The stakes are high to address childhood pneumonia, which has persistently remained the leading infectious cause of under-five mortality globally, accounting for an estimated 800,000 deaths each year. To reduce childhood pneumonia deaths – especially in low- and middle-income countries hit the hardest – multi-pronged action is needed to address this leading cause of death. This must include increasing access to the WHO recommended treatment, amoxicillin dispersible tablets (DT). Amoxicillin DT is an effective, low-cost and appropriately designed treatment available within the global market. However, access is still not widespread, particularly in countries with the highest burden of childhood pneumonia deaths.
Urgent efforts are needed to scale amoxicillin DT. This market brief aims to document – primarily in qualitative terms – progress seen over the past eight years since the WHO guidance was updated to recommend the use of amoxicillin DT for childhood pneumonia treatment. Importantly, the brief also highlights key remaining opportunities to unlock persistent barriers, and to transform access to this life-saving commodity. Market barriers described in this document focus on aspects of regulatory, financing, supply, demand, and appropriate use of amoxicillin DT at the global level and at the national level in countries with high burdens of childhood pneumonia. The recommendations coming out of this brief provide strong suggestions for where country governments and partners can collectively focus attention in forthcoming years to continue improving access to amoxicillin DT by addressing key enduring challenges:
- Need for prioritization of access to amoxicillin DT in national strategies and investment cases targeting reductions in child mortality;
- Significant funding gaps persist, requiring greater prioritization by both donors and governments;
- Limited availability of internationally quality-assured products – at completive prices – within high-burden countries;
- Need for more robust quantifications and their use to inform procurement decisions; and
- Concerns around appropriate use, supported by evidence of misdiagnosis and incorrect prescription practices
In support of the Sustainable Development Goals to end preventable child mortality, combined and coordinated efforts across partners and governments of high burden countries is greatly needed to prioritize efforts to tackle the barriers documented in this brief, thus enhance scale-up of amoxicillin DT.