聯合國兒童基金會/世界衞生組織:應對肺炎和腹瀉的新計劃每年可挽救200萬名兒童的生命

 

聯合國兒童基金會/世界衞生組織:應對肺炎和腹瀉的新計劃每年可挽救200萬名兒童的生命

國際消息 00:27

日內瓦/華盛頓/香港,2013年4月12日──聯合國兒童基金會(UNICEF)與世界衞生組織(WHO)今日推出一項嶄新的全球行動計劃,預料每年將可避免200萬名兒童死於全球5歲以下兒童的頭號殺手──肺炎和腹瀉。

Community Health Volunteer Mariam Diarra times eight-month-old Gimbala Keita’s breathing, using a WHO/UNICEF timer, during an outreach visit in Kabe Village in the western Kayes Region. The baby has pneumonia. Ms. Diarra has been trained to count a child’s breaths to gauge respiratory distress and identify pneumonia. If detected early enough, the illness can be treated with antibiotics and recovery may be swift. Otherwise, the child will be referred to the nearest health facility. Community health volunteers provide basic health services and monthly outreach, helping to manage early childhood diseases in their communities. UNICEF supports community-led initiatives to raise awareness about essential family practices, which include exclusive breastfeeding for babies during the first six months of life, fully vaccinating children under age one, sleeping under insecticide-treated mosquito nets, and washing hands with soap. Each volunteer visits about 35 households (or 250 inhabitants) every month. Ms. Diarra is the eldest of three wives who, all together, have 14 children. [#2 IN SEQUENCE OF THREE] In May 2010 in Mali, the country remains one of the poorest in the world, with more than 47 per cent of the population living on less than US $1.00 a day. Many people lack access to basic health care and safe water, and more than half are without adequate sanitation. Maternal and child health indicators are also among the world’s worst: Eight women die from pregnancy-related causes each day, and nearly 20 per cent of children die before reaching their fifth birthday. Pneumonia, diarrhoea, malaria and neonatal conditions are the primary causes of under-five deaths. Additionally, more than one-third of child deaths are directly related to under-nutrition, and about 38 per cent of Malian children are stunted. Wide economic, gender, geographic and other disparities also persist. Working with the Government and other partners, UNICEF supports health, nutrition, water and sanitation and hygiene (WASH), education and protection interventions, especially in rural areas and among vulnerable populations. A health worker prepares a pentavalent vaccine at a health centre in the community of Corosal in Cobán Municipality, in Alta Verapaz Department. The pentavalent vaccine protects against five common diseases: diphtheria, tetanus, pertussis (whooping cough), hepatitis B and Haemophilus influenza type b (also called Hib, a cause of pneumonia and meningitis). The centre, which is open once a month, serves a population of 1,000, and is run by the Ministry of Health with support from UNICEF. Volunteer health workers provide routine health care and immunizations for pregnant women and children under 5 in five surrounding communities. [#2 IN SEQUENCE OF THREE] In November 2012 in Guatemala, the Government and other partners are continuing to assure sustained routine immunization of children – now reaching 92 per cent of all infants – against a range of vaccine-preventable diseases. The country’s last endemic case of measles was in 1997. In the entire Americas Region (covering North, Central and South America), the last endemic measles case was in 2002 and the last endemic case of rubella was in 2009 – part of global efforts to eradicate these diseases. Worldwide, measles remains a leading cause of death among young children: In 2010, an estimated 139,300 people – mainly children under the age of 5 – died from the disease. Nevertheless, these deaths decreased by 71 per cent from 2001 to 2011, thanks in part to the Measles & Rubella Initiative, a global partnership led by the American Red Cross, the United Nations Foundation, the United States Centers for Disease Control and Prevention (CDC), WHO and UNICEF. In Guatemala, despite this success, significant other challenges for children remain, much of it related to poverty levels that affect more than half of all children and adolescents. Poverty also contributes to chronic malnutrition affecting half of all under-5 children (with higher rates among indigenous populations); an average national education level of under six years of primary school (under three years for the rural poor); and high, though decreasing, rates of violence. Guatemala is also one of the world’s most vulnerable countries to climate change, suffering a major climate-related emergency every year since 2008. On the positive side, birth registration is improving, with more than 95 per cent of newborns now being registered. UNICEF is working with the Government and other partners to sustain achievements in health, address the high levels of malnutrition, strengthen responses to crimes against children and increase protection services for children throughout public services.

「預防及控制肺炎和腹瀉的綜合性全球行動計劃」(Integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea)呼籲各界人士群策群力,共同防治這兩種疾病,又同時確立降低死亡率、改善兒童享用拯救生命干預措施服務的宏遠目標。

WHO孕產婦、新生兒、兒童和青少年衞生司司長伊莉莎白.馬松(Elizabeth Mason)博士表示:「應對肺炎和腹瀉的策略方案往往各自為營。然而,孟加拉、柬埔寨、埃塞俄比亞、馬拉維、巴基斯坦和坦桑尼亞等國家的經驗已經證明,更緊密地整合這些策略方案,在改善健康和提升經濟效益方面都很有意義。」

由於可導致肺炎和腹瀉的原因很多,單一的干預措施並不能有效地防治或控制肺炎或腹瀉。較富裕的國家已經證明,有些因素對減少這兩種疾病造成的感染及死亡個案至關重要。例如,良好的營養和乾淨的環境,有助保護兒童避免感染肺炎和腹瀉;正獲採用的新型疫苗,亦可以保護兒童免受疾病感染;良好的醫療服務和正確用藥,可以確保兒童得到所需治療。但是,低收入與中等收入國家,在目前多項應對肺炎和腹瀉的工作上,仍未充分顧及到這些因素。

On 13 October, in the village of Manzoorabad in Jamshoro District in Sindh Province, a glass of unclean water sits on the edge of the ‘charpoy’ where Mohammed Ali, 2, lies. When he was admitted to the UNICEF-supported nutrition stabilization centre in Jamshoro City two months ago for severe malnutrition – a consequence of tuberculosis and pneumonia – doctors did not think he would survive. The centre was created following the 2010 flooding in the district, which is still recovering. By 15 October 2011 in Pakistan, over 5.4 million people – including more than 2 million children – had been affected by monsoon rains and flooding. Over 1.52 million houses were damaged or destroyed, and millions of acres of land were affected. In Sindh Province alone, more than 2.5 million people were in need of safe drinking water and sanitation facilities, food and medical care, and an estimated 1.1 million people required emergency shelter. The crisis comes one year after the country’s 2010 monsoon-related flooding disaster, which covered one fifth of the country in water. As of 26 October, in response to the latest crisis, UNICEF and its partners are administering essential newborn, child and maternal health services; supporting outpatient therapeutic feeding programmes and supplementary feeding programmes for malnourished children as well as for pregnant and lactating women; providing safe drinking water, sanitation facilities and hygiene kits; and supporting temporary learning centres. UNICEF funding needs for the next six months are US$50.3 million – part of the joint United Nations Rapid Response Plan. But, despite a recent increase in donations, 70.9 per cent remains unfunded.

UNICEF健康計劃全球負責人米奇.喬普拉(Mickey Chopra)博士表示:「這是一個關乎均衡的問題:雖然低收入國家的貧困兒童,他們面臨因肺炎或腹瀉死亡的風險最大,但是卻更難獲得所需的干預措施服務。」他補充道:「我們非常清楚我們的目標。如果我們在死亡率最高的75個國家,為所有人提供僅20%最富有家庭享有的基本干預措施服務,我們最快就可以在2015年實現《千禧發展目標》的最後期限內,挽救200萬名兒童的生命。」

A packet of oral rehydration salts (ORS), to treat dehydration caused by diarrhoea, is displayed at UNICEF's central supply warehouse in Copenhagen, the capital. The packet bears the UNICEF logo. The salts are a component of an emergency health kit. Designed to meet the initial primary health care needs of a displaced population without medical facilities, the kit contains basic drugs, medical supplies and equipment for 10,000 persons for 3 months, as well as basic sterilization equipment. The Copenhagen warehouse stocks components for 40 different kinds of kits, which are often used in emergencies. In 2005 in Denmark, UNICEF Supply Division Headquarters in Copenhagen, the capital, is the centre of UNICEF's global supply operations on behalf of children and families. Supply Division carries out the procurement, shipment and distribution of supplies for UNICEF-supported programmes, including bulk purchases, storage of standard kits and preparation of supplies and equipment for direct distribution to health centres, schools or other institutions in recipient countries. It also assists Governments and other United Nations agencies and development partners in procuring quality supplies. UNICEF Supply Division is also the largest purchaser of vaccines in the world. The Copenhagen warehouse is complemented by two strategic hubs (in Dubai and Panama), which together hold enough emergency supplies to meet the needs of 320,000 people for three weeks. The Division procured over US $1.1 billion in supplies in 2005 in response to an unprecedented number of natural disasters, food crises, conflicts and other humanitarian emergencies. The Copenhagen facility is also used by the Office of the United Nations High Commissioner for Refugees (UNHCR), the International Federation of the Red Cross and Red Crescent Societies (IFRC) and other organizations to stockpile emergency items. WHO/UNICEF的新行動計劃,明確地確立了到2025年前要實現的全球目標:將因嚴重肺炎和腹瀉造成的5歲以下兒童死亡率,在2010年的水平上減少75%,基本上根除這兩種疾病造成的5歲以下的兒童死亡個案。此外,將全球5歲以下兒童患上發育遲緩的數目減少40%。

這項行動計劃的目標水平較當前水平顯著為高。例如,這項計劃呼籲讓90%的兒童獲取肺炎抗生素,以及治療腹瀉的口服補液鹽,即在當前水平上分別增加31%和35%;計劃的中期目標,是致力讓至少半數6個月以下嬰兒接受純母乳餵養──在2012年這一數值只有39%;讓所有兒童獲得改善的衞生設施和安全的飲用水──目前相關的獲取比率分別為63%和89%;基於一些國家在採用新型肺炎球菌以及輪狀病毒疫苗方面,已經取得良好進展,計劃目標到預定日期前,實現90%的疫苗接種覆蓋率。

這項行動計劃呼籲各國政府及其他持分者,優先考慮援助最難以獲得防治肺炎和腹瀉服務的人群。在目前因肺炎和腹瀉導致的兒童死亡個案中,近90%發生在撒哈拉以南的非洲地區和南亞地區。

正當國際社會加緊實現《千禧發展目標》中有關衞生的目標(其中包括降低兒童死亡率的目標)之際,這項行動計劃適時推出。國際社會的行動包括聯合國秘書長發起的「每個婦女每個兒童」倡議(Every Woman Every Child initiative)及其旗下的「重申承諾.致力兒童生存」全球運動(Committing to Child Survival: A Promise Renewed)。該運動由UNICEF發起,目前已有170多個國家承諾,到2035年根除所有可避免的兒童死亡。

要擴大和改善保護兒童免患腹瀉和肺炎的工作,以及為患病兒童提供適切治療,更緊密地整合現有各項計劃,以及各類執行者(其中包括社區和私營部門)之間的協作將十分關鍵。此外,亦必需確保所有工作能夠長期執行。

Women hold their babies in the village of Sarkin Yamma Soffoua, in Sarkin Yamma Commune. The village has benefited from sessions raising awareness of essential family practices, including exclusive breastfeeding, proper hand washing and the treatment of diarrhoea with oral rehydration salts. In September-October 2010 in Niger, children continue to face high rates of illness and mortality. One of the world’s poorest countries, Niger has the world’s 12th highest rate mortality rate for children under age five, and only 10 per cent of children under six months old are exclusively breastfed. In addition, an ongoing food emergency puts nearly 400,000 children at risk of severe acute malnutrition. UNICEF is responding to these conditions with a host of health programmes that extend vital healthcare services to remote areas and educate communities about life-saving practices. UNICEF supports a Ministry of Health programme that is establishing integrated health centres to reduce infant mortality, improve maternal health, and combat preventable diseases including malaria and HIV/AIDS. The centres offer prenatal and neonatal care, promote breastfeeding, and educate families on the use of mosquito nets to prevent malaria. An estimated three quarters of all children now have access to healthcare, compared to less than half of all children in 2006. UNICEF and partners are also supporting a three-year campaign to encourage exclusive breastfeeding during a child’s first six months, a practice that dramatically improves babies’ chances of survival. UNICEF and partners also support programmes in which facilitators educate community members about essential family practices, including proper hand washing and the use of mosquito nets. Three-month-old Abdoulrachid Hamissou smiles in the village of Foura Guiké, in the southern Maradi Region. Abdoulrachid has benefitted from the promotion of essential family practices in the village. Four volunteers in the community promote essential family practices that reduce child diarrhoea, prevent malaria and improve hygiene. They also promote exclusive breastfeeding and growth monitoring for children, practices that help prevent malnutrition. In October 2009 in Niger, rates of malnutrition are escalating due to irregular rains and faltering crop yields. The country already has high chronic malnutrition rates, with half of children experiencing stunted growth, and one of the highest child mortality rates in the world, with 17 per cent of children dying before the age of five. Late and erratic rains led to failed harvests in the southern regions, where farmers and pastoralists were already contending with reduced pasture lands and high food prices. Meanwhile, heavy rains caused the worst flooding in decades in the northern Agadez Region, destroying farms and wiping out crops. The flood damage in Agadez leaves little food or employment for southern migrants who travel north to work the fields each year. According to the Government, over 100 agricultural zones, and nearly two million people, are food insecure, numbers that may rise. In response, UNICEF, the World Food Programme (WFP), Médecins sans frontières (MSF) and other partners are providing health care and nutritional support throughout the country. Food distributions have also been launched in the southern regions to limit rising malnutrition rates.