by Leith Greenslade, co-Chair of the Pneumonia Innovations Network and Founder & CEO of JustActions
The growth in global health financing that began in 2000 and peaked in 2013 spawned the development of several public-private partnerships that have achieved some of the strongest results in public health (IHME, 2017). It was largely through the efforts of Gavi the Vaccine Alliance, The Global Fund to Fight AIDS, TB and Malaria and their partners that child deaths from vaccine-preventable infections and malaria fell so sharply, and the rise of HIV/AIDS was halted and reversed over the period (GBD, 2016). And with many public and private sector actors now aligned to end maternal deaths, to expand access to contraception, and to end malnutrition and non-communicable diseases, we should start to see more rapid advances in maternal survival and modern contraceptive uptake, as well as declines in child malnutrition and chronic disease. All are essential to achievement of the Sustainable Development Goals (SDGs); however, one major cause of death and disability is still largely missing from the picture.
Pneumonia is the fifth leading cause of death and the leading infectious killer in the world (Chart 1). It targets children under five and the elderly. In most countries, pneumonia kills more children under five than any other cause, and deaths among the elderly are rising due to aging populations and rising rates of air pollution, smoking and alcohol use (Chart 2). As a result, the vast majority of low, middle and high income countries are struggling to control their pneumonia burdens which they cannot afford to ignore if they hope to achieve the health SDGs. This is why more than 35 organizations1 have joined forces in the first public-private partnership dedicated to helping countries drive down pneumonia deaths to SDG achievement levels.
Chart generated by the Every Breath Counts Coalition
The Every Breath Counts Coalition will initially support ten countries2 where extremely high rates of child malnutrition, air pollution, and poor access to vaccines, diagnostic and treatment services are keeping pneumonia deaths high, especially among children under five. The Coalition will work with national, state and local governments in these countries to identify the most critical gaps in pneumonia prevention, diagnosis and treatment. The goal is for each country is to endorse a national “Pneumonia Control Strategy” which sets target annual reductions in child pneumonia deaths and details how to achieve them with a combination of vaccine coverage increases (especially the pneumococcal conjugate vaccine), reductions in child malnutrition (especially wasting), air pollution improvements (especially in the household), and improvements in the provision of diagnostic and treatment services in the health system (especially child-friendly antibiotics, pulse oximetry and oxygen), Financing the Pneumonia Control Strategies is very much the responsibility of governments in the context of advances in Universal Health Coverage. The Every Breath Counts partners are also committed to mobilizing additional support from members, non-government country stakeholders, and external actors with a commitment to infectious disease control.
The Every Breath Counts Coalition will begin its work in Nigeria, where the Federal Ministry of Health is committed to pneumonia control, and Save the Children, UNICEF, and USAID will lead the effort, with the support of Dalberg Global Development Advisors. The Coalition has also established four teams to work on: (a) developing a more robust set of pneumonia prevention, diagnosis and treatment indicators for use in official health surveys and in the Lives Saved Tool (LiST) model; (b) improving the quality and reach of pneumonia advocacy and communications; (c) rapidly advancing the uptake of pulse oximetry and oxygen solutions, and (d) identifying and filling the most critical gaps in pneumonia research. The Indicators Team is chaired by the Clinton Health Access Initiative (CHAI), the Advocacy and Communications Team is chaired by The Access Challenge, the Oxygen Team is chaired by UNICEF, and the Research and Development Team is chaired the Malaria Consortium, with support from the University of Southampton which published “Sizing Up Pneumonia Research.”
To achieve the ambitious vision of ending preventable pneumonia deaths by 2030 in the countries with the heaviest burdens and the steepest challenges, success will depend on government leadership and the full and sustained commitment of the Every Breath Counts members over the next decade.
But it can be done.
The Every Breath Counts Coalition is in support of the Sustainable Development Goals, especially SDG 3.2,3 the Global Strategy for Women’s, Children’s and Adolescents' Health and the UN Secretary-General’s Every Woman, Every Child (EWEC) movement.
You can support Every Breath Counts on social media using #EveryBreathCounts.
1 The Access Challenge, Assist International, the Bill & Melinda Gates Foundation, the Clinton Health Access Initiative, Concern Worldwide, École Polytechnique Fédérale de Lausanne, Every Woman, Every Child Innovation Markeplace, Gavi, GE Foundation, Global Alliance for Clean Cookstoves, Global Good/Intellectual Ventures, GSK, Grand Challenges Canada, ICV Group, Barcelona Institute for Global Health, “la caixa” Foundation, LeanMed, Lifebox, McCann Global Health, Malaria Consortium, Masimo, Newborn Foundation, Oxygen for Life, Partners in Health, PATH, Pfizer, Philips, Results for Development, Save the Children, Sesame Workshop, UNICEF, Unitaid, United for Oxygen, University Melbourne Center for International Child Health, USAID.
2 Chad, Nigeria, Angola, Niger, Somalia, Mali, DRC, Afghanistan, Pakistan and Ethiopia.
3 SDG 3.2 requires all countries to reduce newborn and child mortality to below 12 and 25 deaths per 1,000 live births respectively by 2030.