Call to cut Indian child deaths from pneumonia and diarrhoea

Lack of access to life-saving treatment and prevention measures such as vaccination programmes is costing the lives of many Indian children

India continues to have the largest pneumonia and diarrhoeal disease burden in the world, according to The Johns Hopkins Bloomberg School of Public Health in the United States. It also points out that many Indian children do not have access to life saving treatment and prevention measures.

India loses around 400,000 children to these preventable diseases before they turn five, the latest report has revealed. In its Pneumonia and Diarrhoea Progress Report 2013, published by the International Vaccine Access Centre, the organisation has reported that India topped the list of countries with the most child deaths.

Although India has made some progress in the coverage of pneumonia interventions since the previous year’s report and is poised to protect more children from both diseases with the forthcoming national scale-up of pentavalent vaccine and the promise of an indigenous rotavirus vaccine, the current report has noted that the coverage remains below targeted levels.

In 2012, India lost 436 children below five years per 1,000 live births due to pneumonia and diarrhoea; latest estimates by the United Nations Children’s Fund (UNICEF) reveal that pneumonia and diarrhoea together claimed the lives of more than 1.7 million children under five across the globe.

In 2012, India lost 436 children below five years per 1,000 live births due to pneumonia and diarrhoea

This year, the Integrated Global Action Plan for Prevention and Control of Pneumonia and Diarrhoea (GAPPD) was developed and issued by the World Health Organisation and UNICEF, outlining key universal interventions, with the goal of ending mortality in children by 2025. GAPPD set forth coverage targets of 90% for vaccinations and for access to pneumonia and diarrhoea treatment, and 50% for exclusive breastfeeding of children during their first six months.

The 2013 report also evaluates the 15 countries with the highest absolute number of child deaths from pneumonia and diarrhoea. India and Nigeria, with the largest disease burdens, continue to have low coverage levels for prevention and treatment interventions, therefore having the lowest GAPPD scores.

‘We must recommit ourselves to tackling these preventable childhood diseases,’ said Dr Naveen Thacker, Secretary, Child Health Foundation and former president of the 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.’

Although India has taken a few steps in addressing pneumonia with the introduction of the Haemophilus influenzae type B (Hib) vaccine in nine states, the National Technical Advisory Group on Immunisation 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 N K Ganguly of the National Institute of Immunology.

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