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* Breastfeeding for first six months of life critical
* Coherent, reliable vaccine distribution another key
* Simple, cheap measures like hand washing important too
* India, Pakistan, Nigeria, Congo, Ethiopia singled out
By Ransdell Pierson
NEW YORK, June 8 (Reuters) - Concerted efforts to control diarrhea and pneumonia, the biggest killers of children under the age of five, could save the lives of up to 2 million of the world's poorest children each year, the United Nations Children's Fund said on Friday.
The lives saved would be largely in Sub-Saharan Africa and South Asia, according to a new study from the Fund.
"Scaling up simple interventions could overcome two of the biggest obstacles to increasing child survival (and) help give every child a fair chance to grow and thrive," said Anthony Lake, executive director of the Fund, known as UNICEF.
The study called for coherent and reliable distribution plans for new vaccines against the major causes of pneumonia and diarrhea - including the influenza virus, rotavirus and pneumococcal bacteria.
It noted that one of the simplest and most effective ways to protect babies from disease is exclusive breastfeeding during the first six months of life, although fewer than 40 percent of infants receive such protection.
"Infants not breastfed are 15 times more likely to die due to pneumonia than are exclusively breastfed children," it noted.
Pneumonia and diarrhea, which often occur simultaneously, account for 29 percent of deaths among children under five worldwide - or more than 2 million a year. Nearly 90 percent of the children who die from the two diseases live in sub-Saharan Africa and South Asia, the report said.
It noted that about half of those deaths occur in just five mostly poor and populous countries: India, Nigeria, the Democratic Republic of the Congo, Pakistan and Ethiopia.
Current care for children with pneumonia is haphazard in the 75 countries with the highest mortality rate, it added, with fewer than one-third of affected children receiving antibiotics.
Likewise, the study said inexpensive but potentially life-saving oral rehydration salts are used by only one third of the children with diarrhea in developing countries.
"Child deaths due to pneumonia in these countries could fall 30 percent, and child deaths due to diarrhea could fall 60 percent," the report said, if interventions among poor children were raised to the level seen in the richest 20 percent of households in the same countries.
In that event, deaths of children from all causes could be reduced about 13 percent in those 75 countries by 2015, it said.
Adequate nutrition, hand washing with soap, safe drinking water and basic sanitation are also deemed vital safeguards against pneumonia and diarrhea, but are largely absent in impoverished regions.
"This report is a call to action" against the two childhood scourges, UNICEF said, adding that a global action plan will be released next year and set out a "clear and integrated vision" of how to proceed.
The UNICEF report was issued ahead of a planned meeting next week in Washington convened by the governments of Ethiopia, India and the United States on child-survival objectives. Some 700 experts from government and the private sector are expected to attend.
UNICEF, a U.N. agency, works for children's rights, their health, development and protection from violence, exploitation and abuse, according to the www.unicef.org Web site.