Pneumonia may be the leading killer of children, but that doesn’t mean it is a priority for global health spending. Only 2 percent of the $30.6 billion in international assistance spent on health care was directed to the disease. The impact is clear, progress against pneumonia deaths is not keeping up with other lesser child killers.
The findings are a part of a report released yesterday for World Pneumonia Day by the Washington-based Institute for Health Metrics and Evaluation. The more than 900,000 lives claimed by pneumonia in 2013 represent 14 percent of all deaths for children under 5 years old. Progress has been particularly slow in high-burden countries in sub-Saharan Africa, finds the report. Pneumonia deaths, in fact, increased in the Democratic Republic of Congo, Chad and Cameroon, according to Pushing the Pace: Progress and Challenges in Fighting Childhood Pneumonia.
Reducing the number of children who die each year requires improvement on responding to and preventing pneumonia.
“Achieving the ambitious new goal of ending preventable child deaths by 2030 will not only require significant additional investments in preventing, diagnosing and treating childhood pneumonia, but these investments will need to be targeted to sub-Saharan Africa and South Asia where deaths are most concentrated and progress is lagging,” said Chris Murray, institute director.
The good news is it is possible to prevent pneumonia cases before they happen. Immunizations are a key tool. The Gavi Alliance, a global vaccine organization supported by the likes of the United States and the Gates Foundation, helped some 40 million children receive the vaccine against Haemophilus Influenzae type b (Hib) pneumonia and 15 million the pneumococcal conjugate vaccine.
“Vaccines are protecting millions of children worldwide from pneumonia, but there is a pressing need for more effective care and treatment to achieve global goals faster. This means investments in innovations for new diagnostic tools and wider access to child health services that integrate pneumonia with care for other childhood illnesses, like diarrhea, malnutrition and malaria, to save more lives,” said Amie Batson, Chief Strategy officer for PATH.
The report tells two stories, one of progress and one of challenges. The reduction in deaths across sub-Saharan Africa has been slow. The overall decline in child pneumonia deaths by 58 percent from 1990 to 2013 is due to other regions and specifically China and India. The two populous countries join Iran, Bangladesh, Mozambique and Indonesia in reducing pneumonia deaths by more than 70 percent.
Money for pneumonia is increasing. It more than doubled in a matter of three years, from $306 million in 2008 to more than $663 million in 2011. The majority of the money went to Gavi and the distribution of vaccines. The report says that vaccines are not enough to stop pneumonia’s deadly path.
“If we want to achieve MDG4 by 2015 and end preventable child deaths by 2030 we need to make sure that our spending tracks disease burden more closely than it has to date,” said Leith Greenslade, vice chair at the MDG Health Alliance.
Diagnosis and treatment of pneumonia are critical. So are reducing the things that make people susceptible, like indoor smoke inhalation. Stronger overall health systems in the countries that saw the largest improvements are also considered to be behind their success.
The bottom line is that deaths can be prevented if more is done to stop pneumonia.
“Without a sustained and focused effort to improve the prevention, diagnosis, and treatment of the major childhood illnesses, including pneumonia, we will not achieve the new global child survival goal of ending preventable child deaths by 2030,” said Keith Klugman, director of the pneumonia program for the Gates Foundation, in the report’s introduction.