 Pneumonia: Little progress on a big killerAcute respiratory infections (ARI), mainly pneumonia, kill more than 2 million children each year. Yet many countries are only beginning to take steps to reduce the devastating but largely preventable toll. Many ARI deaths could be averted if families knew pneumonia's danger signs, if health workers were trained to diagnose and treat pneumonia, and if clinics stocked life-saving antibiotics. Since 1992, however, only 16 countries have undertaken surveys of clinics to determine health workers' training and the availability of basic antibiotics. And only 23 countries have completed household surveys to gauge families' awareness of danger signs.In 10 of the countries that surveyed clinics, fewer than half of health workers are trained in pneumonia case management. In several countries, such as Colombia, the Dominican Republic, Indonesia, Malaysia, Thailand and Zimbabwe, a high percentage of clinics stocked antibiotics, but a much lower percentage of health workers were trained to treat pneumonia. Pakistan and Papua New Guinea had low rates for both antibiotics and training. Among countries with household surveys, only in Egypt do more than half of caretakers know when to seek treatment. But there is good news from the world's two most populous countries: China has trained 88% of health workers in standard case management of ARI, and India is a close second at 87%. Nearly all clinics surveyed in both countries stock necessary antibiotics. At the beginning of this decade, few countries had programmes to reduce
mortality from pneumonia. Of 88 countries where pneumonia is thought to
be common, 59 have now started control programmes, and household surveys
are being carried out in 60 countries.
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