Running head: A PLAN FOR CHILDREN

A Plan for Children:
Reducing Child Mortality Rates Through Pneumonia

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A PLAN FOR CHILDREN

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Abstract
An astounding number of children die everyday from preventable causes.

One ofthese causes is pneumonia, a disease that kills over two million children a year, more thanAIDS, malaria and measles combined.
reducing child mortality.

Alleviating the damage of pneumonia is crucial in

The continent of Africa particularly suffers from childhood

pneumonia, and Nigeria is the country that is most affected, making it an area in urgent needof improvement.

Organizations such as UNICEF have proposed numerous methods to resist

pneumonia, but the best plan may be to start immunizing children routinely and eradicate thedisease itself.

To make this possible in Nigeria, for example, it is necessary to raiseawareness and have the Nigerian government take measures to start a new immunization
program.

The procedure of large-scale immunization would be effective in various otherdeveloping countries, leading to the mitigation of child mortality itself.

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A Plan for Children:
Reducing Child Mortality Rates Through Pneumonia
In the year 2000, global leaders convened in the United Nations headquarters in New
York to adopt a set of goals aimed at achieving a common objective: to tackle problems ofpoverty and human rights, and create a more suitable world for future generations to live in.
These goals are called the Millennium Development Goals, possibly the most widely
supported goals the globe has ever agreed on.

The goals cover a large variety oftransnational issues including hunger, primary education, and gender inequality.

However,the most important theme, relating directly to six of the eight goals, is improving the lives ofchildren.

One of these goals is to reduce child mortality (The United Nations Development

Group [UNDG], 2010).
Despite the considerable efforts made by countries and organizations around the world,child mortality remains a serious problem.

High child mortality rates lead to greater

problems such as overpopulation and less economic growth, affecting all countries regardlessof their levels of development.

According to UNDG (2010), “28,000 children die every day

from largely preventable and known causes” (p. 12).

The situation is especially dire in

Africa, where in the most underdeveloped countries, as many as one in five children die

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before their fifth birthdays.
developed countries.

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These deaths are not from accidents or cancer, as is normal in

They are caused by diseases that mostly do not concern the developed

world: pneumonia, diarrhea, malaria, measles, and HIV/AIDS.

Of these, the single largest

killer of children worldwide is pneumonia, a disease that kills more than 2 million children
each year, which is more than deaths caused by AIDS, malaria and measles combined (The
United Nations Children’s Fund [UNICEF] and World Health Organization [WHO], 2006).
With global attention focusing on the HIV/AIDS pandemic, it is not well known that one infive child deaths are caused by pneumonia.

Because pneumonia is responsible for so many

children’s deaths, it is crucial to lessen the harm done by pneumonia in developing countries
in order to reduce child mortality.
Pneumonia: Symptoms and Causes
According to a paper on pneumonia and child mortality written by UNICEF and WHO(2006), pneumonia is a type of acute respiratory infection that damages the lungs, interferingwith the lungs’ intake of oxygen and making breathing itself laborious.

The paper went on

to explain that the consequences of most acute respiratory infections are moderate, such as thecommon cold, but in the case of children with weaker immune systems, they often lead tomore life-threatening diseases including pneumonia.

Common symptoms of childhood

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pneumonia are labored breathing, cough, fever, chills, and wheezing.

According to the paper,

the leading causes of pneumonia are infections of bacteria and viruses, and in Africa over halfof the cases are caused by a bacterium called Streptococcus pneumoniae.
One of the reasons children living in underdeveloped countries are especiallysusceptible to pneumonia is that they are often undernourished.

According to the paper by

UNICEF and WHO (2006), the lack of certain nutrients, especially zinc, weakens children’s
immature immune systems and leaves them helpless to combat the bacteria causing
pneumonia.

Furthermore, the children’s living environments are often important factors.

Babies living in unsanitary, crowded homes with exposure to pollution or parental smoking
are more likely to catch pneumonia.
easy to diagnose.

Another obstacle in tackling pneumonia is that it is not

According to PneumoACTION from the Johns Hopkins Bloomberg

School of Public Health (2010), “one study showed that only about one in five caregivers
recognized that difficult or fast breathing is a reason to seek medical care immediately” (para.
14).

Without proper diagnosis, the patients do not have any chances of receiving treatment.

PneumoACTION also stated that merely half of the children in impoverished countries aretaken to suitable hospitals.

The treatment for pneumonia is usually a course of antibiotics

which cost less than a dollar a day, which means that as long as children are taken to medical

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facilities that are properly equipped, it is likely that they would have good chances ofrecovering.
Taking the above points into account, it can be said that there are an overwhelming
amount of obstacles that need to be overcome until childhood pneumonia can be controlled.
These obstacles exist in most developing countries in general, but they are especiallyprevalent in certain areas of the African continent, creating an environment in which
pneumonia is easily spread and not treated sufficiently.

According to data from an article by

O’Brien, et al. (2009), it is estimated that in a population of 100,000, the incidence rate ofpneumonia in Africa is 3397 and the death rate is 362, the highest in the world by aconsiderable margin.

Mitigating the threat of pneumonia in the African continent would

conspicuously decrease the overall child mortality rate around the globe.
Example: Pneumonia Mitigation in Nigeria
Among the nations in Africa, Nigeria suffers most from the effects of childhood
pneumonia, followed by Ethiopia and the Democratic Republic of Congo (O’Brien, et al.,2009).

According to an article by Odeh (2009), it is estimated that every year, pneumonia

affects six million children in the country, killing 200,000.

This is an urgent problem in

Nigeria, affecting families or communities both financially and emotionally.

Focusing on

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Nigeria is likely to provide an idea leading to a solution for all countries struggling withchildhood pneumonia.
Now, there are many possible solutions to mitigating the threat of pneumonia indeveloping countries, from prevention to treatment.

WHO and UNICEF (2009) proposedseveral, one of which is to improve the treatment equipment in hospitals.

According to a

research paper by Duke et al. (2008), the installment of better oxygen systems in hospitals in
Papua New Guinea led to the reduction in mortality rates for pneumonia, lowering the risk ofdeath by 35%.

However, although highly effective for treating pneumonia patients, the highcost of supplying the equipment makes it difficult to achieve.

The paper reported that thisoxygen system cost as much as 51 US dollars per patient, and 1673 dollars for each life saved.
Like many other developing countries, Nigeria spends only 5% of its GDP on health, making
it impractical to spend large amounts of money on one patient (WHO, 2006).
proposed solution is to prevent pneumonia infection using zinc supplementation.

AnotherAsmentioned earlier, the lack of nutrients, especially zinc, is said to weaken children’s immune
systems, thus making them susceptible to pneumonia.

This method is cost-effective since

zinc supplements only cost “US$0.02 per tablet as purchased from Nutriset” (Harvey, 2005,
para. 3).

However, an experiment done on children in Nepal, giving one group of children

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daily zinc supplementation and another group placebos to investigate the effects, produced theresult that zinc supplementation is not enough to mitigate pneumonia deaths (Tielsch et al.,2007).

Now, what is a solution that is cost-effective, easy to start, and capable of producing

good results? The answer may lie in vaccines.
Vaccines are safe, effective ways to prevent pneumonia infections.

As explained

earlier, many factors in children’s lifestyles and environments contribute to the spreading ofpneumonia, and it may be difficult to achieve tangible improvement in such broad fields.
However, it should be far simpler to wipe out the bacterium itself.

Disappointingly, theNigerian government does not include pneumonia vaccines in its routine immunization.
With the introduction of vaccines, the number of children who develop the disease in the firstplace would decrease dramatically.
Using vaccines is an ideal solution in many ways.
effectiveness.

One obvious advantage is its

There have been numerous cases in which introduction of the pneumonia

vaccine produced remarkable results in countries with low income.

For example, in a study

conducted in eastern Gambia on infants aged 6 to 51 weeks, the efficacy of the vaccine was
77% against pneumococcal diseases caused by bacterium targeted by the vaccine, and 16%
reduction in all deaths (Cutts et al, 2005). This is more effective than measures including the

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installment of oxygen systems that was mentioned earlier.

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Furthermore, according to the

Global Alliance for Vaccines and Immunisation [GAVI] (2010a), vaccines also often bringabout a phenomenon called “herd immunity”, meaning that even when a fraction of the
population is immunized, the protection spreads over to others in the area as well.

GAVI

introduced a case in the United States, in which the introduction of a pneumonia vaccine
eventually led to a 70% decrease in the disease occurrence among children who had not been
vaccinated.

The strategy of vaccination would not only effectively prevent pneumonia in

individuals, but would also help eradicate the disease in surrounding areas.
However, critics may claim that procuring enough vaccines is impossible due to its
costs.

It is true that the pneumonia vaccine is a complicated vaccine that takes one wholeyear to produce, making it relatively expensive (Walsh, 2011).

Nevertheless, although theinitial expenditure may be large, the cost-effectiveness of vaccines will overcome the highcosts.

GAVI (2010a) stated that “at a price of US$ 5 per dose, pneumococcal vaccines are avery cost-effective intervention in 68 of the poorest countries” (p. 14).

Keeping this in mind,

according to Walsh (2011), there is a new pneumonia vaccine that will be sold in Africa for$3.50 a dose, almost 35 dollars cheaper than the cost in Europe.

When used correctly, thevaccines will be a good investment in the long run, reducing the amount of money neededA PLAN FOR CHILDREN

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later for treating pneumonia patients.
In order to put this plan into motion, the Nigerian government needs to makepneumonia a higher priority.

When low-income African countries start new immunization

programs, they generally rely on organizations such as GAVI to fund them.

For example, in2009 Rwanda started a historic vaccination program with the help of GAVI, and was able tovaccinate almost every child younger than one year of age (GAVI, 2010b).

However,

Nigeria cannot be supported by GAVI due to its low routine immunization rate (Leo, 2010).
To gain support, Nigeria needs to improve its health system and pave the way for a new andmuch-needed immunization program.

It is possible, because in the past the Nigerian

government put considerable effort in eradicating polio, and succeeded in raising theimmunization rate to 61% in the year 2008 (UNICEF, 2010).

If the country puts the same

degree of effort into starting pneumonia vaccination, it should not be an impossible feat.
Conclusion
Large-scale vaccination is a method that would be effective in reducing childhood
pneumonia cases not only in Nigeria, but in other developing countries as well.

There are agreat number of countries that have yet to include pneumonia vaccines in their immunization
programs, including Uganda and Angola, both among the top ten nations in the world in terms

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of pneumonia-caused death rates (O’Brien, et al., 2009).

Furthermore, the action would

bring more attention to the situation worldwide, stimulating more people and governments tomake donations for pneumonia immunization.

The important theme is to take action, raiseawareness, and speed up the process of saving children from the threat of pneumonia.

For

an improved future in which more children around the world can grow up to become healthy,
productive adults, we need to start by preventing pneumonia in each and every country. (1858words)

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12References
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