IN NIGERIA - World Pneumonia Day

2011FIGHT PNEUMONIAFINAL REPORT SMALL GRANTS PROGRAMIN NIGERIA

INTRODUCTIONPneumonia is the leading cause of death in children under five around the world, taking the lifeof one child every 23 seconds. But until recently, pneumonia has received little of the attentionit deserves.In 2009, WHO and UNICEF released the Global Action Plan for the Prevention and Control ofPneumonia (GAPP) showing that pneumonia deaths could be reduced by two-thirds if existinginterventions to protect against, prevent, and treat pneumonia could be scaled up to reach 90percent of the world’s children. Targets set by GAPP now provide measures for trackingprogress in pneumonia control.Motivated by GAPP, a diverse group of organizations formed the Global Coalition Against ChildPneumonia. Working together, the Coalition launched the first World Pneumonia Day (WPD)in 2009, to raise awareness and generate action to reduce child mortality from pneumonia. TheInternational Vaccine Access Center (IVAC) then partnered with the GAVI Alliance, GlobalAlliance for Clean Cookstoves, and Best Shot Foundation to create the Small Grants Programto fund a wide variety of events around the world for WPD.This report focuses on the WPD 2011 activities in Nigeria, the country with the second highestburden of childhood mortality from pneumonia, after India. Although Nigeria lags behind inkey GAPP and child mortality indicators, progress in combatting pneumonia has begun underthe leadership of the Nigerian government, and with the support of a host of dedicated partners.Increasing coverage of routine vaccines and introducing new vaccines against the two leadingcauses of fatal pneumonia — Haemophilus influenzae type b (Hib) and pneumococcus — are highpriorities for Nigeria. But vaccination is not the only strategy for pneumonia control‚ interventionsto increase breastfeeding rates, reduce exposure to indoor smoke, and improve access totreatment must also be implemented to truly succeed in this fight.For Nigeria’s WPD 2011 celebration, small grants were awarded to six organizations for a totalof 14 events, which reached over 20,000 people. Events targeted a group of diverse stakeholders,including politicians, health care professionals, religious and community leaders, and thousandsof families. Harnessing the power of local organizations is the best way to excite widespread,grassroots support, crucial for the sustained change needed to address pneumonia. Severalother organizations, some of which are previous grantees, also joined in by hosting their ownWPD activities — evidence of the catalytic nature of the Small Grants Program.With pneumonia as the second leading cause of under 5 deaths in Nigeria, accelerating uptakeof proven interventions for pneumonia control is urgently needed to propel the country’s marchtowards the United Nation’s Millennium Development Goal (MDG) 4: reduce child mortality bytwo-thirds by 2015.

TABLE OF CONTENTS• Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2• Pneumonia: The Forgotten Killer . . . . . . . . . . . . . . . . . . . . . 4• Uniting Against Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . 5• Pneumonia in Nigeria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6• About the Small Grants Program . . . . . . . . . . . . . . . . . . . . 7• Grantee SpotlightsNigeria Supreme Council for Islamic Affairs . . . . . . . . . . . 8So-Healthi . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9University of Ibadan —Health Promotion and Education Dept. . . . . . . . . . . 10Paediatric Association of Nigeria . . . . . . . . . . . . . . . . . . . . 11Vaccine Network for Disease Control . . . . . . . . . . . . . . . . 12Mexzen Care for Life Foundation . . . . . . . . . . . . . . . . . . . 13• Non-Grantee SpotlightsBreath of Life . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14Village Health Relief Initiative . . . . . . . . . . . . . . . . . . . . . . 14National Primary Healthcare DevelopmentAgency and Pfizer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15• Summary of World Pneumonia Day 2011Events in Nigeria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16• Snapshots of Events Around the World . . . . . . . . . . . . . . 17• Looking Forward . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18• IVAC’s Efforts in Nigeria . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19• Global Coalition Against Pneumonia. . . . . . . . . . . . . . . . . 20TOP: Commercial motorcyclists (okada) participating in the pneumonia advocacy and sensitization campaign at the World PneumoniaDay event in Cross River State, Nigeria. MIDDLE: A participating doctor is interviewed by the press after the pneumonia advocacyevent at the Department of Paediatrics, Lagos University Teaching Hospital, Lagos, Nigeria. BOTTOM: Fashion Showparticipant waves as he walks across the stage, Abuja, Nigeria.

PNEUMONIA: THE FORGOTTEN KILLERPneumonia is the world’s leading killer of children under five, taking the life of one child every23 seconds — more than HIV/AIDS, malaria, and measles combined. In 2010, nearly 1.4 millionchildren under five died from pneumonia. It is often referred to as the “forgotten killer” becausehistorically it has received little attention despite its importance. In the last decade, global healthleaders have worked to turn the tide on pneumonia, and in doing so created a global movementto save children’s lives through annual recognition of World Pneumonia Day.In 2009, WHO and UNICEF released the Global Action Plan for the Prevention and Control ofPneumonia (GAPP) showing that pneumonia deaths could be reduced by two-thirds if existinginterventions to protect against, prevent, and treat pneumonia could be scaled up to reach 90percent of the world’s children. These interventions include:■■■Ensuring effective case management and treatment at thecommunity levelBreastfeeding exclusively for the first six months of life andproviding zinc supplementationReducing indoor air pollution■■Immunizations with vaccines against Hib, pneumococcus,measles and pertussisPreventing mother-to-child transmission of HIV■Promoting regular hand washingINTERVENTIONS TO PREVENT PNEUMONIA EXIST — THE CHALLENGEIS DELIVERING THEM TO CHILDREN WHO NEED THEM. OVERCOMINGTHESE HURDLES WILL SAVE THE LIVES OF MILLIONS OF CHILDREN.—Orin Levine, Ph.D.Executive Director, International Vaccine Access CenterGlobal and national statistics on childhood mortality quoted in this report come from Liu L, Johnson HL, Cousens S, et al. Global regional,and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet 2012; 379: 2151-61.Recommendations for pneumonia control quoted in this report come from the Global Action Plan for Prevention and Control of Pneumonia(GAPP). WHO/UNICEF 2009.4 global coalition against child pneumonia

UNITING AGAINST PNEUMONIAGAPP emphasized the need for global health partners to better coordinate efforts against childhoodpneumonia. In response, a diverse group of advocacy, academic, and service organizationsjoined forces in 2009 to form the Global Coalition Against Child Pneumonia. Working together,the Coalition launched the first-ever World Pneumonia Day on November 2, 2009 — now observedannually on November 12 — to raise awareness about the disease, promote interventionsto protect against, prevent, and treat pneumonia, and generate action to combat the world’sleading killer of young children.The Coalition remains united in efforts to support the achievement of the United Nations’ MillenniumDevelopment Goal (MDG) 4 of reducing child mortality by two-thirds by 2015. In 2010,Coalition member organizations urged their governments to support a World Health AssemblyResolution stating that intensified efforts to address the prevention and treatment of pneumoniaare vital to reducing child mortality and achieving MDG 4, and requiring countries to report annuallyon progress controlling childhood pneumonia. The resolution was adopted by all WorldHealth Organization Member States.Reducing the burden of the world’s leading child killer will be a major factor in countries’ effortsto achieve the MDGs, and advocates, governments, and the public all have a role to play.LEFT: Her Excellency, Mrs Obioma Liyel-Imoke with other dignitaries leading in pneumonia advocacy walk. RIGHT: Her Excellency, Mrs Obioma Liyel-Imoke, Wife ofthe Cross River State Governor lending her voice to raise awareness about pneumonia at the event.PROVISION OF IMMUNIZATIONS AND OTHER HEALTH SERVICES IS ABASIC HUMAN RIGHT THAT EVERY CHILD DESERVES.—Dr. Mohammad Pate, Minister of State for Health, NigeriaFight Pneumonia In Nigeria 5

PNEUMONIA IN NIGERIAAccording to recent WHO estimates, 868,000 children under the age of five years died in Nigeriain 2010. Pneumonia is the second leading cause of death in this age group, killing more than140,000 children each year. As a result of a high child mortality rate and a large population,Nigeria is second only to India in the total number of childhood deaths. Considering Nigeria’swealth of human and natural resources, access to health services are generally low and coveragerates for interventions that protect against, prevent, and treat pneumonia are lower than manyother countries in the region.Despite the burden of disease, Nigeria has made extraordinaryprogress in improving access to vaccination in recentyears. Coverage for all vaccines increased substantiallyover the 2000-2010 decade. According toWHO/UNICEF estimates, DTP3 coverage more thandoubled from 29% to 69% during this time period.In late 2011, Nigeria conducted an important masscampaign to deliver a new meningitis vaccine. InJune 2012, Nigeria introduced the pentavalentvaccine, which protects against Hib, pneumoniaand meningitis, along with four other childhooddiseases. Efforts to eradicate polio are at an alltimehigh as the country fights to escape being oneof the three polio endemic countries in the world.Causes of Death in ChildrenUnder 5 Years in Nigeria, 2010MALARIA20%PNEUMONIA14%OTHERDISORDERS15%NEONATALCAUSES30%Nigeria has a major opportunity to reduce child mortalityfrom pneumonia by rolling out new vaccines,closing gaps in vaccination coverage, and increasing accessto prevention and treatment services. Advocacy throughthe Small Grants Program is one way to kick start these efforts.DIARRHOEA10%MEASLES 1%INJURY 3%MENINGITIS 3%AIDS 4%Gaps in Coverage of Pneumonia ControlInterventions in Nigeria1009080TARGET INTERVENTION COVERAGE AS RECOMMENDED BY GAPPGAP BETWEEN CURRENT COVERAGEAND RECOMMENDED COVERAGE.70CURRENT INTERVENTION COVERAGE.PERCENTAGE6050403020Pneumonia interventioncoverage statistics come fromInternational Vaccine AccessCenter. Pneumonia ProgressReport 2011.100MEASLESVACCINECOVERAGE(2010)PERTUSSISVACCINE(DTP3)COVERAGE 2010% CHILDREN WITHSUSPECTEDPNEUMONIATAKEN TOHEALTH FACILITY% CHILDREN WITHSUSPECTEDPNEUMONIARECEIVINGANTIBIOTICS% CHILDRENEXCLUSIVELYBREASTFED INFIRST 6 MONTHSNational immunizationcoverage statistics quotedin this report come fromWHO/UNICEF estimatesof national immunizationcoverage.6 global coalition against child pneumonia

ABOUT THE SMALL GRANTS PROGRAMWorld Pneumonia Day 2011 — The International Vaccine Access Center (IVAC), GAVI Alliance, GlobalAlliance for Clean Cookstoves, and Best Shot Foundation funded local advocacy activities in 14 developingcountries to advocate for pneumonia control through prevention, protection, and treatment.Small grants were awarded to 14 organizations, 6 of which are located in Nigeria.Objectives:■ Amplify the need for a three-pronged approach to protect against, prevent and treat pneumonia,as outlined in the GAPP, in order to effectively control the disease and save lives.■ Use World Pneumonia Day as a platform for advocates to engage governments and urgethe prioritization and full funding of child survival programs, with a particular emphasis oncountries with the highest pneumonia disease burden.■ Generate and support international grassroots events designed to reach, educate and assistcommunities in need, with a particular emphasis on the developing world.■ Generate media coverage around Coalition members’ studies that shed light on progress,challenges and opportunities in the fight for pneumonia control.■ Prioritize blogs and social media activity to amplify and deepen the conversation aboutpneumonia and to inspire action.■ Engage new voices and faces of pneumonia — from everyday people to well-knowncelebrities — as campaign messengers.Diverse advocacy activities were undertaken in Nigeria, including petitions to government to increasefunding and introduce new vaccines, grassroots community education and awarenesscampaigns, and provision of free immunizations and other health services.Grantees were chosen through a competitive process by a panel of experts. A total of 113applications were submitted, 21 of which were from Nigeria. Small grants were awarded to 14organizations, including 6 in Nigeria, for their innovation, ability to reach vulnerable populations,targeting of key stakeholders, and leveraging of other funds.Small Grants Recipients: Nigeria■ Danjuma Abdullahi, Nigeria Supreme Council for Islamic Affairs, Abuja■ Rosemary Archibong, So-Healthi, Calabar■ Ademola Adelekan, University of Ibadan —Health Promotion and Education Department, Ibadan■ Ekanem Ekure, Paediatric Association of Nigeria, Lagos■ Chika Offor, Vaccine Network for Disease Control, Lagos■ Dr. Odiraa Nwankwor, Mexzen Care for Life Foundation, AbujaNIGERIAN ADVOCATES ARE BRINGING PNEUMONIA TO THE ATTENTIONOF FAMILIES, HEALTH PROFESSIONALS, AND POLITICIANS – THIS IS FIRSTSTEP TOWARDS ENSURING THAT EVERYONE HAS ACCESS TO SERVICESTO PROTECT AGAINST, PREVENT, AND TREAT THE DISEASE.—Lois Privor-Dumm, MIBS, Director of Alliances & Information, IVACFight Pneumonia In Nigeria 7

SMALL GRANTS PROGRAM — SPOTLIGHTSNigeria Supreme Council for Islamic AffairsAbuja, NigeriaCreating Awareness on Childhood PneumoniaThe Nigerian Supreme Council for Islamic Affairs (NSCIA) sought to use WPD 2011 to gain supportfor pneumonia advocacy from religious leaders and spread pneumonia messages as widelyas possible.In one of the first major efforts to include religious leaders in pneumonia control, NSCIA organizedlectures at mosques throughout Abuja to teach both leaders and community membersabout pneumonia prevention and treatment.Sermons were delivered at six mosques around Abuja, and worshippers were asked to bring themessages home to their families and communities. Radio jingles about pneumonia were broadcastto surrounding states on Aso Radio (FM 93.5).NSCIA also called on the Nigerian Government to provide immunizations against commoncauses of childhood pneumonia. In response, the Federal Capital Territory (FCT) Primary HealthCare Board indicated interest in collaborating with NSCIA in the fight against pneumonia in ruralcommunities of FCT. In addition, the Health Human Services Secretariat promised to make vaccinesmore widely available in this area.Highlights:■ Over 18,050 people were reached by NSCIA World Pneumonia Day 2011 messages.■ 3,500 information, education, and communication materials were distributed.■ Religious leaders at six mosques committed to creating awareness of pneumonia.■ Radio jingles with pneumonia information were broadcast to 18 states.■ Connections between NSCIA and the government were built for the purpose of raisingawareness of pneumonia and increasing immunization coverage.LEFT: Worshippers from the six Area Councils listen to a lecture on pneumonia. RIGHT: Dr. Saddiq Abdulrahman of Health and Human Services Secretariat lectureson pneumonia.8 global coalition against child pneumonia

SPOTLIGHTS — CONTINUEDSo-HealthiCalabar, NigeriaDrown Pneumonia, Rescue a ChildThe primary goal of So-Healthi’s (Society for Health Enlightenment Initiative) WPD 2011 projectwas to train traditional birth attendants, mothers, and community leaders in pneumonia preventionmethods.For their main event, So-Healthi hosted a boat regatta to gain publicity for pneumonia messages.Over 300 people attended, including children, pregnant women, nursing mothers, traditional birthattendants, nurses, pharmacists, doctors, community leaders, and government officials. To reachthose who did not attend the boat regatta, So-Healthi teams visited six nearby villages to deliverinformation on the dangers of indoor smoke and other ways to protect against pneumonia.Training sessions on pneumonia prevention and treatment were held at the boat regatta for 45traditional birth attendants (TBA) from ten local government wards. A local medical team wasalso present at the regatta to conduct pneumonia screenings for children, and two children werediagnosed and treated for pneumonia.Visits to the Chairman of the Bakassi Local Government Council also proved fruitful. Governmentofficials announced that free doses of pneumococcal conjugate vaccine were being administeredat local clinics that day. And the wife of the Chairman of the Bakassi Local Government expressedher satisfaction about the rally and requested further collaboration on health care programswith So-Healthi.Highlights:■ 300 people attended the So-Healthi WPD 2011 Boat Regatta.■ 45 TBAs from 10 government local wards were trained in pneumonia prevention and treatment.■ Sensitization events were held in six rural villages, reaching hundreds of people.■ Future collaborations for pneumonia prevention activities were planned betweenSo-Healthi, government, and the community.Young men compete in a boat regatta to raise awareness of pneumonia.Fight Pneumonia In Nigeria 9

SPOTLIGHTS — CONTINUEDUniversity of Ibadan - Health Promotion and Education DepartmentIbadan, NigeriaGenerating Political Will for Pneumonia Control ProjectThe University of Ibadan leveraged WPD 2011 to generate political will among Oyo State legislatorsfor introduction of the Hib vaccine and provision of free pneumonia treatment for childrenunder five years of age.The university’s activities began with a workshop to provide key policymakers with evidencedemonstrating the need for pneumonia control, as well as information on the human, material,and financial resources necessary to launch these programs.Student rallies were also organized to bring attention to pneumonia issues outside the Ministryof Health and State Legislature’s House Committee on Health. Five members of the House Committeejoined the rally.In response to university’s call to action, government officials promised to begin free health programsfor children under five. Introduction of Hib vaccine was projected for the coming year.The Chairman of the House Committee on Health also promised to ensure that adequate fundingis set aside for pneumonia control in 2012 Appropriation Bill.Highlights:■ Influential state legislators were reached with key pneumonia messages.■ Students and other community members made their voices heard to legislators.■ Government officials projected introduction of the Hib vaccine for 2012.■ Government officials promised to increase funding for pneumonia control programs forchildren under five.Oyo State House of Assembly Members including the Hon. Speaker of the House during the pneumonia workshop.10 global coalition against child pneumonia

SPOTLIGHTS — CONTINUEDPaediatric Association of NigeriaLagos, NigeriaPress Conference to Herald the World Pneumonia Day CelebrationThe Paediatric Association of Nigeria (PAN) held a press conference on World Pneumonia Day2011 to raise awareness about the severity of childhood pneumonia in the country. More than50 people attended the session, which featured a documentary about the challenges of pneumoniafor a typical Nigerian family. Present were ten different national television and newspapermedia organizations as well as doctors, nurses, and medical students.The documentary also aired the weekend following World Pneumonia Day on the NationalTelevision Authority (NTA), a channel with over 90 million viewers.During the National Pneumococcal Summit, Dr. Ekarem Ekure, Secretary of PAN, took the opportunityto call upon the federal government to include the pneumococcal conjugate vaccineinto routine immunization schedules in Nigeria.Highlights:■ Documentary on pneumonia issues was featured on national television.■ A press conference delivered pneumonia messages to ten different media outlets.■ A petition was made to the federal government during the National PneumococcalSummit to introduce the pneumococcal vaccine.Press conference with Dr. Temiye, Acting Head of Paediatrics, Lagos University Teaching Hospital, Lagos, Nigeria.Fight Pneumonia In Nigeria 11

SPOTLIGHTS — CONTINUEDVaccine Network for Disease ControlAbuja, NigeriaFashion for PneumoniaThe Vaccine Network for DiseaseControl organized a festival tocelebrate WPD 2011 and raisethe profile of pneumonia anddisseminate information aboutdisease prevention, recognition,and treatment. Events served asa platform to advocate for theintroduction and free provisionof the pneumococcal conjugatevaccine for children under fiveyears of age.The day’s activities were varied, ranging from educational presentations by experts to "edutainment"performances by children. Pediatricians presented papers on pneumonia and held question and answersessions for adults and children. Complementarily, children from one orphanage and two localAbuja schools performed a pneumonia-themed fashion show, dance competition and play.Highlights:■ A total of 230 parents, children, journalists, policy makers and potential sponsors learnedabout pneumonia.■ Pneumonia messages were converted into a variety of forms, such as theater and dance.TOP: Students ask questions about pneumonia after the performance, Abuja, Nigeria. BOTTOM: Children perform a play about pneumonia prevention.12 global coalition against child pneumonia

SPOTLIGHTS — CONTINUEDMexzen Care for Life FoundationLagos, NigeriaOne Last Case of Childhood Pneumonia in NigeriaFor WPD 2011, The Mexzen Care for LifeFoundation reached out to parents,health care workers, and policy makersin Lagos through a public awarenesslecture and theatrical performanceabout how to recognize pneumoniasymptoms and seek health care.Mothers who attended the events wereadministered a pre- and post-test, assessingunderstanding of importantpneumonic topics. The tests showed the mothers’ knowledge improved as a result of the activities.Both the lecture and performance emphasized the need for increased political will from policymakers at all levels of government, especially in regards to the availability of vaccines and otheraspects of pneumonia prevention.Highlights:■ Mothers participating in the event had improved understanding of pneumonia.■ The event received media coverage from a major national daily newspaper.■ The Medical Officer of the Isolo Local Government agreed to prioritize procurement ofvaccines for pneumonia prevention once made available by the state.TOP: The Flaming Fire Drama Ministry performs skit on recognizing the symptoms of pneumonia. BOTTOM: Mothers and children who gathered for the WPD events.Fight Pneumonia In Nigeria 13

MORE WORLD PNEUMONIA DAY ACTIVITIES(NOT FUNDED BY THE SMALL GRANTS PROGRAM)Breath of LifeAbuochichie, Bekwarra, Cross River State, NigeriaAwareness MarchBreath of Life (BOL) celebratedWorld Pneumonia Day2011 with an advocacy andsensitization march for pneumoniain Abuochiche, a ruralcommunity. Led by the FirstLady of Cross River State, Mrs.Obioma Liyel-Imoke, participantstook to the streets withsigns and banners to educateparents about pneumonia. Acoalition of partners providedPneumonia advocacy and sensitization walk in Abuochichie, Cross River State.funding for pneumonia preventioneducation, free screening, treatment of sick children, and vaccination for 1,000 childrenunder the age of five years. Mrs. Liyel-Imoke, a previous grantee, is one of the best examplesof the catalytic effects of the WPD small grants. She has continued to hold advocacy eventsby leveraging local resources.Village Health Relief InitiativeLagos, NigeriaAwareness MarchWorld Pneumonia Day parade, Lagos, Nigeria.Village Health Relief Initiativeled an awareness march downthe streets of Lagos, Nigerianeighborhoods to inform residentsabout childhood pneumonia.The public was excitedto learn that there are vaccinesto prevent and drugs to treatpneumonia. After the march,the Director of Village HealthRelief Initiative, Dr. AdegboyegaOderinde, led campaignersto a school to teachstudents about the disease.14 global coalition against child pneumonia

MORE ACTIVITIES…National Primary Healthcare Development Agency and PfizerAbuja, NigeriaThe National Pneumococcal SummitThe National Pneumococcal Summit 2011, themed Fight Pneumonia, Save A Child, wasorganized by the National Primary Healthcare Development Agency and Pfizer as part ofWorld Pneumonia Day commemorations in Nigeria. The Summit aimed to:■■■■■Create awareness about the burden of pneumoniaDevelop partnerships among stakeholders to fight pneumoniaMobilize resources for the fight against pneumoniaChart a road map to prevent, protect, and manage the diseaseElicit political commitment at all levels of governmentParticipants included representatives from the Federal Ministry of Health, National PrimaryHealthcare Development Agency, State Ministries of Health, the press, academia, the PaediatricAssociation of Nigeria, and Pfizer pharmaceuticals.Presentations and discussions covered the need for introduction of PCV, the merits of PCV 10versus PCV 13, and the desire by some states to initiate vaccine procurement for their own needs.NIGERIA HAS THE POWER TO PROTECT EVERY CHILD FROM PNEUMONIAAND OTHER INFECTIOUS DISEASES. LET US STAND TOGETHER ANDMAKE THIS HAPPEN.—Mrs. Obioma Liyel-ImokeWife of the Governor of Cross River StateLEFT: Interview with Guest Speaker, Dr. Ify Anyaoku. RIGHT: Executive Director of the Village Health Relief Initiative teaches students about pneumonia.Fight Pneumonia In Nigeria 15

SUMMARY OF WORLD PNEUMONIA DAY2011 EVENTS IN NIGERIATo mark World Pneumonia Day 2011, the six Small Grants Program recipients hosted 14 events, reachingover 20,000 people across Nigeria. Events were attended by many stakeholders — children,mothers, health professionals, worshippers, religious leaders, community leaders, and politicians —illustrative of the broad partnerships that are crucial to the success of the pneumonia control effort.Although World Pneumonia Day is celebrated on November 12, pneumonia control is a yearlongbattle, requiring constant work to deliver messages and services to people all across Nigeria. Organizationstaking part in WPD 2011 have demonstrated their commitment to this fight. With enthusiasmand creativity, grantees and others carried out an impressive collection of events to takeon pneumonia in their communities. Their contributions, whether small or large, have served ascatalysts for change, propelling the country towards a future where Nigerian children are free fromthe burden of pneumonia.Range of WPD Events Conducted by Grantees in Nigeria■■■■Boat regattaCommunity meetingsFashion showFree medical treatment■■■■LecturesParadesPneumonia screeningsPolitical meetings■■■■Press conferencesRadio showsReligious sermonsTheatrical playsMap of Nigeria showing locations of WPD events in 2011IBADANLAGOSCALABAR16 global coalition against child pneumonia

SNAPSHOT OF EVENTSAROUND THE WORLDThe International Vaccine Access Center (IVAC), GAVI Alliance, Global Alliance for Clean Cookstoves,and Best Shot Foundation funded local advocacy activities in 14 developing countries toadvocate for pneumonia control through protection, prevention, and treatment. Small grantswere awarded to 24 organizations across these countries.Inspiring advocates to drive change worldwide■ 62 events held in 29 countries across six continents■ 24 local organizations in 14 countries awarded small grants■ More than a dozen new organizational members of the Global Coalition Against ChildPneumonia recruited■ Governments of at least 11 countries directly targeted by World Pneumonia Day outreacheffortsSpreading the word far and wide■ 494 total media placements — including 240 unique news stories — generated in 52 countries■ More than 120 blog posts mentioning World Pneumonia Day in the week before November 12— many as a result of relationships established with more than 75 influential bloggerscovering global health, parenting and general interest topics■ More than 6,000 new Facebook fans and Twitter followers recruited — achieving morethan a 10-fold increase over regular traffic through World Pneumonia Day social mediachannels■ 2,575 mentions of World Pneumonia Day and 2,082 mentions of the #WPD2011 hashtag onTwitter during the week of World Pneumonia DayProtecting against, preventing and treating pneumonia■ Thousands of children provided with free medical care through events in at least six countries— including Malawi, where the first pneumococcal vaccine was administered thanks to GAVIsupport■ At least four research reports about the status of pneumonia interventions released byCoalition members in coordination with World Pneumonia DayFight Pneumonia In Nigeria 17

LOOKING FORWARDOver 868,000 Nigerian children die each year, about a quarter of which are from vaccine preventablediseases such as pneumonia, diarrhea, meningitis and measles. Nigeria stands to make rapidimprovements in child survival by extending vaccine services to children and families currently withoutaccess.In 2012, the Nigerian government made several very heartening commitments to expand immunizationservices during the first-ever National Vaccine Summit held in April, 2012. The First Lady, Dame PatienceJonathan, urged the creation of a national fund under a future Nigerian Alliance for Vaccines and Immunization(NAVI), a public-private partnership, to provide vaccine financing from within the country.She also called for a biannual African Vaccine Summit to measure progress of vaccination initiatives. Ahigh priority in the next few years is Nigeria’s plan to rollout the pentavalent and pneumococcal conjugatevaccines, which will substantially reduce deaths from pneumonia and other diseases.A call to action was made to Nigerian leaders from across traditional and religious sectors to committo ensuring excellence at primary health care facilities in their communities.The goal of these efforts is to achieve universal coverage for all Nigerian children by year 2015. IfNigeria can achieve 90% coverage of 5 key vaccines in the next ten years, it can prevent the deathof more than 600,000 children and avert $17 billion in cost and productivity losses.THERE WILL SOON COME A DAY WHEN PNEUMONIA IS NO LONGER ATHREAT TO OUR CHILDREN.— Dr. Ado Muhammad, Executive DirectorNational Primary Health Development Agency5 key vaccines are Haemophilus Influenzae Type b (Hib), pneumococcal conjugate (PCV), rotavirus, measles and pertussis.Averted deaths and costs statistics come from Stack ML, Ozawa S, et al. Estimated economic benefits during the 'Decade of Vaccines'include treatment savings, gains in labor productivity. Health Affairs. 2011; 30(6): 1021-1028.18 global coalition against child pneumonia

IVAC’S EFFORTS IN NIGERIAIVAC is dedicated to supporting the Nigerian government and other partners in the effort to expandaccess to lifesaving vaccines in the country. Below are descriptions of currently ongoingprojects to produce research, create awareness, provide technical support, and build strong partnershipsfor immunization efforts in Nigeria.Current projects■ AVI-TAC (The Accelerated Vaccine Initiative — Technical Assistance Consortium)GAVI’s Accelerated Vaccine Initiative is supported by a technical assistance consortium,including PATH, IVAC, and the Center for Disease Control, who together help developingcountries to accelerate introduction of new vaccines for children. Under the AVI-TAC, theLarge Country Introduction (LCI) effort focuses on Nigeria and India. Major projects undertakenby the LCI in Nigeria include the following:• PAFFIN Project (Parliamentary Advocacy and Financing for Immunization in Nigeria)IVAC works with the Health Reform Foundation of Nigeria (HERFON) and parliamentariansto increase knowledge of the value of immunization programs and identify opportunitiesand barriers to improving oversight of immunization budget performanceand ways to assure sustainable immunization financing.• Nigeria Vaccine SummitApril 16-17, 2012 — IVAC, along with the Nigerian government, Nigerian Pediatric Association,and many other Nigerian and international stakeholders, held the first NationalVaccine Summit to galvanize high-level and grassroots support for vaccines in Nigeria.■LARI in Nigeria (Landscape Analysis of Routine Immunization)IVAC conducted a systematic landscape analysis in eight representative states to help advisegovernment and partners of the strategies likely to improve service delivery and vaccineuptake.NIGERIA’S LEADERS ARE TAKING COURAGEOUS STEPS TO PROTECTTHE HEALTH OF THEIR CHILDREN. THE COMMITMENTS MADE AT THECOUNTRY’S FIRST-EVER NATIONAL VACCINE SUMMIT ARE IMPRES-SIVE, AND IF IMPLEMENTED, WILL GREATLY REDUCE THE NUMBEROF CHILDHOOD DEATHS.—Chizoba Wonodi, MBBS, MPH, DrPHLead, Nigeria Country Programs, IVACFight Pneumonia In Nigeria 19

GLOBAL COALITION AGAINSTPNEUMONIAAction for Humane Hospitals/Action pour l'Humanisation des HôpitauxAfrica Fighting MalariaAfrica Health Research OrganizationAlternative SanteAmerican Academy of PediatricsAmerican India FoundationAmerican Jewish Joint Distribution Committee(JDC)American Tamil Medical AssociationAmericaresAntibiotic Consensus Society of UgandaArab Pediatric Infectious Disease SocietyAstitva Welfare SocietyAsian Strategic Alliance for PneumococcalDisease Prevention (ASAP)Barcelona Centre for International HealthResearch (CRESIB, Hospital Clinic-Universitatde Barcelona)Best for BabesBest Shot FoundationBoston University School of Public Health Centerfor International Health and Development(CIHD)California Immunization Coalition (CIC)CARECenter for Vaccine Development - Mali(CVD-Mali)Centre National d'Appui a la lutte contre deMaladie (CNAM)Centers for Disease Control and Prevention(CDC)Center for Health, Education, and DevelopmentCommunicationChildren's Hospital No. 1Chinese Society of Pediatric PulmonologyChristian Medical College - Vellore, IndiaCitizen News Service (CNS)Columbia University Mailman School ofPublic HealthCroatian Center for Global HealthCSI Hospital BangaloreDestinee Charity FoundationThe Earth Institute, Columbia UniversityEgyptian Medical Students Association (EMSA)EmergingMarketsGroup, Ltd. (EMG)Epidemiological Laboratory (Epi-Lab)Episcopal Relief and DevelopmentERCON SeriesEvery Child By Two (ECBT)Fighting Infectious Diseases in EmergingCountries (FIDEC)La Fundacion del Centro de EstudiosInfectologicos (FUNCEI)GAVI AllianceGiveVaccines.orgGlobal Action for Children (GAC)Global Alliance for Clean CookstovesGlobal Health CouncilGlobal Health StrategiesGlobal Healthcare Information NetworkGlobal Science Academy (GSA), India20 global coalition against child pneumonia

Haffkine Institute, Mumbai, IndiaHasaan FoundationHealth and Sustainable DevelopmentAssociation of Nigeria (HESDAN)Health N Rights Education Programme (HREP)Hedge Funds vs. Malaria and PneumoniaHong Kong Pediatric SocietyImmunization Action CoalitionIndian Academy of Pediatrics, West BengalBranchInfectious Diseases AssociationInstitute of Child Health, IndiaInternational Pediatric Association (IPA)International Rescue Committee (IRC)International Society for Tropical Pediatrics(ITSP) - PhilippinesInternational Society of Tropical Pediatrics —Thailand ChapterInternational Union Against Tuberculosis andLung Disease (The Union)International Vaccine Access Center (IVAC) atJohns Hopkins Bloomberg School of PublicHealth International Vaccine InstituteJohn Snow Inc. (JSI)Johns Hopkins Bloomberg School of PublicHealthJordan University Hospital (JUH)Jordan University Medical School, Division ofPediatric Infectious DiseaseKageno Worldwide, Inc.KidBitzKolpin Society of NigeriaLaboratory for Public Health ResearchBiotechnology (LAPHER Biotech)Living SafelyThe MacDella Cooper Foundation (MCF)MACS Initiative (Monitoring and Accelerate ChildSurvival Initiative)March of WashingtonsMeasles InitiativeMedical Teams InternationalMeningitis Research FoundationMillennium Villages ProjectMinistry of Health, Malawi - ARI ControlProgrammeMinistry of Health - MaliMinistry of Health - ARI Programme, MaliMinistry of Public Health and Population -YemenNational Foundation for Infectious Diseases(NFID)National Institutes of Health (NIH)National Media FoundationNepal Paediatric SocietynetSPEAR, Kemri-Wellcome TrustThe Nigerian School ProjectNYU School of Medicine, Department of MedicalParasitologyONEOtunba Tunwase National Paediatric CentreThe Paediatric Association of NigeriaPakistan HelpPan African Thoracic SocietyFight Pneumonia In Nigeria 21

GLOBAL COALITION AGAINSTPNEUMONIA — CONTINUEDParents of Kids with Infectious Diseases (PKIDs)PATHPediatric Association of TanzaniaPaediatric Infectious Disease Society, NigeriaPaediatrics Association of DRCThe Pediatric Infectious Disease Societyof ThailandThe Pediatric Infectious Disease Society of thePhilippinesPediatric Lung AssociationPGIMER School of Public HealthPneumonia Advocacy andWorking Group of UgandaPhilippines Foundation for Vaccination (PFV)Pneumococcal Awareness Council of Experts(PACE)Polk County Health DepartmentPopulation Services International (PSI)Project HOPEThe Rollins School of Public Health (RSPH) atEmory UniversitySabin Vaccine InstituteSave the ChildrenSHD Team "Sustainable Health DevelopmentTeam"Shifa International HospitalSIFATSociedad de Infectologia de CordobaSouthern African Society of Paediatric InfectiousDisease (SASPID)Stop TB and HIV/AIDS - The GambiaSustainable Health DevelopmentTaiwan Pediatric Society of ThoraxTask Force for Global HealthThere Is No Limit FoundationTripoli Medical Center, Tripoli, LibyaUganda Pediatric AssociationUnited Nations Children's Fund (UNICEF)United Nations FoundationUniversity of EdinburghUniversity of GlasgowUniversity of Melbourne, Centre for InternationalChild HealthUS Coalition for Child SurvivalUS Fund for UNICEFVaccines for Africa Initiative (VACFA)Visiting Nurses Association of SW Florida, Inc.Voices for VaccinesWater for PeopleWomen for Women of Sierra LeoneWomen's Refugee CommissionWorld Consulting Group, Ltd.World VisionZGD - Zeus Global Development22 global coalition against child pneumonia

www.worldpneumoniaday.orgPHOTO CREDITS: COVER PAGE: Lola Akinmade/Photoshare/2007. Page 3: TOP: Breath of Life/2011,MIDDLE: Mr. Dapo/Paediatric Association of Nigeria/2011, BOTTOM: Studio 24/ Vaccine Network forDisease Control/2011. Page 5: TOP: Breath of Life/2011 BOTTOM: Breath of Life/2011. Page 9:LEFT: Onu Photos/Nigerian Supreme Council for Islamic Affairs/2011, RIGHT: Onu Photos/NigerianSupreme Council for Islamic Affairs/2011. Page 10: Sunny Inah/So-Healthi/2011. Page 11: OgunleyeOladimeji/University of Ibadan/2011. Page 12: Mr. Dapo/Paediatric Association of Nigeria/2011. Page13: TOP: Studio 24/Vaccine Network for Disease Control/2011 BOTTOM: Studio 24/Vaccine Networkfor Disease Control/2011. Page 14: TOP: Bowel Media Consultants/Mexzen Care for Life Foundation/2011. BOTTOM: Bowel Media Consultants/Mexzen Care for Life Foundation/2011. Page 15: TOP: Breathof Life/2011, BOTTOM: Okeowo Olorunju/Village Health Relief Initiative/2011. Page 17: LEFT: BowelMedia Consultants/Mexzen Care for Life Foundation/2011, RIGHT: Okeowo Olorunju/Village HealthRelief Initiative/2011. INSIDE BACK COVER: Anna Helland/Photoshare/2002Report written by Daniel Erchick, Chizoba Wonodi, and Lois Privor-Dumm.©2012 International Vaccine Access Center (IVAC) at Johns Hopkins Bloomberg School of Public Health. All rights reserved.Johns Hopkins Bloomberg School of Public HealthInternational Vaccine Access Center (IVAC)855 North Wolfe Street • Suite 600 • Baltimore, MD 21205Email: ivac@jhsph.edu • www.jhsph.edu/IVAC