Five Inspiring Moments from 2016 in Fighting Child Pneumonia

By Dignamartha Kakkanattu
Social Media and Communication Assistant
International Vaccine Access Center

The crisp start of a new year is the perfect time to take stock of last year’s achievements. For child health advocates, that includes studies that found the global poverty rate was cut in half compared to 1990 and under-5 childhood mortality decreased by 52 percent since 1990. In particular, the effort to stop pneumonia—the leading infectious cause of death among children under five worldwide—saw five inspiring moments in 2016.

Strides were made in reducing the prices of vaccines that protect against some of the most severe causes of pneumonia; increasing access to oxygen therapy that can help the very young survive; revealing the connection between air pollution and pneumonia, working towards a tipping point for action against this underlying problem; communicating the need for appropriate access and use of antibiotics; and connecting experts globally.

These seminal events not only provide inspiration and hope, but also lay the foundation to propel progress in 2017. Let’s take a look back.

Credit: 2014 VillageReach, Courtesy of Photoshare

Vaccine Price Reduction

Vaccines against pneumonia received much attention in 2016 as they became more affordable than ever before. A first-line preventive measure for pneumonia is to give the immune system the ability to fight off infection. Vaccines against Streptococcus pneumoniae (pneumococcus), Haemophilus influenzae type b (Hib), pertussis (whooping cough), and measles provide the body with the ability to resist pneumonia-causing pathogens. Vaccines have long been proven to make significant contributions to preventing disease. Yet the children who are most at risk of disease, living in resource poor countries, have often been last to receive these life-saving interventions.  Prices, although not the only barrier, have been shown to be a significant reason for delays in access.

Gavi, the Vaccine Alliance’s efforts have paid off in a big way. Increasing demand and multiple suppliers enabled UNICEF to secure the lowest price for the pentavalent vaccine at 84 cents per dose, significantly lower than what many thought would be achieved. In the next three years, UNICEF will purchase 450 million doses from six different suppliers, and these vaccines will be delivered to 80 countries. The pentavalent vaccine protects children from five diseases: diphtheria, tetanus, pertussis, hepatitis B and Haemophilus influenzae type b (pneumonia-causing pathogen).

Also notable was progress in the fight against pneumococcus, a leading cause of severe pneumonia. GlaxoSmithKline (GSK) committed to further reduce price of pneumococcal vaccine for Gavi countries.  Moreover, the international medical humanitarian organization, Doctors Without Borders/Médecins Sans Frontières (MSF), saw a win when  GSK and Pfizer agreed to reduce pneumococcal conjugate vaccine prices for humanitarian organizations that offer services to refugees and children in conflict settings.

Credit: 2010 Amber Willier, Courtesy of Photoshare

Increased Access to Oxygen

More countries saw improvements in access to oxygen-based diagnosis and treatment in 2016. Pneumonia weakens the lungs making it difficult to properly absorb oxygen into the blood stream. Pulse oximetry, a common tool in the developed world to detect low blood oxygen levels in children suffering from severe pneumonia, is now being used with increased frequency in low income settings. Detection of low blood oxygen levels helps health providers know when oxygen therapy is needed.

One example of increased usage of life-saving diagnosis and treatment is the United for Oxygen initiative, introduced through a partnership of the Clinton Global Initiative, a host of global organizations, and the Government of Ethiopia. This effort helps improve access to oxygen for pregnant women and children under five, and it helps ensure that health facilities have the resources and trained staff to offer these services in the future.

In addition, PATH marked World Pneumonia Day with the launch of the HO₂PE Campaign to make oxygen a priority in low-and-middle-income countries. The campaign will focus on raising awareness among policymakers of oxygen use, availability, and benefits, especially for pneumonia treatment.

Credit: 2016 Min Zaw, Courtesy of Photoshare

Air Pollution and the Connection to Pneumonia

In 2016, the press and global health community focused on the huge impact air pollution has on health.  WHO and UNICEF released two separate reports to highlight the problem and call for action. Both reports described how toxic air is harmful for children because they have weaker immune systems, breathe faster than adults, and their respiratory tracks are more vulnerable than those of adults. Exposure to outdoor pollution, tobacco smoke, and indoor air pollution, particularly from cook stoves, increase the risk for respiratory infections and may cause long term damage to the lungs.

The very small, ultrafine airborne pollutants might be invisible to the human eye, but their harmful effects to the environment and health are visible. Around the world, 300 million children live in areas where they breathe air that is six times the toxicity levels recommended by international guidelines. This is a growing concern because many countries continue to industrialize and urbanize, which means there will be an increase in the use of energy, coal, and fuels that produce air pollution.

Highlighted in the 2016 Pneumonia & Diarrhea Progress Report: Reaching Goals Through Action and Innovation, Professor Heather Zar of the University of Cape Town in South Africa is studying the connection between the exposure to tobacco smoke during pregnancy and infancy, and the incidence and severity of pneumonia. Early findings from the study show that an infant’s lungs will function poorly by six weeks of age if the mother was exposed to environmental tobacco smoke during the pregnancy. The negative impact on the child’s lungs may increase his/her risk of developing pneumonia.

Experts estimate half of the pneumonia deaths among children are linked to air pollution, including toxic air produced in homes from lighting, heating, and cooking food. To better understand and resolve this problem, the Bill & Melinda Gates Foundation is supporting research conducted by the National Institutes of Health to study the impact of gas cook stoves on infant pneumonia compared to traditional wood-based cook stoves.

Credit: 2013 Jessica Ziegler/URC-CHS, Courtesy of Photoshare

Antimicrobial Resistance and the Issue of Excess versus Access

Antimicrobial resistance (a.k.a. antibiotic resistance) received a lot of attention in 2016. It occurs when bacteria, viruses, parasites, and fungi stop responding to the effects of existing antibiotics and cannot be killed. While overuse and misuse of antibiotics are major contributors of this public health issue, lack of access to antibiotics is a bigger problem in many low-resource countries.

Young children living in the poorest communities around the world often do not receive amoxicillin, the recommended antibiotic to treat pneumonia. Studies have identified a correlation between under-5 pneumonia deaths and availability of antibiotics. In 2016, the complex nature of resolving antimicrobial resistance took country leaders to a high-level meeting at the United Nations General Assembly (UNGA). Among discussion items was to consider excess versus access as they develop national action plans to resolve this high-profile public health problem.

Learn more:

• Advocating for Amoxicillin Amidst AMR
• 2016 Pneumonia and Diarrhea Progress Report

Credit: 2016 JustActions

Connecting Pneumonia Fighters Around the World

In time for World Pneumonia Day 2016, JustActions featured over 30 hidden heroes who work behind the scenes in pneumonia advocacy, research, and interventions. These are the people who dedicate countless hours to bring an end to this life-threatening disease so that thousands of children in low- and middle-income countries may have a brighter future.

While this campaign gave credit to their hard work and dedication, it also gave the Pneumonia Fighters an opportunity to meet each other virtually. Connecting the many people who work in pneumonia advocacy creates the opportunity to build partnerships for future collaboration. It is exciting to see the faces of the many hidden heroes—and even more exciting to know that this is only the tip of the iceberg. There are thousands of others in the fight to stop pneumonia.

Continuing the Fight in 2017

These five inspiring moments in 2016 provide the foundation for advocates to continue their battle to bring an end to pneumonia and improve child health globally. With these accomplishments, the leap into 2017 will be bolder, knowing that progress is possible.