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Progress against pneumonia lags behind other childhood killers

Markson Farley, right, checks a child's temperature during a training in Liberia to help workers spot pneumonia. (2013 Credit: Direct Relief)
Nearly a million children worldwide die every year from pneumonia – more than die from HIV, measles and malaria combined.
Put another way, one of every six children under the age of 5 years old dies from this infectious respiratory illness. Today is World Pneumonia Day and many in the global health community are pushing for a more aggressive fight against pneumonia.

Pneumonia is an infectious respiratory disease, and if you are living in a high-income country, you probably don’t given it much thought. You rightly might think that it largely affects the elderly. It’s something that a grandparent may have died of after a series of health problems landed them in the hospital.

We have seen strong declines in pneumonia deaths around the world, but progress lags behind improvements seen in other health conditions, such as diarrhea and malaria. Today global leaders are meeting in New York to consider the innovations, technologies and investments needed to “push the pace” in accelerating progress against pneumonia.

As highlighted by a report published by the Institute for Health Metrics and Evaluation (IHME), the number of children who died from pneumonia in 2013 is equivalent to every child under 5 in six major American cities* dying in a single calendar year.

Worldwide, child pneumonia deaths fell 58 percent between 1990 and 2013. But reductions in under-5 deaths from diarrheal diseases and measles were much faster, dropping by 68 percent and 83 percent, respectively. These trends are shown below, based on results from the Global Burden of Disease (GBD) study, where pneumonia is synonymous with lower respiratory infections.

Global pneumonia trends, 1990-2013

Source: GBD Compare

In some countries with a high burden of pneumonia deaths, this uneven progress was even more pronounced. In the chart below, you can see that in Nigeria child mortality from diarrhea and measles dropped 60 percent and 86 percent between 1990 and 2013. By contrast, the country recorded a 4 percent decline in under-5 pneumonia deaths.

Nigeria and Tanzania, 1990-2013

Source: GBD Compare

We know what works to fight pneumonia in children. Improving access to prompt diagnosis and treatment of pneumonia and scaling up vaccines that protect children against particularly deadly strains has occurred in many countries. So why has progress against pneumonia fallen behind?

One possibility is that the burden of major risk factors for pneumonia – such as malnutrition and household air pollution – have barely budged since 1990 in several countries. In fact, overall health loss due to childhood undernutrition has crept upward in some places over time, including the Democratic Republic of the Congo and Chad, as seen in the chart below.

DRC and Chad, risk factors

Source: GBD Compare

The next ambitious global health goal is to end preventable child deaths by 2030. In order to move this target closer to reality, policymakers, program leaders and development partners will need to hone in on what’s hindering further progress against pneumonia and substantially push the pace in tackling this deadly disease.

* Boston, Los Angeles, New York City, San Francisco, Seattle and Washington. City-specific population statistics were extracted from the United States Census Bureau’s “State & County QuickFacts” inquiry function.



About Author

Nancy Fullman

Nancy Fullman is a policy translation specialist at the Institute for Health Metrics and Evaluation (IHME), where she leads efforts to translate IHME’s research into actionable, policy-relevant materials and to engage stakeholders around the uses of global health evidence in decision-making. Nancy’s areas of expertise include malaria and other infectious diseases, impact evaluations and research around health service delivery. She received an MPH in health metrics and evaluation from the University of Washington.