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Ignored- the world’s leading killer of children

Pneumonia kills 1.5 million children a year, yet gets far less attention than the big infectious diseases that take a lesser toll.With that sort of death toll, experts and campaigners can’t understand why pneumonia is not top of the global health agenda.

If you asked any member of the western public which disease was responsible for the largest number of child deaths, they’d probably say Aids, TB or malaria. But that’s not so. In the number one slot is pneumonia. In the UK it used to be called ‘the old man’s friend’, though it does not take much of a toll of the elderly any more. It’s a long time since it killed children in large numbers here. Maybe that’s why it is so disregarded in the rich world.Why is it that pneumonia is the biggest killer of children in the world and almost nobody talks about it?

Last year, the WHO and Unicef produced a global plan for preventing and controlling pneumonia. It claimed that pneumonia deaths could be cut by two-thirds by a few very simple measures, widely implemented. One of them is exclusive breastfeeding of babies and another is ensuring children with pneumonia get antibiotics. The third is vaccination. the International Vaccines Access Centre (IVAC), of Johns Hopkins Bloomberg School of Public Health has produced a pneumonia report card, showing the extent to which the 15 countries with the highest pneumonia death toll in children have brought in these measures. These countries account for three-quarters of all child deaths from pneumonia. The results are not good. The best score is 61% – in Afghanistan, where donors are particularly keen to achieve health improvements – and the worst is 23% in Nigeria.

Orin Levin, the Executive director of IVAC points out that “the road to MDG [millennium development goal] 4 goes right through pneumonia – it is unavoidable.” The millennium development goal is to reduce childhood deaths by two-thirds between 1990 and 2015 – impossible to realise without progress on pneumonia.

Levine hopes the introduction of the pneumococcal vaccine will change the picture, in tandem with stepping up breastfeeding and the availability of antibiotics. A lot depends, though, on the Global Alliance for Vaccines and Immunisation (GAVI), which must raise the funds to enable countries to start immunising. A dozen developing countries are due to begin next year.

There are “some challenges,” Levine says. “The most pressing is that GAVI has a funding shortfall.” GAVI is fully-funded up to 2015 for its existing programmes, but it needs to expand in a major way if it is to pay for new vaccines for pneumonia and rotavirus (against another leading cause of child deaths – diarrhoea). It needs to raise $4.3bn, almost as much money as it has already spent over the last decade.

There are also “some policy issues,” he adds. Nigeria has the second highest number of pneumonia deaths after India, but GAVI has recently raised the bar for countries wanting to qualify for funds for the pneumococcal vaccine – they used to have to demonstrate that they could vaccinate 50% of the population. That has risen to 70%. Some regions of highly populous Nigeria may not get there. “It is not a policy that encourages the use of life-saving vaccines in the most affected countries,” says Levine.

It’s unacceptable in this day and age that pneumonia kills a child in the developing world every 20 seconds.

Reference : Sarah boseley CNN

Photo credit CNN

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