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The fight against pneumonia in five charts

Pneumococcal vaccines have saved millions of children’s lives, but with a child still dying of pneumonia every 43 seconds, there’s more work to do. 

  • 12 November 2024
  • 4 min read
  • by Priya Joi
Credit: cottonbro studio on Pexels
Credit: cottonbro studio on Pexels
 

 

Pneumonia kills 2,000 children worldwide every day, making it the biggest infectious cause of death in children. The introduction of pneumococcal conjugate vaccines (PCVs) has significantly lowered the burden of death and disease from pneumonia (and also protects against a cause of meningitis), but millions of children remain unvaccinated.

The Haemophilus influenzae type b (Hib) and measles vaccines also prevent pneumonia, and while the pertussis vaccine (included in DTP for diphtheria, tetanus and pertussis) doesn't directly prevent pneumonia, it does reduce the risk of secondary complications.

While the Gavi-supported roll-out of PCV since 2009 had saved 1.2 million children by the end of 2023, many children still need access to the vaccine.

1. Progress in reducing pneumonia deaths in children under five years has been slower than for other vaccine-preventable diseases.

Chart: Progress in reducing pneumonia deaths in children under 5 years has been slower than for other vaccine-preventable diseases


Compared with measles, for which deaths have fallen to around a sixth of cases in 20 years, pneumonia deaths have fallen much more slowly. Childhood pneumonia deaths are tightly linked to undernutrition, lack of safe drinking water and sanitation, indoor and outdoor air pollution as well as inadequate access to health care.

2. Nevertheless, under-five deaths from pneumonia have almost halved since 2009

Chart: Nevertheless, a positive finding is thta under 5 deaths from pneumonia have been halved since 2009


Much of this progress has been thanks to an innovative mechanism called the Advance Market Commitment that Gavi launched in 2009, which effectively created a US$1.5 billion fund to guarantee the purchase of vaccines made by vaccine manufacturers. This would revolutionise access to life-saving pneumococcal vaccines for children in lower- and middle-income countries.

3. Vaccination has been critical to saving lives

Infographic: 1.2 million lives saved by 2023


Since Gavi supported the first roll-out of the PCV vaccine in 2009, 438 million children of all ages have been vaccinated with Gavi-supported vaccines in 64 countries, averting an estimated total of 1.2 million deaths by the end of 2023. This has saved an estimated US$ 33.4 billion in cost of illness averted with Gavi support.

Many of these children live in the most impoverished parts of the world, where access to antibiotics and the hospital care that is sometimes needed is not easily available. For these children, the PCV vaccine could be the difference between life and death.

In countries where PCV roll-out is increasing, health workers are seeing dramatic reductions in childhood pneumonia deaths. Kenya introduced PCV to its routine immunisation schedule in 2011 with Gavi support. By 2019, according to data reported in The Lancet, there was a 92% reduction in PCV-10 type invasive pneumococcal disease in children aged up to five.

Nigeria followed suit with PCV introduction in 2014. In that year, nearly 480 children per 100,000 in Nigeria died of pneumonia or other lower respiratory infections. By 2019, that number had declined to 386 per 100,000.

Now, fragile countries are introducing PCV to their routine immunisation programmes. Chad has just introduced PCV along with rotavirus and malaria vaccines. Next year, Somalia and South Sudan will also introduce PCV with Gavi's support.

4. Gavi-supported countries continue to have higher coverage of vaccines against pneumococcus, rotavirus and Haemophilus influenzae type b (Hib) than the rest of the world

Chart: Gavi-supported countries continue to have higher coverage of vaccines against pneumococcus, rotavirus and Haemophilus influenzae type b (Hib) than the rest of the world


Both pneumococcal and Hib vaccines protect against pneumonia. Ensuring that these vaccines reach young children is increasingly urgent given the rise in resistance to the bacterial strains that can cause disease.

5. Coverage of pneumococcal vaccine coverage is improving but needs to be higher

Chart: Coverage of pneumococcal vaccine coverage is improving but needs to be higher


There has been huge progress since 2009, yet more countries need to be able to roll out PCV, and some of the countries already providing it to their people need greater support in reaching every child who needs it.

Gavi has spent US$ 1.47 billion on its pneumococcal vaccine programme between 2021 and 2025, which has saved an estimated US$ 33.4 billion in the cost of illness and death.

Between 2026 and 2030, Gavi plans to spend US$ 1 billion on its PCV programme, which will continue to save millions more lives, but this is contingent on the Vaccine Alliance meeting its replenishment target of US$ 9 billion to fund all of its programmes over those five years.