US based, Johns Hopkins Bloomberg School of Public Health recently highlighted the Pneumonia and Diarrhoea Progress Report 2013 which showed that India continues to have the largest pneumonia and diarrhoeal disease burden in the world. It also points out that many Indian children do not have access to life-saving treatment and prevention measures.

This report was published by the International Vaccine Access Centre (IVAC).

Pneumonia and diarrhoea continue to be the leading killers of children under the age of five worldwide. According to the latest estimates by the United Nations Children’s Fund (UNICEF), pneumonia and diarrhoea together claimed the lives of more than 1.7 million under-five children in 2012 alone.

“Today, pneumonia and diarrhoea will kill thousands of children and tomorrow. And every day thereafter. Marking World Pneumonia Day, and with World Diarrhoea Day around the corner, we must recommit ourselves to tackling these preventable childhood diseases,” said Dr Naveen Thacker, secretary, Child Health Foundation and former president, Indian Academy of Paediatrics. “There are simple, low cost solutions, such as hand washing with soap; controlling indoor air pollution; encouraging exclusive breast feeding, oral rehydration solution and zinc supplementation; administering vaccines and increasing access to treatment that can save these children’s lives.”

This year, the Integrated Global Action Plan for Prevention and Control of Pneumonia and Diarrhoea (GAPPD) was developed and issued by the WHO and UNICEF, outlining key interventions that should be universally adopted, with the goal of ending preventable pneumonia and diarrhea mortality in children by 2025. GAPPD set forth coverage targets of 90 per cent for vaccinations, 90 per cent for access to pneumonia and diarrhoea treatments, and 50 per cent for exclusive breastfeeding of children during their first six months of life.

This report evaluates the 15 countries with the highest absolute number of child deaths from pneumonia and diarrhoea, based on UNICEF’s latest estimates, and reports on their progress in implementing GAPPD interventions with respect to coverage targets.

This report also reveals gradual increases in the utilization and coverage of evidence-based interventions by many of the high-burden countries, while challenges persist for others. Seven countries achieved some, but not all GAPPD coverage targets and eight others failed to reach any of the targets. India and Nigeria, the two countries with the largest pneumonia and diarrhoea disease burdens, continue to have low coverage levels for prevention and treatment interventions. India did not meet any of the nine GAPPD coverage targets that were evaluated in the Progress Report.

“India has taken a few steps in addressing the pneumonia disease burden by introducing the Haemophilus influenzae 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 NK Ganguly, distinguished biotechnology professor, National Institute of Immunology.

According to the recent Progress Report, by adopting a comprehensive and combined approach to pneumonia and diarrhoea, 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.