BY DR. NATHAN MULURE AND DR. MAGDALENE KURIA
We write as two doctors deeply frustrated by the failure of our continent to save more children and babies. We both work in East Africa, and continue to see too many African children dying before their fifth birthdays from diseases that are preventable and treatable.
Indeed, better medicines and improvements in infrastructure have all made a difference. For instance in 1960, about one in four Tanzanian and Ugandan children died before their fifth birthdays. Today, it is one in twenty. Kenya had a slightly better ratio then and still has today.
However, over the same period, the death rate in Sweden has gone from one in 50 toddlers to one in more than three hundred. Such a big gap.
The youth are Africa’s great gift to an ageing world, but even the children who survive are not contributing as much as they could to the African continent. Too many of them are growing up with lifelong limitations brought about by childhood diseases that are preventable or treatable.
When an African child survives birth, he is most likely to die from one of the three big child killers - malaria, diarrhoea, or pneumonia - despite child-friendly treatments already existing and more research to develop new medicines for all three diseases. Scientific efforts are however not enough.
Too many African children never get access to medical care.
A recent study, which pooled data from 33 African countries, estimated that only about twenty% of children with a malaria-induced fever receive the right treatment. Those who do often receive crushed-up bitter pills that they spit out, instead of the child-friendly malaria formulations that Novartis researchers and expert African doctors work so hard to develop.
Last year, for instance, Kenya introduced child-friendly, dispersible amoxicillin tablets to help treat pneumonia in children with Tanzania and Uganda soon to follow.
The problems in treatment manifest most starkly when we assess the growing threat of respiratory illnesses. Some children have always had asthma but it has become much more common as more and more children now live in urban areas.
In cities, the mites that trigger asthma thrive and the pollution makes it worse. Yet, in a 2013 study, 95% of the children with asthma treated at Uganda’s major referral hospital had previously received a prescription for antibiotics.
This means that a nurse or doctor had wrongly diagnosed the asthma as breathing difficulties related to a bacterial infection. As doctors, we have both seen exactly the same pattern of asthma treated with useless, repeated prescriptions for antibiotics or cough medicines.
Research from Boston University (BU), commissioned by Novartis and published in the International Journal of Tuberculosis and Lung Disease last month, shows that patients diagnosed with asthma in Kenya often do not have the treatments they need to avoid attacks that may be life threatening. Half of those in the study who knew they had asthma did not have medicines at home. Of those who did, many had tablets, not the inhalers recommended by international treatment guidelines.
From the BU study, we also know a lot about why this happens. Medicines for chronic diseases such as asthma are often out of stock in public facilities (where they are dispensed free of charge or at a minimal price to the patient) and too expensive when they are sold in pharmacies.
The theme of this year’s Day of the African Child is “Leave No Child Behind in Africa’s Development.” Too often, the children who are Africa’s most precious resource are not at the centre of development strategies. That must change and we must all play our part.
Imagine if all African children survived to be six years old. Not only would families prosper, our societies would gain extra scientists, teachers, poets, entrepreneurs and workers.
We must strive to overcome the infectious diseases that still kill so many of our children but we will lose them to growing threats such as asthma and diabetes.
Stopping this will take money, government action and a renewed commitment from health professionals, the countless efforts of faith groups, NGOs and companies.
Most of all, though, it will require all of us to reject a world where an African child is fifteen times as likely as a Swedish one to die before his fifth birthday.
No comments:
Post a Comment