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Preventing child deaths from pneumonia in Malawi and other developing countries

A new study conducted by a US medical team (reporting results in The Lancet) reveals the majority of child deaths around the world are still from preventable infectious causes.

Looking at mortality data for under-fives in 2010, the figures suggest two-thirds of deaths were attributable to infectious causes. For newborns less than 27 days old, preterm birth complications and intrapartum-related complications were more common causes of death than infections such as sepsis or meningitis. But in children aged 1-59 months, pneumonia, diarrhoea and malaria claimed the most lives, with over 2 million young children dying from these infectious diseases. And pneumonia was still the biggest killer.

Pneumonia is a lung infection which causes fever and breathing difficulties and can often be fatal in children, especially those under two years. And yet deaths from can be prevented if children are immunised against pneumococcal infections. In developed countries, health programmes normally include vaccination against the bacteria Streptococcus pneumonia. However, the vaccine used in Europe and the United States is unsuitable for developing countries, where different strains of the pneumococcal bacteria are present.

With funding from Western governments and the Bill & Melinda Gates Foundation, the Global Alliance for Vaccines and Immunisation (GAVI) has sponsored the development and launch of broader pneumococcal vaccines, which protect against additional strains. Using a framework (known as Advance Market Commitment) to develop and manufacture vaccines more cheaply, two new pneumococcal vaccines have now been introduced into the world’s poorest countries with support from the GAVI alliance.

Last November, Malawi became the 16th country to introduce one of these new pneumococcal vaccines into its health programme. Researchers believe the vaccine will not only save the lives of children who have been immunized, but also of those around them. Studies suggest that the benefits go far beyond the immunized children, because older adults and younger children are better protected, since they are exposed to fewer sources of infection. This phenomenon is known as “herd immunity”. The vaccine should also help to avert medical costs of treating sick children in Malawi’s overstretched health system. Studies indicate that costs saved can range from anywhere between 986 million and 1.2 billion.

Countries which have already begun rolling out the new pneumococcal vaccines (since December 2010) are Kenya, Guyana, Sierra Leone, Yemen, Honduras, Democratic Republic of the Congo, Mali, Central African Republic, the Gambia, Benin, Cameroon, Rwanda, Burundi, Ethiopia and Malawi. New countries will be joining these in 2012 and by 2015, it’s expected that nearly 60 countries will have the vaccines. Experts believe that this roll out could easily save the lives of 3-4 million children over the next 10 years. So hopefully, when the next few studies of mortality among young children are carried out, these will reveal a significant reduction in deaths from pneumonia.

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