The prevention of death from dehydration arising from diarrhoea is straightforward, using cheap oral rehydration salts or simple home-made fluids. The skills required by workers in health facilities and by mothers at home are easily learned. Since 1992, the Region has been facing a severe epidemic of Shigella Dysentery. The bacteria causing this epidemic are rapidly developing resistance to the first line antibiotics normally used for treatment. The second line treatment is very expensive.
Cholera also continues to affect the region.
Although the management of cases has improved greatly over the past five years, cholera remains a public health problem. This aims to reduce mortality further by ensuring that children receive coordinated treatment and preventive action for their needs. WHO will continue, in close collaboration with national programmes, its research and development efforts, looking for even more effective ways of tackling this problem. It is estimated that of the 75 million children under five in Africa a million and a half die each year of pneumonia. The diagnosis and treatment can be given by suitably trained workers in first level health facilities, provided they are supplied with antibiotics.