Stop the Cycle

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No child should die from diarrhea or suffer its lasting consequences. We can stop the cycle of poor health and poverty for children, their families, and entire communities by taking on diarrhea with a holistic approach.

We're taking action. Will you?

Diarrheal disease is a continuing crisis for the world’s children, demanding greater attention from health policymakers and advocates. Re-establishing diarrheal disease –  and its long-term impacts – as priorities and making simple solutions more accessible will save and improve lives.

The number of deaths from diarrhea is at an all-time low, thanks to the collective work of advocates, health workers, scientists, donors, and policymakers. Still, it doesn’t mean our work is done. Too many children are still getting sick as governments, donor countries, and global health agencies juggle competing priorities.

The cycle of poor child health is perpetuated by inequities in gender, lack of access to primary healthcare, and climate change; these policy and community initiatives for more attention to all of these issues will also move the needle in protecting children against common infections like diarrhea.

Today, we face the same disease, with new challenges.

COVID-19 has changed the world for everyone – including children – and its impact on health has already been far reaching. It has disrupted immunization services and supply chains, increased malnutrition, overwhelmed health systems, and weakened economies. All of these factors conspire to unravel progress against diarrhea and child health more broadly.

At the same time, less than half of the countries tracked by the Countdown to 2030 report have costed national plans for maternal, newborn, and child health. We celebrate those countries that are already taking action. But millions of surviving children still face the physical and mental impacts of persistent diarrhea and risk failing to reach their full potential. We must continue to advocate for proven prevention and treatment tools, and for creative ways of delivering them, to give all children the healthiest start in life.

What can you do? The first step is simple: talk about it.

If we can’t talk, we can’t act. Join a network of advocates who are already taking clear and bold action to move the issue of child health, including a holistic approach to addressing diarrheal disease, up on global and national health agendas. These advocates include those working towards gender equity, tackling climate change, improving primary health care, and those advancing improvements in water and sanitation. Help us change the dialogue by turning taboo into action.

Help us talk about it.

“We are not settling for lower mortality. We must hold policymakers accountable for protecting children from illness, too–especially in the poorest and most remote communities. Equity is essential.

- Helga Fogstad, Executive Director, The Partnership for Maternal, Newborn & Child Health (PMNCH)

Who is a diarrheal disease advocate?

YOU are. Whether you’re a nongovernmental (NGO) or civil society (CSO) staffer, a health care worker, a doctor, a parent, a researcher, or an academic, you can help bring more attention and urgency to diarrheal disease. Below are some examples of how advocates are already shining a spotlight on the issue. No matter who you are, you can take action. Here are some ideas.

  • If you are a civil society or grassroots advocate, you can:

    Raise awareness. Look for #DefeatDD on social media to start. The variables that give rise to diarrheal diseases are an ongoing emergency driven by a lack of access to clean water and basic healthcare. Behind disease outbreak headlines, children are suffering and dying every day, but funders can’t help if they don’t know about it.

    Call for increased budgets for diarrheal disease solutions in your country. Solutions for diarrhea are simple and cost-effective, but they require resources, which are often ignored or under-funded. Encourage your policymakers to elevate these tools when they apply for donor funding vehicles like the Global Financing Facility or Gavi, the Vaccine Alliance. Consider areas that might be traditionally overlooked by health budgets, like WASH in healthcare facilities.

    Familiarize yourself with the facts and figures. The data on the global crisis and the impact of cost-effective, simple solutions is strong—so if you’re talking about diarrhea, facts and figures should be part of your messaging. Start here. If you are an advocate or policymaker in a country where disease burden is high, precision data mapping can help you prioritize.

    Learn about how impacts from diarrheal disease can be reduced with strong and accessible primary health care systems. Strong primary health care systems provide care that removes financial and geographic barriers to access and provide services on time. All of these are critical for children suffering from diarrhea to access the treatment they need before diarrhea causes irreparable physical or mental harm.

    Advocate for gender-equitable approaches to child health, and consider how other social inequities increase the toll of diarrheal disease. Like any other health issue, diarrheal disease doesn’t occur in a vacuum. It’s influenced by the conditions in which families, caregivers, and children live. Whether a child gets sick can be influenced by gender roles, poverty, cultural norms, and climate. As advocates, we have to think broadly, and partner to develop solutions that take these conditions into account.

     

    Examples and opportunities:

  • If you are a donor, you can:

    Increase financial support for adaptable, context-appropriate diarrheal disease interventions within broader initiatives. Solutions to address diarrhea are multi-faceted, which means that the best programs ensure coordination among partners to ensure that the collective risk factors to child health are addressed. Diarrheal disease control should be a critical priority in funding for primary health care and overall child health and well being.  

    Provide resources for programs. Provide resources for programs and research that feature innovative, cost-effective ways to deliver integrated approaches. As a donor, you can ensure more solutions reach larger populations by incentivizing, funding, and measuring flexible approaches that combine and deliver the most-needed solutions. Specifically, include requirements in your calls/requests for proposals that prioritize programs implementing the GAPPD approach.

    Examples and opportunities:

  • If you are a multilateral leader (especially at WHO and UNICEF), you can:

    Champion best practices and global guidance for a multifaceted approach to diarrhea. You provide technical assistance to donors and national governments to implement evidence-based tools, such as those outlined in the Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea. Harness the strength of regional and national program staff to work with member countries on effective implementation of global and national strategies for diarrhea treatment and prevention.

    Work with donors to allocate and track funding that promotes global best practices and recommendations. Improve the tracking of multi-sectoral investments to better understand return on investment and enable stronger accountability.

    Provide guidance to national and subnational governments to ensure interventions focus on high-impact solutions. Serve as an advocate for regular national policy updates to ensure harmonization with global best practices and recommendations.

    Procure high-quality commodities and tools to improve access and accountability to proven treatment solutions and vaccines. Ensure efficient prequalification of relevant, high-quality, effective interventions—especially those manufactured locally—to lower costs and ensure WHO-approved commodities are available to all children. Ensure procurement decisions are in lockstep with technical guidelines.

    Examples and opportunities:

    • WHO and UNICEF set the gold standard and roadmap for integration by launching the GAPPD.
    • Following a 2019 World Health Assembly resolution, WHO and UNICEF have established a global network to exchange latest evidence and tools on WASH in health care facilities.
    • In July 2019, the World Health Organization added co-packaged oral rehydration solution (ORS) and zinc to its Model List of Essential Medicines (EML), as well as to the EML for children’s medicines (EMLc). UNICEF must now ensure adequate supply of co-packaged ORS and zinc.

  • If you are a national or subnational government decision-maker, you can:

    Adapt normative global standards that address diarrheal disease to your local policy and programmatic needs. Use the GAPPD and IMCI to determine what specific plans, investments, and partners can be tailored to the national and subnational level to achieve the greatest health impact. Ensure your national list of essential medicines for children includes co-packaged oral rehydration solution and zinc to reflect the updated global standard from WHO and UNICEF.

    Prioritize the fight against diarrhea in child health policies and in increased domestic and partner resource mobilization. Prioritizing more domestic funding demonstrates greater commitment to improving child health. Ensure that diarrheal disease solutions are included in Global Financing Facility Country Investment Case frameworks (especially WASH, which is often lacking in GFF applications), as well as other funding mechanisms.

    Encourage and incentivize cross-sectoral action and collaboration to bring integrated solutions to all communities. All too often, WASH, health programs, and departments are segmented into silos—creating barriers to reaching a common goal of addressing diarrheal disease. Creating linkages can help to promote a comprehensive protect, prevent, and treat approach.

    Invest in primary health care to mitigate the toll of diarrhea and other common childhood illnesses on families and children. Investments in primary health care can stem the long-term consequences of diarrhea. When parents and caregivers can access preventive healthcare and treatment from a stable primary health system, their children suffer less diarrheal disease and grow to their potential.

    Examples and opportunities:

    • Kenya, Zambia, Senegal, Ghana, Uganda, and Vietnam have co-packaged ORS and zinc on their national Essential Medicines Lists. Countries interested in updating their lists can find resources here.
    • The Government of Madagascar adopted a joint approach to include nutrition-sensitive interventions, such as food and hand hygiene, to its nutrition strategy to help address stunting.
    • The Government of Uganda carries out twice-annual Integrated Child Health Days, which increase access to a package of child health interventions, including immunizations and basic medicines.
    • Thanks to strong national investments, Uganda and Nigeria stood out as exceptions to overall decrease in routine immunization coverage during the height of the COVID-19 pandemic, and in August 2022, Nigeria’s introduction of rotavirus vaccine marked a new chapter for the nation’s children.
    • The PATH Kenya Early Childhood Development (ECD) project integrates nutrition and works at the sub-county with the Governor and his wife as one of the key champions of ECD.

No matter who you are, you can be an advocate. Join the movement.

Learn more and help us tell policymakers and influencers that, together, we can defeat diarrheal disease. Follow DefeatDD on Twitter/X (join the conversation using the hashtag #DefeatDD) and Facebook.

Together, we can Stop the Cycle.

DefeatDD.org

Further reading: