Why improved diagnosis and treatment of pneumonia must remain a priority

For over 10 years, Malaria Consortium has been at the forefront of pneumonia implementation research, working to improve diagnostic aids, streamline the training of health workers and increase access to treatment at all levels of the health system.

We believe that pneumonia must be a priority because it continues to be the biggest infectious killer in children under five globally. In 2019, the disease accounted for an estimated 672,000 deaths. The majority of these deaths were preventable and treatable. Forty percent of under-fives with pneumonia are currently incorrectly diagnosed and only 34 percent receive correct treatment. Early and correct diagnosis of pneumonia and treatment at all levels of the health systems could prevent more than two-thirds of pneumonia deaths.

As an organisation focused on health systems strengthening, Malaria Consortium has developed a model based on WHO’s Health Systems Framework to demonstrate what a health system equipped for improved pneumonia case management looks like and as governments and health systems look to recover from the impact of COVID-19, this model provides a framework to build systems resilience while increasing access to and quality of services for the diagnosis and management of pneumonia cases.

The model has been shaped by our experiential learning from undertaking implementation research including through the Acute Respiratory Infection Diagnostic Aid project (2016–2019), which studied the usability and acceptability of respiratory rate (RR) counting aids and the AIRR study (2020-2022) which is developing a RR aid using artificial intelligence. It has been further strengthened by Malaria Consortium’s experience in supporting integrated community case management (iCCM), which enables community assessment and treatment for uncomplicated cases of pneumonia, malaria, diarrhoea and malnutrition.

Through our leadership of the Every Breath Counts Research Group, we carried out an eDelphi survey process throughout 2020 and 2021, consulting 350 experts globally to establish what they feel are key research priorities for pneumonia over the next decade. It is critical that donors step up and support the pneumonia research community to close remaining knowledge gaps and fund implementation research as defined by the priorities that emerge from the survey. As a global partnership we’re not waiting around for this alone, we’re getting started with the next part of our work: to support the pneumonia response in two of the highest burden countries, Ethiopia and Chad. This new year-long project will help to provide a full understanding of pneumonia case management in the two countries and develop and support the respective Ministries of Health to operationalise a sustainable pneumonia control strategy.

This new project begins as Malaria Consortium enters its new strategy period from 2021-2025. We are renewing our resolve to accelerate the reduction of the pneumonia burden alongside other diseases including malaria and dengue, while supporting health sector resilience to achieve Universal Health Coverage by 2030. Through resilient health systems providing improved pneumonia case management, the paediatric mortality due to pneumonia burden can be drastically reduced.

Dr Kevin Baker is Malaria Consortium’s Research Advisor and Co-Chair of the Every Breath Counts Research Group.

Stay up-to-date with our work on pneumonia via our dedicated page.