Reaching the pneumonia "tipping point"

Health organizations have joined forces to launch the first World Pneumonia Day, urging governments, donors and civil society to act to prevent and treat the world’s leading child killer.

Pneumonia kills over 4,000 children daily – more than measles, malaria and AIDS combined, says the UN Children’s Fund (UNICEF). However, to date, stamping it out has not been a priority for policy-makers or donors, says the coalition of over 50 health organizations launching the pneumonia movement.

“There has been little traction on the pneumonia issue for years but it now feels like we are at a tipping point,” Orin Levine, executive director of the pneumonia research programme at Johns Hopkins Bloomberg School of Public Health, told IRIN. "Now it is critical for donors, international partners and countries to make protection, prevention and treatment available to all children everywhere with no delay.”

UNICEF and the World Health Organization (WHO) in a Global Action Plan for the Prevention and Control of Pneumonia are calling on donors and national governments to commit US$39 billion to improve prevention and treatment in 68 high-prevalence countries between now and 2015.

Preventing pneumonia requires increasing the number of children vaccinated against common causes of pneumonia, such as streptococcus pneumonia (pneumococcal disease) and Haemophilus influenzae type b (Hib), and improving community-level treatment of pneumonia through training and access to antibiotics, according to the plan.

The plan also calls for improving health, hygiene and nutrition practices by promoting exclusive breastfeeding, hand-washing, reducing indoor air pollution and giving zinc to children during diarrhoea outbreaks.

“Nearly half of [pneumonia] deaths could be prevented with existing vaccines and the vast majority of cases could be treated with inexpensive antibiotics,” Save the Children Board member and former US Senator Bill Frist said in a communiqué launching Global Pneumonia Day. “Yet lives continue to be lost from this preventable and treatable disease, and until recently there was very little outcry.”

Pneumonia facts

Pneumonia takes the life of one child every 15 seconds, and accounts for 20 percent of under-five deaths worldwide each year

Pneumonia has the most deadly impact – 98 percent of pneumonia deaths – in South Asia and sub-Saharan Africa
In Africa pneumonia is the second cause of under-five mortality after diarrhoea
Source: World Pneumonia Day website

Research groups specializing in pneumonia say vaccine roll-out in Africa and Asia has been slow due to lack of money and awareness.


Vaccines against two of pneumonia’s common bacterial causes, Hib and pneumococcus, are routinely used in industrialized countries but are not yet available in most of the developing world, according to GAVI Alliance, a public-private partnership providing immunization and health system support worldwide.

"Vaccine coverage is improving but at a “slower pace than we would like to see," WHO spokesperson Olivia Lawe-Davies told IRIN.

GAVI plans to speed up the introduction of pneumococcal vaccines in 42 countries to reach 130 million children by 2015.

“Millennium Goal four cannot be met without this investment...Immunization is one of the most cost-effective ways to save lives. And improved health is a fundamental driver for long-term development,” said Julian Lob-Levyt, head of the GAVI Alliance, in a 2 November communiqué.

Millennium Goal four aims to reduce by two-thirds the deaths of under-five children by 2015.

Affordable treatment

GAVI Alliance has developed a funding mechanism to encourage pharmaceutical companies to produce a pneumococcal vaccine at 10 percent of the normal price, costing developing country governments on average 15 cents per dose.

For those children who contract pneumonia the antibiotics that could save their lives cost less than $1, but currently less than 20 percent of children receive them, according to WHO and UNICEF.

''Pneumonia contributes to 60 percent of the in-patient admissions in any hospital in Uganda, and the worst scenario is seeing a mother walk into the emergency unit…because she was not aware of the seriousness of her child's illness, and seeing that child pass away because it was too late to intervene,” said Sabrina Bakeera-Kitaka, President of the Uganda Paediatrics Association in a 2 November statement.

Donors who sign on to the Global Action Plan at the 2010 World Health Assembly would agree to increase the supply of antibiotics to health clinics in hard-hit countries and train community health workers in pneumonia case management.

“With increased donor support, we can save many more lives and make an incredible leap towards further reducing child mortality in the world. This is an historic opportunity we must not ignore,” said GAVI’s Lob-Levyt.