Best Practice Pneumonia and Diarrhea Demonstration Projects: Integrating the Prevention, Diagnosis and Treatment of Pneumonia and Diarrhea into Child Survival Efforts
in support of:
► A Promise Renewed: Committing to Child Survival
► United Nations Commission on Life-Saving Commodities for Women and Children
► Integrated Global Action Plan for Pneumonia and Diarrhoea
► Every Woman, Every Child
June, 2013
4.4 million child deaths must be prevented in less than
1000 days to achieve Millennium Development Goal 4
2011 2015
4 million child deaths
6.9 million child deaths
4.4 million cumulative lives to be saved
800,000 pneumonia
500,000 diarrhea
300,000 malaria
1,800,000 newborn
1,000,000 other*
Source: MDG Health Alliance, 2013.
*other = injuries, AIDS, meningitis, measles
10 countries hold the key to preventing
1.3 million pneumonia and diarrhea deaths
0
50,000
100,000
150,000
200,000
250,000
300,000
Pneumonia Diarrhea
60% of the l.3 million
lives to be saved come
from these 10 countries
Source: MDG Health Alliance, 2013.
Momentum is building for integrated approaches
to financing and delivering child survival programs
• United Nations Commission on Life-Saving
Commodities for Women and Children, 2010
• Global Vaccine Action Plan, 2012
• A Promise Renewed: Committing to Child
Survival, ―Five Strategic Shifts‖, 2012
• Integrated Global Action Plan for Pneumonia
and Diarrhea, WHO/UNICEF, 2013
―The current, fragmented approach is costing us dearly in terms of duplication, inefficiency, poor use of human
resources, and high procurement costs. It is costing patients most of all: they are dying of preventable diseases and
suffering without therapies readily available elsewhere. A strategic approach to global health delivery will help us to
move from the fragmentation of services and providers registered in most developing (and many developed)
countries towards integrated, effective delivery systems that provide value for patients.”
—World Bank President Jim Kim, Paul Farmer and Michael Porter, Lancet, 2013
New Child Survival Partnership Pledge
“As organizations deeply committed to child survival, we
pledge to work together to achieve unprecedented levels
of coordination in the prevention, diagnosis and treatment
of the leading causes of child death in the countries where
child deaths are concentrated—engaging both the public
and private sectors and prioritizing the most effective
child survival interventions especially vaccines, ORS, zinc
treatments, amoxicillin dispersible tablets, long-lasting
insecticide treated bed nets, artemisinin combination
therapies, breastfeeding support, nutritional supplements
and improved water, sanitation and hygiene.”
—Pneumonia Roundtable April 30, 2013, New York City
Best Practice Pneumonia and Diarrhea
Demonstration Projects
Vaccination
Accelerate Hib,
pneumococcal
and/or rotavirus
vaccines
Nutrition
Improve breastfeeding,
complementary
feeding/reduce
micronutrient
deficiencies
Wash
Integrate water,
sanitation and
hygiene campaigns
and programs
Innovation
Test/evaluate new
medicines, devices
and service
approaches
Evaluation
Independently
monitor and
evaluate impact
Treatment
Increase coverage
of ORS, zinc and
amoxicilllin
dispersible tablets
Goal
Accelerate child
pneumonia and diarrhea
mortality reductions
in the countries with
the largest numbers
of under 5 deaths
Flexible $ to demonstrate
that by integrating the
delivery of best practice
child survival interventions
in the areas where deaths
are concentrated, rates of
reduction in child
mortality can be
accelerated to the levels
required by MDG4
• Goal: To prevent 500,000 child deaths by
2015 to achieve MDG4
• Pneumonia, diarrhea and malaria cause
361,000 child deaths
• Best Practice Projects should demonstrate
how to accelerate child mortality reductions
to levels required for MDG4 achievement
by combining:
– 80%+ coverage of measles, pentavalent and
pneumococcal vaccines and long-lasting
insecticide Treated Bed Nets
– 60%+ rates of exclusive breastfeeding, hand
washing with soap and access to toilets and
clean water
– 80%+ coverage of Rapid Diagnostic Tests for malaria
– 80%+ coverage of ORS, zinc, amoxicillin dispersible tablets and Artemisinin Combination Therapies
– 80%+ coverage of Community Management of Acute Malnutrition and Vitamin A and zinc
supplementation
Nigeria
Kaduna, Bauchi, Kebbi, Taraba and Anambra are high burden states scheduled for new vaccine introduction
Projects should operate at scale in the high burden regions where new vaccine introduction is
planned, engage both the public and private health sectors, stimulate local manufacturing of
health commodities, invest in commercial approaches to demand generation, test diagnostic
and treatment innovations and rigorously and independently monitor and measure impact
Potential Implementing Partners: UNICEF, Save the Children, PATH, Malaria Consortium
• Goal: To prevent 200,000 child deaths by
2015 to achieve MDG4
• Pneumonia and diarrhea cause 104,000 child
deaths
• Best Practice Projects should demonstrate
how to accelerate child mortality reductions
to levels required for MDG4 achievement
by combining:
– 80%+ coverage of measles, pentavalent and
pneumococcal vaccines
– 60%+ rates of exclusive breastfeeding, hand
washing with soap and access to toilets and
clean water
– 80%+ coverage of ORS, zinc and amoxicillin
dispersible tablets
– 80%+ coverage of Community Management of Acute Malnutrition and Vitamin A and zinc
supplementation
Pakistan
Projects should operate at scale in the high burden regions where new vaccine introduction is
underway, engage both the public and private health sectors, stimulate local manufacturing of
health commodities, invest in commercial approaches to demand generation, test diagnostic
and treatment innovations and rigorously and independently monitor and measure impact
Potential Implementing Partners: Aga Khan Network, Save the Children, Centers for Disease
Control and Prevention
Punjab and Sindh Provinces have the highest concentrations of under 5 deaths in Pakistan
• Goal: To prevent 300,000 child deaths by
2015 to achieve MDG4
• Pneumonia, diarrhea and malaria cause
232,000 child deaths
• Best Practice Projects should demonstrate
how to accelerate child mortality reductions
to levels required for MDG4 achievement
by combining:
– 80%+ coverage of measles, pentavalent and
pneumococcal vaccines and Long-lasting
Insecticide Treated Bed Nets
– 60%+ rates of exclusive breastfeeding, hand
washing with soap and access to toilets and
clean water
– 80%+ coverage of Rapid Diagnostic Tests for malaria
– 80%+ coverage of ORS, zinc, amoxicillin dispersible tablets and Artemisinin Combination Therapies
– 80%+ coverage of Community Management of Acute Malnutrition and Vitamin A and zinc
supplementation
Democratic Republic of Congo
Projects should operate at scale in the high burden regions where new vaccine introduction is
planned, engage both the public and private health sectors, stimulate local manufacturing of
health commodities, invest in commercial approaches to demand generation, test diagnostic
and treatment innovations and rigorously and independently monitor and measure impact
Potential Implementing Partners: Management Sciences for Health, Population Services
International, Save the Children
Equateur, Badundu, Katanga, Sud-Kivu and Kasai Occidental have the highest concentrations of under 5 deaths
• Goal: To prevent 100,000 child deaths by
2015 to achieve MDG4
• Pneumonia, diarrhea and malaria cause
54,000 child deaths
• Best Practice Projects should demonstrate
how to accelerate child mortality reductions
to levels required for MDG4 achievement
by combining:
– 80%+ coverage of measles, pentavalent and
pneumococcal vaccines and Long-lasting
Insecticide Treated Bed Nets
– 60%+ rates of exclusive breastfeeding, hand
washing with soap and access to toilets and
clean water
– 80%+ coverage of Rapid Diagnostic Tests for malaria
– 80%+ coverage of ORS, zinc, amoxicillin dispersible tablets and Artemisinin Combination Therapies
– 80%+ coverage of Community Management of Acute Malnutrition and Vitamin A and zinc
supplementation
Uganda
Projects should operate at scale in the high burden regions where new vaccine introduction is
planned, engage both the public and private health sectors, stimulate local manufacturing of
health commodities, invest in commercial approaches to demand generation, test diagnostic
and treatment innovations and rigorously and independently monitor and measure impact
Potential Implementing Partners: Malaria Consortium, Clinton Health Access Initiative
Western, Southwest, Eastern and East Central Regions have the highest concentrations of under 5 deaths
• Goal: To prevent 80,000 child deaths by
2015 to achieve MDG4
• Pneumonia and diarrhea cause 30,000 child
deaths
• Best Practice Projects should demonstrate
how to accelerate child mortality reductions
to levels required for MDG4 achievement
by combining:
– 80%+ coverage of measles, pentavalent and
pneumococcal vaccines
– Introduction of rotavirus vaccine
– 60%+ rates of exclusive breastfeeding, hand
washing with soap and access to toilets and
clean water
– 80%+ coverage of ORS, zinc and amoxicillin dispersible tablets
– 80%+ coverage of Community Management of Acute Malnutrition and Vitamin A and zinc
supplementation
Kenya
Projects should operate at scale in the high burden regions where new vaccine introduction is
planned, engage both the public and private health sectors, stimulate local manufacturing of
health commodities, invest in commercial approaches to demand generation, test diagnostic
and treatment innovations and rigorously and independently monitor and measure impact
Potential Implementing Partners: PATH, Clinton Health Access Initiative, Centers for Disease
Control and Prevention
Western and Nyanza Provinces have the highest concentrations of under 5 deaths
How you can help
► INVEST in one or more of the 5 Best
Practice Projects – Nigeria, DRC, Pakistan,
Uganda and Kenya
► REQUEST a proposal for India, Ethiopia,
Tanzania, Bangladesh or Niger
► ENGAGE one or more of the agencies
interesting in leading the Best Practice
Projects: UNICEF and PATH for Nigeria,
MSH and PSI for DRC, Save the Children for
Pakistan, PATH and UNICEF for Kenya and
Malaria Consortium for Uganda
► SPEAK with other donors interested in
investing to maximize the pool of funding
and expertise available for the Best Practice
Projects
Best Practice Pneumonia and Diarrhea Demonstration Projects are a product of the Diarrhea & Pneumonia Working Group chaired by UNICEF and the Clinton Health Access Initiative.
Please contact Leith Greenslade at [email protected] for more information.