What causes more deaths than HIV, malaria, and measles—combined? Bet you didn’t guess pneumonia.
Despite the fact that in 2013, a child died from pneumonia every 35 seconds, minimal funding has gone to addressing this serious public health issue.
A new report published yesterday by the Institute for Health Metrics and Evaluation (IHME) includes statistics like this one. However, these grim realities can mask critical successes, lessons for how all countries can fight childhood pneumonia.
The graphic below shows how the toll of childhood pneumonia has changed over time for a subset of high-burden countries. Globally, child pneumonia deaths fell 58% between 1990 and 2013. A number of large countries saw even more dramatic declines.
Bangladesh, the leader of progress in South Asia, is a prime example of how gains in child health can be achieved when a disease is addressed from every angle. From 1990 to 2013, Bangladesh recorded an 80% drop in child pneumonia deaths. In 1990, Bangladesh had the sixth highest number of child pneumonia deaths in the world; by 2013, the country fell to the 14th highest. To take on its biggest childhood killer, Bangladesh substantially improved the three key components of reducing pneumonia: prevention, treatment, and risk reduction.
Prevention: Bangladesh introduced the pentavalent vaccine in January 2009, a 5-in-1 vaccine that includes protection against Haemophilus influenzae type b (HIb), one of the bacteria that causes pneumonia in children. A 2012 report found that immunization delivery has worked well in rural and hard-to-reach areas, with many localities recording levels of 90% coverage or higher (immunization rates we struggle to maintain in many places in the United States).
Treatment: Bangladesh has worked hard at determining the best ways to treat those with childhood illnesses. Integrated management, which involves training skilled health workers on the treatment of several childhood diseases, including pneumonia, is considered crucial to receiving timely pneumonia care in rural areas. Research conducted by iccdr,b unveiled how to improve compliance with integrated treatment at primary care facilities, and when patients should be referred to higher levels of care. After these guidelines went into practice in rural Bangladesh, the percentage of pneumonia-stricken children who received proper care skyrocketed from fewer than 40% to more than 90%.
Risk reduction: Both malnutrition and household air pollution are key risk factors that heighten young children’s susceptibility to pneumonia – and makes their prognosis worse if they develop it. Bangladesh’s progress in reducing malnutrition has been heralded as a success story–and the data show it: an 87% decrease in rates of early death and illness due to childhood underweight between 1990 and 2010. In those same twenty years, Bangladesh also recorded a 74% reduction in rates of early death and illness due to household air pollution among children under 5.
While Bangladesh has made tremendous gains against childhood pneumonia, the disease still claimed the lives of nearly 15,000 children in 2013. The global health community has proposed aiming to end preventable child deaths by 2030, a target that will require heightened efforts. Bangladesh is readying itself for the next big move: this year, the country plans to introduce the pneumococcal conjugate vaccine (PCV), an immunization that protects against the main strains of bacteria associated with deadly forms of pneumonia. If we check in on Bangladesh at this time next year, there’s a good chance we’ll see even greater reductions in child pneumonia deaths.