Can innovation help stop children dying from pneumonia?

Pneumonia is the world’s number one cause of preventable death among children under five years old. Every year, pneumonia kills nearly one million children – more than AIDS, malaria and tuberculosis combined. What makes this number of pneumonia deaths so unfathomable is that its cure is well-known, inexpensive and widely available.

Amoxicillin has long been held as a basic, effective antibiotic treatment for bacterial pneumonia, believed to account for 80% of pneumonia deaths among children. Even if children live in places where there is no doctor or clinic, amoxicillin can be obtained through a community health worker. If amoxicillin can cure bacterial pneumonia, why does pneumonia continue to claim so many young lives?

For families who live too far away from or are too poor to access health centres and lab tests, community health workers are their first point of contact – and sometimes the only lifeline – when their children fall sick. Community health worker are not highly trained medical professionals. They are men and women from the same community who often work as volunteers and, equipped with only basic knowledge and rudimentary supplies, provide front line health care.

They often work in places where pneumonia is one among many other endemic diseases. Malaria and pneumonia have very similar symptoms in a sick child. Distinguishing the cause of illness can be very tricky. A mistaken diagnosis can result in mistaken decisions on the treatment. In the case of pneumonia, the numbers tell us that the consequences of such a chain of events contribute to catastrophic consequences for children under five.

But what does a community health worker need to navigate safely to ‘Correct Diagnosis’?

A key answer lies in technology. And making sure that every community health worker has in her or his possession, technology that can help her/him to arrive at a correct diagnosis.

In Mali, Community Health Volunteer Mariam times a baby’s breathing, using a WHO/UNICEF timer. The baby has pneumonia. Mariam has been trained to count a child’s breaths to gauge respiratory distress and identify pneumonia. © UNICEF/NYHQ2010-2382/Asselin

Since the 1990s UNICEF and WHO have been supplying community health workers with a compact, hand-held device called an Acute Respiratory Infection (ARI) timer. The ARI timer looks a lot like a stop watch. It is intended to help count the number of breaths of a sick child within a 60 second count down, measured off by audible ticking. Rapid breathing signals a pneumonia infection.

Unfortunately, the ARI timer can be difficult for a community health worker to use, as it requires manual counting, which even for the most trained health professional is very difficult.

Since the ARI timer was introduced, the technology we have available has far exceeded what most of us could have ever imagined 20 years ago. Yet two decades on, while technology has advanced in leaps and bounds, there are still too many children dying from preventable and treatable diseases.

© UNICEFCAR/2014/TerdjmanA doctor in Ethiopia consults with a young patient and his mother. © UNICEF/ETHA2013_00496/Ose

Could technology help create a user-friendly, child-friendly and more accurate diagnostic device?

For UNICEF, the obvious answer goes much further than resounding “YES”. In a focused product innovation project, we have been collaborating with global health partners, the health technology industry, and with academics and design professionals to conceptualize and envision the possibilities in pneumonia diagnostics.

To mark World Pneumonia Day (today – 12 November), we are inviting innovators in health technology to help save the lives of millions of children from the worlds’ leading cause of preventable death. To do this we have released a Target Product Profile (TPP) to define the functional and performance parameters to radically improve the detection of pneumonia in young children.

Our goal is to work with innovators to provide community health workers with a device that will enable them to make a correct pneumonia diagnosis.

The TPP is an important step in reaching out to the experts in the field to join hands in harnessing technology and innovation to improve lives. If you have the interest and capabilities to develop a product living up to what the TPP outlines, we wants to hear from you. Please contact me at: kgandrupmaino [at]

Read more about UNICEF’s innovation work on Acute Respiratory Infection timer here.

To know more about how Malaria Consortium is identifying the most accurate and user-friendly tool for diagnosis of pneumonia symptoms by community health workers, visit their Pneumonia Diagnostics project page.

See the latest Target Product Profile here.

Kristoffer Gandrup-Marino is the Chief of Innovation at UNICEF’s Supply Division.

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