Experts task FG on the inclusion of pneumococcal vaccine in routine immunization

 ..as the globe marks ‘World Pneumonia Day’

There is no gain saying that Nigeria is the economic powerhouse of the West African region. Despite been one of the wealthiest country on the African continent, its health indices is a course of major concern to health experts in view of the fact that about a million children under the age of 5 die annually from preventable childhood deaths which include pneumonia, diarrhoea, malaria, malnutrition and neonatal problems in the country.

With latest statistics which suggest that an estimated 56 million episodes of lung infections among Nigerian children annually, the 2008 estimates reveal that about 177,000 children under the age of five die of pneumonia in the country with this figure been the highest in Africa and second highest overall in the world.

Even as Nigeria lies within the Pneumococcal Meningitis belt of Africa where mortality in children and adults has remained high despite availability of antibiotics for treatment, this disease which is an infection of the lungs has attracted remarkably little attention over the past decade, limited funding and reportage in comparison to disease like malaria, Acquired Immune Deficiency Syndrome, (AIDS), etc. and continued to become an economic burden for families and communities, thereby contributing to the cycle of poverty.

Giving this worrisome development, health experts in the country have tasked to Federal Government to ensure pneumonia is given a policy priority by ensuring that pneumococcal vaccine is included in the National Programme on Immunisation (NPI).

In an exclusive interview with Oluwakemi Odukoya, physician in the Department of Community Health & Primary Care, College Of Medicine, University of Lagos, revealed that pneumonia, which is an infection of the lungs that causes cough, fever and make breathing difficult, is the world's leading killer of children under five, with the incidence of this disease estimated to be 0.29 episodes per child annually in developing countries and 0.05 episodes per child annually in developed countries.

While noting that these figures translate into about 156 million new episodes annually worldwide, of which 151 million are in the developing countries, pneumonia has now created an economic burden for families and communities with financial costs such as hospital stays and medications, transportation to health centers, caretakers’ inability to work or take care of other family members while they are caring for a sick child and families often times taking large loans to pay for care of their seriously ill child, which may further drag them into deep poverty.

According to Odukoya, “Globally, less than two-thirds of children with pneumonia are taken to an appropriate health care provider and in Nigeria, only an estimated 1 of every 5 children with pneumonia receives appropriate treatment. The burden that pneumonia places on families and the health system in resource-constrained countries in turn exacerbates inequalities. The coverage rate for interventions is consistently lowest among the poorest members of society and highest for the most affluent. However, children who are poorly nourished can also have weakened immune systems, putting them at higher risk of contracting pneumonia.”

The medical expert maintained that by raising awareness about pneumonia among leaders and health providers, educating the public to recognize pneumonia and seek proper treatment and the deployment of new and effective vaccines against Haemophilus Influenzae type B (HiB), and pneumococcus will go a long way in reducing the cases of children dying from pneumonia related deaths.

 “We can protect children from pneumonia and many other diseases through exclusive breastfeeding during the first 6 months of life of which only 20 percent of babies are exclusively breastfed, good nutrition, hand‐washing, reduced indoor air pollution, new and effective vaccines against HiB and pneumococcus. We need to focus resources on this neglected disease to reduce the number of children dying from pneumonia,” Odukoya stated.

Lending her view, Christina Campell, National President, Medical Women Association of Nigeria has (MWAN) called for the inclusion of pneumococcal vaccine in the National Programme on Immunisation (NPI). This, Campbell disclosed, would help reduce infant mortality in the country, which presently is outrageously high.

According to Campbell, “pneumococcal vaccine should be integrated into the national programme of immunisation. This is because pneumonia is at par with malaria as a major killer of children under the age of five. Note that the present vaccine regime for children in Nigeria is incomplete without pneumococcal vaccine hence the high prevelance of infant mortality in the country. We as an association would not relent in their agitation for the inclusion of the vaccine in the National Programme of Immunisation, as we have already approaching the government to do something about it urgently.”

Even as Nigeria continues in its quest to attain the Millennium Development Goals (MDGs) by2015, there is the need to prevent pneumonia in children which is an essential component of a strategy to reduce child mortality.

No doubt, there is the need for the Ministry of Health to collaborate with the National Primary Health Care Development Agency (NPHCDA) to ensure that pneumonia vaccines are included in 2011 strategy plans in the country’s routine immunisation process. More importantly, the Federal, State and Local Governments should ensure through appropriate intervention, that the mortality and morbidity of this ‘forgotten killer’ (Streptococcus pneumonia) be curtailed at all levels, bearing in mind the resolution of the World Health Assembly in May 2010.

As it is in the case with the United States of America and Germany where the inauguration of a National Advisory Committee on Vaccination and Immunisation is recommended, with this in place, understudying and understanding the pattern of infectious diseases in Nigeria whether periodic or seasonal and use evidence - based research epidemiology and surveillance will guide the nation.

It will be recalled that  World Pneumonia Day-celebrated every 12^th November and is in its third year seeks to raise awareness of pneumonia as a public health issue and help prevent the millions of avoidable child deaths from pneumonia that occur each year.