Newborn Deaths - A Global Problem and a Call for Action

Professor Zulfiqar Bhutta, Chairman, Departmant of Paediatrics

Every day around the world, there are 10,000 deaths of newborn babies who have not yet completed four weeks of life. This amounts to an annual four million deaths during the neonatal period, the time when an infant is most at risk.

Although most research and funding for newborn deaths are focused on high-income countries, virtually all (99%) neonatal deaths occur in the developing world.

In March 2005, AKU researcher Dr Anita Zaidi, Associate Professor of Paediatrics and Microbiology (MBBS '88), published a paper in the prestigious medical journal Lancet regarding health risks faced by newborn babies born in hospitals in developing countries.

The article became the subject of a BBC News report headlined ‘Developing World at Superbug Risk’ and also received coverage from Reuters International as well as global news networks such as MSNBC and ABC News from the United States. The startling finding was that unsanitary practices during labour and delivery, as well as in after-birth care, create an infection risk for the developing world's newborns, that is up to 20 times greater than in developed countries.

A key observation from the study was the alarming level of antibiotic resistance in the developing world's newborn baby nurseries. Dr Zaidi and colleagues estimated that 70 percent of bacteria isolated from bloodstream infections in such nurseries may not be treatable by common antibiotics such as ampicillin and gentamicin, which are recommended for this purpose by the World Health Organization. This work was conducted through a collaborative international effort in which Dr Zaidi led a team of paediatric infectious disease specialists from Harvard Medical School and Mayo Clinic, USA. "Recognition by the world's media is an important dimension of this work," says Dr Zaidi, an AKU alumna and an active member of the University’s child health research team. "It brings attention to this problem so that solutions can be debated, and hopefully acted upon."

Newborn health has been a key focus for paediatric research at AKU. Dr Zulfiqar Bhutta, Chairman

Dr. Anita Zaidi, Associate Professor, Departmant of Paediatrics

of Paediatrics and an internationally recognised child health researcher, has been part of a global advocacy campaign devoted to highlighting the problem of newborn health in developing countries. He emphasises that 70% of newborn deaths can be prevented through 16 simple and cost-effective interventions, including clean and skilled delivery by trained midwives, giving only breast milk to babies, and extra care for babies with low birth weight.

Much of this knowledge has been made available to the public and health care workers through a series of prominent articles published in the Lancet Newborn Survival Series (March 2005). These analytic commentaries, which Dr Bhutta has co-authored along with other international leaders in the field, define the scope of the problem and describe low cost but effective solutions to save babies from dying soon after birth.

Dr Bhutta has now co-authored a follow-up paper in Lancet (May 2006) that details progress since the initial call to action. "The most heartening thing is that the campaign has started producing results," he says. "Among other developments, leaders of WHO, UNICEF and World Bank have made public commitments to improving newborn health; UNICEF has produced a revised health and nutrition strategy recognising the importance of newborn survival; and private donors, primarily the Bill and Melinda Gates Foundation, have approved grants of US $60 million to advance survival of newborns in high mortality countries." The problem of newborn survival is vast and there is still much to do. It is encouraging to note, however, that AKU's child health experts have been able to create a discernible impact.