Royal College of Physicians of Edinburgh
Press Release
18 September 2013
SPOTLIGHT ON SCOTLAND AS STILLBIRTHS PRESENT NEW GLOBAL HEALTH CHALLENGE & CHILD MORTALITY GAP WIDENS
International medical experts will meet in Edinburgh today, at an event organised by the Royal College of Physicians of Edinburgh, to review progress in tackling a range of global health challenges and disease areas [1]. During the event, delegates will hear that while there are 2.6 million stillbirths annually, a tragedy also affecting Scottish families daily, this is almost invisible as a priority on the global heath agenda. They will also learn that while global action has reduced child mortality rates, the health inequalities between higher and lower-income countries have widened.
STILLBIRTHS – THE NEW GLOBAL HEALTH CHALLENGE (or $2 to save a life)
In 2011, a Lancet and World Health Organisation report highlighted that 7300 babies are stillborn every day around the world [2]. The majority of these deaths, occurring in the third trimester of pregnancy or during labour, are completely preventable, yet a new analysis has shown that stillbirths are almost completely invisible as a global health priority. Out of 250,000 disbursements of donor funding of US$6 billion dollars for maternal, newborn and child health, stillbirths were mentioned only twice.
Stillbirths affect at least 2.6 million families worldwide every year. 98% of stillbirths occur in low and middle-income countries with the highest death rate recorded in Pakistan (46 per 1000 births). While such countries are disproportionately affected by stillbirths, this also affects higher income countries including Scotland. A new analysis which will be presented to the meeting will highlight that there were 274 stillbirths in Scotland in 2012, twice as many deaths as neonatal (those in the first month after birth) and almost four times as many as the deaths of Scottish children aged 1-11 months. The stillbirth rate in Scotland is 4.7 per 1000, with regional variation of 1.7 to 9.9.
Prof Joy Lawn, Professor of Maternal, Reproductive and Child Health and Director of MARCH Centre, London School of Hygiene & Tropical Medicine, said,
“Every year there are over 2.6 million stillbirths globally which are entirely preventable, especially the 1.2 million that happen while during labour. Despite this, stillbirths are invisible on the global health agenda. There is compelling evidence for potential for change with more focus on evidence-based measures costing an estimated annual running cost of US$2.32 per person. This would give a triple return on investment with lives saved for mothers and newborns, as well as preventing stillbirths”.
“In Africa the risk of stillbirth during labour is about 45 times higher than for a woman in a Scotland. However, stillbirths do occur in higher income countries including Scotland where four times as many stillbirths occur annually than deaths in children aged 1 – 11 months. In relative terms, stillbirths, even in the UK, do not attract the attention they deserve. Stillbirths present a global health challenge and there is a need for all governments to give this greater priority, to recognise their responsibilities in reducing the level of stillbirths and better supporting families affected by this tragedy.”
WIDENING HEALTH INEQUALITIES IN CHILD MORTALITY
New data published by UNICEF within the last few days, and which will be presented at the event by Prof Mickey Chopra, Head of Health, UNICEF, New York , has shown that child mortality in the under-5 age group has almost halved since 1990, as a result of global health policy initiatives [3]. During this period the number of deaths in under 5s worldwide has decreased from nearly 12 million annually to 6.6 million in 2012. Deaths in the first month of life (neonatal) have made much slower progress and now account for 44% of all under-5 deaths. While the global rate has declined, child mortality has increasingly become concentrated in sub-Saharan Africa and South Asia. 82% of all deaths in under -5s are now experienced in these two regions, up from 67% in 1990.
Comparison of mortality rates in under 5s in these regions with the UK and other European countries makes stark reading. Under 5 mortality rates 2012: Sierra Leone – 182 deaths per 1000 live births, Angola – 164 deaths per 1000 live births, Chad – 150 deaths per 1000 live births, UK – 5 deaths per 1000 live births, France – 4 deaths per 1000 live births, Norway – 3 deaths per 1000 live births. Of the 6.6 million under-five deaths in 2012, most were from preventable causes such as pneumonia, diarrhoea or malaria; around 44 per cent of deaths in children under 5 occurred during the neonatal period.
‘LIVE’ INTERNATIONAL CONTRIBUTION TO EVENT
The meeting will be held at the RCPE and webstreamed live to medical audiences around the world. Confirmed international centres linking in, and contributing, to this event include – Egypt (Cairo & Alexandria); Pakistan (Karachi); Malaysia (Kuala Lumpur); Bangladesh (Dhaka); India (Kerala & Mumbai); Sudan (Kartoum): South Africa (Johannesburg); Somalia (Burao) and Wales (Bangor).
Other speakers at the event will include – Dr Richard Smith CBE, Director, United Health Chronic Disease Initiative, and Prof David Heymann, Head and Senior Fellow, Centre on Global Health Security.
Dr Neil Dewhurst, President of the Royal College of Physicians of Edinburgh, said,
“Edinburgh has enjoyed a reputation as a leading international centre of medical excellence and innovation over the centuries. With a membership of over 12,000 doctors in 85 countries, the RCPE is delighted to be convening this international event which will enable senior doctors from around the world to review progress in addressing global medical challenges and to consider how they can contribute to and inform future global health policy.”
Contact Graeme McAlister on 0131-247-3693 or 07733-263453
ENDS
[1] ‘Global Health: Paradigms, Progress, Priorities and Partnerships: RCPE Hot Topic Symposium’ will be held at the RCPE, 9 Queen Street Edinburgh on 18 September 2013 from 9.00am to 4.40pm
[2] Stillbirths, The Lancet, April 2011
http://www.thelancet.com/series/stillbirth
[3] ‘Committing to Child Survival: a promise renewed. Progress Report 2013 (published 13 September 2013), UNICEF. http://www.apromiserenewed.org/
Journalists wishing to interview Prof Joy Lawn should contact Graeme McAlister on 0131-247-3693 or 07733-263453.
