WASHINGTON -- Three million newborns who die each year could be saved with low-tech and low-cost measures but are condemned because funding and research is devoted to high-tech solutions used almost exclusively by the rich, an international study said Thursday.

Every year, four million babies die in the first month of life, according to research announced Thursday and being published by the international medical journal The Lancet. That amounts to more than 10,000 neonatal deaths per day.

''Virtually all (99 percent) occur in low- and middle-income countries, yet most research, publications, and funding focus on high-tech care for the one percent of deaths that occur in rich countries,'' the study said.

Globally, the three major causes of neonatal deaths are infections: sepsis, pneumonia, diarrhea, and tetanus (accounting for 36 percent of deaths); premature birth (28 percent); and problems related to complications during childbirth (23 percent). Infections are the major cause of death after the first week of life.

The international community has committed itself to the U.N. Millennium Development Goals, one of which is to reduce the death rate for children younger than five years by two-thirds by 2015. This target ''will not be met'' unless neonatal mortality is cut substantially, especially in Africa and South Asia where two-thirds of all neonatal deaths occur, the study said.

''If we now continue to fail children under threat, we will be delivering a verdict of wanton inhumanity against ourselves,'' said Richard Horton, The Lancet's editor. ''We will be a knowing party to an entirely preventable mass destruction of human life.''

Measures to prevent three million of the four million annual newborn deaths are startlingly simple and cheap.

They range from tetanus immunization--involving two 20-cent injections--during pregnancy to exclusive breastfeeding, clean delivery, and antibiotics to treat illness.

''At less than one dollar per capita [person] per year in additional spending to provide these life saving interventions to 90 percent of mothers and babies, the cost is affordable,'' said Gary Darmstadt, a Johns Hopkins University academic and research adviser to the aid group Save the Children USA, which helped produce the study.

For the 75 countries with the highest neonatal mortality, the total cost would amount to about $4.1 billion per year on top of the $2.0 billion now being spent, the study said.

The key to getting services to those needing them most, however, would lie in establishing the right mix of services for a given community and making sure that the people who are supposed to benefit are aware of the services and their importance.

''Although low-cost interventions exist, there is no one-size-fits-all solution for making them widely available within countries,'' said Vinod Paul, a pediatrics professor at the All India Institute of Medical Sciences and senior adviser to the Indian government.

Many of the measures also would help save some of the 515,000 mothers who die during or soon after childbirth every year, help prevent some of the four million annual stillbirths, and boost survival rates for children under five years of age, the study added.

''It is time for governments and assistance agencies to take joint responsibility to reduce the needless deaths of women and children,'' said Anne Tinker, director of Save the Children USA's Saving Newborn Lives initiative. ''Political commitment, increased human and financial resources, community involvement, and coordinated country-level support will be required to turn what we know into action.''

In addition to assailing global funding and research as favoring measures that save rich lives, the study found that neonatal mortality appeared to have fallen between the cracks in developing countries' and international donor agencies' health programs. Prevention of newborn deaths has been lost between safe motherhood and child survival initiatives, which tackle causes of illness and death after the first month of life, it said.

Even so, low-income countries including Botswana, Honduras, Indonesia, and Sri Lanka halved their neonatal death rates in the 1990s. The study credited this to ''sustained political commitment at the highest level of government.''

The study, based on the work of academics and health economists in Africa, Asia, the UK, and the United States, was supported by the World Health Organization ) and the U.N. Children's Fund (UNICEF ) and funded by the U.S.-based Bill and Melinda Gates Foundation and the U.S. Agency for International Development (USAID).

If funding and services for newborns are failing to reach the world's poorest, the same is to be said of global aid in general, according to a report last week from international charities Oxfam and ActionAid.

The groups accused the wealthiest nations of failing the poor with a ''self-serving and hypocritical'' system of aid, saying 40 percent of it is ''tied,'' forcing developing countries to buy overpriced goods and services from donor countries.

It accused the United States and Italy of being the worst culprits in so-called aid ''round tripping,'' spending some 70 percent of their aid on their own companies.

''This is the ultimate form of round tripping--taking with one hand what is given with the other while advertising your 'generosity','' the report said, noting that the inefficiency involved also inflated procurement costs by some $7 billion per year.

They said just one-fifth of aid actually goes to the poorest countries--and only half of that is spent on basic services such as health and education.

The report, ''Millstone or Milestone,'' said international institutions imposed impossible bureaucratic conditions on recipient nations. Senegal, for example, had to play host to 50 delegations from the World Bank in 2003.

It faulted rich countries for ''using aid to reward strategic allies and pet projects at the expense of the neediest countries,'' saying that the existing international aid system had grown out of the Cold War when donor countries frequently used aid to obtain political leverage and fly the national flag.

Aid continues to be misdirected at ''donor darling'' countries like Nicaragua which received the equivalent of $178 per person in 2001 compared with Niger which got $22 per person despite a similar income level.

''Donors tend to be more concerned about the success and visibility of their project or program than the success of a country's development plan,'' the report said.

It added that donor nations often bypassed local delivery networks, undermining them and leaving countries less able to stand on their own feet.

All aid should be untied, technical expertise should be trained locally, goods and services should be procured locally when possible, and the focus should be on directly helping the poor, it said.

''These are major challenges to the aid system since they imply a redistribution of power between recipients and donors and a far greater openness and accountability than currently exists,'' Oxfam and ActionAid concluded.

© 2005 OneWorld US

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