PEDIATRICS Vol. 83 No. 6 June 1989, pp. A84
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UPDATE ON THE WORLD'S CHILDREN

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Less than 5% of the poor world's children were being immunised at the start of the decade. Now the proportion is over 50%. The UN target is 85% vaccination coverage by the end of 1990. China is expected to achieve this by the end of this year, and India, with 20% of the world's infants, is now passing the 60% level. Immunisation saves lives and reduces morbidity—poliovaccination prevents 190 000 cases every year. But only 25% of pregnant women are vaccinated against tetanus, which kills 800 000 infants annually. Improvemments in transport and cool storage of vaccines have extended the reach of immunisation programmes. Almost half the developing world's children are not protected by immunisation—another 2-3 million lives could be saved and 240 000 cases of poliomyelitis could be prevented a year. Rapid spread of knowledge about family planning, especially birth spacing, is a major break-through. Births that are "too many or too close" or to mothers who are "too old or too young" cause up to a quarter of all maternal and infant deaths world wide. Sensible spacing of births could save the lives of 3 million children and 200 000 mothers every year. The use of oral rehydration therapy saves almost a million children annually and has been a success story. But another 1.6 million child deaths from diarrhoea could be saved if use of this simple and cheap technigue could be extended.