World Pneumonia Day, November 12 – Leading child health agencies have joined forces to announce plans to work together on an unprecedented scale to increase access to amoxicillin in dispersible tablet form – the recommended antibiotic treatment for children under five suffering from pneumonia.*

In 2011, a staggering 1.3 million children died from pneumonia, making it the leading killer of children under five. Despite the existence of low-cost and highly effective antibiotics, less than one third of children with suspected pneumonia use antibiotics and a tiny minority receive amoxicillin in the ideal form for small children – a tablet that dissolves in liquid.

Making amoxicillin in this form available to the children most at risk of dying from pneumonia would potentially save 1.56 million children over five years, according to a 2012 report by the United Nations Commission on Lifesaving Commodities for Women and Children.

The immediate focus of this new multi-agency push is to increase access to amoxicillin in dispersible tablet form in the ten countries suffering the highest numbers of child pneumonia deaths, including India (400,000 deaths), Nigeria (130,000 deaths), Democratic Republic of Congo (88,000 deaths), Pakistan (67,000 deaths), Ethiopia (41,000 deaths), Uganda (22,000), Niger (20,000), Bangladesh (19,000), Tanzania (18,000) and Kenya (18,000). Two thirds of all child pneumonia deaths occur in these countries.

A key plank of the strategy is to reach the children most at risk of death from pneumonia – children living in families with very low incomes, often in rural areas and far from the reach of formal health services. By focusing on children in the poorest households many more lives can be saved.

Convened by UNICEF and working in partnership with governments and civil society, all partners will collaborate on a strategy to increase access to amoxicillin in dispersible tablet form in the ten target countries that includes:

  • increasing the number of local suppliers of quality, affordable amoxicillin dispersible tablets and improving the packaging and instructions for use;
  • fast-tracking the local registration of amoxicillin dispersible tablets;
  • listing amoxicillin as the recommended treatment for child pneumonia in all relevant national, state and local country guidelines;
  • accelerating progress toward the community case management of pneumonia, i.e. empowering, training and equipping frontline health workers and local private health providers to diagnose, treat and refer (when necessary) cases of child pneumonia;
  • increasing family awareness of the dangers of pneumonia and the critical importance of seeking care quickly; and
  • exploring new models of service delivery that better integrate pneumonia diagnosis and treatment with the delivery of vaccines (e.g. pneumococcal and Hib), diarrhea treatment (e.g. oral rehydration salts and zinc) and the rollout of Rapid Diagnostic Tests for malaria.

In countries where malaria and pneumonia are leading killers of children under 5 (e.g. Nigeria and Democratic Republic of Congo) health care workers need to distinguish children presenting with malaria from those presenting with pneumonia, and treat them accordingly. The rollout of tests for malaria will help identify children with pneumonia so that they can be treated with amoxicillin, reducing wastage of malaria medicines.

With three years left to 2015, accelerated action on child pneumonia is critical to the achievement of Millennium Development Goal 4. The goal of the new effort is to increase access to the most effective antibiotic treatment for the children most at risk of dying from pneumonia in the ten countries where those deaths are concentrated. It is consistent with the Global Action Plan for the Prevention and Control of Pneumonia and the Declaration on Scaling Up Treatment of Diarrhea and Pneumonia endorsed by the Child Survival, Call to Action in June 2012.

Click here for the full statement.

*WHO Priority Life-saving Medicines for Women and Children 2012 recommends amoxicillin, 250mg and 500mg scored, dispersible tablet in blister packs of 10.

For more information on pneumonia see, Committing to Child Survival: A Promise Renewed, Progress Report, UNICEF 2012, Pneumonia and Diarrhea. Tackling the Deadliest Diseases for the World’s Poorest Children, UNICEF 2012