Integrated global action plan for the prevention and control of pneumonia and diarrhea Programme

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Integrated Global Action Plan Pneumonia Diarrhea GAPPD WHO UNICEF programme

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Now I have comprehensive information from both the textbook (Park's Preventive & Social Medicine) and the official GAPPD documents. Here is the full answer:

Integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (GAPPD)

Launched: April 2013 | By: WHO and UNICEF | Goal period: Up to 2025

Background

Pneumonia and diarrhoea together account for approximately 29% of all deaths in children under 5 years globally, resulting in the loss of around 2 million young lives each year. Prior to GAPPD, WHO and UNICEF each had separate plans - the Global Action Plan for Pneumonia Prevention and Control (2009) and a Comprehensive Diarrhoea Control Plan (2009) - but countries demanded a more coordinated, integrated approach. GAPPD emerged from a series of five multi-country regional workshops that identified common interventions and the need for a unified framework.

The GAPPD builds on a key insight: many of the interventions that protect, prevent, and treat pneumonia also address diarrhoea, making an integrated approach far more efficient than disease-specific programmes.

(Source: Park's Textbook of Preventive and Social Medicine, p. 194; WHO/UNICEF, 2013)

The GAPPD Framework: PROTECT - PREVENT - TREAT

The programme is organized around three core pillars, each containing specific, evidence-based interventions:

1. PROTECT

These interventions provide the foundation for keeping children healthy and free from disease:

Intervention	Notes
Exclusive breastfeeding for the first 6 months	Protects against both pneumonia and diarrhoea
Adequate complementary feeding after 6 months	Maintains nutritional status
Vitamin A supplementation	Reduces severity and mortality
HIV prevention (PMTCT)	Prevents HIV-related susceptibility to both diseases
Indoor air pollution reduction	Reduces smoke from biomass fuels
Handwashing with soap	Core hygiene behaviour
Safe drinking water and sanitation	WASH interventions

2. PREVENT

These interventions prevent children from falling ill:

Intervention	Notes
Immunization - DTP3, Hib, PCV, Measles, Rotavirus	Core vaccines against both diseases
Cotrimoxazole prophylaxis for HIV-positive children	Prevents opportunistic pneumonia
Zinc supplementation	Reduces diarrhoea duration and severity
Safe disposal of child stool	Prevents faecal-oral transmission
Improved water supply (point-of-use water treatment)	Prevents diarrhoeal pathogens

3. TREAT

These interventions ensure appropriate case management:

Intervention	Pneumonia	Diarrhoea
Oral Rehydration Salts (ORS)	-	Yes
Zinc	-	Yes (therapeutic)
Antibiotics (amoxicillin for pneumonia)	Yes	For dysentery
Oxygen	Yes (severe)	-
Low-osmolarity ORS	-	Yes
Care seeking and facility access	Both	Both
Integrated Community Case Management (iCCM)	Both	Both

Specific Goals for 2025

(As stated in Park's Textbook of Preventive and Social Medicine, p. 194)

Reduce pneumonia mortality in children <5 years to fewer than 3 per 1,000 live births
Reduce diarrhoea mortality in children <5 years to fewer than 1 per 1,000 live births
Reduce the incidence of severe pneumonia by 75% in children <5 years (compared to 2010 levels)
Reduce the incidence of severe diarrhoea by 75% in children <5 years (compared to 2010 levels)
Reduce by 40% the global number of stunted children <5 years (compared to 2010 levels)

Coverage Targets

By end of 2025:

90% full-dose coverage of each relevant vaccine (with 80% in every district)
90% access to appropriate pneumonia and diarrhoea case management (80% in every district)
At least 50% coverage of exclusive breastfeeding in the first 6 months
Virtual elimination of paediatric HIV

By end of 2030:

Universal access to basic drinking water in health care facilities and homes
Universal access to adequate sanitation in health care facilities

By 2040:

Universal access to adequate sanitation in homes

Ongoing:

Universal access to handwashing facilities (water and soap)
Universal access to clean and safe energy technologies in facilities and homes

Action at Country Level

GAPPD recommends that governments and partners:

Generate political will and commit resources
Develop/update a situation analysis for pneumonia and diarrhoea using local data
Prioritize interventions based on local context and burden
Develop/update a costed plan for accelerated action
Identify areas of harmonization between programmes, the private sector, academia, and civil society
Use data to identify groups at greater risk or missed by services
Monitor progress toward defined goals and coverage targets
Strengthen accountability for results and resources

Why an Integrated Approach?

Pneumonia and diarrhoea share common risk factors: malnutrition, lack of breastfeeding, indoor air pollution, lack of clean water/sanitation, and incomplete immunization
Many interventions protect against both diseases simultaneously (e.g., breastfeeding, handwashing, vaccines)
An integrated approach is more cost-effective and efficient than single-disease programmes
It avoids duplication and facilitates coordinated health system strengthening

Key Challenges Identified

Lack of coordination and intersectoral collaboration
Shortage of human resources in low-resource settings
Insufficient financial resources
Inadequate access to healthcare and supply chain management
Uneven coverage of proven interventions across districts

Source: Park's Textbook of Preventive and Social Medicine, pp. 193-194; WHO/UNICEF GAPPD Executive Summary (2013); BMJ Archives of Disease in Childhood, GAPPD development paper

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