This World Pneumonia Day, for the first time, children in Malawi received life-saving pneumococcal pneumonia vaccines. And soon, through the work of the GAVI Alliance, children living in 18 additional countries will likely receive the same vaccine, bringing the number of countries that have introduced pneumococcal vaccines to their national immunization programs since 2006 up to 77.

 

And still, on this World Pneumonia Day -- and during each day that has followed -- 4,300 children died of pneumonia worldwide.

 

"Pneumonia is the leading killer of children, but what a lot of people don't realize is it doesn't have to be," says Orin Levine, executive director of the International Vaccine Access Center (IVAC). "There are a number of innovations or approaches already in existence that we can use to address pneumonia, with even more innovation on the way."

 

Today, many prevention methods exist to keep children and adults safe from pneumonia. Vaccines against two of the main causes of life-threatening pneumonia -- pneumococcus and Hib -- exist, but millions of children in developing countries still lack access to these important medications.

 

In addition to vaccinations, using clean cooking stoves that release minimal amounts of indoor pollution, improving nutrition, and practicing exclusive breastfeeding with infants are important actions people can take to protect themselves and their families from the deadly disease.

 

But even with a huge increase in vaccines and prevention practices, it's likely that pneumonia will never disappear completely.

 

"Pneumonia is going to be a problem for as long as anybody can see because everybody's at risk everywhere in the world," Levine says. "Instead of eradication, we're going to need to reduce the burden of the disease so that it's a manageable, small problem instead of a large one."

 

In order to do that, he says, the global community must continue building the momentum around universal access to vaccines and treatments.

 

"We are making unprecedented progress in accelerating access for children in poor countries to new pneumonia vaccines," Levine says. "We need to continue that work and extend it to all children everywhere, including in middle income countries."

 

To support those efforts, World Pneumonia Day organizers this year focused on sparking conversations. But next year, organizers will push the public a bit further, encouraging them to move from talking about pneumonia to taking action to prevent it.

 

"I think this World Pneumonia Day was the most successful thus far for building awareness of the problem and the way forward is really moving from awareness into action," Levine says. "This next year, we really want people, now that they're aware that pneumonia is a big problem with a package of solutions, to start demanding those solutions and taking action to make that happen."

mHealth is a quickly growing and evolving field in which NGOs, companies, and others find ways to reach patients, connect health care workers, and manage medicine supply chains using mobile technology. In the last 15 years, mHealth has already changed the way health care is delivered in many ways. Today, HIV-positive patients receive reminders to take their life-saving medicines via text message, mobile applications track the distribution of insecticide-treated bednets to prevent malaria in Sub-Saharan Africa, and patients in India are diagnosed by doctors thousands of miles away.

 

And this is just the beginning.  BVGH spoke with Brendan Smith and Patricia Mechael about mHealth's impact thus far and this field's enormous potential in the years to come.

 

Brendan Smith (BS) is director of consulting services at Vital Wave, a firm focused on engaging both public- and private-sector enterprises in emerging markets through mHealth and other approaches. Patricia Mechael (PM) is the executive director of the mHealth Alliance, an initiative hosted by the United Nations Foundation working to advance mobile health solutions globally.

 

What were the key innovations in the past 15 years that have opened up the global health field for mobile technology-based solutions?

BS: To me, the biggest innovation that has opened up this space is the expansion of mobile networks and mobile phone ownership, especially in the developing world. Not only has this catalyzed growth in mobile health, but it has also fueled other forms of social mobile enterprises. One of the most important developments in this field has been the development of mobile money, such as "m-Pesa," which allows people to transfer money using SMS or USB technology. This application has reached millions of people who have never had access to this type of advanced technology before.

 

PM: I think some of the major developments have just come from the natural progression of how people use their cellphones in their daily lives. A lot of health workers as well as people in the general population are becoming more creative with how they leverage cell phone technology to administer, deliver, and access health information and services.

 

What key lessons have you learned in your mHealth work?

PM: For me, one of the critical lessons learned is that mHealth is not necessarily about the technology. The technology is a tool - a means to an end - and mobile technology might not be the best approach to accomplishing your objective. It is critical to thoroughly understand your problem before even thinking about mobile solutions. Another lesson is that there are many one-off type approaches to mobile health, but you can have a greater impact by taking a systems-level approach; looking at the way a system functions and then pinpointing where mobile technology could have an impact.

 

BS: You must have a business model to ensure success, no matter what your end goal may be. There are a lot of great pilot programs in global mHealth, but they traditionally rely heavily on grant funding or one time donations. Because they often don't have a business model to help them grow and become sustainable, these pilot programs don't stick around. Another major lesson learned is that multi-sector partnerships are critical in making mobile health solutions work. You need partners that can help you communicate to patients, you need partners with mobile technology expertise, and you need partners on the business end.

 

What are the best ways for biotech and pharmaceutical companies to get involved in mHealth?

PM: There are some really amazing opportunities in mHealth -- such as identifying counterfeit drugs -- that biotech and pharmaceutical companies can get involved in. But first, it's important to examine a company's strategic priorities and then to look at the ways that mobile technology can be leveraged to accelerate those priorities.

 

Where do you see the greatest opportunities for growth in mHealth in the next 10 years?

BS: The focus of mHealth is often on very sophisticated and complicated applications that can interface with health information systems and logistics management systems, but there's a lot you can accomplish with voice: connecting workers to patients and workers to each other and to the rest of the health system. I think the opportunity that can be realized just by connecting people that were not connected before in a vocal conversation is one of the big opportunities yet to be seized. While many in the field are moving on to more sophisticated programs, the potential gains from something as simple as voice can be significant.