Global Forum Renews Political Will on Childhood Pneumonia

7 February, 2020

Extracts and a comment from me below, thanks to Global Health Now. Full text here: https://www.globalhealthnow.org/2020-02/global-forum-renews-political-wi...

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While the global health community has mobilized swiftly against the Wuhan coronavirus, preventable childhood pneumonia kills more than 800,000 children each year—making it more lethal than HIV, malaria, and tuberculosis combined.

“Pneumonia has fallen through the cracks. There’s no global institution responsible for pneumonia—quite shocking given that it’s been the leading killer of children for decades,” says Leith Greenslade, coordinator of Every Breath Counts, a public-private partnership devoted to childhood pneumonia.

To advance solutions for this “global cause without champions,” scientists, global health leaders, and health ministers of high-burden countries convened in Barcelona last week in a first-ever Global Forum on Childhood Pneumonia. Their goal: To develop an action plan to end the preventable deaths from this historically neglected illness...

The forum encouraged high-burden countries to develop pneumonia action plans outlining concrete strategies for controlling childhood pneumonia, highlighting several themes:

1. Develop multi-sectoral partnerships to reduce deaths...

2. Place vulnerable populations at the center of pneumonia strategy...

Bacterial childhood pneumonia can be prevented by pneumococcal conjugate vaccines and treated using $0.50 antibiotics. In the forum’s final declaration, health ministers for high-burden countries—such as Nigeria — committed to developing and implementing plans that prioritize pneumonia control and treatment for vulnerable populations.

3. Build health systems with pneumonia-specific strategies—but integrate delivery

In their article Childhood pneumonia: A global cause without champions, Watkins and Devi Sridhar caution against focusing on vertical programming for pneumonia; they encourage national governments to invest more in health system strengthening and training community health workers on proper pneumonia diagnostics and treatment.

4. Invest in technical solutions and equipment

“At the moment no international organization is responsible for supporting LMIC governments to pay for pulse oximeters, medical oxygen or amoxicillin,” says Greenslade via email. “Gavi only does vaccines, the Global Fund does HIV/AIDS, malaria and tuberculosis, and the Global Financing Facility/World Bank prefers investing in health systems rather than individual commodities. This is one of the reasons you can walk into health centers and hospitals across Africa and find no pulse oximeters, non-functioning oxygen, stockouts of amoxicillin.”

Several donors stepped up with pledges of support, according to Greenslade: The Serum Institute of India announced a 30% cheaper PCV; the “la Caixa” Foundation and the Spanish government pledged more support for Gavi PCV replenishment; and Unitaid announced a $43 million investment to boost pulse oximetry in 9 countries...

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Comment (Neil PW): Arguably, on the basis of past CHIFA discussions, the key issues are even more basic than this article would suggest. They are about parental awareness and basic healthcare knowledge to ensure a sick child is referred urgently to a health worker so that amoxicillin can be given without delay. It would be interesting to know more about the availability of amoxicillin. On the one hand, we hear of stockouts at health facilities, whereas on the other hand it is widely available from unregistered street vendors. Certainly, every community health worker who is responsible for child care *must* have ready access to amoxicillin - if they do not, then this needs to be addressed with urgency.

Best wishes, Neil

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