The number of children under five dying has declined substantially in the past 20 years and the rate of decline is speeding up, according to a report in The Lancet medical journal. Some developing countries are doing surprisingly well, but rates in the US and Britain are not good by developed world standards -- for reasons that are not clear.
In a study funded by the Bill and Melinda Gates Foundation -- which seems to be a companion piece to this one on falling maternal death rates -- Dr Christopher J L Murray and colleagues analysed data from 187 countries and found a global decline in early childhood deaths from 11.9 million in 1990 to a predicted 7.7 million this year. The UN's Millennium Development Goal of reducing these deaths by two-thirds from 1990 to 2015 will probably still not be reached, but the picture is a lot better than many experts thought.
Especially encouraging are accelerated declines in sub-Saharan Africa over the past 10 years, particularly where governments have focused on child survival and primary care.
Dr Murray suggests that vaccines, AIDS medicines, vitamin A supplements, better treatment of diarrhoea and pneumonia, insecticide-treated bed nets to prevent malaria and more education for women are among factors that have helped lower death rates.
Further to the last point -- about "education for women" -- the New York Times report includes the necessary ritual bow to birth control:
Dr. Flavia Bustreo, director of the Partnership for Maternal, Newborn and Child Health, a group administered by the World Health Organization, said that an important factor in the improvements was "reduced fertility"