Global Action Plan for the Prevention and Control of Pneumonia (GAPP)

Project Leaders: Professor Allan Cripps, Pro Vice Chancellor (Health) Griffith University, and Professor Emeritus Bob Douglas AO, Chairman, Australia 21.

Pneumonia is the leading cause of death in the developing world, especially in children under five years of age. Currently at least two million preventable deaths from this cause occur annually. The prevention of death from this cause is a necessary priority for meeting Millennium Development Goal Number 4, which seeks by 2015 to reduce by 67% the 1990 global under-5 mortality. A 2007 analysis of progress in meeting this goal showed that at current rates of progress, global under-5 mortality is expected to decline by 27% from 1990 to 2015, substantially less than the 67% goal.

Australia 21 is mobilising Australian expertise on control of pneumonia deaths in the third world. We are able to do so because Australians have been particularly prominent in this endeavour during the past forty years as a result of work initiated in Papua New Guinea in the 1960s.

With support from CSL Biotherapies, Griffith University, AusAID and international vaccine manufacturers Merck Ltd and GSK, Australia 21 has in the past 12 months developed an initiative aimed at strengthening the Global Action Plan on Pneumonia Prevention through newly available technology and strengthening of health systems in Indonesia and Papua New Guinea.

In September 2008, Australia21 hosted an initial meeting of experts from Australia, New Zealand and Papua New Guinea to consider the application of currently available pneumococcal vaccines to the achievement of the Millennium Development Goal No. 4. Particular attention in this discussion was paid to the role which new and older pneumococcal vaccines could now play in the global effort.

Following that meeting, Australia 21 appointed an advisory group led by Professor Alan Cripps, Pro Vice Chancellor (Health), Griffith University to develop the Australia 21 initiative further. This group agreed that an appropriate next step would involve bringing researchers and administrators from

Indonesia and Papua New Guinea, to link with Australian scientists who have been working on pneumonia in Aboriginal children and in other developing countries.

Accordingly, a Tri-Nation symposium on childhood pneumonia was held in Sydney in July 2009.  This was attended by forty-three senior ministry delegates, company representatives and researchers from Indonesia, Papua New Guinea and Australia and from international and donor agencies. The day and a half of dialogue was captured in a communiqué which is being widely distributed in the three countries.

The group recognized that there is no single “magic bullet” and no single intervention that will lead to immediate prevention and control of preventable pneumonia deaths in the two countries. It recognized that:

- antibiotic treatment of severe disease

- the administration of oxygen to severely ill children

- vaccination using a range of currently available vaccines

- prevention of low birth weight

- reduction of malnutrition and

- indoor air pollution

are part of a constellation of activities which will come about as a result of strengthening health systems in the two countries.

The symposium delegates agreed that continuing high childhood pneumonia death rates should be addressed as a matter of urgent priority and are evidence of the need for health system strengthening. It proposed the development of strategic research to be undertaken in sentinel demonstration areas in Papua New Guinea and Indonesia. Australia 21 is discussing these matters with funding agents in hope that such strategic research activity could be initiated in coming months.