Sounding the alarm about a forgotten epidemic in Nigeria

Worldwide, pneumonia claims the lives of more children than any other infection.

By Siegfried Modola and Susan Markisz

30 January 2020

Every year, pneumonia claims the lives of more than 800,000 children under the age of five worldwide. In Nigeria, the disease was responsible for an estimated 162,000 child deaths in 2018 alone – the highest number in the world.

Pneumonia is easily preventable with access to vaccines, and readily treatable with low-cost antibiotics. Strong primary health care, with access to health workers with the right diagnostic tools and training, is crucial to both preventing and treating pneumonia.

Above, January 2020: Mothers wait to have their children vaccinated at a health clinic in Yola, in northeastern Nigeria.


Children in poor areas are most vulnerable, often suffering from exposure to unsafe water and sanitation facilities, and insufficient access to vaccinations and other affordable life-saving services. Health worker Helen Emmanuel (left) consults with Sarfatu Jaidal after examining her three-year-old daughter Lydia, in Gah, in northeastern Nigeria.


Other risk factors include children with weakened immune systems through infections like HIV or malnutrition. Health worker Grace Felix uses a Mid-Upper Arm Circumference band (MUAC) to examine Mojes Morris, 3, as he sits on his mother's lap in a village near Yola. The device helps to identify malnutrition in children.


In Nigeria, more children under the age of five died from pneumonia in 2018 than from any disease – 443 deaths per day – representing 19 per cent of child deaths in the country. Health worker Daru Jamo examines 19-month-old Karim Dairu, seated in his mother’s lap in their home near Yola for possible health issues.


Pneumonia can be prevented if newborns and children are breastfed early and have access to clean water. A woman breastfeeds her infant as she waits to have him immunized at a health centre in Yola.


Despite progress over the last two decades, children in poor communities have been left behind. Health worker Benjamin Daniels prepares for a home healthcare visit in Jarede, in northeastern Nigeria.


Pneumonia can be properly identified with the right diagnostic tools. Health worker Benjamin Daniels uses a UNICEF/WHO acute respiratory infection diagnostic aid (ARIDA) respiratory timer, to check for possible signs of pneumonia in 9-month-old Ensteen Anex in Jarede. The timer is a counting device used to assist health workers to measure a child’s breathing rate to look for possible signs of pneumonia.


Funding available to tackle pneumonia lags far behind other diseases. Only three per cent of current global infectious disease research spending is allocated to pneumonia, despite the disease causing 15 per cent of deaths in children under the age of five. Health worker Benjamin Daniels checks for possible signs of pneumonia in two-year-old Jexeriel Jeri, seated on his mother Vanity's lap, in the village of Jarede.


This forgotten health epidemic demands a greater response. Pneumonia is easily preventable with vaccines, and readily treatable with low-cost antibiotics. However, in 2018, 71 million children did not receive the recommended three doses of the primary vaccine to prevent pneumonia (PCV). Just 15 countries account for 70 per cent of pneumonia child deaths, which could be prevented with appropriate antibiotic treatment costing just US$0.40. A health care worker prepares a Pneumococcal Conjugate Vaccine (PCV) against pneumonia for an infant seated on his mother’s lap in a health centre in Yola.


Health workers who are trained and equipped to support both prevention and treatment of pneumonia can change the course of the disease and keep every child alive. A health worker examines one-year-old Beatrice in a health centre in Yola.