Pneumococcal disease is little known, but deadly to more young children worldwide, than AIDS, malaria and measles.
Orin Levine from the Bloomberg School of Public Health says the bacterial infection is a neglected and preventable child killer.
Levine is co-chair of the Pneumococcal Awareness Council of Experts. They’re infectious disease specialists out to stop a common cause of ear and sinus infections, as well as debilitating meningitis and deadly pneumonia.
Levine: “There are a lot of important global health problems, pneumococcal disease, though, is one of those big killers that nobody’s ever heard of.”
Seven years ago, the United States began immunizing American infants. Since then, the vaccine program has nearly wiped out pneumococcal lung infections in the U-S.
But outside of this country, nearly 800-thousand children, under age five, die from pneumococcal illnesses every year. Levine says many of those deaths are from pneumonias in South Asia and Sub-Saharan Africa.
Levine: “Pneumonia is the leading killer of children worldwide. Many people are surprised to hear that, they think it’s AIDS, they think it’s TB, they think it’s malaria or some other, it is in fact pneumonia that kills more children than any other disease.”
Kenyan pediatrician Fred Were is Africa’s representative on the expert council. A pneumococcal diagnosis is now rare in America, but in Africa Were says doctors see the signs too often – fever, cough and ragged, rapid breathing.
Were: “They run out of oxygen, they struggle to breathe. If they stay sick long enough, their hearts fail until it goes through the entire body. The child is looking frightened, restless, troubling to breathe and so is the mother, quite worried.”
For more than six years, Baltimore pediatrician Andrew Swiderski worked in Mauritania, Malawi, the Southern Sudan and Mozambique. In those countries, spotty health care networks force parents to walk hours, or days, to find care for a sick child.
Swiderski: “By the time they make it to the clinic, it is usually beyond the point of help. Even if they do make it in time, it’s not necessarily the case that they have the antibiotics anyway.”
A course of pneumococcal vaccine can cost about 60 U-S dollars, but Swiderski says that with the right mix of philanthropy and government support, that price could drop to six dollars or even 25 cents-a-dose.
Orin Levine from Johns Hopkins wants policy makers, foundations and drug makers to work together to purchase and deliver pneumococcal vaccine to the countries that need it most.
Levine: “So, we have at our fingertips a safe, efficacious vaccine and we need to get it used all over the world as fast as we can. To do that, they need to start by knowing what pneumococcal disease is, and knowing there is a life-saving vaccine available.”
The pneumococcal vaccine could rival other silver-bullet, child survival initiatives - like bed nets to prevent malaria, or vitamin A supplements. But Levine says scant awareness and uncertain demand stall production and keep prices high.
But the pneumococcal experts are proposing a novel arrangement of upfront funding that could encourage drug makers to make the vaccine more accessible in developing countries.
Levine: “The major increases in financing for pneumococcal vaccines that we’ve seen recently include 1.5 billion dollars in something called the Advance Market Commitment, that’s being supported by the Gates Foundation, the governments of Italy, the United Kingdom, Canada, Norway and Russia.”
The United States is not on that list, but Levine and his colleagues hope American health policy makers are listening.
Levine: “Because the bacteria is going to keep trying to work against our solutions and we’ve got to keep out in front of it.”