'We could save 7 million children'

Dr Samba Sow is trying to raise awareness of pneumococcal disease and its effect on his native west Africa. A vaccine has been promised in early 2009, but will it be enough to stop the biggest killer of children in the developing world?
Dr Samba Sow
A quick vaccine could save a tremendous number of lives, says Dr Sow. Photograph: Adrian Brooks

I work in a paediatric hospital and see on a daily basis that the number one killer is streptococcal pneumonia, also known as pneumococcal disease.

It's very fast. We often send patients home to wait for the results of their blood samples – usually because the hospital is full or the parents don't have enough money to stay – but by the time we go to bring them back again, we often find a funeral, or the parents tell us the child died a couple of hours after they left the hospital. This is all the more tragic because it's a vaccine-preventable disease.

I'm trying hard to raise public awareness so that we can place the same importance and attract the same commitment to pneumococcal disease as we do to HIV, and accelerate the introduction of the vaccine into the developing world. If this were done now, by 2030 we would be able to save the lives of 7 million children.

Mali's national decision makers have approved our application for a vaccine, so we are supposed to start in January 2009. But from what I'm hearing it looks like the vaccine may not be ready in time. The donors and decision makers need to put their heads together so that the industry can make more of it. They need to work quickly as any vaccine will save a tremendous number of lives.

In Chile, 10 or 15 years ago, there used to be the same incidence rate of the disease that we now see all over Africa. There was even a similar rate in the US, but since introducing the vaccine those countries have improved dramatically. Now the problem is in the developing world – Asia and Africa, but much worse in Africa. There are 1 million deaths a year worldwide from the streptococcus pathogen, but 90% of these deaths occur in Africa.

The rest of the world is still more interested in diseases like malaria, HIV, tuberculosis – even meningitis. But if you mention streptococcal pneumonia they say "what's that?" For them, pneumonia is just something you get when it's windy or cold.

What we're dealing with now is only a small part of the problem. I want to say the tip of the iceberg, but we don't have icebergs in Mali; we're landlocked. We do have hippos in water, however, and I can tell you that the part of the disease we are able to report on – six years of surveillance data – is just the eyes and ears of the hippo.

Most children start with a traditional healer or go to community doctors because they're cheap and easy to access. Outside the capital city, Bamako, I would say only 5% of those who are very sick go to a hospital. They need transportation and they have to be smart enough to leave the traditional healer. They also have to act early and be fast enough if the child is going to stay alive. A lot of kids die between their house and the hospital, so nobody has any data on those cases. That part of the hippo is still below the water.

Access to healthcare is key. People need to know that this is a contagious disease and they must seek medical help. We need to make sure that if a child is sick, the first person he or she sees is not someone selling antibiotics on the street. When people take the wrong medicines even the best laboratories in the world will have difficulty diagnosing pneumococcus and providing the right treatment. In Africa, most hospitals struggle even with x-rays.

It's always better to prevent a disease than to wait and intervene later, especially in a poor setting. I know there are economic problems everywhere in the world, but when every morning I go into the hospital and see kids dying of preventable diseases, I know we need the streptococcal vaccine today. The rest will follow.

• Dr Samba Sow was speaking to Francis Tamburin

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