Action, not reflection: A call to the global community to tackle child pneumonia

Pneumonia claims over 800,000 lives annually, accounting for 15% of all deaths of children under 5 years old. Yet it remains a neglected killer of children. It can be treated with antibiotics, but only one third of children with pneumonia receive the antibiotics they need.

The world’s first conference on childhood pneumonia, which took place on January 29-31, 2020 in Barcelona, Spain brought together the global community to discuss practical pathways that governments and their partners can take to meet the Sustainable Development Goal on child survival and progress under the Global Action Plan for Pneumonia and Diarrhea (GAPPD) target of three child pneumonia deaths per 1000 live births by 2025.

Achieving these ambitious goals will require a strong focus on strengthening health systems and equitable access to primary health care and quality of services, investments to improve child nutrition, immunization coverage, , water and sanitation, and clean air, as well as mobilizing domestic and private resources to finance these interventions. In Afghanistan, pneumonia treatment is included in a basic package of health services supported by a project co-financed by the World Bank and the Global Financing Facility (GFF).

Country leadership also plays a critical role in driving progress on national, sub-national and local levels. Thirteen of the initial 16 GFF-supported countries—those that have advanced furthest in the GFF process—are either prioritizing addressing pneumonia in their national health plans or tracking at least one indicator related to pneumonia.

For example, in the Democratic Republic of Congo the government is working with the GFF and World Bank to improve knowledge around the diagnosis and treatment of children with possible acute respiratory infection/pneumonia through performance-based financing platforms. These platforms incentivize health care providers and facilities to achieve specific performance criteria, including metrics that promote quality of care. Pediatric antibiotics are included in a list of essential drugs procured through these platforms and a quality checklist seeks to ensure that pneumonia diagnosis and treatment complies with protocol.

Another pillar of success is alignment and buy-in from all partners. Last year, the Global Action Plan (GAP) for Healthy Lives and Well-being for All brought together 12 multilateral health, development and humanitarian agencies, who, by signing it, pledged to better support countries to accelerate progress towards the health-related Sustainable Development Goals, including reducing preventable child deaths due to pneumonia. GAP brings the partners together in a coordinated way behind country strategies and plans, and then puts money behind the words to help catalyze accelerated progress of reforms and development. As one of the GAP signatory agencies, the GFF model can provide a platform to operationalize many of the GAP commitments by encouraging all partners to align programs and financing for health around country priorities.

The Global Forum on Childhood Pneumonia was not a forum for reflection, but a call to action to deliver concrete measures. Strengthening health systems, working across sectors and aligning financing efforts can help countries to ensure that children have access to the care and actions needed to protect them from getting sick and dying from pneumonia.

Leslie Elder

Leslie Elder is a Senior Nutrition Specialist with more than 25 years of experience in international public health, focusing on infant and young child feeding practices and maternal and adolescent nutrition, in addition to broader issues of safe motherhood and maternal, newborn, and child health. Prior to joining the World Bank in 2009, Leslie was Senior Director, Newborn Health and the Deputy and Acting Director of the Bill & Melinda Gates Foundation-funded Saving Newborn Lives program at Save the Children/US. She has additional professional experience supporting USAID-funded nutrition and health projects implemented through the Academy for Educational Development and John Snow, Incorporated as well as earlier stints at the World Bank. She received her MPH degree from Johns Hopkins University Bloomberg School of Public Health and a BSN from the University of Pennsylvania.