The little boy died at home, without medical attention, before his fifth birthday.
It happens to as many as one in five children in poor African and South Asian countries. The boy was deeply mourned, but never counted. His death was not noted in any registry. Except for a fever, no one had any idea why he died—information that might have been lifesaving for family members, or helped health officials recognize and address a widespread problem, or been the earliest indication of a smoldering epidemic.
In 2015, when the Bill and Melinda Gates Foundation wanted to learn why so many die young, they turned to the Emory Global Health Institute (EGHI) to lead the Child Health and Mortality Prevention and Surveillance Network (CHAMPS), designed to help high-child-mortality countries strengthen their capability to collect, analyze, interpret, and share data.
Innovative methods include training local teams to visit families soon after a child dies,gathering information on symptoms and, with permission, taking small needle tissue biopsies, which when examined with specialized tools developed at the US Centers for Disease Control and Prevention (CDC) can identify the specific organisms causing illness and death.
“While we would think we have a pretty good idea of why children are dying—respiratory disease, enteric infections, fevers, and sepsis from different microorganisms—we don’t know those specific causes,” says Jeffrey Koplan, former director of the CDC and now Emory Vice President for Global Health and EGHI’s founding director.
“There are a lot of different things that can cause respiratory failure. A lot of illnesses can lead to gastroenteritis and then death. The objective of this grant is to identify the specific causes of death so that we can develop programs to address them and save lives.”
CHAMPS is big: A $75 million investment for the first three years of a projected twenty-year study, involving hundreds of partners at field sites and programmatic support from Emory, the CDC, and other Atlanta-based and international partners.
But EGHI was created to serve as the mainframe for just such large-scale, long-term efforts — whether addressing high rates of maternal and childhood morbidity, understanding the spike of diabetes in developing nations, or increasing access to safe water.
Borders don’t mean much to infectious diseases, from shape-shifters like HIV and drug-resistant tuberculosis to sudden outbreaks like Ebola, SARS or Zika.
Chronic problems like diabetes and cardiovascular disease no longer belong primarily to richer, fatter nations but take an increasingly heavy toll on the economic stability, development, and even national security of developing nations, all with global impact.