Interventions to address deaths from childhood pneumonia and diarrhoea equitably: what works and at what cost?
Abstract
Global mortality in children younger than 5 years has fallen substantially in the past two decades from more than 12 million in 1990, to 6·9 million in 2011, but progress is inconsistent between countries. Pneumonia and diarrhoea are the two leading causes of death in this age group and have overlapping risk factors. Several interventions can effectively address these problems, but are not available to those in need. We systematically reviewed evidence showing the effectiveness of various potential preventive and therapeutic interventions against childhood diarrhoea and pneumonia, and relevant delivery strategies. We used the Lives Saved Tool model to assess the effect on mortality when these interventions are applied. We estimate that if implemented at present annual rates of increase in each of the 75 Countdown countries, these interventions and packages of care could save 54% of diarrhoea and 51% of pneumonia deaths by 2025 at a cost of US$3·8 billion. However, if coverage of these key evidence-based interventions were scaled up to at least 80%, and that for immunisations to at least 90%, 95% of diarrhoea and 67% of pneumonia deaths in children younger than 5 years could be eliminated by 2025 at a cost of $6·715 billion. New delivery platforms could promote equitable access and community platforms are important catalysts in this respect. Furthermore, several of these interventions could reduce morbidity and overall burden of disease, with possible benefits for developmental outcomes.
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Most deaths from diarrhoea and pneumonia are preventable with high coverage of existing interventions.
“Most deaths from diarrhoea and pneumonia are preventable95 with high coverage of existing interventions (as shown in the second paper in this Series96).”
From Global burden of childhood pneumonia and diarrhoea (2013) · cites this paper as [96]
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- Authors
- Bhutta, Z. A., Das, J. K., Walker, N., Rizvi, A., Campbell, H., Rudan, I., & Black, R. E.
- Affiliations
- Aga Khan University (PK)
- Johns Hopkins University (US)
- University of Edinburgh (GB)
- Corresponding author
- Bhutta, Zulfiqar A
- ORCID
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2013-04
- Volume
- 381
- Issue
- 9875
- Pages
- 1417-1429
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2026569930
- Cited by
- 675
- References
- 85
- Citations by year
- 2026: 14 · 2025: 13 · 2024: 19 · 2023: 25 · 2022: 124 · 2021: 46 · 2020: 127 · 2019: 35 · 2018: 30 · 2017: 54 · 2016: 57 · 2015: 54 · 2014: 46 · 2013: 30
- FWCI
- 57.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- eCommons - AKU (Aga Khan University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Keywords
- pediatric pneumonia, childhood diarrhea, under-five mortality, Lives Saved Tool, intervention cost-effectiveness, vaccination coverage, community health workers, child morbidity
- MeSH terms
- Anti-Bacterial Agents, Breast Feeding, Child, Preschool, Dehydration, Diarrhea, Female, Fluid Therapy, Health Promotion, Health Services Accessibility, Humans, Infant, Male, Pneumonia, Risk Factors, Global Health, Zinc
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