What should be done in acute emergencies?

Davis (Sept 28, p 868)' convincingly challenges the assumption that children under age 5 years can be singled out as the most vulnerable group during acute emergencies and that, as a result, emergency public health interventions can be reduced to a standard package of child survival measures. We have witnessed in refugee camps how such focused strategies channelled a disproportionate share of scarce resources towards inefficient intensive feeding programmes for under-5s, in situations in which drinking water was lacking and diarrhoea rampant. In a highly absurd instance a 5-year-old marasmic child, not belonging to the target group of under-5s, was excluded from supplementary feeding.