In many African countries, one child in five dies before they are five years old. 98-99% of childhood deaths occur in developing countries and more than 50% is associated with malnutrition.

Economic, political, social, and environmental factors all play a part. Between 1998 and 2001, African countries paid out $17.5 billion more in debt repayments than they received in aid or new loans. These repayments are made to the world's richest nations and international institutions.

Armed conflict is also associated with poor child health, as war disrupts food production, displaces populations, and diverts vital resources from health and education. Meanwhile, HIV/AIDS continues to devastate the fabric of African society. UNICEF has warned that there will be 18 million orphaned children due to HIV/AIDS by 2010.

But positive steps are being taken. Debt relief is starting to make a difference and changes to international trade practices would have a great impact. There are presently fewer armed conflicts in Africa than at any time in the past decade, and new global partnerships are helping to improve education and fight the most common childhood illnesses.

So what can paediatricians from rich countries do to help African children now? The UK's reliance on overseas trained staff should be urgently addressed, but perhaps the most effective way is through advocacy.

"2005 is a year when the UK government will be in a position to make real changes in terms of the cancellation of debt and unfair trade practices. As a body, UK paediatricians, on behalf of so many children living in poverty in Africa, could add considerable weight to the arguments for change,” they conclude.

MEDICA.de; Source: British Medical Journal