23 Nov IVAC 2016 Pneumonia Diarrhea Progress Report
IVAC released it’s new Pneumonia Diarrhea Progress Report which finds limited progress in combatting pneumonia and diarrhea among young children, especially in the nations most severely impacted by the two diseases. In 2015, pneumonia led to one of every six deaths globally that occurred in children under five years old. Yet pneumonia is preventable with vaccines and simple and inexpensive treatments.
Of the 15 countries profiled in the report – those with the highest rates of death globally due to the two diseases – seven have mortality rates of 25 per 1,000 live births or higher due to pneumonia and diarrhea alone. This translates into an estimated 450,000 deaths among children under age five in these countries.
“Pneumonia and diarrhea fly under the radar,” says Kate O’Brien, MD, MPH, a professor in the Bloomberg School’s Department of International Health and IVAC’s executive director. “These illnesses are so common that many people and organizations fail to recognize the need to step up efforts and identify creative solutions to fight them. Although most cases are easily prevented and treated, they often prove deadly when families cannot access basic health services such as vaccines and antibiotic treatment.”
These interventions include vaccination, exclusive breastfeeding, access to care and use of antibiotics, oral rehydration solution and zinc to treat the illnesses. These measures are known to prevent childhood deaths due to pneumonia and diarrhea and could help achieve the United Nations’ Sustainable Development target goal of reducing under-five mortality to at least 25 per 1,000 live births by 2030.
Overall GAPPD scores in 2016 varied widely from a low of 20 percent (Somalia) to a high of 74 percent (Tanzania), with all 15 focus countries falling below the 86 percent target for the overall GAPPD score. In 2015, the scores varied from 20 percent (Somalia) to 72 percent (Tanzania), virtually unchanged compared to this year’s scores.
Twelve countries improved their GAPPD scores since 2015, with Niger making the biggest gain, up 11 points. In 2015, seven countries improved their score.
Only six of the highest-burden countries (Angola, Ethiopia, India, Niger, Sudan and Tanzania) have introduced rotavirus vaccines in their routine immunization program to help prevent a substantial portion of diarrhea deaths and hospitalizations. India introduced rotavirus vaccines in four states in 2015.
Fifteen years after pneumococcal conjugate vaccines’ first introduction globally in 2000 (the United States was first to implement the vaccine), five of the highest pneumonia burden countries (India, Indonesia, Chad, China and Somalia) are still not using the vaccine in their routine immunization programs. India recently announced a partial introduction in five states, beginning in 2017.
Antibiotic use to treat pneumonia in the 15 highest-burden countries varies greatly, from seven percent in Ethiopia to 64 percent in Afghanistan.
Rates of exclusive breastfeeding during a child’s first six months of life remain low. Currently, 10 of the 15 countries with the most child pneumonia and diarrhea deaths have exclusive breastfeeding rates that still fall short of the 50 percent GAPPD target. There is strong evidence demonstrating that about half of all diarrhea episodes and about a third of respiratory infections could be averted by breastfeeding.
The report was funded by the Bill & Melinda Gates Foundation.