Zinc: a simple, underutilized treatment for diarrhea

Diarrhea is the second leading infectious killer of children less than five years old, yet treatment for this illness is relatively simple: ORS and zinc. This basic combo costs just pennies in some regions and is remarkably effective. The combination of ORS and zinc is the gold standard for diarrhea treatment, recommended by the World Health Organization (WHO) and UNICEF. WHO even added co-packaged ORS and zinc to its Essential Medicines List in 2019. Oral rehydration solution, or ORS, is an effective lifesaver containing just three ingredients of water, sugar, and salt. But there is a reason ORS is recommended to be combined with zinc.  

Zinc is a micronutrient that helps the body’s immune system and metabolism function. Zinc also plays a role in wound healing and DNA creation. If that wasn’t enough, zinc also supports healthy growth and development during infancy, childhood, and adolescence.

Zinc has an especially important role in diarrheal disease recovery because it can reduce the duration and severity of diarrheal episodes. Zinc and other essential nutrients can also become depleted through diarrhea, making children more prone to additional diarrhea episodes due to nutrient deficiency. Additionally, children recover more quickly from diarrhea episodes when taking zinc because it strengthens the immune system.

Despite the clear benefits, use of both ORS and zinc as recommended by WHO and UNICEF is just 15%: a staggering statistic, especially considering that uptake is often lowest where burden is highest.

There are many reasons so few children receive zinc treatment, often including a lack of awareness or a preference for antibiotics. Because of this, healthcare workers may assume that caregivers don’t want ORS and zinc and therefore not offer it. These and additional factors cause significant variation in use of ORS and zinc across and within countries.

Including co-packaged zinc and ORS in a national Essential Medicines List to align with the WHO recommendation can improve uptake and access of both medicines. This is an important step to increase awareness of the effectiveness of ORS and zinc for health providers and families around the world. This effective combination helps children to recover quicker and stay healthy longer.