Chryso D’Angelo
UNITED NATIONS, Nov 2 2009 (IPS) – Seven-month-old Marta lived in the central highlands of Guatemala when she came down with a high fever and rapid, shallow breathing.
The local community health worker diagnosed her with severe pneumonia, gave her a dose of antibiotics, and advised her grandfather to take her to the hospital over 19 miles away. Marta beat pneumonia, thanks to a proper medical assessment and life-saving drugs, but nearly two million other children in developing nations won t be as lucky.
In the U.S., low-cost antibiotics have made childhood deaths from pneumonia a rare occurrence. But in developing countries, it is estimated that only one in five children with pneumonia receives antibiotic treatment, said Mary Beth Powers, chief of Save the Children s Survive to 5 campaign.
The first ever World Pneumonia Day on Monday, Nov. 2 strives to encourage governments, health care professionals and the public into action against this global health crisis, which kills 1.8 million children under age five each year a toll greater than measles, malaria, and AIDS combined, according to the Global Coalition against Child Pneumonia.
Pneumonia is the biggest killer of children that we never hear about, said Dr. Orin Levine, executive director of Pneumo ADIP at the John Hopkins Bloomberg School of Public Health and a member of the 100-strong coalition made up of global health organisations and academic institutions, including CARE, GAVI Alliance and Save the Children.
The group is dedicated to bringing pneumonia vaccines and antibiotics to developing countries and training healthcare workers to diagnose and treat the disease.
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Vaccines against pneumonia (Streptococcus pneumoniae and Haemonophilus influenzae type b or Hib) exist, but their distribution in the developing world is not at the levels needed to prevent high childhood fatality rates from pneumonia.
While pneumonia affects children and families everywhere, it has the most deadly impact in South Asia and sub-Saharan Africa, according to Dr. Levin, where 98 percent of pneumonia deaths occur.
Deaths is Asia are attributed to the high population and limited use of the vaccines, according to the WHO, while Africa sees a lack of vaccines, a high rate of HIV infection, and poor basic medical care as contributors to deaths.
Pneumococcal vaccination is standard in some of the world s high and upper-middle income countries, but not until recently have developing countries doled out vaccines.
That is changing, thanks to the Global Alliance for Vaccines and Immunisation (GAVI), a global health partnership, which benefits from funding by the Bill and Melinda Gates Foundation as well as various public and private donors. GAVI offers low-income countries pneumococcal vaccines for as little as 15 cents per dose.
Rwanda was the first African country to launch the pneumonia vaccine, Dr. Levine told IPS. They are rolling out community-based management by scaling up the use of village health workers so that treatment gets as close to children s home as possible. Eleven developing countries are on the road to improved pneumonia prevention and treatment, thanks to the GAVI Alliance. Twelve additional countries have submitted applications and are awaiting GAVI approval. Eligibility is determined by national income and only countries with a Gross National Income (GNI) per capita below 1,000 dollars in 2003 qualify.
If fully rolled out in GAVI-eligible countries, the pneumococcal vaccine could save the lives of more than 440,000 children by 2015, said Dr. Julian Lob-Levyt, CEO of the GAVI Alliance.
The next step in the fight against pneumonia is the implementation of the Global Action Plan for Prevention and Control (GAPP), released Monday by WHO and UNICEF. The six-year plan to control the disease has a three-pronged pneumonia strategy, which includes: creating a healthy environment for children by promoting exclusive breastfeeding and ensuring adequate nutrition and good hygiene; vaccinating them against pneumonia; and treating the illness in community clinics and hospitals through effective case management and with an appropriate course of antibiotics.
Dr. William Frist witnessed the benefits of a community-based approach on a recent trip to Mozambique.
We visited a family whose eldest child was ill. After a brief examination, the community health worker was able to ascertain that the child s illness had progressed beyond a cold to pneumonia, recalled Frist, a pioneer in heart-lung transplantation.
We immediately placed the child on a bicycle-ambulance where the community health worker would drive him about two miles to the nearest clinic. If the community health worker hadn t intervened when he did, it is possible that the child would have died, Frist said.
As former U.S. Senate majority leader, Frist added that the U.S. is committed to investing in maternal, newborn and child health in developing countries.
The Maternal, Newborn and Child Survival Act, now before Congress, would expand the reach of life-saving tools vaccines, antibiotics and trained health workers to more mothers and babies in poor countries, said Frist.
The U.S. Senate released a companion version of the bill, the Global Child Survival Act of 2009, on Oct. 28. If passed, the bill would put the United States in a position to make highly effective health care measures available to vulnerable mothers, newborns and children in developing countries.
This is an important next step toward providing millions of parents with hope that their babies will grow up healthy and live to see their fifth birthday, said Charles MacCormack, president and CEO of Save the Children.
