The flu season is in full swing. As a physician at Tufts Medical Center, I have already seen far too many people suffering from H1N1. But it really hit home recently when my son, who is at college overseas, called to tell me that he had a sore throat, runny nose, chills and a headache. Was he going to be one of the lucky ones with mild H1N1, or one of the unlucky ones who would get very sick, possibly with pneumonia? I couldn't fathom the latter.
Suddenly, I could relate to the estimated 20 million mothers around the world who have a child hospitalized for pneumonia. Worse, one in ten of these mothers will lose a son or daughter who is under age five in 2009, as they have every year for the last thirty years.
Pneumonia is the number one killer of children under age five around the world--killing more children than HIV, tuberculosis and malaria combined. It is so prevalent in the world that the first World Pneumonia Day this November 2 will establish the global call for action to tackle childhood pneumonia head on.
It is in our interest too, that we pay attention to this inaugural day.
Children in the US who visit their doctor because of fever may already have contracted pneumonia or other serious bacterial infections. But at least until this year's H1N1 outbreak, more than 95 percent of them did not have serious illnesses, they did not need to be hospitalized, and they did not need antibiotics.
Here, children rarely get pneumonia. Why? First, because of research. Next, because of the one-two punch: we have access to two vaccines--conjugate pneumococcal and Hib--that prevent the most common causes of pneumonia and most children in the US get these two vaccines.
But this year is different.
Recent data from the Centers for Disease Control and Prevention showed that more than 25 percent of people in the US who died from H1N1 had both the virus and bacterial pneumonia. Unfortunately, one third were children who had a type of bacterial pneumonia that even the available vaccines could not have helped.
Still, the problem of pneumonia is much worse for children in lower-income countries, especially in Africa and Asia. Many have bacterial pneumonia that the vaccines could have prevented. However, the vaccines aren't getting to these children.
Along with access to life-saving vaccines, we desperately need simple, inexpensive, accurate, and immediate ways to diagnose whether children have serious bacterial infections. We need to know within minutes, not the 2-5 days that it usually takes. We need this ability in rural areas and urban slums in Africa and Asia, and in the US, too. The best way to accomplish this is to start with global health research.
In the US, the delay caused by waiting for information about serious bacterial infections costs an estimated $37 million a year for unnecessary hospitalizations and antibiotics. Given the national discussion about health reform and cost savings, this matters. However, in Africa and Asia, antibiotics are never able to be prioritized for children with serious bacterial infections, because diagnostic testing is just unavailable. When the antibiotic supply runs out, children with serious bacterial infection just die.
We have the knowledge to improve health globally, but we aren't using it. Every child should have access to the two pneumonia vaccines. For those who get sick, we should be able to identify them in time and prioritize basic treatment when they need it. Research can show us how to overcome the barriers. It is only a funding source away.
With or without World Pneumonia Day, the US must fund research. We can defeat childhood pneumonia.
It is time to get serious and grab the opportunity to move this global health agenda forward with these goals in mind. Everyone wins, including my son, who is one of the lucky ones.
Patricia Hibberd, MD, PhD is director of the Center for Global Health Research at Tufts University and a Paul G. Rogers Society Ambassador for Global Health Research at Research!America. She can be reached at patricia.hibberd@tufts.edu.