Poverty and war have devastating effects on child health, a report by the United Nations Children's Fund (UNICEF) confirms.
UNICEF's flagship report, The State of the World's Children 2008, notes with satisfaction that mortality rates for children under five years of age actually hit a record low, down from 20 million in 1960 to 9.7 million in 2006.
AdvertisementStill more than half, more than 26,000 children under five die everyday.
The report said globally in 2006, 62 countries were making no or insufficient progress towards a key 2015 child mortality target. Those in the sub-Saharan region came off the worst.
Sierra Leone, with 270 deaths before the age of five per 1,000 live births, was at the bottom of the league. Other countries in that league are Angola with 260, Afghanistan at 257, Niger at 253 and Liberia at 235.
The attainment of the 2015 goal - called the fourth Millennium Development Goal (MDG), which requires a two-thirds reduction in the 1990 under-five mortality rate - "is still possible, but the challenge is formidable", the report says.
The industrialised world and parts of the developing world are making good progress.
The world's best performers were Sweden, Singapore, San Marino, Liechtenstein, Iceland and Andorra, with three infant deaths before the age of five per 1,000 live births.
But other parts of the developing world are left behind. This includes in particular sub-Saharan Africa, home to 28 of the 30 countries with the highest mortality rates.
Here, the annual average rate of reduction in the child mortality rate between 1990 and 2006 was only 1% per year - meaning the rate will have to increase to 10.5% per year between 2007 and 2015 if the region is to meet the fourth MDG.
In addition to sub-Saharan Africa, insufficient progress was recorded in the Middle East and North Africa (Mena) and South Asia.
But other developing countries have made good progress towards the target.
In East Asia and Pacific, and Latin America and the Caribbean, mortality rates almost halved to 27 deaths per 1,000 live births - leaving those regions on track to meet the goal.
In industrialised countries in general, there are six deaths per 1,000 births.
Nonetheless, the report laments, an average of more than 26,000 infants under five die every day around the world.
They mostly die from preventable causes such as diarrhoea, malaria, malnutrition, mother-to-child transmission of HIV, unsafe water, poor hygiene and neonatal problems.
The solutions to child deaths are well-known, says the report - "simple, reliable and affordable interventions with the potential to save two-thirds of the children currently at risk are readily available".
"The key," said David Bull, executive director of UNICEF UK, "is to expand the reach of proven health strategies to help save the lives of children in the poorest and most difficult-to-reach communities."
Such interventions that have already been shown to be effective include promoting breast-feeding, immunisation, vitamin A supplementation and the use of mosquito nets.
But obstacles include limited, disease-specific rather than integrated approaches to health care; the low profile of maternal and child health; intermittent financing and lack of political will.
In many cases, lack of progress may be attributed to poverty and war - as in the three worst performers, Sierra Leone, Angola and Afghanistan.
"Today we are calling for the global community to put child survival at the heart of the development agenda and make it a priority at this year's G8," said Mr Bull.
"Child survival must be a global imperative."
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