Open Letter to Global and National Health Leaders on COVID-19

Open Letter to Global and National Health Leaders on COVID-19

The Nigerian Minister of Health launches world’s first pneumonia control strategy, January 2020

10 March 2020

The Every Breath Counts Coalition joined UNICEF, Save the Children, ISGlobal, the “la Caixa” Foundation, the Bill & Melinda Gates Foundation, USAID, Gavi and Unitaid to convene the first Global Forum on Childhood Pneumonia in January 2020. Our audience of 350 individuals representing more than 55 countries discussed strategies to control pneumonia, the leading cause of child death in most low- and middle-income countries (LMICs) and a major cause of mortality among older adults in high-income countries.

The Global Forum occurred against the backdrop of a rapidly spreading coronavirus and in the weeks since the virus has continued to spread, with several countries now experiencing coronavirus-related pneumonia fatalities.

We are extremely concerned that the virus will cross into the countries that are already experiencing heavy burdens of pneumonia deaths, especially among children, and we are writing to urge global and national health leaders, including the twelve agencies who signed the Global Action Plan for Healthy Lives and Well-being for All, to collaborate to support national preparedness to control an outbreak of viral pneumonia in these countries.

The Global Forum recommended that high-burden countries develop “pneumonia control strategies” to reduce child pneumonia deaths to relevant global targets.* These strategies would expose the most critical gaps in prevention, diagnosis and treatment services, identify the populations most at risk of death and lay out a plan for protecting vulnerable populations.

In most countries, this will require greater investments to reduce child malnutrition (especially wasting), limit exposure to air pollution (indoor and out), and increase coverage of the “pneumonia-fighting” vaccines (Hib, pneumococcal conjugate and measles). To reduce the risk of death for those who do become infected, many countries will need to increase rates of care-seeking and improve access to fast, accurate and affordable diagnosis and treatment at all levels of the health system, including increasing the use of pulse oximetry, medical oxygen and related respiratory technologies, which are currently unavailable in many settings.

In the context of an emerging viral pneumonia epidemic in LMICs, effective implementation of pneumonia control strategies can also serve as pneumonia “preparedness” efforts, reducing the risk that novel pathogens like COVID-19 will derail health progress to date, especially on child survival, and limiting pneumonia-related mortality and morbidity.

It would be catastrophic if a pneumonia pandemic led to a dramatic increase in child pneumonia deaths, undoing much of the progress achieved in recent years and threatening the achievement of the Sustainable Development Goals. We call on global and national health leaders to support country efforts to develop and introduce pneumonia control strategies and to ensure that any emergency efforts to improve the diagnosis and treatment of COVID-19 are implemented in a way that strengthens the ability of LMIC health services at all levels to reduce pneumonia deaths, especially among children, over the long term.

To sustain the momentum created by the Global Forum, we also invite all global and national health leaders to review and endorse the Forum Declaration which commits governments and their partners to (1) developing pneumonia control strategies, (2) prioritizing vulnerable populations, (3) financing pneumonia control, (4) accelerating breakthrough innovations, (5) tracking progress, and (6) strengthening partnerships. Together, these actions can dramatically reduce pneumonia mortality and the risks associated with a viral pneumonia epidemic. The Declaration can be signed here.

The Every Breath Counts Coalition will continue to advocate for pneumonia control as critical to reducing pneumonia deaths, to the national achievement of child survival and other health goals, and to protect vulnerable populations from pneumonia epidemics caused by novel pathogens like COVID-19. We hope that we can count on global and national health leaders to respond to the COVID-19 in a way that strengthens the way LMIC health systems prevent, diagnose and treat pneumonia broadly, reversing decades of under-investment in pneumonia control and protecting vulnerable populations from future epidemics.


Author: Leith Greenslade, Coordinator, Every Breath Counts Coalition

*The Global Action Plan for Pneumonia and Diarrhoea (GAPPD) target requires countries to reduce child pneumonia deaths to less than 3 per 1,000 births by 2025 and the Sustainable Development Goal child survival target (3.2) requires countries to reduce child deaths to at least 25 per 1,000 births by 2030.