Zinc in childhood diarrhoea

Bangladesh is leading the world in the first national scale up of zinc treatment for diarrhoea in children under five.

ICDDR,B scientists in collaboration with Johns Hopkins University and the World Health Organization documented the effectiveness of zinc therapy when used during the management of diarrhoeal episodes in children. Zinc treatment reduces the severity and duration of diarrhoea, but also prevents future episodes, and lowers the overall number of deaths by 50%. The use of zinc has the potential to dramatically cut the number of childhood deaths and contribute significantly to achieving Millennium Development Goal 4 for child mortality, both in Bangladesh and other developing countries.

ICDDR,B has been translating research into country-level action through its implementing partners in the Scaling Up Zinc for Young children (SUZY) project since 2003, and since late 2006, Baby Zinc tablets have been widely available for all children under five years in Bangladesh.

Key milestones for the national scale up include:

• A unique private-public partnership between ICDDR,B (research), The ACME Laboratories Ltd (pharmaceutical manufacturer) and Dhansiri Media Production House (mass communications)
• Technology transfer for production of dispersible zinc tablets from Nutriset (France) to ), The ACME Laboratories Ltd (Bangladesh)
• Endorsement of zinc treatment by the Bangladesh Pediatrics Association and the Ministry of Health and Family Welfare, leading to the revision of the Ministry’s guidelines for treatment of childhood diarrhoea
• Training of 500 paediatricians in Bangladesh
• Training of 500 village doctors and drug sellers in Bangladesh
• 4 international conferences to share lessons on scaling up zinc

After one year into scale up:

• Three out of every four mothers of children under five in Bangladesh know about zinc treatment for diarrhoea
• One out of two licensed doctors is prescribing zinc for the treatment of diarrhoea in children under five compared to one in five unlicensed providers
• Up to five million Baby Zinc blister packs have been produced, far exceeding the original three million forecast

Despite the apparent success of the initial stages of scale up, research continues on how to maximize the impact of zinc further. In the future zinc may also be recommended with each Expanded Programme on Immunization visit as well as in the treatment of pneumonia. Additionally, studies continue into routine food supplementation so that children do not become zinc deficient.

This cutting edge research and transfer of knowledge to action was made possible through a grant from the Bill and Melinda Gates Foundation, however funding for the research is scheduled to end in October 2008. In order to continue the task of augmenting the national scale through research, ICDDR,B is actively seeking collaborative partners for further support of this critical intervention and globally significant programme which has the scope to affect child mortality goals worldwide.