Pneumonia, which is the world's leading infectious killer among children, claims the lives of nearly 1.6 million children under five every year, with more than 3,70,000 or nearly one-quarter of deaths occurring in India alone.
A Pneumonia Report Card released by the International Vaccine Access Centre (IVAC), on behalf of the Global Coalition against Child Pneumonia, evaluates prevention, protection and treatment efforts in India and in 14 other countries with the most child pneumonia deaths against the pneumonia intervention targets established in the Global Action Plan for the Prevention and Control of Pneumonia (GAPP) issued by the World Health Organisation and the United Nations International Children's Emergency Fund in 2009.
The report card reveals the need for urgent efforts in India to reach target levels of coverage for the life-saving interventions that can prevent, protect against and treat pneumonia in children. India has the highest number of pneumonia-related deaths in the world.
Overall scores of the countries illustrate the need to scale up coverage of all GAPP interventions. These scores, which combine coverage levels on all the target interventions, range from a high of 61 per cent to a low of 23 per cent. Importantly, not all countries had current coverage level estimates for all of the GAPP interventions, highlighting the importance of improving systems for collection of information. None of the countries profiled meet or exceed target levels for all interventions for which data is available.
The 15 countries evaluated in the Report Card — including Afghanistan, Angola, Bangladesh, Burkina Faso, China, Democratic Republic of the Congo, Ethiopia, India, Indonesia, Kenya, Niger, Nigeria, Pakistan, Tanzania and Uganda — are responsible for nearly three-quarters of all pneumonia deaths. Children in these countries are anywhere from 17 to 400 times more likely to die of pneumonia than a child living in the United States.
Coverage of interventions in the prevention category — namely, vaccines that prevent pneumonia or pneumonia-related illness — is between 60-90 per cent in countries where vaccines are in use, or zero where vaccines have not yet been introduced. These findings illustrate that moderate to high coverage rates are possible for pneumonia vaccines in these countries.
Only three countries reported coverage above the target level of 90 per cent for any vaccine, showing that the targets are achievable, but that continued efforts to raise coverage in nearly all countries is critical.
Furthermore, with levels of coverage for vaccines generally higher than those for interventions designed to protect against or treat pneumonia (including exclusive breastfeeding in the first six months of child's life and use of antibiotics), efforts to leverage vaccines to improve the coverage of other interventions are also needed, particularly as vaccines have been shown to address inequities of access to care in many countries.
