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Treating diarrhoeal disease in children under five: the global picture
  1. Carla Chan Unger1,
  2. Shumona Sharmin Salam1,
  3. Md Shafiqul Alam Sarker1,
  4. Robert Black2,
  5. Alejandro Cravioto3,
  6. Shams El Arifeen1
  1. 1Centre for Child and Adolescent Health, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh
  2. 2Centre for Global Health Faculty, Johns Hopkins Centre for Global Health, Baltimore, Maryland, USA
  3. 3International Vaccine Institute, Seoul, Republic of Korea
  1. Correspondence to Carla Chan Unger, Centre for Child and Adolescent Health, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), 68 Shaheed Tajuddin Ahmed Sharani, Mohakhali, GPO Box 128, Dhaka 1212, Bangladesh; carla.chan.unger{at}


Rates of childhood mortality due to diarrhoea remain unacceptably high and call for renewed global focus and commitment. Affordable, simple and effective diarrhoeal treatments have already been available for many years, yet a shift in international health priorities has seen coverage of recommended treatments slow to a near-standstill since 1995. This article reviews coverage of recommended childhood diarrhoeal treatments (low-osmolarity oral rehydration solution (ORS) and zinc), globally and regionally, and provides an overview of the major barriers to wide-scale coverage. It is argued that to ensure smooth supply and equitable distribution of ORS and zinc, adequate financing, relevant policy changes, strong public, private and non-government organisation (NGO) collaboration, local manufacturing of pharmaceuticals, mass media awareness and campaigning, in conjunction with strong government support, are necessary for successful treatment scale-up.

  • Comm Child Health
  • General Paediatrics
  • Infectious Diseases
  • Epidemiology

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