New international health estimates reduce global death rates

A week ago, international health researchers in The Lancet estimated the causes and numbers of death among the world's children. It's been followed by another Lancet study showing major improvement in child death rates. In fact, this new paper reduces the most recent number of estimated deaths by 820,000, from the 8.8 million figure we reported on last week to about 8 million. Why the change, and how reliable is it? It's important to remember that with the exception of a few countries (those in North America and Western Europe, a couple in South America, Russia, Australia and a smattering of others), most countries do not keep accurate counts of who is born or dies (or what they died of). That's left to international health researchers to estimate. This new Lancet paper used, for the first time, a sophisticated technique called Gaussian process regression to try calculate child mortality figures. This process is especially good at providing estimates when data is lacking (the previous Lancet study attempted to reduce these uncertainties by citing raw numbers instead of rates.)

The good news for international health is that there appear to be many signs of progress: In 1970 there were 40 countries with child mortality rates above 200 per 1000, now there are no countries with that rate. 80 per 1000 is now the highest mortality bracket, populated with such nations as Nigeria, Guinea-Bissau, Mali, Niger, and Chad. Yet many areas with the highest infant mortality rates are currently experiencing an acceleration in the reduction of their death rates, thanks to intensive international health programs and infrastructure development. The UN millennium Development Goals called for a two-thirds reduction in under-5 child mortality, and according to these figures, 54 countries are on track to meet these goals (31 are developing countries.)

Among the poor performers in the developed world is the UK, with the highest under-5 mortality in Western Europe at 5.3 per 1000, and currently 33rd on the world list. But the Brits still sport better international health figures than their neighbor across the pond: The USA ranks 42nd globally, at 6.7 per 1000. Rates of decline in the USA are about 2-3% per year, compared to 3-5% in most of the developed world. Many countries in sub-Saharan Africa, including Niger (with among the world's highest rate to begin with), achieved 3% rate reductions. And its not that highest mortality countries experience the greatest rate of declines because they have the most improvement to make: Western European nations with the lowest infant mortality were also among the leaders in continuing to lower their rates (of course a small reduction in a small rate can look like a higher-percentage improvement over time compared to a larger reduction in a very high rate.)

According to international health and infant mortality expert Deborah Maine of Boston University, maternal and child mortality can be cut in half every 7 years if evidenced-based policies proven to reduce them are comprehensively put in place.

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