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U.S. falls behind other developed countries in infant mortality The United States ranks 29th. The rate has not improved because of an increase in premature births, health officials say.

A rise in twins and triplets, driven by the use of infertility treatments, contributed somewhat to the rise in premature and low-birth-weight births, Petrini said. But even accounting for those trends, premature births are increasing, possibly tied to rising rates of obesity, diabetes and hypertension.

"We as a nation place less emphasis on primary care and prevention than a lot of these other industrialized democracies do that have lower rates than we do," said Dr. Ann O'Malley of the Center for Studying Health System Change, a Washington-based research group.

The PIH Vision: Whatever it takes At its root, our mission is both medical and moral. It is based on solidarity, rather than charity alone. When a person in Peru, or Siberia, or rural Haiti falls ill, PIH uses all of the means at our disposal to make them well—from pressuring drug manufacturers, to lobbying policy makers, to providing medical care and social services. Whatever it takes. Just as we would do if a member of our own family—or we ourselves—were ill.

Sastry endorses David Kolb’s “learning loop” model: concrete experience, observation and reflection, forming abstract concepts, then further implementing and analyzing. She ponders if this cycle can transcend classroom learning to engender change in the world. Her own research and consulting in health care delivery are based on such a stepped method. She stresses that an integrated, holistic perspective is also required. For instance, a malnourished patient will be unable to absorb drugs administered for AIDS; medicine is insufficient without food. As to the larger picture, she says “obviously we’ve got to tackle global warming and carbon emissions, but we also need to tackle poverty.”

From one month to five years of age, the main causes of death are pneumonia, diarrhoea, malaria, measles and HIV. Malnutrition contributes to more than half of deaths. Pneumonia is the prime cause of death in children under five years of age. Nearly three-quarters of all cases occur in just 15 countries. Addressing the major risk factors – including malnutrition and air pollution – is essential to preventing pneumonia, as is vaccination. Antibiotics and oxygen are vital tools for effectively managing the illness. Diarrhoeal diseases are a leading cause of sickness and death among children in developing countries. Treatment with Oral Rehydration Salts (ORS) combined with zinc supplements is safe, cost-effective, and saves lives. One African child dies every 30 seconds from malaria. Insecticide-treated nets prevent transmission and increase child survival. Over 90% of children with HIV are infected through mother-to-child transmission, which can be prevented with antiretrovirals, as well as safer delivery and feeding practices. About 20 million children under five worldwide are severely malnourished, which leaves them more vulnerable to illness and early death. About two-thirds of child deaths are preventable through practical, low-cost interventions. WHO is improving child health by helping countries to deliver integrated, effective care in a continuum - starting with a healthy pregnancy for the mother, through birth and care up to five years of age. Investing in strong health systems is key to delivering this preventive care.

Over 200 scientific and medical journals are taking part. For our theme issue, we asked a wide variety of commentators worldwide—including clinicians, medical researchers, health reporters, policy makers, health activists, and development experts—to name the single intervention that they think would improve the health of those living in poverty.

Some of Rigobon’s findings: In Chile, when the price of wheat goes up by 10%, the price of bread goes up by 5% 18 months later. In Colombia and Peru, it takes three years for this same percentage increase to occur, with these countries taking longer “to digest the international shock of commodity prices.” Not only do the prices of bread, cookies, meat, chicken, move in lockstep with wheat, but in some cases, so do housing, health and education. But Rigobon found that when the international price of oil increases, there is an immediate impact on all products related to oil. What’s worse, when the price of oil increases, the price of gas at the pump or for a rental car goes up disproportionately.

It’s been true for years, notes Rigobon, that “oil is unconditionally negatively correlated with cereals.” If oil is up, maize, sorghum and wheat prices are down. But this has recently changed, a sign “of the unique times we’re in, the policy challenges we’re facing.” We are simultaneously facing recession (due in large part to the sub-prime mortgage crisis), and inflation, in both food and oil prices. Central banks, he notes with scorn and wonderment, don’t include food and energy in their calculations of “core inflation.” If the job of these banks and government is to take care of their citizens, they must respond to this crisis along the lines of the response to 9/11 or Enron. Rigobon endorses well-communicated, transparent policies, and some tough measures like interest rate increases.

MIT Sloan School, GHD Project and MIT teams have made great progress in defining ways to work together to improve health care delivery, including training the cadre of leaders in the field. The Global Entrepreneurship Lab: Global Health Delivery (G-Lab GHD), the new version of MIT Sloan’s flagship international course, epitomizes the value of this collaboration as it brings together the expertise of MIT faculty with GHD’s experience in implementation.