1 FIGHT PNEUMONIA. 1 THE GLOBAL COALITION AGAINST CHILD PNEUMONIA 0

2 SAVE A CHILD. PNEUMONIA CIS THEH WOIRLLD’S DLEADRING KEILLEN R OF UNDER AGE FIVE. World Pneumonia Day: A Platform for Action ...... 5

Coordinating Strategies ...... 7

Results at a Glance ...... 8

Supporting Targeted, Local Advocacy Efforts through Small Grants ...... 10

Small Grants Recipients ...... 11

Engaging Governments to Achieve Change ...... 12

Reaching and Educating Communities in Need ...... 16

Issuing Research and Generating Media Coverage ...... 20

Using Digital Media to Inspire Action ...... 22

Engaging New “Faces of Pneumonia” ...... 24

The Continued Fight Against Pneumonia ...... 26

The Global Coalition Against Child Pneumonia ...... 28 Child at Healthy Center, Phalombe, Malawi. WORLD PNEUMONIA DAY: A PLATFORM FOR ACTION

Pneumonia takes the life of one child every 20 seconds — more than AIDS, malaria and measles combined — and is responsible for nearly 20 percent of deaths in young children. It is often re - ferred to as the “forgotten killer” because historically it has received little of the attention it de - serves. In the last decade, global health leaders have worked to change that, and in doing so created a global movement to save children’s lives through the annual recognition of World Pneumonia Day.

In 2009, WHO and UNICEF released the Global Action Plan for the Prevention and Control of Pneumonia (GAPP) showing that pneumonia deaths could be reduced by two-thirds if existing interventions to protect against, prevent and treat pneumonia could be scaled up to reach 90 percent of the world’s children. These interventions include:

I Ensuring effective case management and treatment at the community level; I Breastfeeding exclusively for the first six months of life and providing zinc supplementation; I Reducing indoor air pollution; I Including full vaccinations in national immunization programs; I Preventing mother-to-child transmission of HIV; and I Promoting regular hand washing.

Ultimately, the vision outlined in the GAPP is one in which every child is protected against pneu - monia through a healthy environment and access to measures that combat pneumonia.

As part of this vision, the GAPP emphasized the need for global health partners to better coor - dinate in order to achieve a number of goals, including increasing awareness of pneumonia as the leading cause of death among children under age five in developing countries and identifying local champions to support key child pneumonia messages.

Concurrent with the release of the GAPP and in support of its vision, a diverse group of advocacy, academic and service organizations joined forces in 2009 to form the Global Coalition Against Child Pneumonia . Working together, the Coalition launched the first-ever World Pneumonia Day on November 2, 2009 — now observed annually on November 12 — to raise awareness about the disease, promote interventions to protect against, prevent and treat pneumonia as called for in the GAPP, and generate action to combat the world’s leading killer of young children.

fight pneumonia. save a child. 5 The Coalition remains united in efforts to support the achievement of the United Nations’ Millen - nium Development Goal (MDG) 4 of reducing maternal, newborn and child mortality by two-thirds by 2015. In 2010, Coalition member organizations urged their governments to support a World Health Assembly resolution stating that intensified efforts to address the prevention and treatment of pneumonia are vital to reducing child mortality and achieving MDG 4, and requiring countries to report back annually on progress controlling childhood pneumonia. The resolution passed and was adopted by all World Health Organization Member States. Building on that important inter - national achievement, in 2011, Coalition members worked to ensure that governments prioritize funding and urgent action for interventions to protect against, prevent and treat pneumonia by reaching out directly to decision-makers and increasing public awareness. Reducing the burden of the world’s leading child killer will be a major factor in countries’ efforts to achieve the MDGs, and advocates, governments and the public all have a role to play.

“Because of distance and lack of access to health services, I lost three of my children from pneumonia. Now that I know the danger of pneumonia, I will always bring my child to the clinic when I see these signs.”

—Martha Guzee, a 30-year-old mother, Liberia

Mother holding child with pneumonia in Lucknow, India.

6 global coalition against child pneumonia Maganizo Manuelo, a community leader in Salima, Malawi, weighing baby.

COORDINATING STRATEGIES

In 2011, the third year of World Pneumonia Day, advocates worldwide rallied together to achieve the following objectives:

I Amplify the need for a three-pronged approach to protect against, prevent and treat pneu - monia, as outlined in the GAPP, in order to effectively control the disease and save lives;

I Use World Pneumonia Day as a platform for advocates to engage governments and urge the prioritization and full funding of child survival programs, with a particular emphasis on countries with the highest pneumonia disease burden;

I Generate and support international grassroots events designed to reach, educate and as - sist communities in need, with a particular emphasis on the developing world;

I Generate media coverage around Coalition members’ studies that shed light on progress, challenges and opportunities in the fight for pneumonia control;

I Prioritize blogs and social media activity to amplify and deepen the conversation about pneumonia and to inspire action; and

I Engage new voices and faces of pneumonia — from everyday people to well-known celebrities — as campaign messengers.

fight pneumonia. save a child. 7 RESULTS AT A GLANCE

On World Pneumonia Day, individuals and organizations around the globe collaborated to raise awareness about childhood pneumonia and its toll, ad - vocate for action at all levels of government and celebrate progress made in the global fight against the illness.

Advocacy Around the World in 2011

The world map highlights (in blue) countries that held pneumonia advocacy events in the year 2011.

8 global coalition against child pneumonia Snapshot of World Pneumonia Day 2011

Inspiring advocates to drive change worldwide I 62 events held in 29 countries across six continents I 24 local organizations in 14 countries awarded small grants I More than a dozen new organizational members of the Global Coalition Against Child Pneumonia recruited I Governments of at least 11 countries directly targeted by World Pneumonia Day outreach efforts

Spreading the word far and wide I 494 total media placements — including 240 unique news stories — generated in 52 countries I More than 120 blog posts mentioning World Pneumonia Day in the week before November 12 — many as a result of relationships established with more than 75 influential bloggers covering global health, parenting and general interest topics I More than 6,000 new Facebook fans and Twitter followers recruited — achieving more than a 10-fold increase in traffic through World Pneumonia Day social media channels I 2,575 mentions of World Pneumonia Day and 2,082 mentions of the #WPD2011 hashtag on Twitter during the week of World Pneumonia Day

Protecting against, preventing and treating pneumonia I Thousands of children provided with free medical care through events in at least six countries — including Malawi, where the first pneumococcal vaccine was administered thanks to GAVI support I At least four research reports about the status of pneumonia interventions released by Coalition members in coordination with World Pneumonia Day

fight pneumonia. save a child. 9 United Church of Zambia Mumbwa Boys & Girls Brigade display a banner at Nakanjoli Basic School during the commemoration of World Pneumonia Day in Mumbwa district, Zambia.

SUPPORTING TARGETED, LOCAL ADVOCACY EFFORTS THROUGH SMALL GRANTS

The International Vaccine Access Center (IVAC) at Johns Hopkins University partnered with the GAVI Alliance, the Global Alliance for Clean Cookstoves and the Best Shot Foundation to award small grants to organizations in 14 low- to middle-income countries to carry out activities advo - cating for adequate protection, prevention and treatment of childhood pneumonia while com - memorating World Pneumonia Day. In the third year of the program, IVAC received an unprecedented 113 grant applications — more than double the number of applications received in 2010 — and through a rigorous review process, narrowed the field to 24 successful applications.

Highlights from many of the activities undertaken by World Pneumonia Day 2011 Small Grants winners can be found in the following sections of this report. The grantees organized a wide va - riety of creative, targeted events and engaged diverse audiences in their own countries to take action against pneumonia.

10 global coalition against child pneumonia Small Grants Recipients

Bangladesh I Syed Borhan Kabir, Poriprekkhit I Erica Khetran, Save the Children Bangladesh Egypt I Salma Hassan, Global Youth Coalition on HIV/AIDS Egypt Ghana I Chief Austin Obiefuna, Afro Global Alliance Ghana Haiti I Jessy Adrien, Haitian Health Foundation and Haitian Pediatric Society India I Bobby Ramakant, Abhinav Bharat Foundation I Mohuya Chaudhuri, New Delhi Television (NDHT) I Renu Pal, Swaasthya Kenya "Fashion for Pneumonia" participant, I Ambrose Agweyu, KEMRI/Wellcome Trust Research Master Kayima Offor, in Abuja, Nigeria . Programme I Fardhosa Ali Mohamed, Safe Womanhood Organization Liberia I Dr. Olusola Oladeji, Save the Children Liberia/UK Malawi I Debra Howe, Save the Children Malawi I Norman Lufesi and Maziko Matemba, Ministry of Health Malawi Moldova I Dr. Natalia Cebotarenco, Coalition for Rational and Safe Use of Medicine (CoRSUM) Nigeria I Danjuma Abdullahi, Nigeria Supreme Council for Islamic Affairs (NSCIA) I Rosemary Archibong, So-Healthi (Society for Health Enlightenment Initiative) I Ademola Adelekan, University of Ibadan — Health The Mariveles Anti-Pneumonia Squad Promotion and Education Department dancers won 2nd Place overall in the I Ekanem Ekure, Paediatric Association of Nigeria "Fight Against Pneumonia" Dance I Dr. Odiraa Nwankwor, Mexzen Care for Life Foundation Competition in Manila, Philippines. (MCLF) I Chika Offor, Vaccine Network for Disease Control Pakistan I Dr. Rano Mal, Aga Khan Health Service Philippines I Dr. Lulu Bravo, Philippine Foundation for Vaccination Rwanda I Ndererimana Eliane, International Rescue Committee Rwanda Zambia I Joachim Mumba, World Vision Zambia

fight pneumonia. save a child. 11 Minister of Health, Dr. Jean Kalilani (left), is the guest of honor among the crowd of onlookers as two month-old baby Bright Masambo Chisale (in the arms of his mother Janet, center) is about to become the first baby vaccinated at the launch of pneumococcal vaccines in Malawi on World Pneumonia Day.

ENGAGING GOVERNMENTS TO ACHIEVE CHANGE

A major focus of the World Pneumonia Day effort was engaging political leadership to advance efforts to protect against, prevent and treat child pneumonia, particularly in countries with high disease burden. Event highlights include the following:

Pneumococcal Vaccine Introduction Brings New Hope to Malawian Families On World Pneumonia Day, Malawi became the 16th GAVI-eligible country to introduce pneumo - coccal conjugate vaccine (PCV) into its routine immunization program, promising to protect mil - lions of children from pneumococcal pneumonia. This was an instrumental step for the country, where 14 percent of under-five child deaths were due to pneumonia in 2008. The first vaccine was given to a two-month old baby boy at a launch ceremony in Lilongwe, officiated by the Min - ister of Health, Dr. Jean Kalilani.

As part of the effort, journalists from the UK’s Press Association and The Times, Australia’s Chan - nel Ten television and Germany’s Der Tagesspiegel went on a four-day tour, visiting hospitals, medical centers and remote village clinics to deepen the reporters’ understanding about the need and opportunity for disease prevention in the developing world.

12 global coalition against child pneumonia Bangladesh Serves as an Archetype for International Investment Between 1990 and 2010, Bangladesh saw a 66 percent reduction in its under-five child mor - tality rate, thanks to renewed focus on key child health interventions. Over the next few years, this trend will continue with the planned rollout of new vaccines, including pneumococ - cal conjugate vaccine (PCV) in 2013. Pneumo - nia accounted for 16 percent of all deaths in children under age five in Bangladesh in 2008. A larger-than-life World Pneumonia Day lung traveled around Dhaka City to raise awareness about child In Bangladesh, key Members of the British Par - pneumonia. liament (MPs) and the UK All Party Parliamen - tary Group for Global Action Against Childhood Pneumonia joined the GAVI Civil So - ciety Organization (CSO) Constituency and the Bangladesh Rehabilitation Assistance Commit - tee (BRAC) for field visits to observe immu - nization in village health centers outside of Dhaka. The visits provided the international vis - itors with context to help guide Parliamentary decision-making on global health issues and a sense of how international investments in im - munization and childhood disease prevention can have an enormous impact in the develop - ing world. Specifically, the trip allowed the del - A rally through the streets of Dhaka, Bangladesh egation to see health interventions at work and demonstrates the energy behind the fight against experience the direct impact of the UK’s sup - pneumonia. port of the GAVI Alliance. In meeting with the Bangladesh Government, Ministry of Health and NGOs, the UK MPs witnessed the nation’s commitment to improving and expanding Bangladesh’s immunization program and to strengthening the health of the population as a whole.

In addition, the Child Health Research Foun - dation (CHRF) observed its third World Pneu - monia Day by organizing a rally along with awareness campaigns at Dhaka Shishu Hos - pital and Mirzapur Kumudini Women’s Med - ical College & Hospital. The rally drew 400 participants and culminated with a speech in front of the National Parliament House where speakers expressed appreciation for an in - creased focus on pneumonia in Bangladesh.

fight pneumonia. save a child. 13 Advocacy in India Inspires Government Action Advocacy efforts around pneumonia are vital in India, which has more child pneumonia deaths each year than any other country in the world. In 2008, approximately 370,000 Indian children under the age of five died of pneumonia.

For the past five years, the small grant awardee Swaasthya has been implementing a maternal and newborn health initiative in the slums of Malegaon, a small city in the state of Maharash - tra, India. Swaasthya noticed delays in commu - nity members reporting to a health care provider when babies came down with pneumonia. To combat this problem, the group organized a rally featuring storytelling about children’s struggles Mr. Bharat Wagh, Health Officer, Malegaon Municipal with pneumonia. In attendance were 450 people, Corporation, makes announcement of a new government including parents, teachers, children, medical of - initiative for treating pneumonia in Malegaon, India. ficers and community leaders. In response to Swaasthya’s advocacy efforts, a government of - ficial announced a new initiative that would pro - vide pneumonia care 24 hours a day at local hospitals in Malegaon.

Nigeria’s Leaders Prioritize Prevention The First Lady of Cross River State, Mrs. Obioma Liyel-Imoke, is a public health crusader who is profoundly dedicated to reducing child pneu - monia deaths in Nigeria — the country with the highest child pneumonia burden in Africa. She created the Breath of Life health initiative that works within communities to promote pneumo - nia prevention. On World Pneumonia Day, Breath of Life, the First Lady and other digni - taries led an energetic advocacy walk to edu - cate parents about child pneumonia in the local Community members join Nigeria’s First Lady of Cross government area (LGA) of Bekwarra. The Min - River State Mrs. Obioma Liyel-Imoke (not pictured) in an istry of Health, the Ministry of Women's Affairs, advocacy walk to raise awareness about pneumonia. Pfizer Pharmaceuticals and NGOs partnered with Breath of Life to provide free vaccination, screening and treatment for 1,000 children. The success of the effort prompted the government to announce plans to replicate the event in the other 17 LGAs and helped support a broader ef - fort to urge Nigeria’s federal government to in - clude pneumococcal vaccines in the country’s routine immunization schedule.

14 global coalition against child pneumonia In Nigeria’s Oyo State, a small grant awardee from the University of Ibadan — Health Promotion and Education Department organized a full-day workshop for state legislators. The workshop generated political priority for pneumonia prevention and control, and discussion surrounding free pneumonia treatment for children under five years of age and the introduction of the Hib vaccine as promised in 2010. The Oyo State government answered the call for action by prom - ising to introduce free health programs within the month and requiring the Ministry of Health to include pneumonia control in their budget for the following year.

Partnerships in Ghana Promote Public-Private Synergy In Ghana, Afro Global Alliance, Ghana Health Service, Ministry of Women and Children Affairs, Stop TB Partnership Ghana and key members of the media joined forces to host a workshop for 32 traditional leaders, chiefs, queen mothers and community leaders, as well as a two-day train - ing seminar on messaging, prevention and care for 40 Community Health Volunteers (CHVs). In addition, the small grant awardee Afro Global Alliance hosted a celebration and parade in Cape Coast, where government officials appealed to the private sector and international organizations to partner with the government to purchase vaccines and to continue raising awareness about the severe toll of pneumonia.

Pneumonia Knowledge Moves Mali Forward In Mali, Minister of Health Madeleine Ba Diallo demonstrated support for government action on pneumonia by presiding over a public rally outside a community health center in Bamako that drew more than 500 participants and en - gaged youth volunteers from the School of Public Health to spread out across the city, dis - seminating information about the causes of pneumonia. Theatrical performances, a balloon release and a question and answer session helped draw attention to pneumonia as a pub - Mali Minister of Health, Mrs. Madeleine Ba Diallo, lic health priority in a country where more than presides over a public rally to fight pneumonia. 20 percent of mortality in children under five years of age is due to pneumonia.

Pakistan’s Innovative Strategy Sparks Meaningful Change In Pakistan, small grant awardee Aga Khan Health Service worked with civil society organi - zations, hospitals and corporate organizations to host nine seminars and 116 health awareness ses - sions across the country, reaching nearly 6,000 people. In addition, 45,000 text (SMS) messages about pneumonia were delivered, and religious leaders addressed pneumonia from 1,100 reli - gious platforms. In part as a result of these ef - forts, the Prime Minister announced that vaccines against pneumonia will soon be avail - Dr. Bhisham Kotak of the Aga Khan Health Service is able as a part of the routine EPI vaccination interviewed by the media at the "Fight Pneumonia — schedule. The GAVI Alliance has approved fund - Save a Child" seminar in Pakistan. ing for introduction of the pneumococcal conju - gate vaccine (PCV) and Pakistan is expected to roll out the vaccine in 2012.

fight pneumonia. save a child. 15 Participants of the Boat Regatta to “Drown Pneumonia, Rescue a Child” in Cross River State, Nigeria, help raise awareness about pneumonia.

REACHING AND EDUCATING COMMUNITIES IN NEED

On World Pneumonia Day, advocates came together to encourage donors, policymakers, health care professionals and the general public to increase efforts to fight pneumonia. From rallies in the street and house-to-house outreach to media events and panel discussions with political leaders, the 2011 effort engaged new audiences and worked to ensure that child pneumonia was a priority issue in communities around the world.

Advocacy in India Centers on Raising Awareness A fifth of India’s deaths in children under age five were due to pneumonia in 2008. Yet, the coun - try is plagued by low breastfeeding rates, suboptimal immunization coverage and limited access to antibiotics. To remedy these problems, small grant awardee Abhinav Bharat Foundation, an organization committed to helping isolated communities in India voice opinions on health and human rights issues, enlisted young journalists with personal experience or knowledge of pneu - monia in their communities to help raise awareness about the illness. These journalists received media coaching and support to produce multi-lingual materials on pneumonia interventions, in - cluding breastfeeding, nutrition, hand washing, vaccination and quality treatment. More than 100 articles were produced in English, Hindi and Urdu through this “Voices From the Field on Childhood Pneumonia” project.

Save the Children’s Every One Campaign in India mobilized people across four states — Delhi, Bihar, West Bengal and Rajasthan — by organizing and hosting media orientation sessions, health camps, street plays and fun runs. In addition, thousands of woolen caps were distributed to keep newborns warm in 200 villages spread throughout 13 districts, courtesy of Save the Children Netherlands.

16 global coalition against child pneumonia Nigerian Boat Regatta Sets Sail toward Healthier Horizons In Nigeria, small grant awardee So-Healthi hosted a boat regatta to raise awareness about pneumo - nia and the fact that it kills nearly 180,000 Nigerian children each year. The event focused on edu - cating families about prevention and treatment of the illness and drew more than 300 participants. During the event, a medical team examined babies and children for pneumonia, and local govern - ment officials announced that pneumococcal vaccine doses donated by Pfizer were being adminis - tered in their state that day. In addition, traditional birth attendants reported that the activities of So-Healthi had helped them to adopt practices that will help prevent pneumonia in children.

Kenya’s Education Efforts Reach At-Risk Families In Kenya, small grant awardee Safe Womanhood Organization (SWH) held a large-scale pneumo - nia awareness event for Somali and Oromo refugees of Eastleigh residing in Nairobi. These refugees, who often do not speak English or Swahili — the languages of their host country — find it hard to decipher publicly-available infor - mation or to engage with neighboring commu - nities. Thus, SWH designed an event to empower them to engage in intervention meth - ods addressing the high rates of infant mortality within the population. Activities included med - Baby Issa clings pensively to her mother’s back as she waits ical examinations for more than 350 children, for her turn during the medical camp on World Pneumonia community education sessions and formal Day at Eastleigh Health Center in Nairobi, Kenya. workshops for Somali and Oromo health work - ers and journalists.

Another small grant awardee, the Kenya Med - ical Research Institute (KEMRI)/Wellcome Trust Research Programme, hosted six awareness events at hospitals across Kenya. The event, called “I Faced Pneumonia,” focused on former and current patients, caregivers and health care workers. The day’s events culminated in the signing of a petition targeting the Ministers of Health and Finance and requesting increased Children perform song about pneumonia to teach others government investment in interventions known about prevention interventions in Kilifi County, Kenya. to reduce the burden of pneumonia.

In a separate celebration, KEMRI’s Kilifi branch organized an event where the town’s residents participated in song and dance to emphasize the importance of vaccines, good nutrition and a clean environment as essential elements in the fight against pneumonia. Event participants were encouraged to immunize their children against the leading causes of pneumonia and were also offered free, on-site health care services including check-ups, immunization and antibiotic treat - ment. Kenya introduced the pneumococcal conjugate vaccine (PCV) nationwide in early 2011 with support from the GAVI Alliance.

fight pneumonia. save a child. 17 Pneumonia Education Encourages Media to Join the Movement in Bangladesh Small grant awardee Poriprekkhit, an NGO committed to creating positive change in Bangladesh through communication, hosted a media workshop in Dhaka to encourage journalists to speak out in the fight against pneumonia. Forty experienced journalists from leading news organiza - tions participated in the one-day workshop, of whom 12 were selected for pneumonia journalism fellowships. Each fellow was tasked with collecting data, conducting interviews and publishing a story on several aspects of pneumonia.

Students Teach Lifesaving Lessons in Egypt Members of the Egyptian Medical Students’ Association (EMSA) organized a week-long educa - tion campaign targeting parents waiting in the outpatient clinics of 20 university hospitals na - tionwide. Through the effort, 5,000 families were educated about the disease and received informational materials, including a pneumonia coloring book for children.

The Egyptian Pharmaceutical Students’ Federation (EPSF) distributed fliers, brochures, posters and t-shirts to more than 40,000 people. The Alashanek Ya Balady Association for Sustainable Development (AYB-SD) held a festival in Cairo that drew more than 1,000 participants. The fes - tival, aimed at families, included performances from several local bands and activities focused on teaching children to make healthy choices.

FIDEC/FUNCEI exhibit booth provides health care profes - A child in Cairo, Egypt proudly holds his new pneumonia sionals information on pneumonia in Buenos Aires, Argentina. coloring book.

The Ashara Gharby Band performs at the World Community and local leaders learn about the harmful Pneumonia Day Festival at the Gezira Youth Center in effects of indoor smoke during Malawi’s “Smoke Out Cairo, Egypt. Pneumonia” event.

18 global coalition against child pneumonia Fostering Immunization Uptake in Argentina The pneumococcal vaccine was incorporated into the Argentinian national immunization scheme in April 2011, providing a way for infants to receive the vaccine for free beginning in 2012. To highlight this, Fighting Infectious Diseases in Emerging Countries (FIDEC), in collaboration with Fundación Centro de Estudios Infectológicos (FUNCEI), hosted informative lectures for more than 200 health care professionals and educated patients about the benefits of pneumococcal vaccination at several public and health vaccination centers in Pilar, Escobar and Ezeiza.

Malawi Smokes Out Pneumonia Small grant awardee Save the Children Malawi hosted a series of community workshops to teach mothers and local leaders in Rumphi about the risks of indoor smoke, as well as a “Smoke Out Pneu- monia” celebration that drew more than 500 participants with music, dancing, poetry and drama presentations. Indoor air pollution is a leading contributor to child pneumonia and is designated as one of the top five public health threats in developing countries by the World Health Organization. Women and babies, particularly in rural areas, are exposed to high levels of indoor pollution resulting from cooking over open fires and are frequently unaware of the danger. The workshops helped to raise awareness of the links between indoor smoke pollution, pneumonia and infant mortality.

Through these activities in Malawi, 196 women were trained on how to improve indoor air quality by using the Esparanza "rocket" stove. These stoves are being built and installed in 196 house- holds to benefit 289 children under the age of five who will have significantly less smoke and in- door pollution in their environment.

Reaching Families Far and Wide, Cote d'Ivoire Promotes Pneumonia Awareness in Rural Areas In Cote d'Ivoire — a country where one in 10 children will die before their fifth birthday — Stop Tuberculosis Bouake organized an event that drew more than 200 parents, health care workers, counselors and community volunteers with the aim of creating awareness in this rural community around the severity of pneumonia, its prevention and its treatment. The importance of nutrition, breastfeeding and proper hygiene were emphasized.

Case by Case, Madagascar Treats Children and Tackles Pneumonia In Madagascar, Population Services Interna - tional (PSI) kicked off its national pneumonia program on World Pneumonia Day, seeking to increase the appropriate case management of the disease. The program promotes care-seek- ing behavior among parents whose children experience pneumonia symptoms and works to improve the quality of service from providers by training them on integrated management strategies. A puppet show is part of several events organized in Madagascar to raise awareness about pneumonia.

fight pneumonia. save a child. 19 Dr. Ojo conducts a media interview at the Paediatric Association of Nigeria's press conference in Lagos, Nigeria.

ISSUING RESEARCH AND GENERATING MEDIA COVERAGE

Several Coalition partners, including IVAC, Save the Children and the GAVI Alliance, released new research to coincide with World Pneumonia Day and to attract the attention of media and opinion elites. Reports highlighted recent cost-effective advancements in the battle against pneumonia but also underscored the long road ahead to eliminating child pneumonia deaths.

• Pneumonia Progress Report 2011 A report released by IVAC showed that while progress is being made toward immunization targets in the 15 countries with the most child pneumonia deaths, the latest data show that all of these coun - tries have suboptimal levels of protection and treatment interven - tions, including exclusive breastfeeding during the first six months, access to care facilities and treatment with antibiotics.

According to the study, over the course of a year, 10 of the 15 profiled countries have introduced the newest-generation pneumococcal vaccines, have applied or have been approved for introduction sup - port from the GAVI Alliance. However, all countries in which data are available show coverage levels for exclusive breastfeeding during the first six months of life range from only 10 to 60 percent, and for access to care and antibiotic treatment range from merely 5 to 70 percent — all far lower than the GAPP target level of 90 percent.

20 global coalition against child pneumonia • Pakistan’s Lady Health Workers Can Treat Pneumonia at Home In The Lancet , Save the Children published the findings of a study in Pakistan that showed that children treated at home for severe pneumonia by Pakistan’s Lady Health Workers were more likely to recover than children referred to health facilities. The study addresses a barrier to ef - fective treatment for millions of children around the world — the difficulty in accessing quality health services. These findings could lead the way to changing pneumonia treatment guide - lines globally.

“This study adds to the evidence base that frontline health workers can safely and effectively manage illness and prevent child deaths, especially in communities where doctors and health facilities are out of reach for poor families.”

—USAID Administrator Raj Shah

• Cost Effectiveness of Pneumococcal Vaccines in GAVI Countries A paper commissioned by the GAVI Alliance and published in the journal International Health estimated that the pneumococcal vaccines now being introduced in the world’s poorest countries are highly cost-effective for the countries needing vaccination most and have the potential to save the lives of 3 to 4 million children over the next 10 years. The paper high - lighted the fact that in just over one year, GAVI has helped 16 countries introduce pneumo - coccal vaccines into their national immunization programs, a rate of vaccine introduction that is unprecedented.

With data to drive coverage, World Pneumonia Day continued to receive widespread attention from media as the topic gained traction among journalists, government leaders and opinion elites. Over half of the unique news stories written around World Pneumonia Day mentioned one or more of the research reports and data.

In addition, and particularly in developing countries where World Pneumonia Day events took place, journalists told stories that were in-depth and personal and illustrated the link between preventing pneumonia deaths and reaching the 2015 deadline for achieving the MDGs.

Media coverage of World Pneumonia Day and blog posts echoed the call for action by organi - zations and activists around the world. The urgency to scale up interventions radiated through - out news stories, blogs and op-eds focused on World Pneumonia Day.

fight pneumonia. save a child. 21 More than 98% of pneumonia deaths in children occur in developing countries, including Nigeria, Malawi and Bangladesh, despite pneumonia being among the most solvable problems in global health. We have the tools to protect and prevent children from catching pneumonia and to treat those suffering with this illness.

Impact of Pneumonia on Children

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SPOTLIGHT ON NIGERIA

Pneumonia in Nigeria Prevention and Treatment

177,000 children Less than 150 Naira under the age of five died of pneumonia in Nigeria in 2008. (or $0.95 USD) is the typical cost for antibiotics, an effective treatment for most types of serious pneumonia. 56 million estimated episodes of lung infections occur among Nigerian Only 20% of babies children every year. in Nigeria are exclusively breastfed.

We can protect children from pneumonia and other diseases through exclusive breastfeeding during the first 6 months of life.

Global Action Plan for Prevention and Control of Pneumonia (GAPP). World Health Organization and United Nations Children’s Fund, 2009. Countdown to 2015 Decade Report (2000-2010): Taking Stock of Maternal, Newborn and Child Survival. World Health Organization, 2010. Global Alliance for Clean Cookstoves, 2011. Pneumonia Facts: Nigeria. World Pneumonia Day Coalition, 2010.

USING DIGITAL MEDIA TO INSPIRE ACTION

World Pneumonia Day 2011 found new ways to expand the conversation about pneumonia and bring attention to the activities taking place around the globe on November 12. A large emphasis of the campaign was about “going viral,” using a variety of online social networking sites and digital tools that helped introduce conversation threads about World Pneumonia Day and in - spired new supporters to take action. These online vehicles allowed for rich content to be dis - seminated widely and the Coalition’s tools and messages to be shared among diverse audiences.

New tools, such as a compelling infographic, a Prezi presentation illustrating complex research, an animated video conveying the importance of the fight against pneumonia, a “take action” widget making it easy for supporters to send a message to Congress, and a refreshed website, Facebook page and Twitter feed all combined to tell the story in new, visually compelling ways and provided opportunities to share and discuss content and take action.

The Centers for Disease Control and Prevention (CDC) collaborated with ABC News to host a Twitter chat with ABC’s chief health and medical correspondent, Dr. Richard Besser, to discuss pneumonia and other health issues. On November 8, the United Nations Foundation (UNF) and its Shot@Life campaign helped support the Million Moms Challenge Global Baby Shower on Twitter. During an hour-long child health discussion, pneumonia, vaccines and clean cookstove interventions to mitigate the disease were extensively discussed.

22 global coalition against child pneumonia On World Pneumonia Day this year, the Egyptian Medical Students’ Association (EMSA), an organization comprised of dedicated Egyptian medical students and professionals, began a nationwide “Pro - tect Your Child” awareness and vaccina - tion campaign, which aimed to vaccinate high risk children against pneumonia and inform the Egyptian population about the dangers of pneumonia and the risk it poses to their children. EMSA also endeavored to reach out to the larger pneumonia advocacy community in Egypt by establishing the Egyptian Coalition against Child Pneumonia, now the largest pneumonia coalition in Africa and the Middle East. Collaborating with members from this coalition, EMSA conducted a week of successful advocacy activities celebrating World Pneumonia Day (for more information, see p. 18).

In order to further expand the reach of their campaign, EMSA also drew attention to the cause through their Facebook and YouTube pages, where they shared informative videos. In fact, as part of their efforts, EMSA developed an Arabic translation of the World Pneumonia Day video, highlighting how well visual and digital tools communi - cate messages and resonate with broad audiences around the world.

Save the Children U.S. also revamped and pro - moted the Mission Pneumonia online quiz to educate Americans about key issues related to pneumonia and how they can make a differ - ence on behalf of children worldwide.

Prominent blogs including Global Pulse, Tree - Hugger, LilSugar, MTV Act and The Huffington Post Impact were inspired to join the conversa - tion about World Pneumonia Day. All told, more than 120 English language blog posts Johns Hopkins PneumoniaFighters dance through campus bringing awareness to their World Pneumonia about World Pneumonia Day were published Day events in Baltimore, MD. this year.

The results were telling: In the two months leading up to World Pneumonia Day, the campaign’s social networks grew nearly tenfold, the geographic diversity of visitors to the World Pneumonia Day website was measurably higher than in 2010 and the average time spent on the site increased 50 percent. Due to the widespread interest generated throughout social media channels and the library of tools and resources available for organizers, it is no surprise that most visitors to the web - site visited the “Act” page to learn how to get involved in the campaign. In fact, “Act” was the web - site’s most-visited page in the month leading up to November 12. The increased effort in the digital and social media space invited a whole new population of pneumonia fighters to join the effort.

fight pneumonia. save a child. 23 Children perform at World Pneumonia Day Stakeholders Dialogue at National Press Club in Dhaka, Bangladesh.

ENGAGING NEW “FACES OF PNEUMONIA”

Understanding that both celebrities and individuals who have faced pneumonia are incredibly effective messengers, Coalition partners sought to engage new spokespeople to help tell the story in 2011. The spotlight they turned on the issue of childhood pneumonia helped to garner attention and reach new audiences. The following are highlights:

Community Leaders Reach Mothers in Nigeria In Nigeria, Imams, traditional leaders and members of the community learned about pneumonia through a program run by small grant recipient, the Nigerian Supreme Council for Islamic Affairs (NSCIA), and were charged with sharing their knowledge with mothers and children in their communities. The NSCIA activities reached more than 5,000 worshippers and called on the gov - ernment to provide immunization against common causes of childhood pneumonia.

Children Persuade Policymakers to Pursue Pneumonia Prevention in Bangladesh Small grant awardee Save the Children Bangladesh and its partner, the Bangladesh Pediatric As - sociation (BPA), organized a coalition of young pneumonia ambassadors who, with great passion, performed plays, marched in rallies and participated in stakeholder dialogues and other activities to spread messages of pneumonia prevention and federal action. These children were individually selected to be ambassadors because they are survivors of pneumonia or witnessed family members suffering from the illness. The children are committed to raising their voices on behalf of the 25,000 children who die of the disease each year in their country. On World Pneumonia Day, the children implored policymakers to take action and support a pneumonia campaign similar to the country’s recent polio eradication campaign and to work toward accessible health care for every child.

24 global coalition against child pneumonia Celebrities Increase Issue Visibility to Help Save Lives Save the Children’s Every One campaign ambassador and Bollywood star Shabana Azmi called on governments both in the developed and developing worlds to do more to stop 1.5 million children from dying every year from pneumonia. She emphasized her support of health workers in addressing pneumonia, tweeting messages about the cam - paign to more than 100,000 Twitter followers.

Academy Award-winning actress and Global Ambassador of the

Julia Roberts Global Alliance for Clean Cookstoves, Julia Roberts, issued a state - Academy Award-winning ment in recognition of World Pneumonia Day to raise awareness actress is about the connection between the use of clean cookstoves and fuels Global Ambassador of the and the prevention of pneumonia in children. Global Alliance for Clean Cookstoves.

“The deployment of clean cookstoves and fuels can significantly reduce worldwide childhood death from pneumonia. Combined with our part - ners’ global efforts to encourage vaccinations and increase basic health and wellness education, the Alliance is playing an important role in re - ducing pneumonia and other preventable deaths among the world’s most vulnerable people.”

—Actress Julia Roberts

Actress Mandy Moore added her voice to the fight in a blog post on The Huffington Post, supporting World Pneumonia Day and efforts to stop the “forgotten killer.” In her blog post, she urged Congress to continue investing in lifesaving global health solutions.

In Nepal, the nationally acclaimed band Ku - tumba lent their support to the Every One campaign, raising awareness about the dan - gers of pneumonia. The group played concerts EVERY ONE campaign in Nepal went musical with popu - in three cities, with a total audience of more lar Nepali folk instrumental band Kutumba performing their brand of typical Nepali folk tunes and messages of than 14,000 people. newborn and child survival.

fight pneumonia. save a child. 25 Child treated for pneumonia at the Embu Provincial General Hospital visits the "I Faced Pneumonia!" event.

THE CONTINUED FIGHT AGAINST PNEUMONIA

In just three years, World Pneumonia Day has earned international recognition among health leaders, medical professionals, journalists, activists and community leaders as the day for the world to collectively raise its voice and take action on behalf of the millions of children who die from pneumonia each year. It is a day when the unified voice against pneumonia is louder, stronger and more powerful.

The recent progress in reducing pneumonia deaths demonstrates that when these proven inter - ventions are utilized to the fullest extent, even more lives will be saved and much suffering will be averted. These results reinforce the need to reinvigorate political and social action to educate, inspire and create meaningful change in the countries that need it most.

That’s why in 2012 the Global Coalition Against Childhood Pneumonia will continue to focus on motivating action year round — from opinion leader involvement and social media conversation to government commitment and parent education — to advance the global fight against pneumonia.

26 global coalition against child pneumonia BY COMBINING VOICES, RESOURCES AND NETWORKS, PWE BERLIEVEI WOE CAN RMAKEI PNTEUMOY NIA A FROM THE U.S. TO UGANDA AND INCREASE GLOBAL ACTION ON IMPROVING CHILD SURVIVAL AND

A woman and her infant in Mexico. HEALTH OVERALL. GLOBAL COALITION AGAINST CHILD PNEUMONIA

I Action for Humane Hospitals/Action pour I Episcopal Relief and Development

l'Humanisation des Hôpitaux I ERCON Series

I Africa Fighting Malaria I Every Child By Two (ECBT)

I Africa Health Research Organization I Fighting Infectious Diseases in Emerging Countries

I Alternative Sante (FIDEC)

I American Academy of Pediatrics I La Fundacion del Centro de Estudios

I American India Foundation Infectologicos (FUNCEI)

I American Jewish Joint Distribution I GAVI Alliance

Committee (JDC) I GiveVaccines.org

I American Tamil Medical Association I Global Action for Children (GAC)

I Americares I Global Alliance for Clean Cookstoves

I Antibiotic Consensus Society of Uganda I Global Health Council

I Arab Pediatric Infectious Disease Society I Global Health Strategies

I Astitva Welfare Society I Global Healthcare Information Network

I Asian Strategic Alliance for Pneumococcal Disease I Global Science Academy (GSA), India

Prevention (ASAP) I Haffkine Institute, Mumbai, India

I Barcelona Centre for International Health Research I Hasaan Foundation

(CRESIB, Hospital Clinic- I Health and Sustainable Development Universitat de Barcelona) Association of Nigeria (HESDAN)

I Best for Babes I Health N Rights Education Programme (HREP)

I Best Shot Foundation I Hedge Funds vs. Malaria and Pneumonia

I Boston University School of Public Health Center for I Hong Kong Pediatric Society

International Health and I Immunization Action Coalition

Development (CIHD) I Indian Academy of Pediatrics,

I California Immunization Coalition (CIC) West Bengal Branch

I CARE I Infectious Diseases Association

I Center for Vaccine Development - Mali (CVD-Mali) I Institute of Child Health, India

I Centre National d'Appui a la lutte contre de Maladie I International Pediatric Association (IPA)

(CNAM) I International Rescue Committee (IRC)

I Centers for Disease Control and Prevention (CDC) I International Society for Tropical Pediatrics (ITSP) -

I Center for Health, Education, and Development Philippines

Communication I International Society of Tropical Pediatrics - Thailand

I Children's Hospital No. 1 Chapter

I Chinese Society of Pediatric Pulmonology I International Union Against Tuberculosis and Lung

I Christian Medical College - Vellore, India Disease (The Union)

I Citizen News Service (CNS) I International Vaccine Access Center (IVAC) at Johns

I Columbia University Mailman School of Public Health Hopkins Bloomberg School of Public Health

I Croatian Center for Global Health I International Vaccine Institute

I CSI Hospital Bangalore I John Snow Inc. (JSI)

I Destinee Charity Foundation I Johns Hopkins Bloomberg School of

I The Earth Institute, Columbia University Public Health

I Egyptian Medical Students Association (EMSA) I Jordan University Hospital (JUH)

I EmergingMarketsGroup, Ltd. (EMG) I Jordan University Medical School, Division of Pediatric

I Epidemiological Laboratory (Epi-Lab) Infectious Disease

28 global coalition against child pneumonia World Pneumonia Day is led by a committed and diverse group of NGOs, communitybased or - ganizations, academic institutions, government agencies and foundations working together as the Global Coalition Against Child Pneumonia. Now more than 140 organizational members strong with representation on five continents, the Coalition uses World Pneumonia Day as the primary annual rallying point around its mission: to raise awareness about pneumonia and to advocate for global action to protect against, prevent and treat the disease, which kills more young children than any other illness. For more information on the Coalition and its work, please visit www.worldpneumoniaday.org

I Kageno Worldwide, Inc. I Philippines Foundation for Vaccination (PFV)

I KidBitz I Pneumococcal Awareness Council of

I Kolpin Society of Nigeria Experts (PACE)

I Laboratory for Public Health Research Biotechnology I Polk County Health Department

(LAPHER Biotech) I Population Services International (PSI)

I Living Safely I Project HOPE

I The MacDella Cooper Foundation (MCF) I The Rollins School of Public Health (RSPH) at Emory

I MACS Initiative (Monitoring and Accelerate Child University

Survival Initiative) I Sabin Vaccine Institute

I March of Washingtons I Save the Children

I Measles Initiative I SHD Team "Sustainable Health

I Medical Teams International Development Team"

I Meningitis Research Foundation I Shifa International Hospital

I Millennium Villages Project I SIFAT

I Ministry of Health, Malawi - ARI Control Programme I Sociedad de Infectologia de Cordoba

I Ministry of Health - Mali I Southern African Society of Paediatric Infectious

I Ministry of Health - ARI Programme, Mali Disease (SASPID)

I Ministry of Public Health and Population - Yemen I Stop TB and HIV/AIDS - The Gambia

I National Foundation for Infectious Diseases (NFID) I Sustainable Health Development

I National Institutes of Health (NIH) I Taiwan Pediatric Society of Thorax

I National Media Foundation I Task Force for Global Health

I Nepal Paediatric Society I There Is No Limit Foundation

I netSPEAR, Kemri-Wellcome Trust I Tripoli Medical Center, Tripoli, Libya

I The Nigerian School Project I Uganda Pediatric Association

I NYU School of Medicine, Department of Medical I United Nations Children's Fund (UNICEF)

Parasitology I United Nations Foundation

I ONE I University of Edinburgh

I Otunba Tunwase National Paediatric Centre I University of Glasgow

I The Paediatric Association of Nigeria I University of Melbourne, Centre for International

I Pakistan Help Child Health

I Pan African Thoracic Society I US Coalition for Child Survival

I Parents of Kids with Infectious Diseases (PKIDs) I US Fund for UNICEF

I PATH I Vaccines for Africa Initiative (VACFA)

I Pediatric Association of Tanzania I Visiting Nurses Association of SW Florida, Inc.

I Paediatric Infectious Disease Society, Nigeria I Voices for Vaccines

I Paediatrics Association of DRC I Water for Pepole

I The Pediatric Infectious Disease Society of Thailand I Women for Women of Sierra Leone

I The Pediatric Infectious Disease Society of the I Women's Refugee Commission

Phillippines I World Consulting Group, Ltd.

I Pediatric Lung Association I World Vision

I PGIMER School of Public Health I ZGD - Zeus Global Development

I Pneumonia Advocacy and Working Group of Uganda

fight pneumonia. save a child. 29 P“LETR'S COONTINGUE TRO BUEILD SON TS HE MADE THIS YEAR AND REDOUBLE OUR EFFORTS TO ENSURE THAT EVEN MORE CHILDREN STAY ALIVE TO REACH THE NEXT WORLD PNEUMONIA DAY.”

MELINDA GATES, BILL & MELINDA GATES FOUNDATION

www.worldpneumoniaday.org

This report was produced by the International Vaccine Access Center (IVAC) at Johns Hopkins Bloomberg School of Public Health in March 2012 and gratefully acknowledges the contributions of advocates around the world who are working to stop pneumonia and save millions of young lives.

Country statistics on childhood mortality quoted in this document came from Black R, Cousens S, Johnson HL, et al. Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet. 2010; 375: 1969–87.

PHOTO CREDITS: COVER PAGE: Akash/UNICEF/2006. PAGE 2: Kiron/UNICEF/2011. PAGE 4: Matthew Feldman/IVAC/2012. PAGE 6: Nadeem Salmani/Abhinav Bharat Foundation/2011. PAGE 7: PATH/2011. PAGE 10: Yotam Mugala/World Vision, Zambia/2011. PAGE 11: Studio 24/Vaccine Network for Disease Control/2011. Vincent A. Isip/MHO-Mariveles/2011. PAGE 12: PATH/2011. PAGE 13: Belal Hossain/CHRF/2011. Belal Hossain/CHRF/2011. PAGE 14: Hermant Patil/Swaasthya/2011. Breath of Life/2011. PAGE 15: EVERY ONE Campaign – Save the Children/2011. Rizwan Khowaja/Aga Khan Health Service/2011. PAGE 16: Sunny Inah/So-Healthi/2011. PAGE 17: Mike Tambo/2011. Anne Ashitiva/KEMRI/Wellcome Trust Research Pro - gramme/2011. PAGE 18: FIDEC/FUNCEI/2011. Michael Mourad and Eman Wafik/EMSA/2011. AYB-SD/2011. Amos Gumulira/EVERY ONE Campaign – Save the Children/2011. PAGE 19: PSI/Madagascar/2011. PAGE 20: Mr. Dapo/Paediatric Association of Nigeria/2011. PAGE 23: Hector Velasquez/Johns Hopkins Bloomberg School of Public Health/2011. PAGE 24: Save the Children, Bangladesh/2011. PAGE 25: The Oprah Winfrey Network/2011. Arun Gurung/Kutumba/2011. PAGE 26: Ambrose Agweyu/KEMRI/Wellcome Trust Research Programme/2011. PAGE 27: Rick Maiman/Photoshare/2000. IN - SIDE BACK COVER: Siddique/UNICEF/2006.

©2012 International Vaccine Access Center (IVAC) at Johns Hopkins Bloomberg School of Public Health. All rights reserved.

Johns Hopkins Bloomberg School of Public Health International Vaccine Access Center (IVAC) 855 North Wolfe Street • Suite 600 • Baltimore, MD 21205 Email: [email protected] • www.jhsph.edu/IVAC