The challenge of pneumonia & acute diarrhoea at global, regional & national levels: Time to refocus on a top most priority health problem

In the developing countries, communicable diseases contribute to an enormous share of disease burden in all age groups, especially children1-3. Of 8·79 million children below the age of five who die worldwide each year, 68 per cent (5·97 million) die due to infectious diseases the major contributors being pneumonia (18% or 1.7 million deaths) and diarrhoea (15% or 1.5 million deaths)4. Five countries: India, Nigeria, Democratic Republic of the Congo, Pakistan, and China contributed nearly 50 per cent of these deaths. Nearly, 2.4 million (27.4% of the global figure) child deaths occur in the South-East Asia (SEA) Region alone; 21 and 14 per cent were contributed by pneumonia and diarrhoea, respectively. Among countries of this region, India suffers quite heavily from the global burden; out of 1.83 million child deaths, 20.3 and 13 per cent were caused by these two diseases. In the context of the aim of UN Millennium Development Goal 4 (MDG 4)5 to reduce mortality of under five children by two-thirds between 1990 and 2015, many countries in the SEA Region seem not to be on track to meet this target6 . The magnitude of the problem is even more challenging when morbidities are considered. Significantly, the median incidence of diarrhoeal diseases in under five children in developing countries has not changed much since the early 1990s – it was 3.5 episodes per childyear in 19937 vs. 3.2 episodes per child-year in 20038.