November 12th, 2013 9:45 am ET - Rana Hajjeh, MD, Director, CDC Division of Bacterial Diseases
Last year, in observance of World Pneumonia Day, Cynthia Whitney, Branch Chief for Respiratory Diseases in the Division of Bacterial Diseases (DBD) and I co-authored a commentary for the CDC Journal of Emerging Infectious Diseases in which we urged the global community to consider the massive problems of pneumonia and to take a moment to consider what we each could do to help solve the problem of pneumonia claiming far too many children. Indeed 2013 has been a very busy year for all committed in the fight against pneumonia—which is part of an urgent and historic global effort to save lives and improve health for millions of women, newborns, and children outlined in the United Nations Millennium Development Goals (MDG).
The National Center for Immunization and Respiratory Diseases’ (NCIRD) DBD leads the agency’s pneumonia activities by engaging in research and promoting best practices that address pneumonia everywhere.
Through DBD staff collaboration with partners here at CDC and globally with health care providers, researchers, policy makers, and the greater public health community, we are seeing progress toward reducing disease and deaths due to pneumonia. DBD works with the Advisory Committee on Immunization Practices (ACIP)—which provides advice and guidance to CDC’s Director regarding vaccine use and related agents for control of vaccine-preventable diseases in the United States—and was front and center during the Committee’s meetings this year. Our scientists’ research helped inform the ACIP recommendation on pneumococcal conjugate vaccine (PCV13) for immunocompromised children aged 6-18 years. PCV13 covers 13 pneumococcal serotypes which cause the majority of pneumococcal infections in young children. DBD’s research demonstrated an 88% decline in PCV13-type pneumococcal disease among children less than five years of age in the United States, and 45-65% decline in other age groups due to herd immunity. This year, we completed studies of PCV effectiveness against invasive pneumococcal disease in South Africa and Uruguay and completed the review of vaccine schedules to guide global policy makers adopting PCV into childhood immunization programs. The findings of this comprehensive analysis support the use of either 3 or 4 dose schedules of PCV, and will be published in the Pediatric Infectious Disease Journal in the next few months. We continue to collaborate with partners to assess the effectiveness of PCV in the United States and select developing countries.
In April, WHO and UNICEF, along with other implementing partners released a new Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (GAPP-D) that tackles the two leading killers of children: pneumonia and diarrhea. GAPP-D lays out a framework for scaling up interventions to protect children, prevent disease and treat children who do become sick while addressing the imperative for equity, the importance of integration across nutrition, water, sanitation and hygiene strategies (WASH), health interventions, and the need for renewed and sustained action to ensure that every child has access to proven and appropriate preventive and treatment measures. Simultaneous to the release of GAPP-D, The Lancet published a special series of papers that provides the scientific underpinning for GAPP-D, including the most recent data and evidence on intervention impact and country practices.
Individuals and organizations have stepped up to maximize child survival efforts detailed in “A Promise Renewed” and their progress is highlighted in Committing to Child Survival: A Promise Renewed 2013 Progress Report that notes that though pneumonia killed more than 3,000 children under 5 years of age every day in 2012, the annual total of childhood deaths from pneumonia decreased by 35% from 1.8 million in 2000 to 1.1 million in 2012. The report also discusses that two vaccines against pneumonia-causing bacterial pathogens—Streptococcus pneumoniae (pneumococcus) and Haemophilus influenzae type b (Hib) are currently available in many countries as part of a package for the control of childhood pneumonia. By the end of 2012, Hib vaccine had been introduced in 184 countries (up from 177 countries in 2011), and pneumococcal vaccine in 88 countries (up from 73 countries in 2011) including introduction in 46 low-income countries that historically received available vaccines well behind other countries.
Just last month, I was invited to participate in the GAVI Alliance Mid-Term Review meeting in Stockholm, Sweden co-hosted by Ghana and Sweden. We assessed the progress in delivering on the US$4.3 billion in pledges by public and private donors and countries that will help immunize 250 million of the world’s poorest children by 2015, thereby saving up to 4 million lives. And we discussed how to jointly mitigate challenges in achieving this goal as summarized in the GAVI Alliance’s Mid-Term Report.
Please take a few minutes to review the publications that I have highlighted here and visit the World Pneumonia Day website to learn what people around the world are doing to fight pneumonia and how you can join in the fight against pneumonia through social media and other activities. Though we are encouraged by all that has been accomplished in 2013, much more work must be done. Pneumonia still remains the world’s leading killer of children under age 5, responsible for nearly one in five global child deaths. With only two years remaining to reach the MDG deadline, we must be very focused if we are to achieve Goal 4: Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate.
As his Excellency John Dramani Mahama, President, the Republic of Ghana said at the recent GAVI meeting, “…Every child, no matter where he or she is born, has the right to a healthy life and vaccines are one of the best ways to assure this. There is still a long way to go to ensure that everyone has equal access to immunisation.” I agree.
|On the Calendar|
|November 12: World Pneumonia Day|
November 14: World Diabetes Day
November 17: World Day of Remembrance for Road Traffic Victims
December 1: World AIDS Day
December 3: International Day of Persons With Disabilities
December 5: International Volunteer Day
December 10: Human Rights Day