Pneumonia claimed the lives of more than 800,000 children under the age of five last year globally, or one child every 39 seconds, according to a new analysis.
Nigerian children made up the highest number of those who died, with an estimated 162,000 deaths in 2018 – 443 deaths per day, or 18 every hour.
In Nigeria, 19% of child deaths were due to pneumonia in 2018, and it was the biggest killer of children under-five in 2017.
“Pneumonia is a deadly disease and takes so many children’s lives – even though this is mostly preventable. And yet, this killer disease has been largely forgotten on the global and national health agendas. We can and must change this,” said Pernille Ironside, Acting UNICEF Representative in Nigeria.
The biggest risk factors for child pneumonia deaths in Nigeria are malnutrition, indoor air pollution from use of solid fuels, and outdoor air pollution.
Most global child pneumonia deaths occurred among children under the age of two, and almost 153,000 within the first month of life. 
Sounding the alarm about this forgotten epidemic, six leading health and children’s organisations today launched an appeal for global action. 
In January, the group will host world leaders at the Global Forum on Childhood Pneumonia in Spain.
Pneumonia is caused by bacteria, viruses or fungi, and leaves children fighting for breath as their lungs fill with pus and fluid.
More children under the age of five died from the disease in 2018 than from any other. 437,000 children under five died due to diarrhoea and 272,000 to malaria.
Just five countries were responsible for more than half of child pneumonia deaths: Nigeria (162,000), India (127,000), Pakistan (58,000), the Democratic Republic of Congo (40,000) and Ethiopia (32,000).
Children with immune systems weakened by other infections like HIV or by malnutrition, and those living in areas with high levels of air pollution and unsafe water, are at far greater risk.
The disease can be prevented with vaccines, and easily treated with low-cost antibiotics if properly diagnosed.
But tens of millions of children are still going unvaccinated – and one in three with symptoms do not receive essential medical care. 
Children with severe cases of pneumonia may also require oxygen treatment, which is rarely available in the poorest countries to the children who need it.
Funding available to tackle pneumonia lags far behind other diseases. Only 3% of current global infectious disease research spending is allocated to pneumonia, despite the disease causing 15% of deaths in children under the age of five.
“Increased investment is critical to the fight against this disease,” said Pernille Ironside. “Only through cost-effective protective, preventative and treatment interventions delivered to where children are – including especially the most vulnerable and hardest-to-reach – will we be able to save hundreds of thousands of lives in Nigeria.”
In a joint call to action, the six organisations urge:
Governments in the worst-affected countries to develop and implement Pneumonia Control Strategies to reduce child pneumonia deaths; and to improve access to primary health care as part of a wider strategy for universal health coverage;
Richer countries, international donors and private sector companies to boost immunisation coverage by reducing the cost of key vaccines and ensuring the successful replenishment of Gavi, the Vaccine Alliance; and to increase funding for research and innovation to tackle pneumonia.