Despite the death toll exacted by civil war, poverty and drought, developing nations have generally improved the health of their children through increased immunization, improved primary care and simple techniques like adding iodine to salt.
The annual "State of the World's Children" report, released yesterday by UNICEF, said that by next year, 2.5 million fewer children would be dying annually from malnutrition and preventable diseases than died in 1990. Also, 750,000 fewer youngsters will be disabled, blinded, crippled or mentally retarded.
While much of the progress stems from technical advances such as better vaccines and antibiotics, UNICEF consultants speaking yesterday in Baltimore said governments and human service organizations were also doing a better job getting drugs and equipment to people in remote areas.
Dr. Carl Taylor, an emeritus professor of international health at the Johns Hopkins School of Hygiene and Public Health, said developing nations had greatly reduced the numbers of brain-damaged and retarded children simply by adding iodine to salt -- a technique employed in the United States for decades.
The U.N. report said increased iodization of salt was one of the biggest advances against childhood illness. Almost 60 nations will reach the goal of iodizing 95 percent of their salt by 1995, it predicted.
"The world is on the verge of a great victory here," James Grant, UNICEF's director, said in a statement released in New York. Dr. Alfred Sommer, dean of the Johns Hopkins School of Hygiene and Public Health, unveiled the report in a separate ceremony in Baltimore.
Insufficient iodine in the diet is the largest single cause of preventable mental retardation, causing brain damage in an estimated 26 million people around the world.
Working as UNICEF's representative in China during the 1980s, Dr. Taylor lobbied provincial leaders to start adding the chemical in the country's salt processing plants. UNICEF provided the chemicals and equipment, but had to educate local leaders and instruct plant operators on the process.
It was a simple solution, but not applicable everywhere. In Tibet, consumers simply dug their kitchen salt from open beds in the ground.
"So what we had to do was iodize Tibetan tea, spraying the iodine into tea packages," Dr. Taylor said. Four years ago, the World Summit for Children set ambitious goals for improving the health, nutrition and education of children in the developing world by the year 2000. The goals included cutting childhood deaths by a third and malnutrition by half, controlling major childhood diseases and eradicating polio. Yesterday's report said that more than half of the 100 countries that signed the agreement were on target to reach those goals.