Fighting for Breath

Photo: Save The Children

[This article has been written by Quique Bassat, iCREA researcher, and Gonzalo Fanjul, Policy Director, at ISGlobal, and published in Spanish in Planeta Futuro-El País]

Even in these turbulent times, when we find reasons to argue about almost any trifle, there is at least one thing we can all agree on, that the death of a child is something that violates our most essential nature. And if faced with the deaths of 800,000 children every year that could be prevented it would seems that the violence and the heavy responsibility would be unbearable. However, this death toll is precisely what is happening on our planet today as a result of a disease called pneumonia, and the only reason we continue to accept the situation is because these deaths occur far away and out of our sight. We do not see the victims as our children.

The death of a child is something that violates our most essential nature. And if faced with the deaths of 800,000 children every year that could be prevented it would seems that the violence and the heavy responsibility would be unbearable. However, this death toll is precisely what is happening on our planet today as a result of pneumonia

Pneumonia is an infection of the lower respiratory tract caused by bacteria or viruses. The circumstances in which the disease develops and the profile of the patients who get it make it a textbook example of what we call “diseases of poverty", that is diseases that are more prevalent in the poorest regions and most vulnerable populations in the world for which a cheap and simple treatment exists (in this case, antibiotics and oxygen) but does not reach those affected. The fact the pneumonia is a simple problem to deal with makes it particularly obscene that the disease continues to be the single leading cause of death from infection in children worldwide. Administered during the first few months of a child's life, a vaccine costing just a few euros has the amazing effect of saving a life.

Efforts to combat pneumonia over the last two decades have contributed to unprecedented improvements in child survival. Between 2000 and 2018, the international community has managed to reduce the number of deaths caused by pneumonia by 54% (saving the lives of 953,000 human beings). Nonetheless, this is not enough. The reductions achieved in other leading causes of child mortality, such as diarrhoea (64%) and malaria (68%), have shown that it is possible to achieve more and reach our objectives sooner.  

If we fail to take energetic action now, these recent gains will be eroded by pneumonia deaths and we will fail to reach our goal of ending preventable childhood deaths by 2030.

Photo: GAVI

However, the greatest challenge has nothing to do with scientific advances, but rather with the most basic principle of equity. A report published by ISGlobal, UNICEF and Save the Children highlights the fact that most of the deaths caused by pneumonia occur in low-income countries (such as Chad, Nigeria, Somalia and the Democratic Republic of  Congo) or in marginalized populations in countries like India, Pakistan and Indonesia. In these populations, access to a basic health facility or the cost of an antibiotic are simply insurmountable barriers.

Unfortunately, international cooperation and research do not always come to the rescue in the case of pneumonia as they do in the case of other diseases. Only 5% of international development funds and less than 3% of the total budget for research into infectious diseases is allocated to pneumonia. This represents a significant imbalance when we consider that pneumonia accounts for 15% of all deaths among children under five worldwide.

Only 5% of international development funds and less than 3% of the total budget for research into infectious diseases is allocated to pneumonia. This represents a significant imbalance when we consider that pneumonia accounts for 15% of all deaths among children under five worldwide

You will not be surprised, therefore, to hear that the first challenge in the fight against pneumonia is to rescue the problem from invisibility. In the past, some of the responses that have already been shown to be most effective—such as creating primary health care systems, vaccinating children in remote areas and promoting breastfeeding—have been passed over in favour of programmes that donor and recipient governments find more eye-catching. The second task is to strengthen the lines of research and innovation that would enable us to resolve some of the challenges posed by this disease. We are currently in the final phase of the development of new preventive treatments, such as the vaccine against respiratory syncytial virus, the most common cause of viral pneumonia. We could also bring to fruition some promising innovations in the production, storage and distribution of oxygen and in the development of new antibiotics better suited for use in children or capable of combatting even the most resistant infections.

But none of these innovations is more essential than the treatments that already exist. As current vaccines have been shown to prevent deaths from pneumonia, what we need to do now is make sure they get to those who need them most. For instance, GAVI, the Vaccine Alliance is a mechanism created to fund and implement the most effective vaccines in countries that cannot afford them. Therefore, we need the Government of Spain and those of other countries to ensure that GAVI and other similar organisation have the funds they need to continue their work in the coming years.

Next January, Barcelona will host a conference on this topic entitled Fighting for breath. This meeting, convened by organisations like our own that have been engaged in this fight for years, will be the first global forum on childhood pneumonia. Now that the Spanish elections are over, our country has an opportunity to demonstrate that it is capable of working across its differences for a truly worthwhile cause. And no cause can be more important than saving the lives of thousands of girls and boys who could just as well be our own children.

More information

• One Child Dies of Pneumonia Every 39 Seconds
• Fighting for Breath. Call to Action.
• Fighting for Breath: The Global Forum on Childhood Pneumonia.