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Vaccines Make Gradual Headway Against Child Pneumonia

Matthew O. Berger

WASHINGTON, Nov 12 2010 (IPS) - It had seemed her kids had the flu or a cold. But when it got worse, she took little Abigail to hospital. It was already too late; Abigail died in her mother’s arms.

Returning home, Shannon Duffy Peterson’s son exhibited the same symptoms, and she rushed him to hospital. He was saved after two days of care, but within 72 hours Peterson had almost lost both her kids to pneumonia, which kills more children globally than any other disease . These easily preventable deaths happened in the U.S. state of Minnesota, the heartland of the richest country on earth, where vaccines against the primary causes of pneumonia are widely available.

Now, Peterson, an advocate with Parents of Children with Infectious Diseases, spreads the message that parents should vaccinate their children against as many diseases as possible.

But this advice is much easier to follow in a country like the U.S. than in many others, including the 15 countries with the highest rates of child pneumonia deaths.

Nearly three-quarters of pneumonia deaths among children five and under occur in just these 15 African and Asian countries, according to a new study by the International Vaccine Access Center (IVAC) done on behalf of the Global Coalition against Child Pneumonia. Nearly one-quarter of these deaths occur in India alone.

Children in these 15 countries, the study says, are anywhere from 17 to 400 times more likely to die of pneumonia than a child living in the U.S.

“The problem is that children who need [the vaccines] most – those in the poorest parts of the world – haven’t been getting it,” said IVAC’s executive director Orin Levine, speaking at an event Friday commemorating World Pneumonia Day. “Children who live in countries that can afford it get it; those who live in countries that cannot don’t.”

But, he says, this is the year that pattern is really starting to change. Through the work of groups like the GAVI Alliance, a public-private partnership that strives to make vaccines and immunisations more available to people in poorer people countries, nearly all of the countries highlighted in the study, titled the Pneumonia Report Card, are expected to increase existing vaccine coverage in the next five years and introduce the vaccines they are lacking.

Action against pneumonia is a cheap, high-impact way to save children in developing countries, say experts. Currently, pneumonia, despite not having as high a global health profile as killers like malaria or HIV/AIDS, kills more children each year than any other disease, at a rate of over 1.5 million a year – more than AIDS, malaria and measles combined. And 1.16 million of those deaths occurred in just those 15 countries highlighted by the report card.

“We talk a lot about saving children’s lives, but we don’t talk a lot about pneumonia and diarrhoea, which are the two biggest killers,” says Levine.”Pneumonia is the biggest solvable problem in global health. We have safe, effective, proven, methods that can save children’s lives if we can just expand access to them.”

Last year, the World Health Organisation and UNICEF issued a Global Action Plan for the Prevention and Control of Pneumonia, or GAPP, which laid out a plan to provide access to simple pneumonia interventions for 90 percent of the world’s children, which it said would prevent up to two- thirds of child pneumonia deaths.

Those simple interventions include vaccines for measles, pertussis, pneumoccal and Hib and protection measures like treating children with suspected pneumonia with antibiotics or simply encouraging breastfeeding during the first six months of a child’s life.

Breastfeeding provides crucial antibodies for the child that not only help protect against pneumonia but also diarrhoea and other killers, explains Salim Sadruddin, a child health and nutrition advisor with the NGO Save the Children. Sadruddin also notes how easy it is to provide this care with just a small amount of resources and investment.

“Even lay workers can be trained very easily in a very short time to provide care to people who don’t have access to a health centre,” as many people in rural villages in sub- Saharan Africa or central Asia do not, Sadruddin says.

The report card released Thursday evaluated the 15 countries’ progress in expanding access to these interventions. It found that coverage in these countries ranges from 61 percent to 23 percent, all far off the 90 percent target.

But Levine notes that this is the first time they have had numbers tracking global progress and that for some measures – like measles and pertussis vaccines – coverage is already high, generally between 60 and 90 percent.

Ezekiel Emanuel, a special advisor to the U.S.’s Office of Management and Budget who has argued for greater U.S. leadership on global maternal and child health initiatives, says, “We are in the midst of the biggest roll-out of pneumococcal vaccine in developing countries.”

He says it is “impressive” that we have a vaccine but that “we need to get out there and immunise.”

But breastfeeding, which the report says has coverage levels of about 10 to 60 percent, and treatment with antibiotics, under 10 to 50 percent, remain even further behind immunisations.

World Pneumonia Day is one way to try to raise the profile of this preventable but overlooked disease, says Levine. “I think that’s really what it’s going to take – people demanding action.”

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