Bill & Melinda Gates Foundation

Tackling the Two Biggest Killers of Kids: Pneumonia and Diarrhea

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April 12, 2013

Most people are surprised by the fact that the two biggest killers of children between 1 month and five years are pneumonia and diarrhea. It’s estimated that these alone account for up to 2 million deaths annually worldwide (Lancet 2012, GBD 2010).  Severe pneumonia and diarrhea in children are complex diseases of poverty, when kids are exposed to germs in the air or contamination in their water or food. Diarrhea and pneumonia can be caused by one or a lethal mix of germs the gut and respiratory system. It’s made more complex due to harsh living conditions that impact children’s ability to cope – like poor air quality, a lack of access to sanitation, malnutrition and limited or no access to primary health care.

Today in London and Washington D.C. two important reports are being released that link these two illnesses with key policy recommendations on ending child mortality, recognizing that prevention and control of these disease cannot be adequately addressed without integrated programs.    

A series of papers in the Lancet outlines the disease burden, interventions and costing, barriers to uptake and the way forward.  Integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (GAPPD) produced by the World Health Organization (WHO), lays out a plan to end preventable child deaths from pneumonia and diarrhea by 2025. 

By addressing these two diseases together, the plan goes to the heart of the matter: both diseases are caused by a range of pathogens, and no single intervention alone will eliminate either disease.  But, by addressing the complexity of common causes and risk factors, and implementing common prevention strategies and interventions and similar delivery platforms in clinics, communities and schools, prevention and treatment can become stronger tools by actually getting into the hands of the caregivers.

Pneumonia remains the leading killer of children under 5 years of age, although many of us in the developed world have avoided or conquered pneumonia thanks to vaccination and access to treatment. Children in remote villages or in under-resourced hospitals have a different experience, where drugs are out of stock, vaccination coverage is low and extended care often relies on make-shift oxygen machines.

All of us have had diarrhea, and many of us have taken care of children with diarrhea but in poor communities it can be much more serious.  For example, in rural Kenya, and in an urban slum in Nairobi, over half of the caretakers of young children interviewed knew a child who had died of diarrhea (Olson et al., 2011, AJTMH 85:1134).  Chronic diarrhea can also lead to both physical growth stunting and impaired cognitive development.    

So what can be done?  The good news is that with a mix of vaccines, treatment, and protective measures – these deaths could be entirely preventable. The foundation’s Pneumonia and Enteric and Diarrheal Diseases strategies share similar goals – to accelerate the reduction in global burden of these largely preventable pathogen-caused illnesses. We are working together with many local and international partners to advance critical vaccines, stimulate and improve access to treatment with essential medicines, and collect actionable information on disease trends. More information on our strategies can be found here.

To learn more about the Integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (GAPPD), visit DefeatDD.

To learn more about how the world is uniting to give all children a healthy start to life by ensuring all children have access to vaccines to protect against diseases like pneumonia and rotavirus, visit the Global Vaccine Summit website.

 
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