WASHINGTON – A landmark series of research papers to be published in the leading international medical journal The Lancet on the survival of newborn babies released today finds that 4 million newborn babies worldwide die each year, and nearly 3 million of them could be saved if they and their mothers had access to low-cost care such as tetanus immunizations during pregnancy, exclusive breastfeeding, clean delivery and antibiotics to treat illness. The series of papers analyzes the status of newborn health around the world and calls for immediate and sustained action to save newborn lives.

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The newborn series follows the Bellagio Child Survival series, also published in The Lancet in July 2003, which focused on providing affordable, effective measures that could prevent two-thirds of the nearly 10 million deaths to children under age five each year. The latest series on newborn survival is possible because of new analysis detailing the causes of these deaths and the interventions that are available to prevent them.

“Eight million children are either stillborn or die each year within the first month of life. This figure never makes news,” said Richard Horton, Lancet editor-in-chief, in his series editorial. “The aim of the present Lancet series is to erase the excuse of ignorance for public and political inaction once and for all.”

Almost 40 percent of all child deaths worldwide occur in the first month of life – the neonatal period. Although 99 percent of newborn deaths are in poor countries, almost all of the funding and research worldwide focuses on high-technology solutions for the 1 percent of deaths in rich countries. The burden of maternal, newborn and child mortality falls disproportionately on the world’s poorest countries and on the poorest populations.

A panel of leading international public health experts announced the research findings today at events at the National Press Club in Washington, D.C. and at the London School of Hygiene and Tropical Medicine. The papers will be published over the course of four weeks; however, all four articles and a number of related papers are available with free access online today at http://www.thelancet.com.

“This Lancet series addresses the many challenges we must overcome to prevent newborn deaths, and offers practical steps to do so. Although low- cost interventions exist, there is no one size fits all solution for making them widely available within countries. The goal of this newborn survival series is to provide information that will affect policy globally, and also support practical action in countries so that these proven, cost-effective interventions reach the families that need care the most,” said one of the authors, Professor Vinod Paul, Department of Pediatrics, WHO Collaborating Centre for Training and Research in Newborn Care, All India Institute of Medical Sciences, New Delhi, India, a senior advisor to the Indian government on maternal and child health.

The Millennium Development Goal for child survival calls for a two-thirds reduction in child mortality by 2015 from the base year of 1990. This goal cannot be met without a substantial reduction in neonatal deaths, especially in Africa and South Asia.

“The global commitment to achieving the Millennium Development Goal for child survival is an unprecedented opportunity to reduce newborn mortality,” said Dr. Jacques Baudouy, Director, Health, Nutrition and Population, Human Development Network, World Bank. “But we must all take collective responsibility for this global health crisis and commit to working together in close coordination to achieve this goal.”

Research conducted for The Lancet series found that it is more cost effective to address newborn health within maternal care and child survival programs than through a separate program. Scaling up newborn survival activities also benefits maternal and child survival programs: About 30 percent of the additional cost would be specifically for newborns, while the remaining 70 percent would also benefit mothers and older children.

The cost of providing newborn health interventions at 90 percent coverage is estimated at $4.1 billion (U.S.) per year in addition to the $2.0 billion being spent currently in the 75 countries with the highest mortality.

“At less than $1.00 per capita per year in additional spending to provide these life saving interventions to 90 percent of mothers and babies, the cost is affordable,” said Dr. Gary Darmstadt, Department of International Health, and Director of the Center for International Neonatal Health at Johns Hopkins University, and Senior Research Advisor for Saving Newborn Lives, Save the Children/USA. “When you look at the sheer number of deaths coupled with the fact that extremely cost-effective interventions are available, current funding levels are inexcusably low. Both international donors and leaders in developing countries must be held accountable for commitments to increasing resources, and then spending these resources effectively, based on the evidence we now have.”

The fourth paper in The Lancet series issues calls to action at both the national and international levels. Nationally, the actions include setting and publishing by the end of 2005 national targets for the reduction of neonatal mortality to be achieved by 2015; and producing and publishing by the end of 2007 a plan of action to reach the set neonatal survival targets. This plan should be based on situation analyses, including a defined baseline newborn mortality rate, be evidence-based, specifying strategies to reach the poorest families and should be implemented within maternal health and child survival programs.

Internationally, the actions include: leveraging resources to meet the additional needs identified ($1 per capita) to achieve high coverage of interventions for neonatal survival within maternal health and child survival programs, and promote donor convergence at the country level; and include newborn mortality rates as an indicator for MDG-4, with a target of 50 percent reduction in newborn mortality rates between 2000 and 2015.

“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, Saving Newborn Lives, Save the Children/USA. “Political commitment, increased human and financial resources, community involvement and coordinated country-level support will be required to turn what we know into action. The partnerships for maternal, newborn and child survival are working to coordinate efforts, increase resources and put policies into action.”

About the Series The newborn series follows a series published in The Lancet in July 2003, which focused on deaths of children under the age of five. The series gained widespread attention and has helped raise awareness and promote action for the 6 million children, almost two-thirds of child deaths, who die unnecessarily each year because simple, low-cost interventions are not reaching them. The previous series highlighted the need for further information and action with respect to neonatal deaths.

Many international health and development agencies including the World Health Organization, the World Bank, UNICEF, and Saving Newborn Lives - Save the Children/USA, contributed to the production of the series, which involved

the work of leading academics and health economists from the UK, USA, Asia and Africa. The Bill & Melinda Gates Foundation and USAID provided funding.

Subsequent events to release The Lancet’s newborn survival series will take place in Islamabad, Pakistan on March 10, in New Delhi, India in early April and in other locations in Africa, Asia and South America in the coming months.