Report card on preventing global pneumonia and diarrhea deaths in children finds stalled progress

14 November, 2019

Extracts and a comment from me below. Full text:

The full report is available here:


The 10th annual Pneumonia & Diarrhea Progress Report Card from the International Vaccine Access Center highlights increases in immunization coverage — but a universal failure to meet targets across 23 countries with the greatest burden of disease

BALTIMORE, MD — A report card finds health systems are falling short of ensuring the world’s most vulnerable children have access to prevention and treatment services in the 23 countries that together account for 75% of global pneumonia and diarrhea deaths in children under five.

Globally, pneumonia and diarrhea led to nearly one of every four deaths in children under five years of age in 2017. Released on World Pneumonia Day, the 2019 Pneumonia & Diarrhea Progress Report Card by the International Vaccine Access Center (IVAC) at the Johns Hopkins Bloomberg School of Public Health describes progress in fighting pneumonia and diarrhea in countries with the highest absolute number of deaths and, for the first time, in countries with the highest rates of deaths from these illnesses.

This report analyzes how effectively countries are delivering 10 key interventions—including breastfeeding, vaccination, accessing appropriate health care providers, use of antibiotics, oral rehydration solution (ORS), and zinc supplementation—to help protect against, prevent, and treat pneumonia and diarrhea. These measures are proven to help prevent death due to these illnesses and could help achieve the UN’s Sustainable Development Goal target of reducing under-five mortality to at least as low as 25 per 1,000 live births by 2030...

"access to treatments such as basic antibiotics and oral rehydration therapy is surprisingly low across most of the countries included”...

Progress in India... has been mixed. Rollouts of rotavirus vaccines, beginning in 2016, and pneumococcal conjugate vaccine, beginning in 2017, helped India’s scores improve. India’s exclusive breastfeeding rate, at 55%, is among the highest of the 23 countries. However... Half of children with diarrhea receive ORS and 20% receive zinc...

Support for the report was provided by the Bill & Melinda Gates Foundation.


Comment (Neil PW): The role of information, education and communication is not even mentioned in this report, and yet we know that it is fundamental. In India for example, we know from MoH District Health Surveys that more than half of children with acute diarrhoea receive *less* to drink than normal (and one in 20 receive no fluids at all), thereby actively and tragically *increasing* their risk of death. Many of those who reach primary care are also inappropriately treated with antibitotics rather than ORS. By contrast, I understand that Bangladesh has made progress in this regard, thanks largely to BRAC. As we have often said on HIFA about the Gates Foundation and other funders: you need to pay much more attention to basic healthcare information needs. I am exasperated by the constant difficulties that HIFA members have to obtain funding for healthcare information activities. Let's see more investment in this area!

Best wishes, Neil

Coordinator, HIFA Project on Information for Citizens, Parents and Children (current funding = 0)

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - ), a global community with more than 19,000 members in 177 countries, interacting on six global forums in four languages. Twitter: @hifa_org FB: