On Children’s Day, India’s Child Health Record

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As India celebrates Children’s Day, Thursday, November 14, the frightening UNICEF statistic that 1.4 million children under five die every year in this country, the vast majority of them from preventable diseases, should not be forgotten.

A new report released this week by John Hopkins University shows that globally, India has the highest number of children dying as a result of pneumonia and diarrhea, 436,000 every year, and little progress has been made in terms of prevention or treatment.

The Pneumonia and Diarrhea Progress Report, launched on World Pneumonia Day Nov. 12,   examines progress that 15 countries, including India,  with the highest numbers of pneumonia and diarrhea deaths have made in the last year. These countries, which have approximately half the world’s population of children under-five, account for three quarters of the world’s pneumonia and diarrhea deaths.

Progress is measured against the targets set out by the Integrated Global Action Plan for Prevention and Control of Pneumonia and Diarrhea, prepared by World Health Organization and Unicef in 2013, which recommends key interventions with targets to end preventable childhood pneumonia and diarrhea deaths by 2025. India which tops the list in terms of the number of child deaths from pneumonia, continues to have low scores on prevention and treatment.

The action plan recommends a multipronged approach to tackle these diseases. This includes early and exclusive breastfeeding, complimentary feeding, immunization, hand washing with soap, drinking safe water, reducing indoor pollution and proper sanitation. The plan also calls for improved treatment including oral rehydration solution and zinc for diarrhea and antibiotics for pneumonia.

While struggling to increase breastfeeding and improve children’s access to antibiotics, India has made some progress in the last year in terms of pneumonia prevention by introducing the pentavalent vaccine into the government’s immunization program in nine states. The five-in-one vaccine, which protects children against some of the leading childhood diseases, including pneumonia caused by Haemophilus influenzae type b, is now routinely given in those states and has been recommended for inclusion into the national immunization program across the country by the National Technical Advisory Group on Immunization.

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An indigenous and inexpensive vaccine to tackle rotavirus, the leading cause of diarrhea, has been developed and could be rolled out across the country in 2014. However, the pneumococcal vaccine, which protects against the most common cause of pneumonia, is not available in the government immunization program in India, despite its introduction in 88 countries, including our neighbor Pakistan.

We need to prioritize preventing childhood diseases to ensure that more children make it to their fifth birthdays and beyond, and to ensure that those who do aren’t burdened with life-long disabilities.

The socio-economic impact of these diseases is far reaching. According to Unicef, pneumonia and diarrhea usually affect the poorest children, as they are at greater risk because of their poor home environments, under-nutrition and a lack of access to clean water and sanitation. For these families, precious earnings used on treatment could otherwise be spent on food or children’s education.

Often, not recognizing the severity of the disease, parents with limited means don’t seek treatment until children are in a serious condition and need to be hospitalized. With people paying for approximately 75% of their medical expenses themselves, hospitalization costs can drive poor families into debt, as well as limit their time spent on productive activities. India spends 1.4% of its gross domestic product on healthcare, the lowest of any of the BRICS nations. Healthy children are more likely to attend school more regularly and for longer, opening up more avenues to them in the future.

Unless funding is dramatically increased and successes like the polio eradication program, are built upon, progress will continue to be too slow.

How can India truly prosper when our foundations – the health of our children – are so weak? Marking World Children’s Day this year, let us recommit ourselves to the fight against deadly childhood diseases and ensure that election debates ahead of national polls lead to strong policies and increased funding for health so that every child can access quality health services. 

T. Jacob John is a retired professor of clinical virology, Christian Medical College, Vellore, India.  Follow India Real Time on Twitter @WSJIndia.

By T. Jacob John