Worldwide, oral rehydration therapy (ORT) still claims only a modest niche in the market alongside a vast array of modern drugs and traditional treatments of diarrhea, the majority of which are either ineffective or harmful. Often, ORT is used as an adjunct therapy for drugs, instead of as a replacement. Drugs are also several times more expensive than ORT. ORT is not yet seen for what it rally is: the most effective treatment for a major killer disease in the developing world. Recent research has identified a total of 25 different virsues, bacteria, and parasites that cause diarrhea, and more are still being found. Cholera accounts for <1% of all types of accute diarrhea. It can usually be treated with ORT alone. The progressive symptoms for diarrhea are identified, and how ORT replaces salt and water is explained. A 2-tier strategy is recommended by WHO and UNICEF--90-95% of patients can be treated with ORT alone; the remainder require intravenous therapy. Continuation of feeding during diarrhea and additional feeding afterward is recommended. A review of antibiotics, absorbents, antimotility drugs, and anti-emetics shows why they do not work or should not be used. Training in diarrhea management for doctors, nurses, and midwives is inadequate. Supply problems are significant. Yet because OR solution needs no refrigeration and local production is more feasible than vaccines, logistic do not have to be complicated. Effective use of ORT needs to be promoted through communication. Social marketing and information campaigns in Gambia, Haiti, and Egypt are reviewed. The issues concerning use of standardised ORT formula. Salt-and-sugar solution are addressed. The future for ORT includes finding a better formula that would also reduce the volume and duration of the diarrhea itself.

A UNICEF Special Report

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