The Pneumonia and Diarrhea Progress Report 2013 published by the International Vaccine Access Center (IVAC) at Johns Hopkins Bloomberg School of Public Health highlights that India continues to have the largest pneumonia and diarrheal disease burden in the world. It also points out that many Indian children do not have access to life-saving treatment and prevention measures.
India continues to lose more than 400,000 children before their fifth birthday due to these two easily preventable diseases, and many more suffer from severe illness. Similar results were found in the Pneumonia Progress Report 2012 in which India topped the list of countries with the most child deaths due to pneumonia. While India has made some progress in coverage of pneumonia interventions since last year’s report, and is posed to protect more children from pneumonia and diarrhea with the upcoming national scale-up of pentavalent vaccine and the promise of an indigenous rotavirus vaccine – two advancements highlighted in the report, its coverage levels for both pneumonia and diarrhea remain below targeted levels.
Pneumonia and diarrhea continue to be the leading killers of children under the age of five worldwide. According to the latest estimates by the United Nations Children’s Fund (UNICEF), pneumonia and diarrhea together claimed the lives of more than 1.7 million under-five children in 2012 alone.
This year, the Integrated Global Action Plan for Prevention and Control of Pneumonia and Diarrhoea (GAPPD) was developed and issued by the World Health Organization (WHO) and UNICEF, outlining key interventions that should be universally adopted, with the goal of ending preventable pneumonia and diarrhea mortality in children by 2025. GAPPD set forth coverage targets of 90 per cent for vaccinations, 90 per cent for access to pneumonia and diarrhea treatments, and 50 per cent for exclusive breastfeeding of children during their first six months of life.
The 2013 Pneumonia and Diarrhea Progress Report evaluates the 15 countries with the highest absolute number of child deaths from pneumonia and diarrhea, based on UNICEF’s latest estimates, and reports on their progress in implementing GAPPD interventions with respect to coverage targets.
This report reveals gradual increases in the utilisation and coverage of evidence-based interventions by many of the high-burden countries, while challenges persist for others. Seven countries achieved some, but not all GAPPD coverage targets and eight others failed to reach any of the targets. India and Nigeria, the two countries with the largest pneumonia and diarrhea disease burdens, continue to have low coverage levels for prevention and treatment interventions. These factors have resulted in them having the lowest GAPPD scores, which are calculated averages of countries’ coverage rates for key GAPPD interventions. India did not meet any of the nine GAPPD coverage targets that were evaluated in the Progress Report.
“India has taken a few steps in addressing the pneumonia disease burden by introducing the Haemophilusinfluenzae type B (Hib) vaccine in nine states. The National Technical Advisory Group on Immunization (NTAGI) has now recommended the vaccine for a national scale up. However, India still needs to include other vaccines such as rotavirus and pneumococcal in its national programme while simultaneously strengthening its health systems and improving access to other preventive interventions and treatment solutions,” said Professor NK Ganguly, Distinguished Biotechnology Professor, National Institute of Immunology.
According to the Progress Report, by adopting a comprehensive and combined approach to pneumonia and diarrhea, countries can amplify the impact of individual interventions and achieve accelerated progress in the years to come. Also, creating robust monitoring and evaluation systems should be a priority for countries, as these will provide the necessary information for decision-making on health programmes. In addition, country-specific gaps and barriers in access to appropriate treatment for pneumonia and diarrhea need to be addressed. Early successes can already be seen in countries such as Uganda and Tanzania, which have achieved relatively higher coverage of interventions that impact both pneumonia and diarrhea.
“Today, pneumonia and diarrhea will kill thousands of children. And tomorrow, And every day thereafter, Marking World Pneumonia Day, and with World Diarrhea Day around the corner, we must recommit ourselves to tackling these preventable childhood diseases” said Dr Naveen Thacker, Secretary, Child Health Foundation and Former President, Indian Academy of Pediatrics. “There are simple, low cost solutions, such as hand washing with soap; controlling indoor air pollution; encouraging exclusive breast feeding, Oral Rehydration Solution and Zinc Supplementation; administering vaccines and increasing access to treatment that can save these children’s lives”.
EH News Bureau
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