UN Leaders Urge New Effort To End Suffering Of Million In Africa’s Great Lakes Region

The heads of three of the largest United Nations humanitarian agencies today urged the international community to match political progress in the Great Lakes region with a new commitment to end the suffering of the millions of people forgotten by the rest of the world.

After a six-day trip to the Democratic Republic of the Congo (DRC), Burundi and Rwanda the three heads of agencies, on their first joint mission to their common operations, said that what had seen and heard showed the need for closer cooperation by all to help refugees, internally displaced people and returnees.

“We have clearly heard their message: ‘Don’t abandon us at this crucial time and risk a return to the bloody nightmare that we lived through for so many years,’” said James Morris, Executive Director of the UN World Food Programme, Ann M. Veneman, Executive Director of UNICEF and UN High Commissioner for Refugees Ant?nio Guterres in a joint statement.

“The courage of the people of the Great Lakes region must be matched by solidarity from the international community. The beginning of the end to this regional crisis is in sight but in order to reach it and rebuild people’s lives, it is vital that we all stand by them and redouble our efforts.”

All three agencies need substantial additional funding for their work in the Great Lakes countries.

The heads of agencies saw both hope and despair almost daily. On Tuesday, they welcomed 400 Congolese refugees returning home from Tanzania at Baraka port in eastern DRC. An hour later, they heard the testimony of victims of sexual violence including a 12-year-old girl, abused by four men, and a grandmother who left her house to look for food and was raped.

“This is deplorable. It’s not fair. It’s not right. As a result of these horrible crimes, people flee and women are too afraid to even cultivate their fields,” said Morris.

“Women and children must be protected. Violence is unacceptable. It must be stopped,” added Ms. Veneman.

DRC has witnessed some of the most vicious fighting in the world since World War II. A six-year war has cost four million lives and 1,200 people still die needlessly every day. More than 3.4 million people have been displaced from their homes and 17 million don’t have a steady supply of food.

The three heads of agencies said there was hope with DRC’s constitutional referendum and the fact that millions of people had registered to vote in June in the first multi-party presidential elections in 45 years. But this opportunity should be supported by substantial humanitarian assistance both for those people returning and for those who are still under attack in the East.

On their Great Lakes trip, the UN leaders met the presidents of the DRC, Rwanda and Burundi, donors, UN agencies and partner non-governmental organisations. They also met people driven from their homes by attacks in eastern DRC as well as others who have chosen to return home to the three countries after years in exile.

“It is very important to tackle the main problems facing people in the region from a regional perspective,” the three heads of agencies said. “Only a regional approach can be effective.”

In Rwanda, the three UN leaders congratulated President Paul Kagame and his government for having guided the country from the tragedy of the genocide in 1994 that killed an estimated 800,000 people towards peace, reconciliation and development. But the government estimates that one million people require food assistance for the first six months of this year.

“It is a reality that international aid mainly goes to areas with the most media coverage and this region hasn’t been receiving a lot of that,” said Guterres during their visit to Rwanda.

The UN leaders flew from Rwanda on Wednesday to Burundi, where 2.2 million people, including refugees and returnees, need food aid in 2006 because of poor rains, crop disease and poverty. They held talks with the president and visited a feeding centre for malnourished women and children.

Ending their Great Lakes mission in Bujumbura on Thursday, Mr. Morris and Ms. Veneman travel to Kenya to meet President Mwai Kibaki while Mr. Guterres goes to Tanzania.


Financial Capacity And The Onset Of Dementia

A study published in Neurology by researchers in the US has found that declining financial skills could be an early indicator of Alzheimer’s disease in people with mild cognitive impairment (MCI).

The year long study worked with 87 people with MCI, 25 of whom developed Alzheimer-type dementia during the study period and 62 who did not; and with 76 cognitively healthy people as controls. The group was tested at the beginning of the year and at the end with a tool called the Financial Capacity Instrument (FCI). This measured skills including understanding of financial concepts, cash transactions, bank statement management and bill payment.

‘This could be a useful indicator for doctors supporting people with memory problems.

Everyone struggles now and then to divide a restaurant bill or tot up your chequebook. However, this study suggests that if you already experience significant memory problems and start to notice a decline in your financial skills it could be a sign of developing dementia.

More research is needed into memory decline to begin to find useful, early indicators of the development of dementia. Dementia research is desperately underfunded. One million people will develop dementia in the next 10 years. We must act now.’

Dr. Susanne Sorensen
Head of Research
Alzheimer’s Society

Declining financial capacity in mild cognitive impairment by K.L. Triebel, PsyD, R.Martin, PhD, H.R. Griffith, PhD et al

Alzheimer’s Society

Course And Aging Director Publishes Book Examining Impact Of Natural Disasters On Lifespan

Director of LSU’s Life Course and Aging Center, or LCAC, Katie Cherry, along with several LSU colleagues, has published a book titled, “Lifespan Perspectives on Natural Disasters: Coping With Katrina, Rita and Other Storms,” through Springer Publishing.

“I am very excited about this edited volume which is unique in that provides a glimpse of psychological reactions to the storms across the lifespan, from the preschool period to the oldest-old adults aged 90 and over,” said Cherry. “I imagine that this book would be of interest to a very diverse audience, spanning the science to the service ends of the continuum. Given the complex and tragic nature of Katrina, the worst natural disaster in our nation’s history, this book may also appeal to the general public.”

The book explores problems that could develop at all stages of life: children and youth, middle aged adults, older adults and very old adults. It also analyzes risks and dangers inherent in different aspects of an individual’s life, such as in the workplace, as a volunteer, in the medical field and more.

“It is very important to me that I indicate the truly collaborative nature of the book. All of the contributing authors are top notch scholars in their own rights and each worked hard to ensure that their chapters were not only of the highest possible quality but also integrated with the each other’s work,” said Cherry. “To me, an indication of the overall value of the book is sheer number of cross-references indicating the complexity and scope of the topic as well as the range of experiences.”

In addition to Cherry, other researchers affiliated with the LSU LCAC who have contributed to the book include:

* Priscilla Allen, LSU School of Social Work
* Teresa Buchanan, LSU Department of Educational Theory, Policy and Practice
* Jennifer Baumgartner, LSU School of Human Ecology
* Renee Casbergue, LSU Department of Educational Theory, Policy and Practice
* Thompson E. Davis III, LSU Department of Psychology
* Betsy Garrison, LSU School of Human Ecology and LSU AgCenter
* Yoshinori Kamo, LSU Department of Sociology
* Mary Lou Kelley, LSU Department of Psychology
* Loren Marks, LSU School of Human Ecology
* Stacy Overstreet, Tulane University Department of Psychology and LSU LCAC
* Diane Sasser, LSU School of Human Ecology and LSU AgCenter
* Carl Weems, UNO Department of Psychology and LSU LCAC
* Tracey Rizzuto, LSU Department of Psychology

“I know that I speak for all of the contributing authors when I tell you that my hat goes off to Dr. Cherry,” said Betsy Garrison, contributing author and member of LSU’s School of Human Ecology and LSU’s AgCenter. “She has put together a truly noteworthy, comprehensive and moving book. A book that, in a scientifically rigorous way, uniquely captures the experiences of people of all ages and walks of life, including those of us who have led parallel lives for several years now, that of both survivors and scholars. This book demonstrates to the world the collective excellence of life course and aging scholarship at LSU and is a harbinger for the future.”

According to the Springer Web site, the book examines “human strengths and vulnerabilities during large-scale devastation and crisis.” The panel of authors, the majority of whom are from Louisiana, along with chapter contributors from Virginia Tech and University of Michigan, have targeted the book toward both to mental health care providers and to others involved in developing disaster preparedness strategy, intervention and recovery programs at the community, state and regional levels.

“Examining the impact of the 2005 hurricanes through scholarship was an important part of the LSU response and in this book Dr. Cherry has gathered together the work that was completed as part of that response,” said Teresa Buchanan, contributing author and member of LSU’s Department of Educational Theory, Policy and Practice. “It was difficult to do this research under those trying times and conditions that personally challenged us as community and family members. I’m proud of my research team and glad to be one of the Louisiana scholars who made the effort to continue LSU’s mission of generating knowledge in the midst of such crisis, and I’m very grateful to Dr. Cherry for providing this outstanding forum for the dissemination of our scholarship.”

For more information on “Lifespan Perspectives on Natural Disasters: Coping With Katrina, Rita and Other Storms,” visit springer/psychology/psychology+general/book/978-1-4419-0392-1.

Ashley Berthelot
Louisiana State University

Depression Is A Risk Factor Rather Than Early Sign Of Alzheimer’s Disease

A new study by researchers at Rush University Medical Center supports the idea that depression is truly a risk factor for Alzheimer’s disease rather than a subtle early sign of its underlying pathology. The study, published in the April issue of the Archives of General Psychiatry, found no evidence of an increase in depressive symptoms during the prodromal phase before the clinical diagnosis of Alzheimer’s disease.

Numerous observational studies have found higher levels of depressive symptoms in old age to be associated with increased incidence of Alzheimer’s disease and mild cognitive impairment. However, previous studies have not been able to answer the question of whether depressive symptoms actually contribute to the development of dementia (risk factor hypothesis) or are a consequence of the disease (reverse causality hypothesis.)

Robert S. Wilson, PhD, a neuropsychologist at the Rush Alzheimer’s Disease Center, and colleagues examined data from the Rush Religious Orders Study, a cohort of 917 older Catholic clergy without dementia at study onset, to examine the change in depressive symptoms of Alzheimer’s disease before and after the emergence of the cognitive symptoms of the disease.

For up to 13 years, the study participants underwent annual clinical evaluations that included assessment of depressive symptoms, cognitive testing, and clinical classification of mild cognitive impairment (MCI) and Alzheimer’s disease. During the study period, 190 participants developed Alzheimer’s disease.

Consistent with earlier findings in the Rush Religious Orders Study, having more depressive symptoms at baseline was associated with increased incidence of Alzheimer’s disease and MCI.

However, the study found that those who developed Alzheimer’s disease showed no increase in depressive symptoms before clinical diagnosis. Researchers were able to observe patients during a mean of approximately four years before the onset of dementia. Additionally, researchers saw no increase in depression during the three to four years preceding the onset of MCI, which antedates the onset of dementia by several years.

“If depressive symptoms are a consequence of dementia or a reaction to declining function, depressive symptoms would likely increase at some point before dementia is clinically evident,” said Wilson. “We observed no such increase.”

The study also found that even after the diagnosis of Alzheimer’s disease was made there was no general increase in depression, but rather an increase that was confined to individuals with certain personality traits.

“Depressive symptoms may be associated with distinctive changes in the brain that somehow reduce neural reserve, which is the brain’s ability to tolerate the pathology associated with Alzheimer’s disease,” said Wilson. “Understanding how depression contributes to the development of Alzheimer’s disease may suggest new approaches to disease prevention.”

The research was supported by grants from the National Institutes on Aging, which leads the Federal effort to support and conduct basic, clinical, and social and behavioral studies on aging and on Alzheimer’s disease. The Rush Alzheimer’s Disease Center is one of 29 NIA-supported Alzheimer’s Disease Centers across the United States. For more information on the Rush Alzheimer’s Disease Center, visit rush/.

Source: Kim Waterman

Rush University Medical Center

Lack Of Critical Lubricant Causes Wear In Joints, First-Ever Study Finds

Mice that don’t produce lubricin, a thin film of protein found in the cartilage of joints, showed early wear and higher friction in their joints, a new study led by Brown University researchers shows.

This link between increased friction and early wear in joints is a first; no other team of scientists has proven this association before. The finding, published in Arthritis & Rheumatism, sheds important light on how joints work. The discovery also suggests that lubricin, or a close cousin, could be injected directly into hips, knees or other joints inflamed from arthritis or injury — a preventive treatment that could reduce the need for painful and costly joint replacement surgery.

In an editorial that accompanies the journal article, orthopedics researchers from Rush University Medical Center in Chicago call the research an “important contribution to the field” and note that the use of biomolecules like lubricin to prevent joint wear “could have a substantial clinical impact, if successful.”

Gregory Jay, M.D, a Rhode Island Hospital emergency physician and an associate professor of emergency medicine and engineering at Brown, led the research. For 20 years, Jay has studied lubricin’s role as a “boundary lubricant” by reducing friction between opposing layers of cartilage inside joints. In this new work, Jay and his colleagues set out to answer the next question: Does reducing friction actually prevent wear, or surface damage, in joints?

To find out, Jay and his team studied cartilage from the knees of mice that don’t produce lubricin. Directly after birth, the cartilage was smooth. But in as little as two weeks, researchers found, the cartilage began to show signs of wear. Under an electron microscope, scientists could see that the collagen fibers that cartilage is composed of were breaking up, giving the surface a rough, frayed appearance. This damage is called wear, an early sign of joint disease or injury.

Jay and his team then took the work a step further. To better understand how lubricin works, they tried to see the structure of the film. So they put a tiny bit of the protein under an atomic force microscope. At the nanoscale, the molecule appeared as a mesh — row upon row of interlocking fibers — that could repel a microscope probe. This repulsion, created with water and electrical charges, shows how lubricin acts as a buffer, keeping opposing layers of cartilage apart.

“We demonstrated that lubricin reduces both friction and wear and also showed how, on a molecular level, it does this work in the body,” Jay said. “What’s exciting are the clinical implications. Arthritis and sports injuries damage the joints of thousands of people in the United States and millions of people worldwide each year. Our aim is to make a treatment that can actually prevent wear in the joints.”

Through Rhode Island Hospital, Jay has filed two patents on the protein and its sequences and, in 2004, helped form Tribologics, a biotech company formed out of Rhode Island Hospital. The Massaschusetts-based business is developing an injection treatment for inflamed joints that contains lubricin.

Members of the research team included Jahn Torres, a former Brown graduate student in engineering; David Rhee, a former graduate student at Case Western Reserve University; Heikki Helminen, M.D., and Mika Hytinnen, M.D., from the University of Kuopio in Finland; Chung-Ja Cha, a research assistant at Rhode Island Hospital; Khaled Elsaid, a postdoctoral research fellow at Rhode Island Hospital; Kyung-Suk Kim, a professor of engineering at Brown; and Yajun Cui, M.D., and Matthew Warman, M.D., of Boston Children’s Hospital and Harvard Medical School.

The National Institute of Arthritis and Musculoskelatal and Skin Diseases funded the work, along with the Academy of Finland, the McCutchen Foundation, the Howard Hughes Medical Institute and the Burroughs Wellcome Fund.

Source: Wendy Lawton

Brown University

Seismic ‘Stress Meter’ May Provide Early Earthquake Warning

Using remarkably sensitive new instruments, seismologists have detected minute geological changes that preceded small earthquakes along California’s famed San Andreas Fault by as much as 10 hours. If follow-up tests show that the preseismic signal is pervasive, researchers say the method could form the basis of a robust early warning system for impending quakes.

The research appears in the journal Nature.

“We’re working with colleagues in China and Japan on follow-up studies to determine whether this physical response can be measured in other seismically active regions,” said Rice University seismologist Fenglin Niu, the study’s lead author. “Provided the effect is pervasive, we still need to learn more about the timing of the signals if we are to reliably use them to warn of impending quakes.”

Today’s state-of-the-art earthquake warning systems give only a few seconds’ warning before a quake strikes. These systems detect P-waves, the fastest moving seismic waves released during a quake. Like a flash of lightning that arrives before a clap of thunder, the fast-moving P-waves precede slower moving but more destructive waves.

Findings from the new study indicate that the stresses measured by the new instruments precede the temblor itself, so a warning system using the new technology would be fundamentally different from current warning systems.

“Detecting stress changes before an earthquake has been the Holy Grail in earthquake seismology for years and has motivated our research,” said study co-author Paul Silver of the Carnegie Institution of Science’s Department of Terrestrial Magnetism. “Researchers have been trying to precisely and continuously measure these velocity changes for decades, but it has been possible only recently, with improved technology, to obtain the necessary precision and reliability.”

In experiments near Parkfield, Calif., in late 2005 and early 2006, Niu, Silver and colleagues from Lawrence Berkeley National Laboratory (LBNL) gathered two months of measurements at the San Andreas Fault Observatory at Depth, or SAFOD, a deep well seismologists use to make direct measurements of the fault.

The team installed a high-precision seismic source made by a stack of donut-shaped piezoelectric ceramic cylinders that expand when voltage is applied — a sophisticated device akin to a stereo speaker — about one kilometer beneath the surface. At the same depth in an adjacent well, the scientists set up an accelerometer to measure the rhythmic signals from the source device.

When rocks are compressed, the stress forces air out of tiny cracks in the rock. This causes seismic waves to travel slightly faster through the rock. Niu said the variations are so slight they can be measured only with very precise instruments. For example, though the Parkfield instruments were more than a half mile below ground, the setup was sensitive enough to measure fluctuations in air pressure at the Earth’s surface.

“Scientists tried as early as the 1970s to measure changes in wave speed that are associated with the stress changes that precede seismic activity,” Niu said. “For a variety of reasons, their measurements were inconclusive. Using the precision instruments built by our collaborators at Lawrence Berkeley National Laboratory, along with new signal enhancement techniques, we were able to reach the fine level of precision required.”

In analyzing the seismic data, Niu and colleagues found that a distinct change occurred in the rock before each of the minor earthquakes near Parkfield during the test period. A measurable change preceded a magnitude 3 quake on Christmas Eve 2005 by 10 hours. This was the largest local event during the observation period. A smaller but closer magnitude 1 temblor five days later was preceded by a signal about two hours before the quake.

Additional co-authors include Rice graduate student Xin Cheng and LBNL scientists Tom Daley and Ernest Majer. The research was supported by the National Science Foundation, Rice, the Carnegie Institution and LBNL.

Source: David Ruth

Rice University

Comment On Research Suggesting Early Introduction Of Fish Decreases The Risk Of Eczema In Infants

‘There is now a wealth of research indicating that a person’s diet can contribute to their risk of developing asthma and allergies, most likely as a result of their antioxidant, lipid and vitamin E intake. However, the causes of asthma are still largely unknown and the processes involved in asthma and allergy development are incredibly complicated and include family history, environment and lifestyle.

‘Lipids are found in fatty foods such as oils, margarine and fish and previous research has shown that supplementing the diets of adults with asthma with lipids has minimal benefit. In spite of this, there is growing interest in the possibility that childhood asthma and allergies are influenced by maternal diet during pregnancy and also the foods that children are exposed to in their early years. Whilst it is too early to make recommendations on the amount of fish children should be given to reduce their risk and at what age, the results of this large-scale study indicate that this a promising avenue of research to explore further in our attempt to prevent the development of asthma, which currently affects one in every 11 children in the UK.’

Asthma UK

Asthma UK Scotland Welcomes Plans To Raise Legal Age For Buying Tobacco

Gordon Brown, Public Affairs & Communications Manager at Asthma UK Scotland, says:

‘We are delighted that the Scottish Government has taken another step forward in tackling the damage tobacco can do. We know that smoking is bad for everyone’s health, but this is especially true for people with asthma.

‘If you smoke and have asthma you are increasing your risk of an asthma attack, could be permanently damaging your airways and could be blocking the benefit of your asthma medicines.

‘Also, if you smoke as a teenager you are increasing the risk of your asthma persisting so we hope that by raising the age at which people can buy tobacco, significantly fewer people will start this dangerous habit.’

1. Asthma UK is the charity dedicated to improving the health and well-being of the 5.2 million people in the UK whose lives are affected by asthma. Asthma UK Scotland is dedicated to improving the health and well-being of the 390,000 people in Scotland whose lives are affected by asthma.

2. For up-to-date news on asthma, information and publications, visit the Asthma UK website asthma.

A Candidate Gene For Familial Idiopathic Pulmonary Fibrosis Identified

ELMOD2-gene is a prime candidate gene for familial idiopathic pulmonary fibrosis, suggests the recent study published by the researchers at the University and University Hospital of Helsinki, Finland. (Am J Hum Genet. 2006 Jul;79(1):149-54. Epub 2006 May 9)

Idiopathic pulmonary fibrosis (IPF) is a chronic, late-onset disease of lung parenchyma with unknown etiology. IPF has been treated with corticosteroids and immunosuppressive agents, but the prognosis and the response to treatment have remained poor, and the estimated time of survival from the diagnosis is less than 3 years. The pathogenesis and etiology of IPF are unknown, but the reports of multiple affected family members in the same family support the influence of genetic factors.

In their previous studies researchers at the University of Helsinki and the University Hospital of Helsinki observed that the prevalence of idiopathic pulmonary fibrosis distributed unevenly in Finland. The prevalence was two times higher in eastern and southern Savo (45/100 000 inhabitants) compared to the prevalence in Finland (16-18/100 000).

The researchers identified multiplex families with IPF and noticed that familial IPF patients clustered within Savo and Carelia, the same areas with the high prevalence, suggesting that they most likely share a common disease-causing allele introduced by a common ancestor.

They performed a genome-wide scan with six multiplex families. Three regions on chromosomes 3, 4, and 13 obtained NPL scores of 1.7, 1.7, and 1.6, respectively, and on chromosomes 9 and 12 possible shared haplotypes were seen. These five loci were fine mapped with 63 markers in an extended data set.

After fine mapping the researchers did not detect the linkage to the loci on chromosomes 3, 9, 12, and 13. On chromosome 4q31.1 the NPL score increased to 2.1, and one third of the affected families (8/24) shared a 110 kb haplotype, while none of the unaffected family members carried it. The susceptibility haplotype was carried in 34 % of all the genotyped families (12/35), and in 7.7 % (11/143) of 143 controls, with an odds ratio of 6.3 (p=0.0001, 95 % CI=2.3-15.9).

The critical region harbors two novel candidate genes, ELMOD2, and LOC152586 that both are poorly characterized. An in vitro translation assay with LOC152586 failed to produce any peptide suggesting it is not a protein-coding gene. mRNA expression of ELMOD2 was decreased in lung biopsies derived from IPF patients (N=6) compared to healthy controls (N=7).

ELMOD2 is potentially involved in apoptosis, phagocytosis, cell engulfment, and cell migration. It is expressed in functionally relevant tissue, in lung and in fibroblasts, and its expression is significantly decreased in IPF lung compared to healthy lung.
Therefore ELMOD2 becomes a prime candidate gene for familial IPF.


Founded in Turku in 1640, the University moved to Helsinki in 1828. The University of Helsinki has nine faculties: Theology, Law, Medicine, Arts, Science, Education, Social Sciences, Agriculture and Forestry, Veterinary Medicine

P.O. Box 33
FIN-00014 Helsinki


World falling short on promise to reduce child deaths

New country-by-country data reveals alarmingly slow progress on reducing child deaths despite the availability of
proven, low-cost interventions, a UNICEF survey revealed today. UNICEF said that while 90 countries are on track to meet the
target of reducing child deaths by two-thirds by 2015, 98 countries are considerably off track, and globally the pace of
progress is far too slow.

At the current rate of progress, the average global under-five death rate will have dropped by roughly one-quarter by 2015,
far below the two-thirds reduction agreed to by world leaders.

“A child’s right to survive is the first measure of equality, possibility, and freedom,” UNICEF Executive Director Carol
Bellamy said, launching Progress for Children in New York. “It is incredible that in an age of technological and medical
marvels, child survival is so tenuous in so many places, especially for the poor and marginalized. We can do better than

Progress for Children ranks countries on their average annual rate of progress since 1990, which is the baseline year for the
global goal of reducing child mortality by two-thirds by 2015 – a goal agreed to by all governments as part of the UN’s
Millennium Development Goals.

Child mortality refers to the number of children who die before their fifth birthday, and is measured per 1,000 live births.
For example, in 2002, the most recent year for which comprehensive data is available, industrialized countries had an average
child mortality rate of 7 deaths per 1,000 live births; the least developed countries had a rate of 158 deaths per 1,000
births. UNICEF considers child mortality rates the basic measure of a country’s advancement.

The regional tables in the report provide comparisons of how quickly or slowly nations have made progress on child mortality
between 1990 and 2002. The goal of a two-thirds reduction assumed an average annual rate of progress of roughly 4.4 per cent
between 1990 and 2015. The report reveals that no region has met that standard, though nearly 50 individual countries have.
Some 78 countries have failed to average even two percent progress per year in reducing child mortality.

The figures make clear that those countries that have fallen short on progress since 1990 now have a much more daunting task.
At least 39 countries must now reduce mortality by more than 8 per cent per year, on average, during the remaining years to
2015 in order to reach the goal.

Heading in Reverse

Child mortality rates vary considerably among regions and countries, but the most disturbing findings are those countries
whose annual rate of progress has been negative; in other words, they are heading in reverse, with rising child mortality
rates. In several countries in sub-Saharan Africa and the Commonwealth of Independent States, children are less likely to
make it to their fifth birthdays than they were in 1990.

HIV/AIDS remains one of the chief underlying causes affecting child mortality trends, particularly in sub-Saharan Africa.
Botswana, Zimbabwe and Swaziland, which registered the second, third and fourth fastest increases in under-five deaths, also
have the world’s highest national HIV prevalence rates – about 37, 25 and 39 per cent, respectively. Other key factors behind
spiking child mortality rates, as in the case of Iraq and Afghanistan, are the effects of armed conflict and social

Despite a slight improvement, Sierra Leone continues to have the world’s highest rate of child mortality, with more than one
in four children dying before age five (284 deaths per 1,000 births annually).

Latin America and Caribbean countries have seen the most substantial improvement on average, although alarming gaps are
opening up within countries there. Poverty and discrimination are preventing large groups of children within these countries
from accessing basic services.

Malaysia, Malta and Egypt have made the most dramatic leaps forward overall, although Egypt is still battling polio. Iraq
has lost the most ground since 1990.

Root Causes

Inadequate birthing conditions – meaning little or no health care for mothers, and the lack of skilled attendants during
deliveries – cause the largest proportion of preventable deaths. Infectious and parasitic diseases, such as diarrhoea and
acute respiratory infections, followed by malaria and measles are the next biggest killers. Acute respiratory infections and
diarrhoea are at the root of roughly one-third of child deaths.

Malnutrition contributes to more than half of all child deaths. Unsafe water and poor sanitation are also contributing

“The world has the tools to improve child survival, if only it would use them,” Bellamy said. “Vaccines, micronutrient
supplements and insecticide-treated mosquito nets don’t cost much, and would save millions of children. But not enough
children are being reached with these basic life-savers. That’s what has to change. No government should be allowed to let
another ten years pass with so little progress for children. Leaders have agreed to goals and they must be held

Regionally, much of the Middle East and Northern Africa, Latin America and the Caribbean, and East Asia and the Pacific are
on track to reach the goal. But Central and Eastern Europe, South Asia, and sub-Saharan Africa will require dramatic measures
if they are to come close.

For further information, please contact:

Alfred Ironside, UNICEF, Media New York: (1-212) 326-7261, aironsideunicef
Oliver Phillips, UNICEF Media, New York: (1-212) 326-7583, ophillipsunicef
Marixie Mercado, UNICEF Media, New York: (1-212) 326-7133, mmercadounicef