April 7, 2009
By Bill Frist and Colleen Conway-Welch
Quick quiz: What kills the most children under 5? HIV/AIDS, malaria or pneumonia?
If you are like most Tennesseans, you said HIV/AIDS or malaria. That is what 3 out of 5 Americans answered when asked by a pollster commissioned by the U.S. Coalition for Child Survival.
The correct answer is pneumonia, which kills more than 2 million children each year, making it the largest single killer of children under 5 worldwide, although HIV/AIDS and malaria are also enormous public health problems.
Almost four children die from pneumonia every minute. Many deaths take place at home in crowded living conditions where bacteria can flourish or in remote neighborhoods in poor countries, where doctors and nurses are out of reach and antibiotics are hard to come by.
The good news is change is coming.
Consider 3-year-old Sweety, who lives in an extremely poor and rural area of western Bangladesh - to reach her home, you need to travel down a narrow dirt path and then walk across several bamboo logs spanning the water below. Sweety fell ill with extreme pneumonia at age 2. Can you imagine the fear her parents felt at seeing their child struggling to breathe, and being so far away from the nearest health clinic?
Thanks to a pilot health program put in place by local non-profit clinics with U.S. government assistance, Sweety was cured with antibiotics, costing less than $1, due to being treated without delay at home by a community health worker trained by Save the Children.
Save the Children has helped pioneer treatment of children with pneumonia at home with medicines, and recent global research shows that such treatment is just as effective as treating children in hospitals with antibiotic injections. This important work could help change the way life-threatening childhood illnesses are managed in developing countries.
Indeed, the World Health Organization is now on record as saying the potential of these results is enormous in helping improve child survival. As a result, the World Health Organization recommends that severe childhood pneumonia after being assessed and diagnosed at a health facility can be treated at home with oral amoxicillin in low HIV settings. When every breath counts, it's critical that children like Sweety get the help they need nearby and not hours away on foot or by bicycle.
Treating pneumonia, though, is only part of the equation. We have to stop it from occurring in the first place through preventative measures like childhood immunization and breastfeeding. We need to train and equip community health workers and get proper medicines to hard-to-reach communities. And, we need to inform parents that when their young infant or child has fast or labored breathing, she needs immediate treatment.
But, first, as we see from the polling results, we need to get the word out that this neglected disease claims more young lives than AIDS, malaria and measles combined every year. That's why some of the top child health leaders and advocates in the nation, including Save the Children, PneumoADIP at the Johns Hopkins Bloomberg School of Public Health, Hedge Funds vs. Malaria & Pneumonia, and the GAVI Alliance, are calling to establish Nov. 2 as World Pneumonia Day.
The idea is to inform and unite communities around the globe to fight the disease in simple ways. Whether you're a high school student in Nashville creating a new cause page on pneumonia on Facebook, or you're a mother in Nepal helping to educate other moms in your village about ways to prevent childhood pneumonia, every action counts. Won't you join us?
Bill Frist, M.D., is chair of Save the Children's Survive to 5 campaign, and Colleen Conway-Welch, Ph.D., C.N.M., is dean of the Vanderbilt University School of Nursing. She is also involved in Save the Children's Survive to 5 campaign – an effort to reduce child mortality globally.