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World Pneumonia Day: Childhood Pneumonia Mainly Responsible For Under-5 Deaths In India And Globally

Save the Children India, the independent child rights organisation draws attention to pneumonia, which is the number one killer for children under five years of age. Pneumonia continues to cause the deaths of more children under five worldwide than any other single infectious disease. Childhood pneumonia accounts for 14% of under-five deaths.

COVID-19 has further aggravated the situation and has brought the issue to the forefront. Disruptions in immunization services were widespread in 2020, as access to health services and immunization outreach were curtailed due to the COVID-19 pandemic. Lockdowns, grounding of public transportation and rampant vaccine misinformation also played their part in disrupting these life-saving services.

"The pandemic resulted in disruption of essential RMNCH (Reproductive Maternal Newborn Child and Adolescent Health) services including routine immunization. A decrease in childhood vaccination coverage along with an increase in demand for medical oxygen and inpatient care has shaken progress in the fight against childhood pneumonia- the leading infectious cause of death in under-five children.

In India, there was a drop in overall routine immunization coverage which leads to a drop in DPT, Hib (Haemophilus influenza type b) and PCV coverage as well. The DPT & Hib coverage was as high as 91% before COVID struck and PCV coverage was 21% in selected districts of 6 states where it has been introduced before 2021. The drop in coverage of these lifesaving vaccines was due to COVID19 restrictions and the deployment of human resources for COVID response," shared Dr Vinod Kumar Anand, Sr. Consultant - Health, Save the Children, India.

"In India, PCV was introduced in a phased manner starting, June 2017 in select states/districts of Himachal Pradesh, Uttar Pradesh, Rajasthan, Bihar, Madhya Pradesh and Haryana (own state budget). Recently, the Government of India announced a nationwide expansion of the PCV vaccine into the national routine immunisation program in October 2021. This commitment is a major step forwards in ensuring all children receive the vaccine and is welcome," added Dr Anand.

However, 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 increased more than threefold, 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.

Pneumonia, which is a potential complication of COVID-19 as well as other illnesses, remains the leading cause of death in children, causing around three-quarters of a million deaths per year1. Young children are at a particularly high risk of developing severe pneumonia disease and death. More than 80% of deaths associated with pneumonia occur in children during the first 2 years of life.

Madhura Kapdi, Director, Campaign and Communication, Save the Children, India said: "Pneumonia symbolises and perpetuates inequality. *Every day, almost two thousand children worldwide or more than 300 under-five children die from this preventable and treatable disease simply because they do not have access to vaccines, early diagnosis and essential treatments such as medical oxygen. 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 an early and accurate diagnosis, simple antibiotics can treat childhood pneumonia. More severe cases should be managed with medical oxygen. While the pandemic will end, pneumonia will still be with us. We must harness the same urgency, innovation and determination with which the world including India has fought COVID-19 to fight pneumonia, and save lives from this preventable and treatable disease."

About Save the Children, India

Save the Children is India's leading independent child rights' NGO, which has a footprint in 18 states of the country. Beginning its journey in 2008 in India, and registered as 'Bal Raksha Bharat', we have changed the lives of more than 11 million (1.1 crores) children. We firmly believe that every child deserves the best chance for a bright future, which is why we are fiercely committed to ensuring that children not only survive but thrive.

In India and across the world in 120 countries, Save the Children works on-ground - every day and especially, in times of crisis. Our pioneering programs address children's unique needs; giving them a healthy start, an opportunity to learn as well as protection from harm. When a crisis strikes, we are always among the first to respond and the last to leave. We are the outspoken champions for children, ensuring that their voices are heard and their issues are given top priority. Please contact or Shweta Midha at +91 9818738405 / shweta.midha@savethechildren.in or Rufi Zaidi at +91 9811678444 / rufi.zaidi@savethechildren.in for all media queries.

Interventions For Pneumonia

To fight back childhood Pneumonia, other than the expansion of PCV, the Govt of India has launched Social Awareness and Actions to Neutralize Pneumonia Successfully (SAANS) in 2019. Save the Children, India facilitated the development and delivery of the National Pneumonia Campaign for 'SAANS' alongside the government, which was launched in 2019 to promote care-seeking behaviours among the public, it was supported by a social media campaign, which reached 30 million viewers in 2019-2020. While COVID-19 has restricted implementation at the ground level, activities have been sustained through digital channels. Save the Children, India has also launched a project on childhood pneumonia 'project Vishwas' in 2 of the pneumonia high burden states- UP & Rajasthan to implement the govt approved national pneumonia management guidelines. About Project Vishwas

Notes And References:

1. PCV operational Guidelines Jan 2021 MoHFW.
2. Save the Children, (2021), Pneumonia report data. Available on file.
3. Stop Pneumonia, (2019), Fighting for Breath in India - A call to action to stop children dying from pneumonia.

Available from: https://stoppneumonia.org/wp-content/uploads/2019/11/India- 12.11.2019-Web.pdf ·

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.

· In India, UNICEF, CHAI & Save the Children are collectively working for childhood Pneumonia.
· 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.