Controlling Pneumonia and Diarrhea

A key message about the rise in life expectancy throughout the world over the past 200 years, but especially since World War II, has been keeping children alive. While the progress has obviously been phenomenal in general, there are still many areas of the world that are lagging behind and where children still die earlier than they should. This past week a concerted effort was launched to deal with this situation: The Integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhea (GAPPD) from WHO and UNICEF. This is funded in part by USAID, which sponsored a Washington, DC launch (there were also launch events in London and Geneva). The US event from the National Press Club is available as a webcast at this site.

Accompanying the launch was a special issue of the Lancet, which included papers emphasizing the importance of pneumonia and diarrhea as causes of death among children. The papers were summarized by Futurity.org:

Together, diarrhea and pneumonia—regarded as relatively minor illnesses for most people in high-income countries—are the leading causes of death worldwide for children under age five. They account for about 29 percent of all childhood deaths, with the highest mortality among children under two years old.

The research consortium, led by Professor Zulfiqar Bhutta of Aga Khan University in Pakistan, determined that sub-Saharan Africa and southeast Asia experienced the highest burden of the two diseases, with nearly three quarters (74 percent) of deaths from diarrhea and pneumonia occurring in just 15 countries.

Although mortality rates from the diseases are falling in most areas, some countries are still experiencing increasing numbers of deaths each year, including Afghanistan, the Democratic Republic of Congo, Cameroon, Chad, and Mali.

While diarrhea and pneumonia have different symptoms and causes, the researchers said, several risk factors for the two diseases are the same, including under-nutrition, sub-optimal breastfeeding, and zinc deficiency—all of which could be “effectively prevented and treated as part of a coordinated program.”

The authors estimate that nearly a third of episodes of severe diarrhea could be prevented by widespread vaccinations against rotavirus and cholera, and up to two-thirds of pneumonia deaths could be prevented by vaccines.

Powerpoint summaries of the papers are available at the same site as the webcast from the National Press Club.