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Best buys for health

In developing countries, more than 13 million children die each year before their fifth birthday. At least 70 per cent of these deaths can be avoided by simple, low-cost interventions that would have a positive impact on maternal and infant health. Cardiovascular disease kills more people across the world each year than any other ailment, and studies show that death rates can be brought down by a combination of lifestyle changes, adopting simple strategies for prevention, and policy measures that would inhibit the use of tobacco. About 40 million people live with HIV worldwide; tuberculosis caused the deaths of 1.7 million people in 2003; and a preventable disease like malaria kills a million children each year. Death and disability from many of these conditions can be vastly reduced by low- cost health care interventions. A list of 10 "best buy" health interventions has been identified by the Disease Control Priorities Project (DCCP), a collaborative effort of the Fogarty International Centre of the U.S. National Institutes of Health, the World Health Organisation, and the World Bank, supported by a grant from the Gates Foundation. The project advocates, through a trio of new books, meaningful and cost-effective remedies, particularly in developing countries, that could reduce disability and illness and save millions of lives each year. These include simple measures like optimum care of pregnant mothers and the newborn; teaching mothers and birth attendants to keep infants clean and warm, thereby reducing illness and death; vaccinating children at the right time; arresting the spread of HIV through promoting condom use; providing antiretroviral medicines to HIV-infected individuals; providing insecticide-treated bed nets in malaria infested areas; promoting the use of aspirin to prevent heart attacks and stroke; and enforcing traffic regulations by installing speed bumps to bring down the number of deaths from road accidents each year.

In India, although life expectancy has gone up to 64 years and infant mortality rates have seen a dramatic decline, critical health issues remain. Children continue to die from infectious diseases; the under-five mortality rate stemming from preventable diseases remains high. In adults, deaths from cardiovascular disease, cancer, tuberculosis, and HIV infections are on the rise. The effectiveness of low-cost health interventions, particularly in conditions of mass deprivation, has been demonstrated by some remarkable examples — which need scaling up as a national public health priority. For instance, the Chennai-based Kidney Help Trust has had considerable success in implementing an effective low-cost protocol for early diagnosis and treatment of hypertension and diabetes in the Sriperumbudur taluk of Tamil Nadu. Clearly, positive health interventions that are inexpensive and effectual should become a viable part of national health policies for the benefit of millions of poor people.

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