and then they lack access to life-saving treatment.

It doesn’t have to be—both prevention and treatment options are available. PATH is working to focus a spotlight on a new vaccine and new treatments for diarrhea that, combined with the tools we already have in hand, can further improve on the gains made in diarrhea control over the last couple of decades.

Early strides

In the 1980s and 1990s, UNICEF and the World Health Organization led a global effort to reduce diarrhea deaths by promoting preventive measures—such as exclusive breastfeeding and improved access to clean water—and use of oral rehydration solution to counter dehydration. Millions of lives were saved.

But it’s hard for overburdened health systems to maintain focus on stubborn health problems using the same old methods, even as new prevention and treatment options are in development. Research indicated that efforts to control diarrhea in many developing countries were waning.

New tools, new hope

Just in time, the innovation pipeline produced new tools to control diarrhea: vaccines against rotavirus, the most common cause of severe diarrhea; a new formulation of oral rehydration solution, and zinc treatment that shortens the duration of diarrheal episodes. When used with the existing health interventions, these tools will strengthen diarrhea control in the poorest countries, where diarrheal disease was once considered insurmountable.

To move the new tools from the pipeline to widespread use, PATH began the “Enhanced Diarrheal Disease Control Initiative,” which provides policymakers in developing countries with the information they need when considering their investment in control of diarrheal disease. As part of the initiative, we started an online library that brings together information and guidelines, in multiple languages, on new and existing interventions. We’re also developing training materials for health workers and their program managers.

A comprehensive approach using proven interventions and the new tools has already been widely adopted in several countries, and we’re continuing to help countries around the globe find and implement the strategies that are right for them:

• We’re working with ministry of health partners in the Republic of Georgia to convene experts to develop program strategies and in Ukraine to plan for future rotavirus vaccine introduction.
• Our collaborations in Vietnam and Indonesia are bringing updated guidelines to provincial health workers, and we plan to expand education to nationwide in both countries.
• In Kenya, we’re helping gather data on knowledge and practices to be applied toward strengthening prevention and care of diarrheal disease throughout the country—and potentially the region.
• Our work in Nicaragua helped foster a partnership between vaccine manufacturer Merck and the Nicaraguan ministry of health that resulted in three-year demonstration project introducing rotavirus vaccine, starting in October 2006. Working closely with the local nongovernmental organization NicaSalud and the ministry of health, we’re helping document what is learned from the introduction, and we will disseminate the information to help the countries that follow. The lessons learned will also inform our work to accelerate global access to rotavirus vaccines.

A winning combination

Together with existing, tried and true methods, new interventions such as rotavirus vaccines and zinc treatment can reduce the burden of diarrhea in the poorest countries. This convergence of common knowledge and innovation means that the day will sooner come when kids can avoid, or at least recover from, debilitating diarrhea—no matter where they were born.

Photos (from top): PATH/Janie Hayes, Robin Biellik.