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 leith.greenslade@mdgha.org for more information.