International
Pneumonia
Fighting pneumonia in Bangladesh
To mark World Pneumonia Day today we are presenting the first of three special reports from Dhaka, where UK Parliamentarian Jim Dobbin MP highlights his experiences visiting Dhaka’s main healthcare centres.
I am currently in Dhaka, Bangladesh, with a senior delegation of UK parliamentarians looking at the work of the GAVI Alliance and the impact that vaccines are having in the developing world. The GAVI Alliance is one of the UK Government’s headline organistions and I have followed its progress for many years. I am especially interested in its work in rolling out life-saving vaccines in developing countries where 85% of the world’s unvaccinated children live. The results have been staggering to date: since its creation in 2000 it has immunised 288 million children and saved 5 million lives and is aiming to save more than 4 million more by 2015. Therefore when I was given the opportunity to see this work in action in a Dhaka children’s hospital and urban slum I couldn’t pass up the opportunity.
Going into the visit I thought of a similar visit I undertook in Kenya, where I saw crowded wards of whole families huddled together in unsanitary conditions. Medical waste sat in heaps on the floor and sick children ran around the hospital. That was a very moving visit and highlighted to me just how big a gulf there is between the richest nations and poorest.
But, ever since I arrived in Dhaka you can tell that it is a bustling city on the rise. This same sense was evident in the Dhaka Shishu Hospital. I arrived and was met by Professor Samir Saha, the Head of the Microbiology at the hospital. He took us around the wards and the laboratories and explained the work they were undertaking. His team are a pioneering group helping to improve the diagnosis of infections and disease surveillance and to better document the impact of immunisation in Bangladesh. We also met the Government Expanded Programme for Immunisation Team and heard about the great strides they had been making over the past few years. You cannot hide the fact that childhood mortality still greatly affects the country; in fact 55,000 lives every year are claimed by pneumonia. In the hospital wards, we saw the young children fighting this terrible disease, which along with diarrhoea accounts for nearly 40% of all childhood mortality in the developing world. We also saw a the impact of malnutrition and poor healthcare education, which leads to children going undiagnosed and not receiving the vital treatment they need.
But overall it was actually a picture of great hope and improvement. I was delighted to see the progress that Bangladesh has been making in immunisation with the support of the GAVI Alliance. We witnessed a well run and effective immunisation session; heard from maternal health workers about their drive to educate mothers about the healthcare of their children. We visited the central vaccine store for Bangladesh and heard about their checks and balances that ensure that vaccines are stored and distributed correctly.
Bangladesh is just one of many countries benefitting in this way. Thanks to the funding from the UK and other donors such as the Bill and Melinda Gates Foundation, the excellent work of the GAVI Alliance is being replicated across the developing world. Access to life-saving vaccines has been delivered to countries 10-15 years sooner than would have otherwise been possible. Nicaragua became the first GAVI-eligible country to introduce the life-saving pneumococcal vaccine and it is now being used in 15 developing countries and has already reached more than three million children with another 10 million expected to receive the vaccine in 2012. In fact today, Malawi will become the 16th GAVI-supported country to introduce the vaccine.
Therefore the picture is increasingly encouraging in Bangladesh and across the globe, but there are still challenges. With an increasingly close relationship between the major donors and aid providers in the world we can continue to move forward and provide successful vaccinations to those that really need them.
Rwanda is Proud to Pioneer the Pneumococcal Vaccine
In this guest blog for World Pneumonia Day on the 12th of November Dr. Agnes Binagwaho, Minister of Health, writes on Rwanda’s partnership with the GAVI alliance to pioneer the Pneumococcal Vaccine.
In April 2009, Rwanda became the first low-income country to rollout the pneumococcal vaccine (PCV7) through a partnership with Wyeth. This was a great moment for us, for after having achieved dramatic reductions in malaria incidence, pneumococcal disease had stood as the new leading cause of death among Rwandan children. And it was the dedicated work of our partner, The GAVI Alliance for Vaccines, that ensured the pneumococcal vaccine would be both accessible and affordable for use in our country.
Pneumonia remains the single largest cause of death among children under five around the world. Every 20 seconds, a child dies of this preventable disease.
On November 12, 2011, Rwanda will join other countries in observing the third World Pneumonia Day, a day to celebrate the power of immunization to save lives when access is assured.
The PCV7 vaccine also prevents against pneuomoccal meningitis, a debilitating disease that leaves children who survive it with lifelong mental and physical disabilities.
Certainly immunization is not the only way to prevent pneumonia; breast-feeding, improved nutrition, and the reduction of indoor air pollution are also essential, and children must have access to effective antibiotics when they do fall sick. But immunization removes the burden of hospitalization and treatment on the health system and diminishes the time . This is a major economic advantage in countries like Rwanda, where the time lost by parents lose from work in caring for their children. For immunization to work, it needs to be integrated fully in health and community services. This is what we did in Rwanda.
Last year, the pneumococcal vaccine was scaled up in 16 countries. By 2015, GAVI expects that 58 countries will have introduced the latest generation pneumococcal vaccines nationwide, covering another 90 million children. With sustained commitment among all partners, including both GAVI countries and donor countries, we can achieve remarkable progress in the fight against preventable deaths among children.
The number of lives saved by GAVI is a major contribution towards the world’s pursuit of the fourth Millennium Development Goal, but we must sustain the momentum. In Rwanda today, more than 80% of children have access to the pneumococcal vaccine. The children whose lives are being saved through our partnership with GAVI will help to build a Rwanda where health for all is not simply a dream but one of the foundations of a strong, peaceful nation of tomorrow.
Vaccine superheroes to the rescue!
More than 8 million children around the world die each year before their 5th birthday. Two of the biggest killers are pneumonia and diarrhoea — which kill more than AIDS, TB and malaria combined! Here’s the illustrated story of two villains (pneumonia and diarrhoea), two superheroes (vaccines), and why we need your help!
For years, pneumonia and diarrhoea ran rampant across the developing world — Latin America, sub-Saharan Africa, and South East Asia — killing children and making it difficult for families and communities to stay healthy and prosperous.
Bouts of pneumonia and diarrhoea are bad enough anywhere in the world, but in these regions, a lack of clean water, improper hygiene and poor access to health facilities and treatment contributed to so many children’s deaths from these two diseases.
In the Western world, vaccines were developed to help fight pneumonia and diarrhoea for those who could afford them, but they still weren’t ready for children in the poorest places of the world (who needed vaccines that were suited to environments different than the developed world).
Vaccine manufacturers didn’t really have great incentives to change their vaccines, because many developing countries were too small and too poor to afford to buy the new vaccines or negotiate prices.
In 2000, a new partnership called The Global Alliance for Vaccines and Immunisation (GAVI) was formed to help incentivize the development of new vaccines and to improve access to ones on the market. They did this by:
Now, thanks to many donors and the pharmaceutical industry, we have TWO BRAND NEW VACCINES to fight strains of pneumonia and diarrhoea. They’re suitable for children in the developing world, and their prices are lower so they’re more affordable for local governments and donors.
These are exciting new vaccines, but they need help (money!) in getting out to the people who need them. ONE’s excited to launch our new campaign to help raise money for GAVI and awareness of child vaccine programs around the world.
Together, we can help save nearly 4 million lives by 2015!
Help save 4 million lives in the next 5 years
I recently found out that we could save 4 million kids’ lives in the next 5 years. How? With 2 new vaccines that could drastically reduce child deaths in poor countries from 2 diseases, which cause pneumonia and diarrhoea.
However, it’s one thing having these vaccines available; it’s another getting them safely to the places where they are needed. That’s where you come in. In a few weeks world leaders are meeting to decide how much they will pledge to support the roll out of these vaccines in developing countries.
You can help protect children for a lifetime by adding your name to our petition.
Our petition reads:
Dear World Leaders,
Childhood vaccines are one of the most cost-effective ways to save lives and prevent disease for a lifetime. Please fund two proven, new vaccines that will help stop pneumonia and diarrhoea—two of the biggest killers of children in poor countries.
Nearly 1 out of 3 child deaths is caused by these two diseases. But they don’t only kill, they also make children ill. Fewer sick kids means more time in school, less strain on health services, and healthier future generations.
Add your name and urge world leaders to help put an end to these two deadly diseases.
Vaccines are often called a “best buy” in public health as they are cost effective, provide a life time of protection and save millions of lives. For example between 2000 an 2009 5.4 million child deaths have been averted because of effective immunisations.
If enough of us come together and sign this petition we can add to this success and give children in a fighting chance.
Say hello to baby Caleb — he just got the new pneumonia vaccine!
Helen Evans, interim CEO of the GAVI Alliance, reports on the introduction of a new pneumonia vaccine to Managua, Nicaragua.
Greetings from Nicaragua! On Sunday, I joined Minister of Health Dr. Sonia Castro Gonzalez, GAVI board member Dr. Guillermo Gonzalez Gonzalez and my colleagues from the Pan American Health Organization (PAHO) and UNICEF to witness the vaccination of the first child with the new vaccine that protects children in developing countries against the worst forms of pneumonia — the biggest single killer of children under five years worldwide.
Minister of Health Dr. Sonia Castro Gonzalez vaccinates 10-week-old Caleb Alexander Martinez against pneumococcal disease as he is held by his mother Rosa Elia Obando. Photo courtesy of GAVI.
This was a special moment for us all because it marked the beginning of a global immunization program with this new pneumococcal conjugate vaccine in the world’s poorest countries, supported by the GAVI Alliance. GAVI plans to support this vaccine’s introduction in more than 40 developing countries, which will prevent approximately 700,000 deaths by 2015 and up to seven million deaths by 2030.
The significance of the occasion was clearly lost on Caleb Alexander Martinez, who at just 10 weeks, had no idea why the entire community had turned out to watch the minister personally vaccinate him. And even less idea why everyone in the audience cheered as he burst into tears at the prick of the needle!
However, for the parents and health workers present, it was a cause for celebration because pneumonia is responsible for 20 percent of the total deaths of Nicaraguan children under five (18 percent globally) and is an experience that has touched too many of them personally. The introduction of this vaccine, together with other vaccines already funded by GAVI, will enable millions of children to grow up and go to school free from illness and disease.
Historically, there is a 10- to 15-year time lag between when new vaccines are first introduced in rich countries and in developing countries. But with today’s introduction, I am proud to report that the GAVI Alliance has bucked that trend and helped introduce this particular vaccine in the same year it was first used in the United States.
Honduras, Guyana, Kenya, Sierra Leone, Yemen and the Democratic Republic of Congo are among the next GAVI-eligible countries that will be rolling out pneumococcal vaccines in early 2011. If GAVI receives the additional funding it needs, we hope to provide the vaccine to more than 40 countries by 2015.
For every one child who dies of pneumococcal disease in wealthy countries, 2,000 children die in developing countries. Children’s futures should be protected regardless of where they are born. Please help us by calling on donor governments, foundations and the private sector to continue and increase their support for our mission so that millions more children, like Caleb Alexander Martinez, can start life protected from disease.
- Helen Evans, Interim CEO of the GAVI Alliance
A special World Pneumonia Day report: Sierra Leone’s fight to improve healthcare
For World Pneumonia Day this year I am speaking at the flagship UK event, which is being held in the Houses of Parliament. I will be speaking in front of an audience of parliamentarians, Government representatives, leading NGOs and other interested parties and I am proud that I will be able to relay to them the story of Sierra Leone’s progress in fighting terrible diseases such as pneumonia, the leading killer of children worldwide.
In the recent past Sierra Leone has had some turbulence, including political instability and conflict. This was reflected in our healthcare outcomes. Back in the year 2000, during the Civil War, maternal mortality stood at 1,300 deaths per 100,000 and child mortality stood at 252 deaths per 1,000. These are staggering figures, which suggested a bleak future for my country.
But we have spent the last few years building political stability and moving forward. One of the key strands of our redevelopment has been investment in healthcare. Since the year 2000 total expenditure on health as a percentage of gross domestic product has increased by 17% and per capita government spending on healthcare has doubled since 1995.
Our current President, Ernest Bai Koroma, is particularly strident in improving healthcare outcomes. Last April he launched the Free Health Care Services for Pregnant and Lactating Women and Young Children strategy. This has had some impressive initial results. The numbers of children and mothers seeking medical health has doubled and the use of anti-malarial drugs for children has increased by over 372%.
We are striding forward and our maternal and child mortality rates have fallen by an impressive 31% and 23% respectively.
But we do face significant challenges going forward.
Pneumonia is one of these challenges.
Each year this terrible disease claims the lives of 8,500 children in Sierra Leone, that is 23 children every day. Together pneumonia and diarrhoea account for an estimated 40% of all child deaths.
But we are taking this dreadful disease on. We rolled out the Hib vaccine recently, which protects against one of the major causes of pneumonia and next year we will roll out the pneumococcal vaccine, which will help to protect children against the leading cause of pneumonia.
This has been made possible through our determination and through the support of organisations such as the GAVI Alliance, who are helping us to roll out the pneumococcal vaccine next year as well as supporting us through recent years. We are also indebted to the work of a number of other key organisations like the ONE Campaign.
So on the occasion of World Pneumonia Day I am proud to say that Sierra Leone is a country on the move and next World Pneumonia Day I hope to be able to report even further progress in tackling devastating diseases such as pneumonia.
His Excellency Mr Edward Turay is High Commissioner for Sierra Leone in the UK. He has held the position since the beginning of this year and was previously a leading politician for the ruling ACP party in Sierra Leone.
For more information please see:
Make a difference this World Pneumonia Day
More than 1.5 million kids under the age of 5 die every year from pneumonia.
Who knew?
In wealthy countries, we tend to think of pneumonia as a disease of the elderly, but pneumonia actually kills more young children than HIV, measles and malaria combined. Another child dies from pneumonia every 20 seconds.
Today is a day that’s meant to bring attention to pneumonia, the leading killer of young children. You probably didn’t wake up thinking about World Pneumonia Day, but now that you know, it’s a great opportunity to spend a few minutes to learn how you can make a difference.
Pneumonia is an infection in the lungs that makes it impossible to take in enough air to survive, and is particularly dangerous for children that are otherwise weakened by malnutrition and limited access to proper health care. It can be caused by a range of factors, some environmental (like air pollution) and others by infections. These factors can be easily addressed, so fighting pneumonia is a matter of commitment and funding. That’s where you can help.
For infection control, the single best tool is a vaccine. We have a safe, effective vaccine to prevent pneumonia, and yet because 98.5% of child deaths from pneumonia are in low-income countries, many of those children and their families can’t afford the tool that could save their lives.
Fortunately, there’s a well-established organization ready to help poor countries get the vaccine out to children. The Global Alliance for Vaccines and Immunization (GAVI) was established by donors to pool their funding to buy and distribute new child vaccines. So far, it has helped vaccinate 60 million children for a range of diseases including Hib (Haemophilus influenza b) a major cause of pneumonia. There are also new vaccines against pneumococcal disease, the leading cause of pneumonia, and GAVI plans to introduce these in more than 40 of the world’s lowest-income countries by 2015.
But here’s the big caveat: GAVI’s plans to roll out new and underused vaccines are contingent on sufficient funding, and they face a major funding gap between now and 2015. GAVI needs fairly modest financial commitments to help the world’s most vulnerable, and ONE will be putting the heat on donor governments to step up in the next year.
So now that you know, it’s time to take action, and you’ve got a lot of easy options to choose from:
• Join ONE.org and stay tuned as we prepare for a major advocacy campaign for child vaccines
• Read more about the impressive work of GAVI, and consider a donation to cover the cost of vaccinating a child against pneumonia and other infections
• Spread the word about pneumonia by sharing this video, wearing blue jeans, or encouraging your friends and family to sign a PneumoniaGram.
Watch Global Pneumonia Summit Live Right Now
Today is World Pneumonia Day and you can watch the Global Pneumonia Summit live right now.
Child advocates from around the world are gathering in New York City to hear the latest on how we can raise the profile of child pneumonia and get policymakers everywhere to act.
Speakers include:
- Professor Jeffrey Sachs, Director of The Earth Institute at Columbia University and Special Advisor to the United Nations’ Secretary-General
- Singer-songwriter and UNICEF Goodwill Ambassador Angélique Kidjo
- ABC News’ senior health and medical editor Dr. Richard Besser
- WHO and UNICEF present a new report, the Global Action Plan for the Prevention and Control of Pneumonia, which provides a road map for preventing and treat child pneumonia in the world’s poorest countries.
- And leading global health experts, philanthropists, faith-based leaders, corporate representatives and child advocates to begin to change the way the world responds to the #1 killer of children—pneumonia.
New Mechanism for Fighting Pneumoccocal Disease Launched
Today in Lecce, Italy, several donors fulfilled their promise to commit $1.5 billion to fight pneumococcal disease, which includes pneumonia, and is one of the biggest killers of children in developing countries around the world. In 2007, Finance Ministers from Canada, Italy, Norway, Russia, and the UK, gathered in Rome with the GAVI Alliance, the World Bank, the Bill and Melinda Gates Foundation, UNICEF, and WHO and pledged to adopt an innovative mechanism to finance vaccines for pneumococcal disease called Advance Market Commitments. Today that pledge became reality.
Every year, pneumococcal disease kills 1.6 million people, more than a million of whom are under five years of age. Pneumonia, the most common form of pneumococcal disease kills one in four children in developing countries, making it the primary cause of death among young children. A vaccine for these diseases could save millions of lives over the coming years.
A vaccine for pneumococcal disease has existed since 2000, and is already part of routine vaccinations for children in developed countries. However, there is not an affordable vaccine for developing countries. The AMC frontloads financing for the vaccine so that once it is available, it will cost developing countries $3.50 per dose instead of the $70 per dose it costs in developed countries. Over the past two years, the donors involved in the AMC have been working to finalize the legal, financial, and regulatory components of the project. Today, the AMC became fully operational.
Bill Gates, co-chair of the Bill & Melinda Gates Foundation, and panel member at the launch of ONE’s DATA Report yesterday, said “This innovative new model will mean faster access to vaccines for millions of children in poor countries. It’s a great example of how innovation and technology together can produce life-saving advances and make them available to people who need them around the world”.
For more information, read the press release from GAVI Alliance.
-Lisa Fleisher
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TAGS: Bangladesh, Bill and Melinda Gates Foundation, GAVI, Immunisation, Partners, Pneumonia, UK, Vaccines