News 2013
​AKU Plays Key Role in Efforts to Decrease Childhood Mortality from Pneumonia and Diarrhoea by 2025

April 12, 2013

​With less than 1,000 days left till the end of the Millennium Development Goals, major organisations and institutions are stepping up their efforts to reduce deaths of children under the age of five, and are focusing on the major killers of children worldwide: diarrhoea and pneumonia.

In Washington DC, UNICEF and WHO launched the Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea while in London the Lancet launched a special issue about the diseases. The initiatives call for an integrated approach to end deaths from pneumonia and diarrhea, and sets ambitious targets to reduce the loss of young lives and increase children’s access to life-saving intervention.

Both documents based on research led by the Aga Khan University estimates that if action is not taken, then 1.2 million children will continue to die from pneumonia and 760,000 from diarrhoea every year.

AKU’s Professor Zulfiqar Ali Bhutta, and the series lead, insists that the magnitude of the effort needed to eliminate preventable deaths from diarrhoea and pneumonia should not be underestimated.

“The Lancet works and accompanying GAPPD provide a very clear set of priorities and actions that, if implemented, offer an unprecedented opportunity to save lives,” he said at the launch.

Providing statistics, he added that in 2011, diarrhoea and pneumonia were responsible for 2 million deaths of children — 90 per cent in sub-Saharan Africa and the South Asia region.

Moreover, 15 countries – including Afghanistan,  Kenya, Nigeria, Pakistan, Tanzania, and Uganda – accounted for over 50 per cent of the total cases of severe diarrhoea, and nearly 65 per cent of severe pneumonia.

Sharing details of the gigantic global project, Professor Bhutta revealed that AKU led the coordination and development of GAPPD with a grant from the Bill & Melinda Gates Foundation.

“I am particularly pleased that perhaps for the first time AKU was able to successfully lead a global multi-stakeholder assignment of this nature, including the diplomatic tight wire of working with WHO and UNICEF on turf that they traditionally consider their own. Hopefully, this will open doors to many more grants of this nature in the future,” he added.

It must be noted that the Action Plan comes at a time when the global community has strengthened its commitment towards the health MDGs, most recently via Committing to Child Survival: A Promise Renewed, a global movement launched in 2012 by UNICEF and the Governments of Ethiopia, India and the USA, which aims to reduce child deaths drastically over the next two decades.

Speaking at the launch of GAPPD, Dr Mickey Chopra, global head of UNICEF’s health programmes, described the current state of healthcare as “a question of equity.”

“Poor children in low-income countries are most at risk of death from pneumonia and diarrhoea but much less likely to get the interventions they need,” he said.

“We know what to do. If, in the 75 countries with the highest death rates, we apply to the entire population the same coverage of essential interventions enjoyed by the richest 20 per cent of households, we can prevent the deaths of 2 million children even as soon as 2015,” he added.

In fact, evidence from the Countdown to the Millennium Development Goals Report 2012  shows that children are dying from these preventable diseases because proven interventions are not provided equitably across all communities.

For example only 39 per cent of infants less than 6 months of age are exclusively breastfed; about 60 percent of caregivers reported seeking appropriate care for suspected pneumonia, and proper antibiotic treatment was given for about 39 per cent of cases; and 35 per cent of children with diarrhoea received oral rehydration therapy.

Hence, GAPPD calls for improved coordination between existing programmes and a wide range of actors, including increased community involvement, and points to the importance of ensuring efforts are sustainable over the longer term.
It also provides a guide for governments and their partners to plan integrated approaches for the prevention and control of pneumonia and diarrhoea.

“Too often, strategies to tackle pneumonia and diarrhoea run in parallel,” says Dr Elizabeth Mason, Director of Maternal, Newborn, Child and Adolescent Health at WHO. “But as countries like Bangladesh, Cambodia, Ethiopia, Malawi, and Tanzania are already showing, it makes good health sense and good economic sense to integrate those strategies more closely.”

She is seconded by Professor Robert Black of Johns Hopkins University, USA, who said, “While diarrhoea and pneumonia have very different symptoms and causes, several risk factors for the two diseases are the same, including undernutrition, sub-optimal breastfeeding, and zinc deficiency, meaning that they can be effectively prevented and treated as part of a coordinated programme.”