By Geraldine Ryerson-Cruz

What are P and D?

Pneumonia (P) and diarrhea (D) are the leading causes of death for children who survive their first month and haven’t yet reached their fifth birthdays. Those deaths happen mainly in poor households in Southeast Asia and sub-Saharan Africa. P and D have several risk factors in common: poverty, undernutrition and poor hygiene.

No single intervention would eradicate either disease. But because these forgotten killers share so much in common, a set of overlapping interventions would tackle them both to a large degree — if only they were prioritized by health systems in the countries that need them most.


This month, leading scientists and health experts launched the first-ever effort to tackle them simultaneously in a more comprehensive way: the Integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhea (GAPPD). Released by the World Health Organization (WHO) and UNICEF, it lays out a plan to end preventable child deaths from pneumonia and diarrhea by 2025.

At the same time, the Lancet, one of the world’s leading medical journals, focused a special series of studies on the impact these two diseases have on children around the world. This includes extending current progress in tackling global child deaths overall–down to fewer than 7 million deaths in 2011, from 12 million in 1990—and examining how to break down barriers to faster progress.

Scaling Up Simple Solutions

A set of 15 key interventions could reduce diarrheal deaths by 95% and stop two out of three pneumonia deaths, if scaled up across 75 high-burden countries, the Lancet analyses show. Together, P and D took two million child lives in 2011.

Effective, low-cost interventions exist – to protect and prevent against, as well as to treat, these childhood diseases– but they have been characterized by poor scale-up, says Harry Campbell of the University of Edinburgh, who spoke at the April 12th launch in Washington, DC.

For example, fewer than 1 in 3 children with suspected pneumonia receive life-saving antibiotics, most high-burden countries do not have comprehensive coverage of rotavirus and pneumococcal vaccines, and an estimated 2.5 billion people still have no access to improved sanitation facilities.

Going Global

Why do global plans matter? Now more than ever, health policies and systems at the country level are linked to broader international frameworks that identify best practices, give guidance and improve coordination among the variety of stakeholders that have committed to work together to improve maternal, newborn and child health (MNCH).

World Vision sees these as opportunities to improve new global initiatives—by giving input from our experience as they are developed and making sure that they deliver outcomes for children. We also work with our communities and partners through local-level and international campaigns to hold policymakers to account so they make a difference for families.

When there is a gap between political statements and putting those promises into action, advocates for child health can remind leaders of their commitments. For those in the U.S., that can mean joining the Beyond 5 movement to call on lawmakers to protect global health assistance from further budget cuts. Our counterparts in hard-hit developing countries are also joining with peers and partners to ensure children and their well-being are put first.

What You Can Do

Join us in urging President Obama to support policies that prioritize simple nutritional interventions, and urge him to take the lead in making sure “the least of these” have enough to eat.

Ask him to ensure that the U.S. government provides leadership and resources to ensure that children can thrive far beyond their fifth birthday.

Act now to help save millions of moms and their babies from undernutrition.

Photo: Rosie’s daughter is happy they have a toilet, which is not the case for most families in their village in the Sta. Rita region, Samar province in the Philippines. Children’s health suffers because diarrhea is the second highest number of diseases in their village with most of their water source located in their yard. © 2012 World Vision/ photo by Shirley Kimmayong

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