Scarcity of SafeWater a Looming Threat to Children A lack of access to safe water will affect almost 600 million children around the world over the next 2 decades, according to a UNICEF report, Thirsting for a Future: Water and Children in a Changing Climate. The report details how a depletion in sources of safe water increases the risk of death, disease, and malnutrition among children and how climate change will escalate these health risks in years ahead. Many countries are already experiencing reductions in the availability of safe drinking water, as their water sources and sanitation systems are affected by warmer temperatures, rising sea levels, human conflict, and increased flooding and droughts. Flooding can pollute water supplies, while drought conditions can undermine farming yields, leading to malnutrition. For example, as many as 1.4 million children in areas of Nigeria, Somalia, South Sudan, and Yemen are at imminent risk of famine due to water shortages resulting from the combination of drought and conflict. The poorest populations are disproportionately affected by water scarcity. Children living in areas without access to safe water are more likely to be exposed to waterborne pathogens that cause cholera and diarrhea. Furthermore, the time children spend collecting safe water interferes with school attendance and also puts girls in particular in harm’s way as they travel far from home. The demand for water is expected to increase as populations grow and consumption increases. The report provides recommendations to follow to help safeguard children’s access to safe water and sanitation: governments can integrate climate risks into waterand sanitation-related policies and services; businesses can work with communities to prevent contamination and depletion of safe water sources; and communities can develop resilient water and sanitation services and increase water storage capacity. Freeze-dried Rotavirus Vaccine Shows Promise Three doses of a live, oral bovine rotavirus pentavalent vaccine (BRV-PV) protected healthy infants in Niger from severe rotavirusgastroenteritis, reporteda teamof international investigators in the New England Journal of Medicine. Rotavirus is a leading cause of diarrheaassociatedhospitalizationanddeath in childrenyounger than5yearsaroundtheworld, with the highest death rate from this virus occurring in sub-Saharan Africa. Currently there are 2 licensed vaccines in use against rotavirus,butboth require refrigeration.The BRV-PV vaccine, which was designed specifically for use in remote areaswith limited electricity or health clinics, is freeze-dried, does not require refrigeration, and is thermostable for 2 years at 37°C and for 6 months at 40°C. The investigators evaluated theBRV-PV vaccine in a randomized, controlledphase3 trial inMadarounfa,Niger, thatenrolled3508 healthy infants who received doses of the vaccine or placebo at 6, 10, and 14weeks of age.Of the1780infants in thevaccinegroup, 31 cases of severe rotavirus gastroenteritis occurredcomparedwith87cases in the1728 infants in the placebo group—a vaccine efficacy of 66.7%. No serious adverse events were associated with the vaccine. Theefficacy rate reported forBRV-PV in this trial is slightly higher than that of the other 2 licensed rotavirus vaccines previously tested inAfrica (RotateqandRotarix). However, rotavirus vaccine efficacy rates havebeen lower in trials carriedout inAfrica relative tohigher-incomecountries,possibly due to differences in the nutritional status andnatural immunity of study participants.