By Tim Costello, Chief executive of World Vision Australia
The biggest killer of children under five isn’t malaria. It’s not diarrhoea, AIDS or measles.
It’s pneumonia. In fact, pneumonia claims more lives than malaria, measles and AIDS combined.
While it’s an illness more readily associated in developed countries with the elderly and bed-ridden, in other parts of the world – even some classed as middle-income, such as India and China – pneumonia takes the lives of 1.4 million children before their fifth birthday.
And these deaths are almost entirely preventable. So today, on World Pneumonia Day, and at the start of World Vision’s Global Week of Action, we ask everyone to make a commitment to helping children reach five years of age.
In the year 2000, 189 countries signed the United Nations Millennium Development Goals, which aim to improve the lives of those in the developing world.
One of those – MDG4 – aims to reduce child mortality from the 1990 level by two-thirds by 2015. At current rates, we are going to miss that deadline by 15 years.
The work ahead of us may sound like a big challenge – and it is – but the solutions aren’t a mystery. We know how to achieve fewer child deaths, and the solutions aren’t as complex as one would think for such huge advances.
Tackling pneumonia can put us on the path to reducing the number of unnecessary child deaths around the world, especially since 41 per cent of those child deaths due to pneumonia occur in our own region.
Pneumonia can be either bacterial or viral, but both types can be countered through small steps.
Such a simple act as washing hands properly with soap can stop the spread of pneumonia. (Hand-washing can also stop the spread of the second biggest killer of children – diarrhoea.) The bar of soap we may see in our bathroom and take for granted can – quite literally – be a life-saver in the developing world. According to a study published in The Lancet, hand-washing alone can reduce rates of pneumonia by half, and rates of diarrhoea by more than half.
That’s why soap is one of the first things handed out following a disaster, when disease can threaten to run rampant. When I visited Niger’s Mangaize refugee camp, I saw how World Vision’s installation of taps to provide clean water, and distribution of buckets and soap made a huge difference to the people living there.
Good nutrition can also give children the immunity they need to fight pneumonia before it takes hold, or the strength to survive it if it does. And good nutrition starts at birth. Babies who are exclusively breast-fed are six times less likely to die before the age of two months than those who are not. Children who are exclusively breastfed until six months of age are 15-23 per cent less likely to contract pneumonia.
It’s a staggering statistic, to think that over the first eight weeks of life the way a child is fed can have such an impact on their chances of survival. But that’s information we have to give to new mothers and expectant women in the developing world. We need to ensure they have the education and support to breastfeed their children, but we also need to ensure they themselves are receiving adequate nutrition to be able to breastfeed.
After six months of age, it is imperative that good nutrition is continued, including the provision of Vitamin A and zinc, until at least the age of five. Even the stoves used in a child’s home can make a difference to child health. The use of clean burning and fuel efficient stoves has shown not only a significant reduction in environmental impact, but a 50 per cent reduction in childhood pneumonia rates.
We also have to educate families and communities about the signs of pneumonia, and the importance of getting early appropriate treatment and medications. It isn’t maliciousness that leads people to overlook the illnesses their children suffer, it’s ignorance. It’s also a lack of access to healthcare even when parents do realise they need their children to be treated. Only 54 per cent of children with pneumonia in developing countries are taken to qualified healthcare providers.
We need to work with communities so they can recognise the warning signs of disease and when they need to intervene. We need to ensure they have health professionals to treat children who need it, and that proven immunisation programs are implemented in developing countries.
The GAVI Alliance – which works with partners to deliver vaccines – says immunisation can result in a 49 per cent drop in pneumonia infection rates, and for the first time, vaccines against the leading causes of pneumonia are reaching communities in the developing world at the same rate they are reaching children in high-income countries.
By 2015 – the ‘due date’ for the Millennium Development Goals – GAVI and its partners hope to have rolled out vaccination programs in 60 developing countries. But as important as vaccines are, they need to be delivered in conjunction with a concerted program of education and support, as well as access to health care.
These are not outrageous requirements, and it does not place an undue burden on the world’s developed countries to ask them to support developing nations in taking the steps they need to cut child deaths.
We owe it to the world’s children to treat them as we do our own, and put our hands up for health.