This article is more than 5 years old. Information may no longer be current.
WHO/UNICEF plan aims to end preventable child deaths
Click Here to Manage Email Alerts
A 75% reduction in severe pneumonia and diarrhea incidence, eliminating all of these deaths and a 40% drop in stunting associated with these illnesses are the ambitious goals set forth in a newly released WHO/UNICEF Action Plan.
The plan, released by WHO today and supported by reports published in The Lancet, calls for closer integration of efforts to prevent and treat pneumonia and diarrhea and aims to achieve these goals — estimated to cost about $6 billion — by 2025.
Many factors contribute to pneumonia and diarrhea, so no single intervention can effectively prevent, treat or control either disease; however, a number of elements are key to reducing infections and deaths from both diseases, according to the report.
One of the papers in the series suggests that if interventions such as vaccinations, zinc supplementation and breast-feeding promotion continue to be implemented at current levels, about half of all child deaths due to diarrhea and pneumonia could be prevented by 2025. However, if these interventions were scaled up to 80% coverage or more, deaths from diarrhea could be virtually eliminated, and about two-thirds of deaths from pneumonia prevented by 2025.
The data in the series suggest that mass vaccination campaigns will need to play an important role, and the authors estimate that nearly one-third of episodes of severe diarrhea could be prevented by widespread vaccinations against rotavirus and cholera, with up to two-thirds of pneumonia deaths thought to be vaccine preventable.
Mickey Chopra
“This is a question of equity. Poor children in low-income countries are most at risk of death from pneumonia or diarrhea but much less likely to get the interventions they need,” Mickey Chopra, MD, PhD, global head of UNICEF’s health programs, said in a statement about the report. Chopra was one of the authors on the studies that formed the basis of the report and set forth the goals.
Chopra’s statements were supported by another one of the papers in the series, which suggested that most public health practitioners said they felt that pneumonia and diarrheal illnesses are perceived to be low on the list of worldwide priorities, far below HIV/AIDS or malaria.
Other key barriers to reducing disease incidence included inadequate training and support for health workers, poor national coordination and sporadic availability of key commodities — scarcely half of children with severe acute pneumonia receive antibiotics, and only a one-third of children with acute diarrhoea receive oral rehydration salts, and fewer than 1% receive zinc supplements.
The Action Plan’s targets are significantly higher than current levels. For example, it calls for 90% of all children to have access to antibiotics for pneumonia and oral rehydration salts for diarrhea, up from current levels of 31% and 35%, respectively. As an interim target, at least half of all children aged younger than 6 months should be exclusively breast-fed, against 2012 levels of 39%. The report also urges that all children should have access to improved sanitation and safe drinking water.
The Action Plan calls on governments and other stakeholders to prioritize investment in the population groups with the poorest access to services to prevent and treat pneumonia and diarrhea. Nearly 90% of pneumonia and diarrhea deaths in children currently occur in sub-Saharan Africa and South Asia. Although mortality rates from the diseases are falling in most areas, some countries are still experiencing a growing number of deaths each year, including Afghanistan, Burkina Faso, Democratic Republic of Congo, Cameroon, Chad and Mali.
In 2011, diarrhea and pneumonia were responsible for 2 million deaths of children aged younger than 5 years, according to one of the papers in the report.
“We know what to do,” Chopra said in the statement. “If, in the 75 countries with the highest death rates, we apply to the entire population the same coverage of essential interventions enjoyed by the richest 20% of households, we can prevent the deaths of 2 million children even as soon as 2015, the deadline for the Millennium Development Goals.”
Series lead Zulfiqar Bhutta, MD, PhD, agreed: “The magnitude of the effort needed to eliminate preventable deaths from diarrhoea and pneumonia should not be underestimated. However, this Series and the accompanying Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea provide a very clear set of priorities and actions that, if implemented, offer an unprecedented opportunity to eliminate preventable child deaths caused by these two diseases.”
Disclosure: Chopra reports no relevant financial disclosures.
Click Here to Manage Email Alerts