Are some deaths worse than others?

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Successful journalists know the power of telling a human story with each piece. A narrative of an individual or group of people makes readers remember and relate to an issue it in ways they wouldn’t otherwise. Readers want to know more than the “What” of the story. They want the Who, Where, When and Why that help us interpret otherwise chaotic information.

The New York TimesDonald G. McNeil Jr. is one of the world’s most widely-read science and health reporters. He’s covered pneumonia more than most, if not all, of his peers. This leads me to wonder why his recent article seemed to diminish the pain and suffering of pneumonia deaths as compared to those of patients with AIDS, and what, if anything, this tells us about the need for a new narrative around pneumonia in the media. In comparing AIDS deaths to pneumonia deaths, McNeil writes: “Those who slip away from pneumonia are usually very old and weak or very young and weak. Families may be bereft, but less often financially and spiritually broken."

Is it true that watching your baby struggle to breathe while fluid fills her lungs is less heartbreaking then witnessing your previously virile young son gradually deteriorate and grow dependent? Recently, on a trip to Nigeria where I helped make a BBC World film on pneumonia, I met mothers who took out loans to pay for their baby’s pneumonia hospitalization, at a cost equal to a third of the typical Nigerian family’s annual income. One mother emptied her savings, sold her cell phone, took out a loan, and the baby died in spite of it all. When I met her, she was living in a small church where she had been fasting for three days while searching for answers. It’s hard to be more “financially and spiritually broken” than that.

Despite the fact that pneumonia is the world’s leading killer of children, media stories on pneumonia appear only occasionally, while coverage of other diseases like HIV/AIDS is frequent and widespread. Weekly blog postings on HIV have consistently doubled or tripled those on pneumonia. To find out why, let’s revisit our five “W”s and see how HIV and pneumonia compare.

Who: Globally, the highest risk for pneumonia is among babies in the world’s poorest countries – a group with little voice in politics. AIDS generally affects adults, and in the industrialized world, many affected adults have been able to gain champions among politicians and celebrities like Bono, Jennifer Garner and Chris Rock.

What: The scientific challenges of treating and preventing HIV are news stories in and of themselves. The virus is a formidable opponent for scientists looking for vaccines, or a cure. Meanwhile, although new agents of pneumonia sometimes emerge – like SARS virus – most pneumonia deaths, especially in children, result from failure to implement actions and technologies we already have available.

When: AIDS is an emerging disease, and a new disease is always more frightening than a well-known one. HIV/AIDS began as a cluster of rare cancer cases in gay men reported in 1981. Meanwhile, pneumonia was described as far back as Hippocrates.

Where: Ninety-eight percent (98%) of child pneumonia deaths occur in developing countries--out of sight and out of mind for most journalists and cameras. AIDS, on the other hand, affects powerful, visible people like Magic Johnson and Rock Hudson.

Why: There is a self-enforcing feedback loop of public awareness and media: As more stories are written, more people become aware of HIV/AIDS, leading to greater interest and coverage. This awareness-media cycle contributes to the widespread misconception, even among global health donors, that HIV is the leading cause of death in young children. Pneumonia has not created this awareness-media cycle.

If our concern is simply to spin a good yarn, none of this may matter. But if our concern is to save lives, the lack of media coverage of pneumonia or the minimization of its impact can have serious side effects. As the Global Action Plan for Pneumonia makes clear, we can stop this disease by simply implementing available tools and technologies. But if the public is in the dark, they won’t support our efforts, leaving us a steep uphill climb to get vaccines and treatments to kids and families who need it now.

So here’s a challenge to journalists and bloggers: how would you re-write the pneumonia story?

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