15 November 2009
analysis
Pneumonia is the biggest cause of child deaths around the world, especially third world countries. An infection of the lungs which causes cough and fever and can make breathing difficult, the disease kills about two million children under five years of age every year. It kills more children than malaria, measles and HIV/AIDS combined. More than 98 per cent of these deaths occur in just 68 developing countries. This is because childhood pneumonia is strongly linked to malnutrition, poverty and inadequate access to health care. And, unfortunately, Nigeria is one of these 68 high burden countries. In Nigeria, 20 per cent of all deaths in children under the age of five are caused by pneumonia.
This is really unfortunate because most cases of pneumonia can usually be treated with oral antibiotics without hospitalisation. But because little resources are being dedicated to the fight against the disease, it has continued to rampage developing nations, claiming the young and the vulnerable unabated. In fact, in Nigeria, as in many developing countries, the disease is largely forgotten in public discuss.
For example, it is second only to malaria as the leading cause of death in Nigerian children under the age of five. While malaria causes about 24 per cent of child deaths, pneumonia kills 20 per cent annually. So, it kills more children than diarrhea, which kills about 16 per cent, measles (six per cent) and HIV/AIDS (five per cent). But these other killers receive more attention than pneumonia in Nigeria. This probably explains why it is called the neglected disease or the forgotten disease. Because of the lack of attention from stakeholders in the health care sector, most parents are often ignorant of the symptoms of the disease thereby failing to take the right steps until it is too late.
Mrs. Ogunola, a school teacher in Ibadan, almost lost two of her children last year because of this ignorance. Hauwa (4) and Shade (2) had symptoms of cold and they were both coughing. According to their mother, she thought the children were just down with the flu until she took both of them to the hospital. By the time she took them to the local hospital near her Ojoo, Ibadan home however, the condition of the two girls had become quite critical.
"It was my first daughter that first took ill. She had a slight fever and she was coughing. I suspected she had flu and I bought drugs from the neighbourhood pharmacy. When her sister started displaying the same symptoms, I became convinced it was flu because I have always known that flu was infectious. But their conditions became increasingly worse and I had to take them to the hospital. It was when I got to the hospital that I was told they both had pneumonia. I was devastated. I was scared because I knew pneumonia could be deadly and I thought I was going to lose my girls. I feel lucky that they are still alive today", she explained.
After her encounter with the disease, she decided to learn more about the ailment and feels her knowledge has empowered her to fight pneumonia. She said, "Now, I look out for the symptoms each time any of my children takes ill. I am particularly careful when they have cough, have cold chills and fever with very high body temperature. In fact, when I am not sure, I still take them to the hospital to get the correct diagnosis. I have since discovered that deadly as the disease is, it is very simple to treat if diagnosed quickly and correctly."
Now, this is the main issue in the fight against pneumonia; lack of concerted campaigns against the disease. In Nigeria as in many developing countries, people know pneumonia is dangerous. But that is about the only piece of information most people have about the disease. So, they lack information; the most basic tool against the rampaging disease. This meant that concerted efforts would have to be made by all stakeholders if the world must make any progress in the fight against this killer.
It was probably in realisation of this fact that the World Health Organisation (WHO) and United Nations Children's Fund (UNICEF) organised a two-day consultation forum on the disease at the La Mainaz, Gex, France from March 15, 2007. At the end of the informal consultation, the two organisations, in collaboration with other stakeholders, came up with the Global Action Plan for Prevention and Control of Pneumonia (GAPP). The GAPP document was updated in 2008 and finally published in 2009.
GAPP aims to "accelerate overall pneumonia prevention and control in the context of integrated interventions for child survival, by identifying priority activities to reduce pneumonia mortality." The vision of the plan was to ensure that "every child is protected against pneumonia through a healthy environment, and has access to preventive and treatment measures."
The plan seeks to reduce "mortality from pneumonia in children less than five years of age by 65 per cent by 2015 compared to 2000 levels" as well as reduce the incidence of severe pneumonia by 25 per cent in children less than five years of age by 2015 compared to 2000 levels." Specifically, GAPP requires that by the end of 2015, there should be 90 per cent coverage of each relevant vaccine (with 80 per cent coverage in every district); 90 per cent access to appropriate pneumonia case management and 90 per cent coverage of exclusive breastfeeding during the first six months of life.
But to achieve these lofty goals and targets as well as partly achieve the MDG4 goal of reducing child mortality by two thirds by 2015, GAPP recognises that national governments and all local and international partners must take urgent but "focused, coordinated and integrated" action. And, because each day that action is delayed means more deaths, action at all levels had to start immediately.
It was this need that led to the coming together of over 50 organisations and activists working on the disease in April 2009. These organisations and activists decided to form a World Pneumonia Day coalition. The sole aim of the coalition is to "bring focus on pneumonia as a public health issue and to prevent the millions of avoidable deaths from pneumonia that occur each year."
Membership of the coalition is quite diverse as it includes governments, non-governmental and community-based organisations, research and academic institutions, foundations as well as individuals. Some of these partners include the famous John Hopkins Bloomberg School of Public Health, the International Pediatric Association and the Pediatric Association of Nigeria. All the members "have united to bring much-needed attention to pneumonia among donors, policy makers, health care professionals, and the general public."
To start "bringing much-needed attention to pneumonia", the coalition launched an effort to encourage the United Nations to declared November 2, of every year World Pneumonia Day. This singular action seems to have signaled the first real action to fight pneumonia with every nation marking the day for the first time this year with different activities. Just knowing a little bit more about the disease could make a whole world of difference.
At the ceremony in Abuja, WHO Representative, Peter Eriki shared pieces of information that would no doubt influence future policies on the disease by the federal government, which was ably represented by the Minister of State for Health, Dr. Idi Hong. Eriki emphasised the damage pneumonia is doing to everybody when he stated that "Pneumonia is the biggest cause of child deaths in the world, killing 1.8 million children under five years of age every year, more than 98 per cent of which occur in 68 developing countries.
In Nigeria, 20 per cent of all under five deaths are due to pneumonia, only second to malaria (24per cent), followed by diarrhea (16per cent), measles (six per cent) and five per cent due to HIV/AIDS. In spite of its huge toll, relatively few resources are dedicated to tackling this child killer."
The message was not lost on the Minister as he pledged the country's commitment to follow some of the actions recommended in WHO/UNICEF GAPP. Specifically, Hong said the government is already collaborating with development partners to introduce Pneumococcal Conjugate Vaccine (PCV), one of the vaccines recommended in the GAPP document to bring down infection rates by as much as 65 per cent in children below five. He said the vaccine is scheduled to debut in the country by 2010. He explained that government is making concerted efforts to cut pneumonia deaths because "a reduction in the incidence of the disease would also contribute to Nigeria 's attainment of MDGs, especially MDG4."
Just talking about pneumonia at a forum for the first time in the country and everywhere else around the world drew a lot of attention to the disease. It created a lot of awareness on the disease and measures being taken to fight it. It also created the necessary pressure for stakeholders to keep looking for new ways to fight this scourge. As the country celebrated the first world pneumonia day with the rest of the world, an agenda seems to have been set for an all out war against the disease.
Preventing children under five from developing pneumonia in the first place is the most important weapon in winning this war. The World Pneumonia Day created the kind of awareness that can help parents and governments use information to prevent pneumonia. Finally, it is time to fight pneumonia; the forgotten disease. And, the present line of action only needs to be sustained for this neglected disease to become a thing of the past.
Be the first to Write a Comment!
Copyright © 2009 This Day. All rights reserved. Distributed by AllAfrica Global Media (allAfrica.com). To contact the copyright holder directly for corrections — or for permission to republish or make other authorized use of this material, click here.
AllAfrica aggregates and indexes content from over 125 African news organizations, plus more than 200 other sources, who are responsible for their own reporting and views. Articles and commentaries that identify allAfrica.com as the publisher are produced or commissioned by AllAfrica.
