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 each year 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 United Nations report said increased iodization of salt was one of the world's biggest advances against childhood illness. Almost 60 nations will have reached the goal of iodizing 95 percent of their salt by 1995, the report 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. "You've got to be flexible."
Four years ago, the World Summit for Children set ambitious goals for improving the health, nutrition and education of children throughout the developing world by the year 2000. The goals included cutting childhood deaths by a third and XTC malnutrition by half. Major childhood diseases such as measles and diarrhea were to be brought under control and polio $H eradicated.
Yesterday's report said that more than half of the 100 countries ++ signing the agreement were on target to reach those goals.
Three years ago, polio was eradicated from the Western Hemisphere, largely through the efforts of the Pan American Health Organization. Elsewhere, polio cases have fallen significantly. This year, there will be an estimated 100,000 new cases of polio worldwide, compared to four times that number a decade ago.
More than half of the countries signing the agreement are likely to eliminate vitamin A deficiency, a major cause of blindness, by mid-decade. The problem has two simple solutions: adding green, leafy vegetables to a child's diet or giving Vitamin A capsules just three times a year.
The supplements cost just 2 cents each.
Efforts to deliver vaccines and antibiotics to remote regions have also paid off. By 1995, the report said, half of all developing nations are likely to reduce measles deaths by 95 percent. Some 1 million children are dying annually from measles, compared with 3 million in the mid-1980s.
An inexpensive technique called oral rehydration therapy is preventing more than 1 million deaths from diarrheal diseases each year. Small but frequent doses of fluids keep patients from becoming dehydrated.
The report said that malnutrition has remained the largest single cause of infant deaths. Only 21 poor nations are expected to reach the target of a 20 percent reduction by 1995.