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FOR IMMEDIATE RELEASE: November 12, 2012

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Mala Persaud
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Julie Younkin
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Pneumonia Remains the Leading Killer of Children Despite Decline in Global Child Deaths

PNEUMONIA STILL NUMBER ONE KILLER

But there are simple solutions, say global health leaders

(BALTIMORE, MARYLAND) – Marking the fourth annual World Pneumonia Day, November 12th, world leaders and the Global Coalition Against Child Pneumonia are calling for major efforts in the fight against childhood pneumonia, which remains the number one killer of children under age five. Pneumonia claimed 1.3 million lives in 2011 alone, and was responsible for nearly one in five global child deaths.

“Pneumonia can be prevented and cured.  Yet, for too long it has been the leading cause of global deaths among children.  We know what to do, and we have made great progress – but we must do more.  We must scale-up proven solutions and ensure they reach every child in need,” said United Nations Secretary-General Ban Ki-moon, who spearheads Every Woman Every Child, an umbrella movement that has leveraged more than $20 billion in new money for women’s and children’s health and aims to save 16 million lives by 2015.

Investments in preventing, treating, and protecting children against pneumonia have contributed to significant declines in child mortality over the last decade, but access to healthcare facilities and treatment remains out of reach for many children in the developing world, where 99 percent of deaths from pneumonia occur.  According to the Global Coalition Against Child Pneumonia, country leaders and funders must prioritize efforts and investments in proven interventions, including access to vaccines, proper antibiotic treatment, and improved sanitation, as well as the promotion of practices such as exclusive breastfeeding, frequent hand washing, care seeking, and the use of clean cookstoves to reduce indoor air pollution. Several of these interventions also help address the second leading killer of children – diarrhea.

For pneumonia cases that do occur, antibiotics such as amoxicillin are one of the simplest and least expensive methods of treatment. However, antibiotics are administered to less than one third of children with suspected pneumonia, and only a tiny minority receives amoxicillin in the ideal form for small children: a tablet that dissolves in a very small amount of liquid or breast milk. According to the UN Commission on Life-saving Commodities for Women and Children, making amoxicillin available in a dissolvable tablet form to the children most at risk of dying from pneumonia would potentially save 1.56 million children over five years.

According to a Pneumonia Progress Report released today by the International Vaccine Access Center (IVAC) at Johns Hopkins, 75 percent of all childhood pneumonia deaths worldwide occur in just 15 countries, demonstrating the impact we can have with targeted efforts. The report also notes that none of these countries have reached the 90 percent coverage targets for key pneumonia interventions recommended in the Global Action Plan for the Prevention and Control of Pneumonia (GAPP).

GAPP, issued by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) in 2009, specified that child pneumonia deaths could be reduced by two-thirds if three child health interventions – breastfeeding, vaccination and case management including the provision of appropriate antibiotics – were scaled up to reach 90 percent of the world’s children.

Over the past three years, the GAVI Alliance has assisted over 20 countries to introduce the pneumococcal conjugate vaccine, which prevents the most common cause of childhood pneumonia.  While progress is being made, currently only 7 of the 15 countries profiled in IVAC’s report have vaccine coverage levels at or above 80 percent.  Coverage of breastfeeding and access to antibiotics are similarly low in most countries.

Key to getting vaccines and treatments to the children who need them most are frontline health workers, who are the first and often only link to healthcare for many children. However, WHO estimates there is currently a shortage of at least one million frontline health workers, particularly in Africa and parts of Asia. Efforts such as Save the Children’s Every Beat Matters campaign are bringing attention to this shortage to spur action.

Events commemorating the fourth annual World Pneumonia Day will be held in nearly a dozen countries, including Argentina, Burkina Faso, Cameroon, Cote d’Ivoire, Ghana, Haiti, India, Nigeria, Philippines, the United States and Zambia.  In the U.S., landmarks in 15 cities will shine blue lights to raise awareness in their communities of the scourge of childhood pneumonia and what U.S. citizens can do to help. Participating buildings include the Wrigley Building (Chicago), Trump Towers SoHo (New York City) and Pacific Science Center (Seattle), among others.  For more information about World Pneumonia Day and its activities, please visit www.worldpneumoniaday.org.

The Global Coalition Against Child Pneumonia was established in 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 illness. Comprised of over 140 non-governmental organizations, civil society organizations, academic institutions, government agencies and foundations, the Coalition provides leadership for World Pneumonia Day, marked every year on November 12th.

 

Press Release Quote Sheet

PNEUMONIA REMAINS THE LEADING KILLER OF CHILDREN DESPITE DECLINE IN GLOBAL CHILD DEATHS

Photo: UN Photo / Eskinder Debebe

UN Secretary-General Ban Ki-moon

“Pneumonia can be prevented and cured.  Yet, for too long it has been the leading cause of global deaths among children.  We know what to do, and we have made great progress – but we must do more.  We must scale-up proven solutions and ensure they reach every child in need,” said UN Secretary-General Ban Ki-moon, who spearheads Every Woman Every Child, an umbrella movement that has leveraged more than $20 billion in new money for women’s and children’s health and aims to save 16 million lives by 2015.

Photo: GAVI / Olivier Asselin

GAVI Alliance CEO Seth Berkley

“Pneumonia is a painful disease that claims the lives of over a million children every year,” said Dr. Seth Berkley, CEO of the GAVI Alliance, “We have the tools to change this. The GAVI Alliance is taking the lead in ensuring that countries that want to vaccinate their children against pneumococcal disease, one of the leading causes of pneumonia, are supported to do so.”

Photo: UNICEF / NYHQ2010-0697 / Markisz

UNICEF Executive Director Anthony Lake

“Today, pneumonia will kill thousands of children.  And tomorrow.  Every day. It is unconscionable that each year 1.3 million die from such a preventable disease.  This need not be so,” said Dr. Anthony Lake, Executive Director of UNICEF. “There are simple, low cost solutions, such as hand washing with soap, vaccines and treatment like amoxicillin that can save these children’s lives. So what possible excuse can there be for a failure to do still more in the fight against this killer of children?”

Photo: Keith Weller

IVAC Acting Director Kate O’Brien

“IVAC’s Pneumonia Progress Report, issued today, indicates that while vital coverage of vaccines is improving in the countries hardest hit by childhood pneumonia, rates of breastfeeding and access to care remain low,” said Dr. Kate O’Brien, Acting Director of the International Vaccine Access Center at Johns Hopkins Bloomberg School of Public Health. “If the 90% pneumonia intervention targets are reached, we could save the life of one child nearly every minute.”

Photo: USAID

USAID Administrator Raj Shah

“Today, the global community has the knowledge and the affordable tools to change the course of history,” said Dr. Raj Shah, USAID Administrator. “For less than fifty cents, a treatment course of life-saving antibiotics can be provided to a child with pneumonia. We can end preventable child deaths, ensuring millions of children reach their 5th birthday.  Ensuring that no family needlessly suffers the loss of a child would be one of the great moral victories of our time.   It would also be a great economic victory, because it helps lower population growth, and, through the demographic dividend, accelerate economic growth.”

BALTIMORE, MDThe International Vaccine Access Center (IVAC) at the Johns Hopkins Bloomberg School of Public Health (JHSPH) announced today recipients of the 2012 Small Grants for World Pneumonia Day Advocacy Program. The Small Grants Program supports events and activities that promote pneumonia prevention and control in countries where childhood pneumonia has the greatest impact. 

In this, the 4th year of the small grants program, 12 grants have been awarded thus far and additional grants may be announced later in the year. Congratulations to the following Recipient Organizations:

  • Burkina Faso: Association of Community Health and Development (ASCOD)
  • Cameroon: Front for Inter-School awareness on STD / AIDS (FISS-MST/SIDA)
  • Cote d’Ivoire: Stop Tuberculosis Bouake
  • Ghana: Association of People for Practical Life Education (APPLE) in collaboration with Reliance Network (R-Net)
  • Haiti: Haitian Pediatric Society
  • India: Global Health Strategies, India
  • Nigeria: Breath of Life; Vaccine Network; University of Ibadan; Pediatric Association of Nigeria
  • Philippines: Philippines Foundation for Vaccination
  • Zambia: Social Workers Association of Zambia (SWAZ)

Pneumonia is the world’s leading killer of children under five, claiming nearly 1.3 million children under five years of age in 2011, over 90% of whom are in developing countries. Over the last decade, global health leaders have worked to turn the tide on pneumonia by promoting access to interventions that protect against, prevent, and treat the disease for the children who need them most. In this spirit, a diverse group of advocacy, academic, and service organizations formed the Global Coalition Against Child Pneumonia in 2009. The Coalition recognizes a World Pneumonia Day each year to raise awareness of the disease and advocate for funding and implementation of proven interventions.

Commemorated annually on November 12th, World Pneumonia Day has earned the attention of public health leaders, medical professionals, journalists, policy-makers and community advocates as a day to raise awareness and create action to combat this “forgotten killer.”

The Small Grants Program is made possible through support from members of the Global Coalition against Child Pneumonia including IVAC, the GAVI Alliance and the Global Alliance for Clean Cookstoves.

Visit www.worldpneumoniaday.org for more information about the 2012 Small Grants for Advocacy Program and World Pneumonia Day. 

The Global Coalition Against Child Pneumonia was established in 2009 to raise awareness about the toll of pneumonia, the world’s leading killer of children. Comprised of over 140 nongovernmental organizations, academic institutions, government agencies, and foundations, the Coalition provides leadership for World Pneumonia Day, advocating for global action to protect against, effectively treat and help prevent this deadly disease. 

 The International Vaccine Access Center (IVAC) has as its mission to accelerate global access to life-saving vaccines through development and implementation of evidence-based policies. Drawing upon expertise and faculty from the Johns Hopkins Bloomberg School of Public Health, IVAC works to strengthen the evidence base for vaccine introduction including undertaking targeted, policy-focused research in areas such as disease burden, cost-effectiveness, vaccine policy, demand forecasting and disease epidemiology. For more information, please visit www.jhsph.edu/ivac.

Pakistan’s “Lady Health Workers” Successfully Treat Severe Pneumonia at Home

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.

PACE Celebrates Great Strides with Pneumococcal Vaccines on Third Annual World Pneumonia Day

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.

On November 11, 2011, GAVI held a special event to mark World Pneumonia Day 2011 and the first anniversary of the introduction of vaccines against pneumococccal disease. Co-hosted by GAVI Alliance Deputy CEO Helen Evans and Australian Ambassador Peter Woolcott, the event featured speakers Dr. Tom Mboya, Kenya’s Ambassador in Geneva, who read a powerful statement from President Mwai Kibaki of Kenya, and Dr Orin Levine, Executive Director of the International Vaccine Access Center (IVAC).

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.

Ahead of World Pneumonia Day, the first study to provide global estimates of seasonal influenza in children aged under five years and the resultant burden of influenza-related pneumonia is published Online First by The Lancet. The study estimates that, globally, around 90 million children contract seasonal flu each year, causing around 1 million hospital admissions and as many as 111500 deaths due to influenza-related pneumonia-with 99% of these deaths in developing countries. The Article is by Dr Harish Nair, Centre for Population
Health Sciences, Medical School, The University of Edinburgh, UK, and colleagues worldwide.

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.

In research published on November, 10, 2011, new studies from the University of California, Berkeley, focus on the human health effects of exposure to smoke from open fires and dirty cookstoves, the primary source of cooking and heating for 43 percent of the world’s population, particularly affecting women and young children living in poverty.

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.

In a paper published November 9, 2011 in the journal International Health, research led by Dr. Anushua Sinha estimates 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.

“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.

We are pleased to announce the release of the pneumonia-focused coloring book,”How You Can Beat Pneumonia.” After extensive development by the brother-sister team of Jessica and David Alderman, scientific review by world-leading pneumonia researchers and collaboration with a child literature expert, this free resource is now available for use and distribution.

We want children to enjoy reading, learning and coloring with their parents or caretakers, and hope this book will engage children and their families around the world to learn about pneumonia and the ways it can be prevented. We encourage the use of this resource – in schools, in clinics or even in your own home – and best of all, it’s free! Parents are also able to submit photos or scans of colored pages, which will be featured in an online gallery of children’s work!

Find out more and download the book here.

The 2011 Pneumonia Progress Report examines data on several key pneumonia interventions – including exclusive breastfeeding, access to a health care facility, antibiotic treatment and vaccination against pneumonia’s four leading causes – in the 15 countries with the most child pneumonia deaths.

The report is an annual production by the International Vaccine Access Center (IVAC) at Johns Hopkins Bloomberg School of Public Health. Read more about this year’s Progress Report here.