The curious case of zinc for diarrhea: Unavailable, unprescribed, and unused

Abstract

Diarrhea kills nearly 650 children below the age of 5 years each day in India. Oral rehydration solution (ORS) and oral zinc have been recommended for the treatment of acute diarrhea in children by the Indian Academy of Paediatrics (IAP) National task force for use of ORS and zinc in the year 2003[1] and later endorsed in 2006.[2] Zinc was included in the National Programme for the treatment of Diarrhea in 2007.[3] The Integrated Management of Neonatal and Childhood Illness (IMNCI) advocates the use of these two drugs in the treatment of acute diarrhea.[4] The evidence for the use of ORS and zinc as fi rst-line treatment in children in resource limited countries is overwhelming.[5,6] If given early on during an episode of diarrhea it would help save 50% of children who would otherwise die. The treatment is effective, safe, cheap, and easily tolerated by children.[6] More importantly, there are no other alternatives to this treatment. Recognizing the importance of this, the National Rural Health Mission (NRHM) has included ORS and zinc in the list of medicines to be available at the subcenters.[3]