Articles by Siddharth Dube

Siddharth Dube The single-minded focus on child survival has muzzled debate about the quality of life of those who survive into adulthood.
CONCERN about child survival has for some four decades dominated the theory and practice of international public health. The attention to lowering childhood death has, unarguably, paid visible and welcome dividends. Immunisation against infectious diseases, oral rehydration therapy to prevent diarrhoea deaths, and targeted nutrition programmes to control malnutrition have been prime factors in pushing down infant and under-five mortality in India and other poorer nations. But the single-minded focus on child survival has muzzled debate about the quality of life of those who survive into adulthood: how sick are they, what do they eat, are they still poor? The tiny number of people-virtually all from developing countries-who raise such worries have for long been dismissed as impractical fools. Their concerns are discounted by a majority of health experts and economists on the assumption that lowered infant and under-five mortality-and reduced malnutrition-are proof that all people are better off in all ways (for a recent example, UNICHF's The Progress of Nations, especially p 7). This assumption is vitally flawed.