MANILA, Philippines ? Novelty can be a good thing. When faced with a deadline and a target goal however, falling back on tried-and-true methods, remembering why they?re classics and focusing on updating them instead wouldn?t be such a bad idea.

This is the gist of a study addressing one of the reasons the United Nations? goal of reducing childhood mortality worldwide by 2015 might not be met even as the authors propose ways to prevent that outcome.

Olivier Fontaine from the World Health Organization?s Department of Child and Adolescent Health and Development led an international team of 15 researchers, including Beth Vargas from the Research Institute of Tropical Medicine.

Good news

Nine years ago some 190 countries made a commitment to meet what the United Nations identified as 8 Millennium Development Goals by 2015.

One of these was to reduce the number of deaths in children under the age of five by two-thirds between 1990 and 2015. The good news is that in 2006, the number of annual deaths among children under the age of five dropped below 10 million for the first time. According to the Millennium Development Goals Report released last year though, the rate of childhood mortality in 27 nations still remained unchanged.

?Why is greater progress not being achieved? One of the key reasons is lack of knowledge on how to implement existing cost-effective interventions and on how to achieve greater coverage of these interventions in low-resource settings,? the researchers wrote.

The solution, they added, would be to analyze all possible research options thoroughly and then prioritizing them appropriately in terms of which ones could provide the maximum benefit if funded properly.

Fontaine and his colleagues applied a priority-setting exercise developed by the Child Health and Nutrition Research Initiative, to one cause of childhood mortality: childhood diarrhea. Established to help countries meet several of the stated 2015 Goals, the CHNRI had previously linked the continuing high rate of childhood mortality to how research projects were being funded. One example they cited was providing more funding to developing treatments rather than making sure people received the existing therapies.

Diarrhea kills some two million children under the age of five each year, accounting for 18 percent of the childhood mortality rate.

In a November 2008 report from the United States? Centers of Disease Control and Prevention, diarrhea caused by rotavirus disease kills half a million children under five years of age each year, and nearly 90 percent of them come from Africa and Asia.

Based on data gathered by the World Health Organization between 2001 and 2008, 40 percent of the cases where kids under the age of five have been hospitalized with diarrhea were caused by rotavirus infections.

154 questions

Fontaine and his colleagues made a list of 154 questions based on: research from factors that affected health and illness in the population; policies; improving current therapies; and developing new ones.

In light of the 2015 deadline and the criteria, Fontaine?s team found that the top 10 percent of the ordered priorities turned out to be evaluating and possibly improving on existing cost-effective treatments such as oral rehydration salts, zinc supplements, and exclusive breastfeeding.

The researchers were also unsurprised to note that developing new treatments fell into the bottom 20 percent of the priority list.

The study can be accessed in the March 10 issue of the online journal PLoS Medicine.