World Pneumonia Day: Past lessons, future progress

This is a guest post by Dr. Ciro A. de Quadros of the Sabin Vaccine Institute.  

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When I think of my early days as the chief medical officer at a small clinic in the Brazilian Amazon, I marvel at how much has been achieved. In the early 1960s, smallpox devastated the lives of families throughout my country, and indeed the world. Similarly, polio inspired widespread panic and fear of life-altering paralysis, especially in the summer when outbreaks were common.

Vaccines to prevent both diseases were in use, but not widespread – and comprehensive plans to contain each disease were lacking. As scientists, we knew that case management – or treatment planning to ensure that appropriate medical care is provided to those who fell ill – would be essential not only to improving the health of the sick, but also to protecting those who are at risk.

So one by one, village by village, and ultimately country by country, we worked to make sure that cases of smallpox and polio were quickly diagnosed and treated, and then we vaccinated family members and nearby residents who were at risk to put a stop to these vicious threats. We conducted widespread vaccination campaigns – in some cases going door to door to ensure every child was reached. By building on our early successes, we scaled up the strategies that worked and we accomplished what some said couldn’t be done. We eradicated smallpox not just in Brazil, but throughout the world. While it has taken some time, we have also made great strides with polio. In 1994 the Americas were declared polio-free. Today, polio remains endemic in just a few countries, and global eradication is finally within reach.

With smallpox eradicated and polio held at bay, the global public health community has turned its attention in recent years to the fight against the leading childhood diseases, including pneumonia. Pneumonia doesn’t capture public imagination the way smallpox or polio once did, but ironically, it is this disease – and not malaria or AIDS – that is the number one killer of children today, claiming the lives of more than a million children each year. For children without access to measures designed to protect against, prevent and treat pneumonia, the threat is grave.

As we learned with smallpox and polio, vaccines are key to protecting children and their communities from infectious threats. Now, the global health community is coming together in a way never seen before with partners such as the GAVI Alliance, the Pan American Health Organization (PAHO) and the Pneumococcal Awareness Council of Experts (PACE) shining a spotlight on pneumonia, demanding action and getting results that can be measured in the number of lives saved.

Consider this: just five years ago, vaccines preventing pneumococcal disease, the most common cause of pneumonia, were in widespread use in wealthy countries, but none of the countries that shouldered the greatest number of pneumonia infections and death could access them. It used to be that vaccines would be introduced first to children in wealthy countries, while low-income countries could wait as much as 20 years before they had access to the same vaccines.

But today – just two years after the newest generation pneumococcal vaccines were introduced in the US – children in the world’s poorest countries have also begun to receive it. This year, thanks to the tireless work of partners, 16 low-income countries will have introduced pneumococcal vaccines, 12 of them in sub-Saharan Africa – and 18 more are on track to do so in the near future. In Latin America over 18 countries are already using this vaccine in their national immunization programs.

This remarkable progress is due to the financial commitments of the countries themselves and the global development partners, and their understanding of the fact that disease knows no borders – and that all children, everywhere deserve the fair shot at life that vaccines help guarantee. Despite these tenuous economic times, it is imperative that national governments and global development partners maintain this commitment.

As a young man, I believed that one life lost to a preventable disease is one too many. I still believe that. This World Pneumonia Day, I am proud to look back at what has been achieved to prevent deadly diseases that once plagued our children. Those early fights blazed a path for our work today. We have the tools, and the power to stop pneumonia from being the number one killer of children. And I believe that we will.  

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Before joining the Sabin Vaccine Institute in 2003, Dr. de Quadros was Director of the Division of Vaccines and Immunization at the Pan American Health Organization. He also served as the World Health Organization's Chief Epidemiologist for the Smallpox Eradication Program in Ethiopia from 1970 to 1976.

Dr. de Quadros is a leader in the development of successful surveillance and containment strategies for the eradication of smallpox worldwide, and has directed successful polio and measles eradication efforts in the Americas.

Dr. de Quadros serves as Associate Adjunct Professor at the Johns Hopkins School of Hygiene and Public Health in Baltimore, MD; and an Adjunct Professor in the Department of Tropical Medicine at The George Washington University School of Medicine and Health Sciences in Washington, DC. He completed his medical and public health studies in Brazil.