Child Health Olympics: Racing Against Pneumonia and Diarrhea

Child Health Olympics: Racing Against Pneumonia and Diarrhea

Source: Phil Hillyard/Courier Mail

Source: Phil Hillyard/Courier Mail

August 19, 2016

By Lois Privor-Dumm, IMBA, International Vaccine Access Center (IVAC)

I, like many others, have watched the Olympics with a sense of excitement and awe this summer. Every four years, I find myself wondering how these athletes have such super-human strength and power.

Perhaps the most awe-inspiring to me is the decathlon, an event that demands excellence in not one, not two, but ten different events. Olympic decathletes must throw farther, jump higher, and run faster than their competitors. Excelling in just one or two isn’t enough; it’s the integrated approach that matters. I admire their stamina and determination.

While athletes race for medals, records, and renown, we race for a world where every child has a chance to thrive. Like the decathlon, there are many parts, huge challenges, and high stakes, but also tremendous rewards if we can push through to the finish. Ours may not require intense athletic ability, but it certainly demands discipline and dedication to get the job done.

In our global health Olympics, the goal is clear: every family and child has a chance to reach the finish line established by Sustainable Development Goal (SDG) 3—good health and well-being for all. We strive, not for a medal, but for an end to preventable deaths among newborns and children under age five. The race isn’t easy. There are hurdles along the way and the course is long. Sometimes it seems like we may never reach the finish line and achieve the seemingly unattainable goals we’ve set out through the Millennium Development Goals and now the SDGs.

But no Olympic athlete is unprepared, and neither are we. We too have coaches and sponsors—our global community and country leadership—and the tools to achieve SDG3, the strategies and interventions we know can work and will work if we do it right. A strategic approach is crucial. Much like selecting the best Olympic team, you want to select your best prospects for achieving success. In this case, we focus on the most significant causes of death to enable the greatest impact.

Despite huge improvements, the common illnesses of pneumonia and diarrhea still took more than 1.5 million young lives in 2015—this is more than malaria, TB and HIV/AIDS combined. If countries competed to save the most lives, targeting childhood pneumonia and diarrhea would be a smart strategy.

The Race

For a decathlete, being fast and strong is only the start. Competing across so many different events takes technique and careful, strategic planning. Fortunately, for our challenge, a plan already exists: the Integrated Global Action Plan for Prevention and Control of Pneumonia and Diarrhea (GAPPD). GAPPD is a plan for all countries, laying out the steps and targets to reduce the burden of pneumonia and diarrhea. Here is the guidance given by WHO and UNICEF, the rules we must all live by if we aim to tackle pneumonia and diarrhea:

1) Programs must be integrated. As every decathlete knows, you can’t be just a good sprinter, a good thrower, or a good jumper.  You need to have all of the tools and a strategy to get through every challenge before you have a shot at the podium. For pneumonia and diarrhea, one intervention is not enough. You need to consider all interventions—exclusive breastfeeding and good nutrition, hand washing and safe drinking water, control of air pollution, zinc and oral rehydration solution (ORS), amoxicillin, oxygen, vitamin A and vaccines against Haemophilus influenzae type b (Hib), pneumococcus, pertussis (whooping cough), measles and rotavirus—and implement them in an integrated way to protect children, prevent infection, and treat disease.  Additionally, countries must have the tools to diagnose the illness quickly in order to provide adequate care.

2) All must be given an equal chance to compete. Children in poor or remote areas may need extra attention to ensure there’s a level playing field at the start.  Access to care is critical.

3) Political will is essential and so is adequate funding, not just for one intervention, but all. Imagine a racer without sneakers.  They can make it to the race, but are not set up for success.  Countries and partners must be committed to an integrated and comprehensive package of the right interventions and the right resources.

4) All must be engaged and value the chance to root for the success of children everywhere.

Source: BBC

Source: BBC

 

The Results

So, how are we doing in this race? Actually, we have made significant progress. Over the last 15 years, global child deaths due to pneumonia have decreased from 1.7 million to an estimated 922,000 in 2015. That’s almost a 50% reduction. When it comes to diarrhea, the progress is even more pronounced, dropping from 1.2 million in 2000 to 500,000 in 2015. Yet pneumonia and diarrhea remain leading killers of children under the age of 5. While we are getting better, we need to rededicate ourselves and push our “team” to finish this race.

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This analysis from the 2015 Pneumonia and Diarrhea Progress Report shows that we still have work to do. No single country is winning the race to reduce the burden of both pneumonia and diarrhea. Tanzania medaled for pneumonia, achieving high coverage for critical vaccines, introducing pneumococcal conjugate vaccines (along with rotavirus vaccines) with Gavi support, and meeting the 50% target for exclusive breastfeeding.  But even Tanzania can improve on performance, perhaps aiming for gold by improving access to care and ensuring access to antibiotics, particularly amoxicillin dispersible tablets, a low-cost and effective way to treat children in resource-poor situations.

2015 GAPPD-Pneumonia and GAPPD-Diarrhea intervention scores for countries, shown from top to bottom in decreasing order of total child pneumonia and diarrhea deaths

2015 GAPPD-Pneumonia and GAPPD-Diarrhea intervention scores for countries, shown from top to bottom in decreasing order of total child pneumonia and diarrhea deaths

 

This weekend will mark the close of the Olympics, but for athletes returning to their home countries, the end of one challenge will mark the beginning of their planning and preparation for the next round. While promoting child health may lack the high profile of an Olympic event, the spirit of determination, drive, and tenacity of the world’s finest athletes is something we can all learn from and use for inspiration. Like them, we too have the knowledge and tools to achieve our goal—to protect from, prevent, and treat pneumonia and diarrhea, and ultimately save children’s lives. Momentum is building as policy makers, health workers, and parents everywhere are starting to get into the game to fight these illnesses. Let’s strive toward a society where the race to save young lives captures the imagination of the world.

 


Lois Privor-Dumm, IMBA, is director of Policy, Advocacy and Communications at the International Vaccine Access Center (IVAC), based in the Johns Hopkins Bloomberg School of Public Health.