Setting Research Priorities To Reduce Global Mortality from Childhood Diarrhoea by 2015

Childhood diarrhoea still claims nearly 2 million lives each year and remains responsible for 18% of all child deaths [1,2]. Regardless of this, research interest in this disease has been steadily decreasing after the development of cost-effective interventions in the 1980s [3]. In addition, the amount of available research funds per disability-adjusted life year (DALY) are several orders of magnitude lower for diarrhoea when compared to some other diseases, such as autism or diabetes type 2 [4]. The UN’s Millennium Development Goal #4 (MDG4) states that childhood mortality should be reduced by two thirds between 1990 and 2015 [5], but recent estimates show that the progress in mortality reduction has not accelerated in comparison to 30 years ago [2]. Therefore this MDG target is likely to be missed. However, the reduction of child deaths by two thirds could be achieved by 2015 if presently available cost-effective interventions were delivered to those who need them most, and if there were sufficient financial resources to ensure their delivery [6,7]. Why is greater progress not being achieved? One of the key reasons is lack of knowledge on how to implement existing cost-effective interventions and on how to achieve greater coverage of these interventions in low-resource settings [8,9]. This gap in knowledge can only be filled by appropriately targeted research. To assist donors in understanding the potential of different research avenues to contribute to reducing the burden of disease and disability, the Child Health and Nutrition Research Initiative (CHNRI) of the Global Forum for Health Research recently developed a methodology that allows systematic listing and transparent scoring of many competing research options, thus exposing their strengths and weaknesses [10–12]. The Department of Child and Adolescent Health and Development (CAH) of the World Health Organization is currently using the CHNRI methodology to develop research priority issues on the major causes of child deaths. In this paper, we present the results of this research priority-setting process applied by CAH for childhood diarrhoea.