“Pneumonia is the ultimate disease of inequality”: too many children are dying with no access to vaccines and oxygen

Toronto, 12 November 2021 – A decrease in routine vaccinations along with an increase in demand for medical oxygen during the COVID-19 pandemic has shaken progress in the fight against childhood pneumonia in Africa, putting thousands of young lives at risk, according to Save the Children.

In 2020 there was a decrease in the number of children in Africa who received the Pneumonia Conjugate Vaccine (PCV) and the Haemophilus influenzae type b (Hib)[1] vaccine, two vaccines that work to reduce the death rate from pneumonia which still kills 2,000 children every day.

Pneumonia, which is a potential complication of COVID-19 as well as other illnesses, remains the leading cause of death in children, causing around nearly three-quarters of a million deaths per year[2]. Prior to 2020, the child death rate from pneumonia was already falling far more slowly than other major child killers.

Disruptions in immunization services were widespread in 2020 as access to health services and immunization outreach was curtailed due to the pandemic. Curfews, grounding of public transportation and rampant vaccine misinformation also played a role in disrupting these life-saving services.

However two of the countries that combined host 20% of the world’s under five population – Indonesia and India – expanded the PCV vaccine into their national routine immunization program in 2021[3]. While the introduction will be staggered across regions in both countries, this commitment is a major step forwards in ensuring all children receive the vaccine.

In addition to drops in vaccine rates, in the last 12 months, the demand for oxygen to treat COVID-19 patients across all low- and middle-income countries more than tripled, causing shortages in many countries. Medical oxygen is a critical treatment option for children with severe pneumonia. Even before the COVID-19 pandemic, each year 4.2 million children suffering from severe pneumonia in poor countries needed medical oxygen to survive.

Nyaluak*, a three-year-old girl from Pibor in South Sudan, recently recovered from pneumonia thanks to her half-sister Achai*, who walked three hours to take her to a health centre for treatment. Achai said:

“Because no one is washing clothes and bathing this child, that’s why the child is sick and the sickness is entering the body of this child… When I brought the child she was having weeping coughs. This cough, when they gave her some medicine, it was not like before. At that night, she slept well.”

Jessica Winn, Save the Children’s Head of Pneumonia Support Hub, said:

“What makes pneumonia such a disturbing illness is that almost all of the deaths it causes are preventable. Effective vaccines can avert most cases, and with early and accurate diagnosis, simple antibiotics can treat childhood pneumonia. More severe cases should be managed with medical oxygen – a treatment that is largely available to citizens in rich countries, but as we’ve seen in this pandemic, in critically short supply in poor ones.

“While the pandemic will end, pneumonia will still be with us. As a global community, we must harness the same urgency, innovation and determination with which the world has fought COVID-19 to fight pneumonia, and save lives from this preventable and treatable disease.”

Notes:

• The Hib and PCV vaccines, along with the Rotavirus vaccine, were identified through joint research between Save the Children and the Johns Hopkins University School of Medicine as having one of the highest potentials to significantly reduce childhood deaths from pneumonia, along with other interventions. Taken together on a cumulative basis to 2030, these interventions including the vaccines could prevent 3.2 million pneumonia deaths, and an additional 5.8 million lives could be saved from co-benefits in areas including nutrition, newborn interventions, and antibiotic treatments.
• Over the past few years UNICEF and Save the Children have built a partnership on childhood pneumonia across nine high burden “beacon” countries and globally. We saw the power of that partnership at the Global Forum on Childhood Pneumonia held in Barcelona in January 2020. Countries are now confronted by the COVID-19 pandemic. As organizations grounded in a commitment to children, working together is now more important than ever. Right now, progress towards the Sustainable Development Goals, including child mortality and ensuring healthy lives for all is worryingly off track. Without urgent action to improve the health of children and tackle pneumonia the targets remain out of reach.                                                                                                                                    

ENDS

[1] Percentage of surviving infants who received the third dose of Hib-containing vaccine in Africa decreased from 73% coverage in 2017, 2018 and 2019, to 72% in 2020; Percentage of surviving infants who received the third dose of pneumococcal conjugate-containing vaccine (PCV) decreased to 68% in 2020 from 70% in 2019 and 69% in 2018 and 2017 (Source: UNICEF Data Warehouse accessed 04/11/2021)

[2] WHO Maternal Child Epidemiology Estimation (WHO-MCEE) 2018.

[3] India introduced PCV in 2017 for 5 selected states but expanded PCV vaccine to all states in 2021. Indonesia agreed to the national routine in 2021 and will commence rollout in 2022.