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The fight against pneumonia in five charts

Pneumonia kills 2,000 children every day worldwide, making it the most common infectious cause of death in children. The introduction of pneumococcal conjugate vaccines (PCVs) has significantly reduced the burden of death and morbidity from pneumonia (and also protects against a cause of meningitis), but millions of children remain unvaccinated.

The Haemophilus influenzae Type B (Hib) and measles vaccines also prevent pneumonia, and although the pertussis vaccine (included in the DTP for diphtheria, tetanus and pertussis) does not directly prevent pneumonia, it reduces the risk of secondary complications.

Although the PCV rollout supported by Gavi since 2009 has saved 1.2 million children by the end of 2023, many children still need access to the vaccine.

1. Progress in reducing deaths from pneumonia in children under five has been slower than for other vaccine-preventable diseases.

Compared to measles, where deaths have fallen to about a sixth of cases in 20 years, deaths from pneumonia have declined much more slowly. Childhood pneumonia deaths are closely linked to malnutrition, lack of safe drinking water and sanitation, indoor and outdoor air pollution, and inadequate access to health care.

2. Yet deaths from pneumonia among children under five have almost halved since 2009

Graphic: One positive result, however, is that the number of deaths from pneumonia under 5 has halved since 2009

Much of this progress is thanks to an innovative mechanism called Advance Market Commitment that Gavi launched in 2009, which effectively created a $1.5 billion fund to support vaccine purchases by vaccine manufacturers guarantee. This would revolutionize access to life-saving pneumococcal vaccines for children in low- and middle-income countries.

3. Vaccinations are critical to saving lives

Infographic: 1.2 million lives saved by 2023

Since Gavi supported the initial rollout of the PCV vaccine in 2009, 438 million children of all ages in 64 countries have been vaccinated with Gavi-supported vaccines, preventing an estimated 1.2 million deaths by the end of 2023. This has resulted in savings. An estimated $33.4 billion in medical costs were averted with Gavi's support.

Many of these children live in the poorest parts of the world, where access to antibiotics and the sometimes necessary hospital care is not easy. For these children, the PCV vaccine could mean the difference between life and death.

In countries where PCV adoption is increasing, health workers are reporting dramatic declines in childhood pneumonia deaths. Kenya introduced PCV into its routine vaccination schedule in 2011 with support from Gavi. By 2019, according to data published in The lancet, There was a 92% reduction in PCV-10 invasive pneumococcal disease in children up to five years of age.

Nigeria followed suit with the introduction of PCV in 2014. That year, nearly 480 children per 100,000 died in Nigeria from pneumonia or other lower respiratory tract infections. By 2019, that number had dropped to 386 per 100,000.

Now fragile countries are introducing PCV into their routine vaccination programs. Chad has just introduced PCV along with rotavirus and malaria vaccines. Next year, Somalia and South Sudan will also introduce PCV with Gavi's support.

4. Gavi-supported countries continue to have higher vaccination rates against pneumococcus, rotavirus, etc Haemophilus influenzae Type b (Hib) than the rest of the world

Chart: Gavi-supported countries continue to have higher vaccination rates against pneumococcus, rotavirus and Haemophilus influenzae type B (Hib) than the rest of the world

Both pneumococcal and Hib vaccines protect against pneumonia. With increasing resistance to strains of bacteria that can cause disease, it is becoming increasingly urgent to ensure that these vaccines reach young children.

5. Pneumococcal vaccination coverage is improving, but needs to be higher

Diagram: The vaccination rate against pneumococci is improving, but still needs to be higher

Tremendous progress has been made since 2009, but more countries need to be able to introduce PCV, and some of the countries that already provide PCV to their populations need more support to reach every child who needs it.

Gavi spent $1.47 billion on its pneumococcal vaccination program between 2021 and 2025, saving an estimated $33.4 billion in medical and death costs.

Between 2026 and 2030, Gavi plans to spend $1 billion on its PCV program, which will continue to save millions of lives. However, this depends on the Vaccine Alliance meeting its replenishment target of $9 billion to fund all of its programs over these five years.