Poverty is a kind of violence– said Gandhi. But most of the literate and well fed India is insensate to the sights and sounds of hungry India.

Forty two children died of malnutrition in Satna district of Madhya Pradesh (MP) in the last few months. The stories documented by the MP Right to Food Campaign are horrifying. How children go to school not to study but to access water from the drain which runs there. How in absence of food, wild grass is powdered to make "rotis". The percentage of wasted children has gone up from 20 to 33, according to National Family Health Survey (NFHS) data; only 14% children breastfeed within 1 hour of birth; and 82.6% between 6-35 mo age are anemic. The time to act is Now (The Times of India 4th September 2008).

In the US, the Alliance for Pediatric Quality is in the news. The goal of the Alliance is to bring about immediate, measurable change in the quality of care provided to children.

The Alliance is a partnership of the American Academy of Pediatrics (AAP), the American Board of Pediatrics (ABP), Child Health Corporation of America (CHCA) and the National Association of Children’s Hospitals and Related Institutions (NACHRI). Collectively, these organizations represent more than 60,000 pediatricians and 200 children’s hospitals. Last time they decided on 4 quality improvement initiatives. These were to – reduce catheter related blood stream infections, improve survival in cystic fibrosis, improve management in pediatric inflammatory bowel disease and reduce hospitalizations in pediatric asthma. Their efforts have yielded spectacular results.

The Alliance "Improve First" philosophy maintains that spreading well-designed, well-run improvement initiatives with demonstrated results can improve the delivery and outcome of healthcare of children. A series of free webinars, beginning October 7, will highlight the results-to-date for each initiative, spread goals and how pediatric providers can get involved and achieve those goals. Additional information is available at http://www.kidsquality. org/. (Medical News Today 1st October 2008).

Thousands of infants in China were recently documented to have renal calculi and some even developed renal failure. 54,000 infants sought medical attention, 13000 are in hospital and 3 deaths have been confirmed. Infant formula contaminated with melamine is said to be the culprit. The WHO has published a paper on the possible risks of melamine to help countries in decision making process regarding possible health concerns of melamine.

Melamine is used in the production of melamine resins with many industrial uses including adhesives and glues. It was discovered that melamine was deliberately added to raw milk to increase the apparent protein content of milk. In 2007 there was an epidemic of renal failure in cats and dogs, in the US after contamination of pet food with melamine and cynuric acid. While melamine alone has low toxicity, a combination of melamine and cynuric acid results in melamine cynuric acid crystals in the renal tubules and renal failure. (www.who.int/, WHO: Melamine and cynuric acid: Toxicity, preliminary risk assessment, and guidance on levels in food, 25 September 2008)