• The 2000-2010 decade brought a significant reduction in overall child mortality, from 9.6 to 7.6 million. Pneumonia continues to be the number one killer of children around the world-causing 18% of all child mortality, an estimated 1.3 million child deaths in 2011 alone.
• Nearly 99 percent of all pneumonia deaths occur in developing countries, and three-quarters take place in just 15 countries. The majority of pneumonia cases are preventable or treatable.
• Pneumonia is the leading cause of child mortality in India, responsible for the deaths of nearly 400,000 children under five in 2010.
• Percentage of Indian children with suspected pneumonia receiving antibiotics stood at 13 percent in 2010.
• Percentage of under-five Indian children with suspected pneumonia taken to appropriate health-care provider stood at 69 percent in 2010.
• Percentage of children receiving exclusive breastfeeding in first 6 months of life is 46 percent (as per latest available data during 2006-2010).
• Vaccine coverage in the case of DTP3 (third dose of diphtheria and tetanus toxoid and pertussis vaccine) is 72 percent and in the case of measles is 74 percent in 2011.
• India and Nigeria, two large countries with the highest numbers of child deaths worldwide, remain low scorers with an average intervention coverage (interventions in terms of vaccination, breastfeeding, access to care and antibiotic treatment) rate of 55% and 40%, respectively.
• One notable area of progress in India is on coverage of two vaccines that can help prevent pneumonia, Hib vaccine and measles vaccine. While Hib vaccine uptake has been slow in India’s public sector, momentum is now shifting following efforts by the Ministry of Health & Family Welfare (MOHFW), states, health experts and advocates to prioritize implementation of the National Technical Advisory Group on Immunization’s (NTAGI) recommendation to add Hib to the Universal Immunization Programme (UIP).
• Two Indian states, Tamil Nadu and Kerala, introduced Hib vaccines (in the form of the pentavalent vaccine) in December 2011, and six more are slated to do so by the end of 2012. At a recent Hib Symposium in the state of Odisha, MOHFW officials stated that at least twice as many additional states have expressed interest in the vaccine.
• India has joined other WHO Member States in introducing a second dose of measles vaccine into the UIP to ensure its children are protected from the virus, which contributes to the burden of pneumonia. Measles was once one of the leading causes of death in children, but global measles deaths have declined dramatically because of widespread coverage with two doses of measles vaccine. India began a phased introduction of the second dose in 2010; by the end of the first year, the second dose of measles vaccine had been added to routine immunization in 21 states and catch-up campaigns were completed in 197 districts in 14 states.
According to the report titled: Defeating malaria in Asia, the Pacific, Americas, Middle East and Europe, November, 2012, which has been produced by World Health Organization and PATH, http://www.indiaenvironmentportal.org.in/files/file/Defeat
• The Indian Commission on Macroeconomics and Health notes that, in India, 13 household person-days per patient were lost per episode of malaria. Furthermore, the commission estimated that the overall monetary losses to families (income losses together with treatment expenses) could amount to between 200 and 400 Indian rupees (US$ 3.5 to 7).
• With an estimated 22.5 million malaria cases in India, this translates to an annual cost of US$ 79 to 157 million, or 0.01% of gross domestic product each year.
• In states with the highest incidence rates, such as Chhattisgarh, Jharkhand, Meghalaya, Mizoram, and Orissa, the annual cost of illness represents more than 0.1% of a gross state income.
• Tribal populations living in forests in Orissa, India, have incidence rates that are almost 10 times higher than in the plains.
• Odisha is one of the most highly malaria-endemic states in India, accounting for 24% of reported cases in 2010 despite consisting of less of than 4% of the national population. Malaria is particularly common among tribal groups which represent 44% of the population of Orissa.
• A study in Sundargarh District of Odisha showed that forest areas had an annual incidence of 280 cases per 1000 population compared to 30 cases per 1000 on the plains. Approximately 84% of infections in forest areas were due to P. falciparum compared to 69% in plain areas.
• Malaria’s main victims tend to be poorer populations living in rural communities, with limited or no access to long-lasting insecticidal nets (LLINs) and artemisinin-based combination therapies (ACTs).
• WHO estimates that 216 million cases of malaria occurred globally in 2010; 34 million (16%) of these occurred outside of Africa of which 18.1 million (53%) were due to P. falciparum.
• WHO estimates that 655 000 deaths occurred globally, of which 46 000 (7%) occurred outside of Africa. WHO estimates that 2.5 billion people were at risk of malaria outside of Africa.
• There are 98 countries with ongoing transmission of malaria. Of these, 47 lie on the African continent, 21 are in the Americas, and 30 in Europe, Asia, and the Pacific. Of the 98 countries, 81 are in the control phase, 8 in the pre-elimination phase, and 9 in the elimination phase.
• While the disease burden has been declining in countries with fewer malaria cases and deaths, progress has been slower in countries where the bulk of the disease burden lies: India, Indonesia, Myanmar, Pakistan, and Papua New Guinea. These five high-burden countries account for 89% of all malaria cases in the region.
• Malaria transmission occurs in 17 countries of Asia. Approximately 2 billion people in the region live at some risk of malaria, of which 525 million live at high risk (reported incidence more than 1 case per 1000 population per year).
• Most reported cases of malaria in Asia are due to P. falciparum although the proportion varies considerably by country; it exceeds 80% in the Lao People’s Democratic Republic, Myanmar, Timor-Leste, and Viet Nam, while transmission is exclusively due to P. vivax in the Democratic People’s Republic of Korea and the Republic of Korea.
• Insecticide resistance has now been reported in 24 out of 51 countries with malaria transmission outside of Africa.