India loses 4 lakh children every year to pneumonia, diarrhea

,TNN | Nov 13, 2013, 03.46 AM IST

NEW DELHI: As the country with the highest disease burden for pneumonia and diarrhea, India loses 400,000 children before their fifth birthday every year. The Pneumonia and Diarrhea Progress Report 2013, published by the International Vaccine Access Centre (IVAC) at Johns Hopkins Bloomberg School of Public Health on the occasion of World Pneumonia Day on Tuesday, highlighted that many Indian children do not have access to life-saving treatment and prevention measures.

Pneumonia and diarrhea claimed the lives of 1.7 million under-five children in 2012 alone.

Despite having roughly half the world's under-five population, 15 countries — that have been tracked in this report — accounted for 75% of global pneumonia and diarrhea deaths. India, along with Nigeria, had mortality rates 4-10 times higher than the goal set by the Global Action Plan for Prevention and Control of Pneumonia and Diarrhea (GAPPD). In order to substantially decrease the number of child pneumonia and diarrhea deaths globally, it is especially critical for these countries to accelerate their implementation of GAPPD interventions.

The nine intervention measures are coverage rates for pertussis (DTP3), measles, Hib, pneumococcal and rotavirus vaccines (reported separately), access to an appropriate health care provider and antibiotic treatment for children with pneumonia, treatment with oral rehydration salts (ORS) for children with diarrhea and exclusive breastfeeding in the first six months of a child's life.

The overall GAPPD scores take into account interventions that impact both pneumonia and diarrhea, as well as those that only affect pneumonia or diarrhea.

"None of the 15 countries profiled in this report reached such GAPPD-Pneumonia or GAPPD-Diarrhea scores. In fact, for eight of the 15 countries, none of the GAPPD coverage targets were met. For these high-burden, low-performing countries, much work remains in the areas of breastfeeding, child immunization, and health care delivery," the report said.

Burkina Faso showed the greatest improvement in pneumonia-specific intervention scores between 2012 and 2013 (+11%). Slightly lower 2013 GAPPD-Pneumonia scores were seen in a few countries, including Nigeria, Democratic Republic of the Congo (DRC), Niger, Indonesia and Kenya. In case of India, Pakistan and China, there were no changes in their pneumonia intervention scores between 2012 and 2013.

"India has taken a few steps in addressing the pneumonia disease burden by introducing the Haemophilusinfluenzae type B (Hib) vaccine in nine states. The National Technical Advisory Group on Immunization (NTAGI) has now recommended the vaccine for a national scale-up. However, India still needs to include other vaccines such as rotavirus and pneumococcal in its national programme while simultaneously strengthening its health systems and improving access to other preventive interventions and treatment solutions," said Professor N K Ganguly, distinguished biotechnology professor, National Institute of Immunology.

According to the progress report, by adopting a comprehensive and combined approach to pneumonia and diarrhea, countries can amplify the impact of individual interventions and achieve accelerated progress in the years to come. Also, creating robust monitoring and evaluation systems should be a priority for countries, as these will provide the necessary information for decision-making on health programmes. In addition, country-specific gaps and barriers in access to appropriate treatment for pneumonia and diarrhea need to be addressed.

Early successes can already be seen in countries such as Uganda and Tanzania, which have achieved relatively higher coverage of interventions that impact both pneumonia and diarrhea.