Approximately 144,400 children die of pneumonia and diarrhea in Pakistan

Karachi: A staggering two million child deaths can be prevented every year if developing countries including Pakistan focused on fighting pneumonia and diarrhea, WHO and UNICEF officials said at the launch of the newly-integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhea on April 12.

With less than a thousand days left till the end of the ambitious Millennium Development Goals mandated by the UN in 2000, major health organizations and institutions are still struggling to meet the set goals especially in the developing world.

GAPPD targets MDG-4, which asks for reducing childhood mortality, by bringing down deaths from pneumonia to fewer than 3 children per 1000 live births, and from diarrhea to less than 1 in 1,000 by 2025.

The guidelines of GAPPD are based exclusively on the recommendations and findings of a special Lancet issue that provides new data on burden, epidemiology, workable interventions and the financial cost of ending preventable deaths from childhood diarrhea and pneumonia by 2025.The special series has been authored by a consortium of academics and public health professionals led by Professor Zulfiqar A. Bhutta of the Aga Khan University, and its launch also coincided with that of the GAPPD initiative on Friday.

Sharing the findings of the case studies his research unit undertook in Pakistan, Dr. Bhutta said: “In Pakistan, the under-five mortality rate of 89 deaths per 1,000 live births is one of the highest in the world.”
“Moreover, each year approximately 91,000 and 53,000 children die from pneumonia and diarrhea respectively, accounting for more than 30 per cent of the current under-five mortality burden” he added.

Professor Bhutta further explained that the key principles of GAPPD are ‘protect, prevent and treat’. “Very often we underestimate the importance and impact of promoting simple measures. There is no cost to exclusively breastfeeding your child till he is six months old, giving him adequate food, and maintaining proper hygiene,” he elaborated. “Take your child to the nearest health centre, the government now provides most vaccines at a very low cost.”

“Of course, GAPPD also places an onus on the government that it has to ensure that the local population has the required facilities of a health center, essential medicines and supplies, and the workforce in place to support this massive plan to save lives,” he insisted.

When enquired about why health agencies are targeting pneumonia and diarrhea in a seemingly expensive single campaign, Dr Elizabeth Mason, Director of Maternal, Newborn, Child and Adolescent Health at WHO replied: “Too often, strategies to tackle pneumonia and diarrhea run in parallel. But as countries like Bangladesh, Cambodia, Ethiopia, Malawi, Pakistan and Tanzania are already showing, it makes good health sense and good economic sense to integrate those strategies more closely since the causative factors for both diseases overlap.”

Speaking about the collaborative nature of the two initiatives and various partners involved in the projects, Dr Mickey Chopra, global head of UNICEF’s health programs, said: “This is a question of equity. Poor children in low-income countries are most at risk of death from pneumonia or diarrhea but much less likely to get the interventions they need.”
Dr Chopra added: “We know what to do. If, in the 75 countries with the highest death rates, we apply to the entire population the same coverage of essential interventions enjoyed by the richest 20 per cent of households, we can prevent the deaths of 2 million children even as soon as 2015, the deadline for MDGs.”

In his concluding remarks, Professor Bhutta disclosed that the coordination and development of the Plan was done with a US$1.9 million grant from the Bill & Melinda Gates Foundation.

“For the first time, AKU was able to successfully lead a global multi-stakeholder assignment of this nature, including the diplomatic tight wire of working with WHO and UNICEF on turf that they traditionally consider their own. This was the most ambitious global project that our group has undertaken to date. This is an enormous amount of work by many and I am hopeful that these will open doors to many more grants of this nature in the future,” he added.

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