As you read this, look at the time. What were you doing an hour ago? In that time, the world has lost 108 children to pneumonia. 16% of under-five global deaths are caused by pneumonia. In the post-neonatal period, the period from one month to fifty-nine months, it is the single biggest killer. However, the statistics can seem impersonal so let’s explore this further. There are 5.9 million children who will die under the age of five this year. 944,000 of them will die from pneumonia. Or, to really break it down, around 108 children per hour. Imagine the suffering this causes to their families and societies, their potential never reached, their lives never fulfilled. This shocking figure is compounded further when we know, as we do, that most of these deaths are preventable.
So what is pneumonia? Commonly caused by a bacterial infection, inflammation in the lungs leads to fever and breathing difficulties. If untreated it can lead to respiratory failure, lung abscesses and blood poisoning. It affects people across the world but particularly those in low income and middle income countrieswhere the highest rates of under-five mortality can be found.
As we mark World Pneumonia Day, it is important that we don’t just focus on the negatives. We must also celebrate the progress and success we have seen in the last 15 years in tackling this deadly disease. Between 2000 and 2013 the number of deaths caused by pneumonia in under-fives fell by 44%. Under-five mortality rates globally have declined over the last quarter-century by 53%. Since the world signed up to the Millennium Development Goals in 2000, 48 million children’s lives have been saved. This has come from key interventions that have been researched, implemented, and scaled up and it is down to the tireless work of health workers, development agencies, governments, and the millions of volunteeradvocates around the world who use theirtime to give voice to the voiceless. Even with this progress, too many children still die from pneumonia every day.
We know how to prevent and treat it. Two pneumonia-related vaccines, Haemophilus influenza type B vaccine (Hib) and pneumococcal conjugate vaccine (PCV) can prevent common pneumonia-causing bacteria. Globally, however, coverage for these two vaccines is too low; with rates of 56% and 31% respectively. The continued rolling out and scaling up of these interventions is crucial in combatting the disease. Education on the issue is another important factor. This is most applicable in countries with the highest burden such as Pakistan, Ethiopia and Uganda. Families need to be made aware of the danger of pneumonia and, crucially, how to identify it. Only three in five children displaying symptoms of acute respiratory infection get to health providers. Symptoms such as fast breathing, lower chest wall indrawing, or stridor must be recognised as potential pneumonia symptoms. When they get to health workers they must be seeing people who are effectively trained. Antibiotics can help but it requires education to determine whether the child is suffering from pneumonia. If they are misdiagnosed, antibiotics will be wasted and contribute to antibiotic resistance. This will only serve to increase problems in the future. As is often the case, it’s those living in the hard to reach areas who suffer the most. The importance of a strong health system with trained health workers who have access to the vaccines and the treatment, alongside good rural infrastructure cannot be overlooked. Every country in the world has now signed up to the Global Goals and committed to leaving no-one behind. All programmes and interventions going forward must remember this, and tackle some of the structural causes which allow for this disease to flourish. In wider-terms, children who are adequately nourished, exclusively breastfed and have required levels of micronutrients will develop less infections and be better placed to fight them off. The context of pneumonia within wider child health cannot be overlooked.
The new Global Goals are clear. Goal three commits to end preventable deaths of newborns and children under five years of age by 2030. We won’t achieve this if we don’t tackle diseases like pneumonia. Let’s galvanise the successes so far and make sure next year’s World Pneumonia Day will be a cause for celebration. Let’s ensure that the decisions made, and the actions carried out, in the next 12 months prevent children needlessly dying from pneumonia.