The new UNICEF report, Pneumonia and diarrhoea: Tackling the deadliest diseases for the world’s poorest children, identifies pneumonia and diarrhoea as the two primary killers of children under the age of five. The report focuses on the huge potential to narrow the child survival gap between the richest and the poorest by increasing commitment, attention and funding.

Pneumonia and diarrhoea account for nearly one-third of the deaths among children under five globally - or more than 2 million lives each year.

Nearly 90 per cent of deaths from pneumonia and diarrhoea occur in sub-Saharan Africa and South Asia. About half of childhood deaths in the world due to diarrhoea or pneumonia take place in five countries: India, Nigeria, Democratic Republic of Congo, Pakistan and Ethiopia.

Poverty is a major factor in the spread of both diseases, with Pakistan, India, and several countries in sub-Saharan Africa making up the worst-hit nations. 

The prevention and treatments for both diseases often overlap, and include such basic steps as: increasing vaccine coverage; encouraging breastfeeding and hand-washing with soap; expanding access to safe drinking water and sanitation; and disseminating oral rehydration salts to children with diarrhoea and antibiotics to children with bacterial pneumonia.

Appropriate care for children with pneumonia symptoms is haphazard, with less than one-third of affected children receiving antibiotics. Oral rehydration salts, a traditional, low-cost response for children with diarrhoea, are used by only one-third of sick children in developing countries – signalling a failure to deliver one of the tried and true child survival interventions.

New vaccines against the major causes of pneumonia and diarrhoea are already available. The report found that most low-income countries have introduced the Haemophilus influenza type b (Hib) vaccine. While pneumococcal conjugate vaccines are also increasingly available, low-income countries urgently need to introduce them into routine immunization programmes.

Innovations also help to make a difference.  Child-friendly zinc and amoxicillin tablets and flavoured oral rehydration salts in packets are more palatable to children, and new uses for mobile technology and SMS texting are enabling health workers to reach farther into remote communities and other areas where children are at greatest risk.

The report urges the 75 countries with the highest mortality rates to aim to treat poor children with diarrhoea and pneumonia the same way they do those from the top 20 per cent of households, a so-called 'equity approach.'