Commentary: Pneumonia in the Headlines and Around the World
By Dr. Kate O’Brien, Executive Director, International Vaccine Access Center (IVAC)
Everyone may get 15 minutes of fame, however, for common illnesses such as pneumonia headlines are scarce. While Secretary Clinton’s pneumonia diagnosis is viewed by most through a political lens, the candidate’s announcement has also sparked a curiosity about an illness contracted by millions every year.
Pneumonia, an infection of the lungs, is exceedingly common around the world with an estimated 450 million cases annually. In the US, about a million people seek hospital care for pneumonia with a cost to the health system of more than $10 billion each year according to the American Thoracic Society.
While the cost of pneumonia in the US is staggering, in too many countries the price is even higher. In the US, we have ready access to trained physicians with the know-how and equipment to make a diagnosis and when necessary, antibiotics and oxygen to treat illness. While some may balk at the cost, these interventions have been proven effective, and the vast majority of people who contract pneumonia make a full recovery. Sadly, this is not true everywhere.
In parts of Africa and Asia resources are scarce, and HIV infections, crowding, and indoor air pollution are prevalent and put people at risk. Also, the prevention and treatment measures we take for granted, such as vaccines and hand washing, are too often not available. The price of pneumonia in these countries is higher infection rates, more illness and, sadly, more deaths, especially in children younger than five years of age.
For most of my career I have been engaged in the fight against pneumonia. I have worked with nonprofits, governments and businesses to help families everywhere have access to the tools they need to fight this illness. We have made considerable progress. Vaccines to prevent the most deadly causes of pneumonia are rapidly being deployed in countries in most need—thanks to Gavi, the Vaccine Alliance, and country governments. As more children have access to vaccines and medicine to prevent and treat pneumonia, we see less disease and fewer lives lost. Yet, much work remains. More than 900,000 young children still lose their lives to pneumonia each year, these children need access to the same tools as our children, to prevent, diagnose and treat this common illness.
There is also a need to invest in innovations that will help those who contract pneumonia in the US and around the world. For example, pneumonia can have bacterial, viral, or occasionally fungal causes. Currently, there is no reliable test that will identify the cause of the infection in every case. The conventional method involves imaging, bloodwork, or cultures that are inconclusive in more cases than not. Physicians typically treat with antibiotics in case the infection is bacterial, but often the pathogen remains unknown. A test to identify the pathogen would help health workers everywhere to treat pneumonia appropriately and reduce unwarranted antibiotic use, this will help to address issues of antimicrobial resistance which threaten to undermine our ability to treat infections.
More than anything else, there is a need to put pneumonia on our collective radar as a public health problem that requires attention. Last year, pneumonia took more young lives than Zika, Ebola, malaria, tuberculosis, and HIV combined. Globally pneumonia is the leading cause of death for children under five years of age. Yet, pneumonia flies under the radar; it is so common that it is nearly invisible.
Can this change? Absolutely. This week, pneumonia is in the headlines and people are talking about their experience (or their parent’s or their child’s) with the illness. While pneumonia’s 15 minutes of fame may be about to run out, the chance to make a difference remains.
Kate O’Brien, MD, MPH is the Executive Director of the International Vaccine Access Center and Professor at the Johns Hopkins Bloomberg School of Public Health. She is a pediatric infectious disease physician, epidemiologist and vaccinologist.