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[NEW DELHI, 6 November 2006] - Over 3.7 million children die every year in South Asia before they reach five years of age. Of these, 2.2 million children die before they reach their first birthday. Such an enormous number of children dying annually demands that strategies be devised to rapidly reduce these numbers, not just to meet the millennium development goals, but also to ensure the basic human right of children to survival. The Honorable Dr. Sayed M. Amin Fatimi, Aghanistan’s Minister of Public Health released the State of the World’s Breastfeeding – South Asia Report Card, in Kabul on 20th November at the inauguration of the South Asia Breastfeeding Forum -3, an international gathering of health professionals and policy makers. The Report Card assesses and rates the practices, policy and programs related to Infant and Young Child Feeding in eight countries of the region, and ranks them on their performance in promoting IYCF. The countries are Afghanistan, Bhutan, Bangladesh, India, Maldives, Nepal, Pakistan, and Sri Lanka. The Report Card reveals that the region has barely reached the halfway mark in creating the enabling environment for optimal infant and young child nutrition. Sri Lanka is closest to the half way mark, followed by Bangladesh. (www.worldbreastfeedingtrends.org) Evidence has shown that under nutrition among infants underlies the majority of deaths, making optimal infant and young child feeding crucial to any strategy to reduce child mortality. As most of the deaths occur in the first year of life, optimal IYCF in this period rests on early initiation of breastfeeding, exclusive breastfeeding for the first six months of life and continued breastfeeding for two years and beyond with introduction of adequate and appropriate complementary foods from six months onward[1]. New research has shown for the first time that starting to breastfeed immediately after birth significantly increases the chances of survival of babies. If mothers start breastfeeding within one hour of birth, 22% of babies who die in the first 28 days, the equivalent to almost one million newborn children each year, could be saved. If breastfeeding starts on the first day then 16% of lives could be saved. The likelihood of death increases significantly each day the start of breastfeeding is further delayed[2]. Lancet in 2003 published a series on child survival reports that put breastfeeding exclusively during first six months as the single intervention that could cut down all under five-child deaths by 13-15%[3]. With this sort of evidence, IBFAN Asia Pacific* undertook an assessment of the programs and policies of the South Asian governments to see how far they have created an environment that promotes optimal IYCF. Countries were assessed on whether they had policies and programs that supported optimal infant nutrition – support and counseling for women and families, legislation related to maternity benefits, implementation of the International Code to regulate the marketing of commercial infant foods, training for health providers. Optimal IYCF practices and policy and programs for enhancing them need to be drastically improved in India, which stands at 6th rank. Maldives, Pakistan, and Nepal are at the 3rd, 4th and 5th place respectively; Sri Lanka and Bangladesh have the best policies, programs and practices in the region, and stand in the 1st and 2nd rank respectively. Data was not fully available in Afghanistan and Bhutan, however they were also ranked and both are now in the process of generating basic data. For three days, from 20th to 23rd November, 2006 at the South Asia Breastfeeding Partners’ Forum-3, organized around the theme “Breastfeeding Saves Lives, Saves Money”, by the Ministry of Public Health, Afghanistan and the Afghanistan Breastfeeding Promotion Partners along with IBFAN-Asia Pacific, WABA, and supported by WHO, UNICEF and several other organizations. Representatives from the government and civil society organizations from the eight South Asian nations deliberated on strategies to reduce infant mortality. Dr. Arun Gupta, Regional Coordinator of IBFAN-Asia Pacific, recommended that a SAARC fund be established to enhance infant nutrition with a focus on early and exclusive breastfeeding. This fund could be used to provide ‘breastfeeding education services’ and ‘skilled support’ at birth by a trained heath worker that would cost barely US $ 5 per pregnant woman. Radha Holla Bhar, a health activist associated with IBFAN, suggested that US $ 100 must be provided to poor women to facilitate exclusive breastfeeding for six months. The Kabul Declaration on IYCF, endorsed by the Forum, incorporates the priorities and conclusions arrived at after three days of deliberations, including the urgent need to set up a SAARC fund for infant nutrition. While releasing the Declaration, Dr. Faizullah Kakar, Technical Deputy Minister, Ministry of Public Health said,” We will put breastfeeding on a high priority in the health program as we have done with mental health. He reiterated saying that “You can check with me after one year what have we done”.