About the events:

PSI/Madagascar took the opportunity of the 2011 World Pneumonia Day to kick-off its pneumonia program, which seeks to increase appropriate management of pneumonia case in the community.

The program promotes care-seeking behavior to qualified providers among parents when their child present with cough or difficulty breathing using behavior change communication campaigns, improves quality of service from providers by training them on the integrated management of sick children and supervising them regularly, and ensures better availability of the first-line antibiotic recommended by introducing a pre-packaged pneumonia treatment (PPT) so as to constitute the necessary antibiotics for one course-treatment, in a dosage and form suitable for children (flavored, dispersible), provided with illustrated instructions to ensure treatment compliance and recovery.

PSI/Madagascar marked World Pneumonia Day through a press conference, animations using games, radio, a puppet show and mobile video to raise awareness about pneumonia, its manifestation, prevention and the availability of the PPT through community health workers.

In research published in The Lancet on November 11, 2011, children treated at home for severe pneumonia by Pakistan’s "Lady Health Workers" (LHW) were more likely to recover than children referred to health facilities, Save the Children found in a USAID-funded, WHO-coordinated study.

"Pneumonia is highly treatable with inexpensive antibiotics, yet it remains the world’s number-one killer of children," said Carolyn Miles, President & CEO of Save the Children. "Today’s results point to an extremely promising and practical way to reduce child deaths from severe pneumonia in the hardest hit communities. Training and supporting more frontline health workers is at the heart of the solution."

The Lancet study addresses a significant barrier to effective treatment for millions of poor families around the world — the difficulty in accessing quality health services. In poor and isolated communities where pneumonia takes its biggest toll, major challenges include distance to a health facility, lack of transportation and costs.

Amidst a global health workforce crisis, Pakistan is one of a growing number of low-income countries to deploy community health workers to improve child and maternal health. In Pakistan, Lady Health Workers receive several months training, ongoing supervision and basic supplies and attend to about 150-200 families at home monthly.

What Happens When Families Can’t Access a Health Facility?

Previous studies have shown that community health workers can successfully treat children with non-severe pneumonia at home and substantially reduce mortality rates. However, current World Health Organization (WHO) guidelines do not allow for in-home treatment when pneumonia is defined as severe (when a child’s chest draws in instead of expanding during inhalation). Instead, community health workers are to administer the first dose of antibiotic and then refer a child to a facility.

Around the world, many families never make it to a health facility. Until today’s publication, no rigorous randomized study had shown whether community health workers could safely and effectively treat cases of severe pneumonia at home.

"Our study aimed to show that children can recover just as well from severe pneumonia when treated at home as when referred to a health facility. In fact, we found that frontline health workers treating children at home can be even more effective," said the study’s principal investigator, Dr. Salim Sadruddin of Save the Children.

The full research paper can be accessed at The Lancet.

On World Pneumonia Day and the importance of raising awareness:

On the promise of new vaccines in Kenya and beyond:

Dr. Daniel Feiken

On the causes of pneumonia and the toll of the disease:

Dr. Cynthia Whitney

On the impact of the pneumococcal vaccines and importance of vaccination:

On November 12, the world comes together to recognize the third annual World Pneumonia Day and to advocate for solutions to the world’s leading killer of young children. Today, PACE is particularly pleased to celebrate the great strides that have been made in the fight against pneumococcal disease – the leading cause of deadly childhood pneumonia.

Since PACE’s inception in 2006, 59 countries have introduced pneumococcal vaccines into their national immunization programs, with the latest country to take this step being the tiny southeast African nation of Malawi, which will administer its first vaccine today. Thanks to the work of the GAVI Alliance and its partners, 18 more countries are on track to take this step within the coming year, with a total of nearly 60 low-income countries to follow suit by 2015.

“The fact that countries in Africa, Asia and Latin America will introduce the newest generation pneumococcal vaccines shortly after their introduction in the United States is unprecedented, and is expected to have a dramatic impact on pneumonia deaths,” said Ciro A. de Quadros.  “PACE commends our partners for their dedication to tackling the leading killer of young children.”

The Pneumonia Progress Report, released this week by the International Vaccine Access Center (IVAC), underscores the tremendous progress is being made expanding access to vaccines in the countries with the most child pneumonia deaths.

“We are finally beginning to achieve equity among countries rich and poor when it comes to pneumonia prevention, which will mean the difference between life and death for millions of children,” said Orin Levine. “We must continue our resolve to ensure that children in even the hardest-to-reach communities have a shot at a healthy life.”

PACE is amplifying this message with commentaries this week in the Global Post, Huffington Post, Bangladesh’s Daily Star and South China Morning Post.

Update

Students from the International School of Geneva were also given awards for their World Pneumonia Day photography exhibition. The event held at GAVI Secretariat was attended by ambassadors, global health experts and many GAVI partners and ended with a group photograph.

Watch the video!

World Pneumonia Day 2011 event at GAVI Alliance from GAVI Alliance on Vimeo.

Recent estimates of global pneumonia incidence and mortality associated with Streptococcus pneumoniae, Haemophilus influenzae type b, and respiratory syncytial virus (RSV) do not fully explain the pediatric pneumonia burden, and so the role of other pathogens needs to be explored. These include influenza virus, which is associated with a large but unknown number of hospital admissions in young children globally and is vaccine preventable. Many data for incidence and mortality from influenza-associated pneumonia in developing countries remain unpublished. Therefore, the authors formed an international Influenza Study Group to supplement their systematic literature review (containing published data from high-income and developing countries) with available unpublished data.

Read the full study at The Lancet.

Berkeley researchers found a dramatic one-third reduction in severe pneumonia diagnoses among children in homes with smoke-reducing chimneys on their cookstoves, and in a separate study, they found a link between prenatal maternal exposure to woodsmoke and reductions in markers for IQ at ages 6 and 7 years.

While previous research has linked exposure to household cooking smoke to respiratory infections, the latest results come from the first-ever randomized controlled trial – the gold standard of scientific experiments – on air pollution.

"Many people accept the relationship between air pollution and chronic diseases, but pollution's influence on infectious diseases like pneumonia is less intuitive," said Kirk Smith, professor of global environmental health at UC Berkeley's School of Public Health and principal investigator of the RESPIRE (Randomized Exposure Study of Pollution Indoors and Respiratory Effects) study. "This study is critically important because it provides compelling evidence that reducing household woodsmoke exposure is a public health intervention worth investing in. We found as large a benefit for severe pneumonia as more well-known public health interventions, such as vaccinations and nutrition supplements."

Read the full research paper at The Lancet.

STUDIES SHOW GREAT STRIDES IN VACCINATION BUT MORE PROGRESS NEEDED IN SCALING UP PROTECTION, TREATMENT INTERVENTIONS

New approach to treatment shows promise; integrated approach is urged to combat world’s leading child killer on third annual World Pneumonia Day, November 12, 2011

(BALTIMORE, MARYLAND) – New reports issued this week by partners in the Global Coalition Against Child Pneumonia show that community treatment programs, improved cookstoves and new vaccines are cost-effective and can contribute significantly to a reduction in pneumonia deaths. Even so, some of these interventions fall far short of recommended target levels set by the World Health Organization (WHO) and UNICEF.

The Global Action Plan for the Prevention and Control of Pneumonia (GAPP), issued by the WHO and UNICEF in 2009, noted that child pneumonia deaths could be reduced by two-thirds if existing interventions to protect against, prevent and treat pneumonia could be scaled up to reach 90 percent of the world’s children.

In a paper published November 9 in the journal International Health, the authors estimate that two pneumococcal vaccines being introduced in the world’s poorest countries with support from the GAVI Alliance could save the lives of 3 to 4 million children over the next 10 years, and indicate that the vaccines are a highly cost-effective investment for developing countries. With GAVI’s support, 15 of the world’s poorest countries have introduced the newest-generation vaccines that protect against pneumococcal disease. Nearly 60 countries are expected to introduce this vaccine by 2015.

The International Vaccine Access Center (IVAC) at the Johns Hopkins University, U.S.A., has released a report showing that progress in rolling out interventions to control pneumonia has been uneven. The greatest recent progress is in access to vaccines, though there is a lingering lack of access to medical care and antibiotics in the countries where children are most vulnerable to pneumonia.

“We’re knocking it out of the park with our efforts to expand vaccine access in the countries with the most pneumonia deaths, but we need to up our game to protect against and treat this disease,” said Orin Levine, executive director of IVAC and member of the Global Coalition Against Child Pneumonia. “The challenge ahead for all of us is to follow the game plan outlined in the GAPP to expand these life-saving interventions to the people that need them most.”

Save the Children will publish a new study in the November 11, 2011 edition of the medical journal The Lancet that could lead the way to changing pneumonia treatment guidelines based on the remarkable success that “Lady Health Workers” in Pakistan have achieved. Currently, millions of families have difficulty accessing quality care at a health facility.

“We can dramatically reduce the number of children dying needlessly from pneumonia. To achieve this, every family must have access to a frontline health worker with the knowledge to help prevent pneumonia and the skills to diagnose and treat cases that do occur,” said Mary Beth Powers of Save the Children. “A person with an eighth-grade education can be trained to provide this kind of health information and more countries are adopting policies that allow for community-based treatment to save costs and lives.”

Pneumonia claimed the lives of more than 1.5 million children in 2008 – more than any other cause of death, with over 98 percent of those deaths occurring in developing countries. A comprehensive approach to pneumonia control, including breastfeeding infants for the first six months of life, limiting exposure to indoor cookstove smoke, promoting regular handwashing, immunizing children against pneumonia’s leading causes and ensuring access to health care and antibiotic treatment for pneumonia cases that do occur, is vital to limiting this deadly illness.

“Each day nearly 3 billion people rely on solid fuels for cooking, that when burned, fill their households with dense, toxic smoke, dramatically increasing their risks for pneumonia,” said Radha Muthiah, Executive Director of the Global Alliance for Clean Cookstoves, a public-private initiative led by the United Nations Foundation. “In fact, more than half of all childhood pneumonia deaths are cookstoves-related. Reducing household air pollution is essential to protecting children from this devastating illness.”

To date, 15 of the world’s poorest countries have introduced the newest-generation vaccines that protect against pneumococcal disease – the leading cause of pneumonia – into their national immunization programs. On World Pneumonia Day, November 12, Malawi will become the 16th GAVI country to take this step. By 2015, nearly 60 developing countries are expected to introduce the vaccine with support from the GAVI Alliance.

Global health leaders, medical professionals, activists and community leaders are joining forces to shine the spotlight on World Pneumonia Day, with events planned in at least 20 countries, including Argentina, Bangladesh, China, Egypt, Ghana, Haiti, India, Kenya, Liberia, Madagascar, Malawi, Mexico, Moldova, Nigeria, Pakistan, Philippines, Rwanda, Switzerland, the United States and Zambia.

In addition, the Global Coalition Against Child Pneumonia is utilizing social media like never before to raise awareness, educate audiences and spur action. The Coalition is inviting advocates to follow World Pneumonia Day on Facebook and Twitter and to share the World Pneumonia Day infographic and video throughout their social networks. In the United States, people can use the “Take Action” button on the World Pneumonia Day Facebook page to send a message directly to Congress urging leaders to protect funding for the global fight against pneumonia as they work toward negotiating the 2012 budget. Learn more about World Pneumonia Day at www.worldpneumoniaday.org.

The Global Coalition Against Child Pneumonia

The Global Coalition Against Child Pneumonia was established in April 2009 to raise awareness about the toll of pneumonia, the world's leading killer of children, and to advocate for global action to protect against, effectively treat and help prevent this deadly disease. The Coalition is a global network of more than 125 NGOs, community‐based organizations, academic institutions, government agencies and foundations who together provide leadership for World Pneumonia Day, marked each year on November 12 to encourage efforts to combat the disease among donors, policy makers, healthcare professionals and the general public.

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Download a PDF version of the Press Release here.

"Policy-makers increasingly rely on cost-effectiveness analysis, in addition to clinical effectiveness, when considering the introduction of new childhood vaccines. A previous analysis determined vaccination of infants with 7-valent pneumococcal conjugate vaccine (PCV) to be highly cost effective in preventing child mortality in countries eligible for financial support from the Global Alliance for Vaccines and Immunization (GAVI). We aimed to update this analysis by incorporating recent data on global disease burden, indirect effects and higher valency vaccines."

In a separate paper, published in the same issue of the journal, the researchers also examined the economic impact of PCV in middle-income countries. Their findings indicate that "Vaccination would be cost effective for 72 countries with the 7-valent vaccine and for all countries with the 10- or 13-valent vaccines. The economic case for vaccination is compelling for middle-income countries."

More about the research can be found at International Health.