2 November, New Delhi. Challenged by the extreme urgency to end Pneumonia as the single biggest cause of child deaths due to infectious disease, Bal Raksha Bharat released a global call to action to have decisive national policies backed by international cooperation, which could save as many as 5.3 million lives by 2030. The aid organisation has published a major report, Fighting for Breath, to mark the launch of its global effort against pneumonia, which aims to save a million lives in the next five years.

Globally, nearly one million children are dying from pneumonia annually, even though it can be treated with antibiotics costing as little as 30p (Rs. 26) Bal Raksha Bharat revealed today. The report shows that pneumonia, ‘the forgotten child killer’, is responsible for the deaths of more children under five than any other disease. It kills two children in this age group every minute—more than malaria, diarrhoea and measles combined.

More than 80% of the victims are children under two years old, many with immune systems weakened by malnutrition or insufficient breastfeeding and unable to fight the infection. Infants are at their most vulnerable in the first weeks of life. For 2016 in India, it was the leading reason for 43 deaths per 1000 live births, under the age of five. More than 25 million children under the age of two were found not immunised with PCV in 2016.

“While the Indian government has taken several steps to improve the health of children, India continues to top the world ranking in number of deaths due to pneumonia and this is concerning,” informed Thomas Chandy, CEO of Bal Raksha Bharat in India. He added, “We estimate the number of unvaccinated children in the 0–2 age range in developing countries at around 170 million, with India dominating. There is also disturbing evidence that girls with severe pneumonia cases are far less likely to receive care in South Asia – and that they are more likely to die as a result. Some of that evidence comes from India.  We believe that we can save children’s lives if there is concerted action by the government, backed by civil society, corporates and the communities – but we do have to move fast.”

In India, the report recommends:

• Developing a comprehensive national guidelines and multi-sectoral convergent action plans to tackle pneumonia and ensure adequate resourcing for implementation at all levels.
• An increased budget allocation for health and strengthen primary health care and facility based pediatric services by investing in infrastructure, equipment, skilled health personnel and addressing supply chain gaps.

Ensuring that Accredited Social Health Activists (ASHAs) are trained and equipped to manage non severe cases of pneumonia at the community level

• and that primary health care facility staff have a regular supply of life saving commodities.
• Ensuring that national HMIS reports regularly on childhood pneumonia deaths and standardise recording and reporting mechanism at national, state, and sub-state levels.
• Promoting the importance of clean cooking fuels, healthy nutrition practices, toilet use, hand washing, safe drinking water, sanitation, and accessing immunization.

‘This is a disease that leaves desperately vulnerable children fighting for breath and their parents coping with anxiety and, all too often, the grief and trauma that come with loss,’ said Kevin Watkins, Chief Executive of Bal Raksha Bharat UK and lead author of the report. ‘It is indefensible that we allow so many young lives to be destroyed by a disease we have the knowledge and resources to defeat.’

Globally, the organisation wants to see:

• Cheaper vaccines to prevent pneumonia and more investment in immunisation;
• Governments adopting Pneumonia Action Plans that provide universal access to health workers trained to diagnose accurately and early;
• Governments and aid donors ensuring that life-saving antibiotics are available;
• Public-private partnerships to expand provision of the oxygen needed to help children struggling to breathe.

Bal Raksha Bharat is calling for a summit of world leaders to galvanise action and cut the toll from pneumonia.