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Over the past two decades, mortality has declined from 5 million to 1.5 million in 2004, while the incidence remained stable, at approximately 2.5 billion cases per year. The achievement of the Millennium Development Goals depends largely on success in the prevention and management of diarrheal disease, particularly target 4A, which calls for the reduction by two-thirds of under-five mortality between 1990 and 2015. However, little progress has been made. Between 2000 and 2007 the percentage of children under five with diarrhea receiving at least one ORS packet during illness increased from 28% to 33%. Many countries still do not have a national policy on the use ORS or zinc to treat childhood diarrhea.
The seven point plan for prevention and treatment
The seven point plan for prevention and treatment include: 1.Fluid replacement, and 2. zinc therapy for treatment, and 3. Rotavirus and measles vaccines, 4. Exclusive breastfeeding and vitamin A supplements, 5. Handwashing with soap, 6. Improved water supply, 7. Community-wide sanitation promotion for prevention.
Strategies need to overcome competing priorities, while expanding community mobilization and access to community case management programs. Involvement of families and communities; the public and private sectors; and global partnerships and networks, is essential for substantial and sustained reduction in diarrheal disease.
Conclusion
Against this background is a clear call for global advocacy for a renewed effort in diarrhea control which remains a public health and social challenge. Reducing diarrheal deaths will accelerate attainment of MDG 4. What will an effective coalition look like, who will sound the call, who are the partners, and what will success look like? Now is the time for a broad coalition of public health practitioners, private sector investors, engineers, habitat planners and politicians to rise to the challenge to defeat diarrheal disease.
Learning Objectives: 1. Describe the current challenges related to diarrheal disease from the global perspective 1. Identify key activities that can be implemented in terms of diarrhea treatment and prevention