New Delhi: India has improved its vaccination coverage to prevent deaths of children under five years of age from diseases like pneumonia and diarrhoea, but these fatalities from preventable diseases remain a concern in many countries across the world, according to the annual Pneumonia and Diarrhoea Progress Report, released Wednesday.
India has achieved the global target of 90 per cent coverage for three of the five vaccines required to change that situation, adds the report, which is brought out by the International Vaccine Access Center (IVAC) at the Johns Hopkins Bloomberg School of Public Health in the US.
The vaccines whose coverage is monitored in the report are the diphtheria, pertussis and tetanus (DPT) vaccine, the measles vaccine, the haemophilus influenzae Type B vaccine, the pneumonia conjugate vaccine, and the rotavirus vaccine.
“Pneumonia continues to kill more children under five worldwide than any other single infectious disease, claiming an estimated 800,000 children’s lives in 2018, while diarrhoeal diseases — the second leading infectious cause of death of children under 5 — claimed the lives of 437,000 young children. Globally, over 1.23 million children died of pneumonia and diarrhoea before reaching their 5th birthday — the equivalent of over 141 child deaths per hour or 3,400 deaths per day,” says the report, adding that an estimated 2,33,240 children aged below five years died from the two conditions in India in 2017.
The IVAC report tracks progress by analysing 10 indicators from the latest available data on how countries are delivering key interventions — including breastfeeding, immunisation, care-seeking and antibiotics, oral rehydration solution (ORS), and zinc supplementation — that are known to prevent pneumonia and diarrhoea deaths.
Since the launch of the government’s Mission Indradhanush programme in 2014, India’s immunisation coverage has shown massive strides but the child death numbers continue to be daunting.
India’s total of 2,33,240 means that every day, on average, 640 children died of pneumonia or diarrhoea that year — a number higher than the daily Covid casualties that the country has been reporting for the past few weeks.
India’s immunisation coverage has improved
According to the report, India’s coverage of the rotavirus vaccine — rotavirus is the cause of the highest number of diarrhoea cases in the world — increased by 18 percentage points. Its coverage was estimated at 53 per cent in 2019, up from 35 per cent in 2018.
In 2019, India completed the “100-days agenda” — an unprecedented national scale-up of the rotavirus vaccine across states to help protect 26 million children born each year against life-threatening cases of rotavirus diarrhoea, the report says.
India’s immunisation coverage against pneumococcal pneumonia, it adds, also increased by 9 percentage points — 15 per cent in 2019, up from 6 per cent in 2018.
Of the 15 focus countries included in the report, India is one of just four that exceeded targets for exclusive breastfeeding, with its exclusive breastfeeding rate at 58 per cent.
However, nearly every country included in the report lagged in access to treatments against pneumonia and diarrhoea. India failed to reach all four targets for treatment, the report states, adding that the treatment for diarrhoea had the lowest coverage, with only 51 per cent of children receiving ORS and 20 per cent getting zinc.
ORS and zinc, especially when packaged together, are highly effective treatments that have been proven to reduce diarrhoea deaths among children.
Concerns about Covid
Although there was progress in India in 2019, the Covid-19 pandemic threatens the hard-won gains because of disruptions caused in routine health services like immunisation and access to medical oxygen, which is used to treat both pneumonia and coronavirus patients, the report notes.
“Children living in countries that already bear disproportionate impacts of pneumonia and diarrhoea must now also contend with potentially catastrophic impacts of the Covid-19 pandemic,” the report states.
“The fallout of the Covid-19 pandemic threatens to reverse decades of progress in protecting the world’s children from these preventable illnesses,” the report adds, pointing out that the pandemic has aggravated the oxygen crisis globally.
Even before that, the report says, studies found that just one in five children hospitalised with pneumonia actually received the oxygen they needed. Closing these oxygen gaps, it adds, could prevent more than 1,48,000 child pneumonia deaths each year.
“While the world focuses on new innovations in vaccines to respond to the Covid-19 epidemic, we cannot afford to lose sight of the millions of children who die from preventable diseases like pneumonia and diarrhoea,” Mathuram Santosham, IVAC senior advisor, is quoted as saying in a press release accompanying the report.
“These deaths are almost all preventable with vaccines and simple proven treatments that we already have available. India’s hard work to expand rotavirus vaccine highlights the power of committed stakeholders and the success which can be achieved.”