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India unable to meet the MDG target on infant mortality; Pneumonia is the biggest cause

India has failed to meet the MDG of reducing infant mortality to 52 per 1,000 for 2015. Indian Academy of Paediatrics (IAP) district secretary P S N Murthy said that WHO target could not be achieved and the biggest culprit for it was pneumonia.

World Pneumonia Day is annually held on November 12 to raise awareness of pneumonia, promote prevention and treatment and generate action to fight the illness. World Pneumonia Day supports all efforts made to protect and treat people against pneumonia, the single largest cause of child deaths worldwide.This World Pneumonia Day was used to take stock and the infant mortality and India has an under-five mortality are of 52.7 per 1,000 live births.

Pneumonia is an inflammation of parenchyma of the lungs. In most cases, the disease is caused by microorganisms (airborne infections). But there are several non-infectious causes- through aspiration of food and milk, foreign body, drugs, hypersensitivity reaction etc.

Pneumonia is the single largest cause of death in children in India and the country has the highest number of child deaths in the world, with an estimated 1.2 million deaths in 2015—this constitute 20 per cent of the global 5.9 million child deaths.

The 2014 Pneumonia and Diarrhea Progress Report, released by the International Vaccine Access Center (IVAC) at the Johns Hopkins Bloomberg School of Public Health, highlights India’s persisting burden of pneumonia and diarrhoea, but notes marginal progress toward improving coverage of life-saving interventions to prevent child deaths and those suffering from these diseases. According to the report, India ranks third lowest compared to the 15 other high burden countries for its Global Action Plan for Pneumonia and Diarrhea (GAPPD) score – a calculated average of coverage levels for the vital pneumonia and diarrhea interventions.

What is India doing about Pneumonia?

The Ministry of Health & Family Welfare has stated  its commitment to the integrated approach outlined in GAPPD through several recent efforts, including a workshop on “Integrated Approaches for Prevention and Management of Pneumonia and Diarrhoea for achievement of MDG 4,” held this October with WHO in Delhi.

The recent decision by the Union Government to introduce three new childhood vaccines in the Universal Immunization Programme (UIP), including vaccines against rotavirus, rubella, polio (injectable), is a clear indication of the government’s commitment,” said Dr. Vijay Yewale, President, Indian Academy of Paediatrics.

However, India was one of the last countries to introduce Hib vaccination. It is now part of the pentavalent vaccines being progressively introduced throughout the country but many question why it took more than five years from pilot to rollout. The Hib vaccine was first introduced into Gavi-eligible countries fifteen years ago — Guyana launched it in 2001.  

India has yet to introduce the pneumococcal vaccine which would prevent many more cases of pneumonia (Hopkins estimates XX). The pneumococcal vaccine is used in many countries that are much poorer than India such as Bangladesh and Rwanda. According to Gavi, “Since 2010 when Gavi first started supporting this vaccine, 54 Gavi-supported countries have now introduced PCV as part of their routine immunisation programmes. Last year, Gavi surpassed its 2015 target of 45 PCV introductions and is now on track to introduce the vaccine in 80% of the 73 Gavi-supported countries by the end of 2016.” Had India been among them, millions of Indian children would have lived to see adulthood. India’s vaccine industry has often promised that indigenous pneumococcal vaccines are on the way but none have been submitted for registration yet.

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