The 10th pneumonia and diarrhoea progress report card has found that health systems are falling short of ensuring the world’s most vulnerable children access to prevention and treatment services in the 23 countries that together account for 75% of global pneumonia and diarrhoea deaths in children under five.
India, which is home to a large population of under-five children, accounts for a major portion of these deaths, notes the report.
“Rollout of rotavirus vaccines, beginning in 2016, and the pneumococcal conjugate vaccine, beginning in 2017, helped India’s scores improve. India’s exclusive breastfeeding rate, at 55%, is among the highest of the 23 countries. However, the proportion of children receiving important treatments, as with many other countries, remains below targets. Half of the children with diarrhoea receive ORS (oral rehydration solution) and 20% receive zinc supplementation — to help protect against, prevent and treat pneumonia and diarrhoea,” notes the report.
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10 interventions
This report analyses how effectively countries are delivering 10 key interventions, including breastfeeding, vaccination, access to care, use of antibiotics, ORS, and zinc supplementation.
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Meanwhile, additional reports from organisations like Save the Children and UNICEF have noted that, in 2017, the highest risk factors for child pneumonia death in India were: 53% caused by child wasting, 27% by outdoor air pollution, and 22% caused by indoor air pollution from solid fuels.
Pulmonologit Prashant Saxena from Max Hospital, Saket noted that children are the worst hit by sustained high levels of air pollution.
These measures are proven to help prevent deaths due to these illnesses and could help achieve the UN’s Sustainable Development Goal target of reducing under-five mortality to at least as low as 25 per 1,000 live births by 2030.
Increase investment
The report card concludes that progress continues slowly and that the global community must increase investment and support countries in developing smart, sustainable strategies that close gaps and accelerate progress.
Globally, pneumonia and diarrhoea led to nearly one of every four deaths in children under five years of age in 2017. Released ahead of World Pneumonia Day, on November 12, the 2019 Pneumonia and Diarrhoea Progress Report Card, by the International Vaccine Access Center (IVAC) at the Johns Hopkins Bloomberg School of Public Health, describes progress in fighting pneumonia and diarrhoea in countries with the highest absolute number of deaths, and for the first time in countries with the highest rates of deaths from these illnesses.
The Pneumonia and Diarrhoea Progress Report, issued annually for a decade, finds as in past years that immunisation coverage — the most frequently updated indicators in the report — generally makes up the highest scores. Use of exclusive breastfeeding continues to lag behind, as does access to treatment, particularly zinc supplements for diarrhoea.
Newer vaccines
Bill Moss, Professor in the Department of International Health noted that newer vaccines such as rotavirus and pneumococcal vaccine are not yet reaching most children in these 23 countries, and access to treatments such as basic antibiotics and ORS is surprisingly low across most of the countries included.
The report adds that 16 out of 23 countries assessed failed to meet the targets for any of 10 interventions to protect against and treat pneumonia and diarrhoea, as outlined in the World Health Organisation and UNICEF’s Integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea. Three of the 23 countries met the 90% target coverage rate for at least four vaccines, while one was able to attain 90% level of coverage for all four treatment measures.