Stop the Cycle


Integrated Solutions

Proven solutions exist to prevent and treat diarrhea when infants and young children get sick. Since diarrhea has many causes, and infections can respond differently to treatment, successfully combatting it requires an integrated approach that includes both prevention and treatment solutions.


In settings where medical care can be difficult to access, prevention through vaccination is the best way to protect children.

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Using safe water, properly disposing of human waste, and handwashing with soap help prevent diarrhea.

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Breastfeeding & Nutrition

Breast milk is the ideal nourishment for infants, protecting against infections and enabling them to recover more quickly from illness. Proper infant and young child nutrition fortifies the immune system against infectious diseases and promotes healthy, long-term growth and development.

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ORS & Zinc

Diarrhea can lead to dehydration, which can become life-threatening. Oral rehydration solution (ORS) is a simple, lifesaving mixture of sugar, water, and salt that replenishes fluids and electrolytes. Zinc reduces the severity and duration of diarrhea infections. It can also prevent future episodes. The World Health Organization (WHO)  recommends using ORS and zinc together in diarrhea treatment.

ORS and zinc are frontline treatments. Some cases of severe dehydration may require urgent medical care and intravenous (IV) fluids, which are effective.

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It’s not just one intervention. That child deserves to have access to all interventions.

- Dr. Mathu Santosham, Johns Hopkins Bloomberg School of Public Health

A comprehensive approach

Combining both prevention and treatment solutions is the most effective way to defeat diarrhea and break the cycle of poor health and poverty for children, families, and communities.

Proven solutions include vaccines, WASH (safe drinking water, sanitation and hygiene), breastfeeding and proper nutrition, and ORS and zinc treatment. Using these solutions together makes them work better. Diarrhea prevention and treatment solutions are complementary. For example, proper sanitation and hygiene go hand-in-hand. Safe drinking water is a necessary component of ORS and complementary feeding. Effectively implementing WASH solutions is critical to addressing the connection between malnutrition and diarrhea. And rotavirus vaccines only prevent diarrheal disease caused by rotavirus, so additional methods are necessary to prevent and treat other forms of diarrhea.

By integrating prevention and treatment solutions, countries can maximize impact, increase efficiency, and reduce costs.

  • The use of one solution can help to mobilize the adoption of others. For example, WHO and UNICEF recommend that zinc and ORS be used together to treat diarrhea.
  • Combining and implementing solutions together may be more cost-effective, as programs stand to decrease expenses and increase efficiency.
  • National policies providing comprehensive options can empower communities and programs to tailor their approaches to meet local needs.

What all we need is to look beyond certain interventions and not work in silos, hoping that things will change by bringing more interventions in one area of the work. Instead, we need to scale the number of interventions at the national level, benefiting all.

- Dr. Paul P Francis, Technical Officer, WHO India

Fighting pneumonia and diarrhea together

Many of the solutions that we know work for diarrhea can also be utilized to fight pneumonia, which, along with diarrhea, accounts for one in four deaths in children under five years worldwide. The two diseases share many of the same risk factors, and integrating policies and programs that address both can have a big impact.

Protect, prevent, and treat

Overlapping solutions to both diarrheal disease and pneumonia include breastfeeding, handwashing with soap, and providing safe water, sanitation, good nutrition, and immunization.

No one solution is enough

It is critical to promote an integrated approach to prevent pneumonia and diarrhea, especially for children without reliable access to care. Treatments that are vital to the successful management of these diseases can include appropriate use of antibiotics against pneumonia and confirmed bacterial causes of diarrhea, oxygen, ORS, and zinc supplements. However, too often the children most at risk—in poor settings or hard-to-reach communities—don’t receive these interventions.

World Pneumonia Day is November 12. Learn more.

Lasting impact

Recognizing the urgency and potential of an integrated approach, WHO and UNICEF issued the Global Action Plan for the Prevention and Control of Pneumonia and Diarrhea (GAPPD) in 2013. It’s the first plan to simultaneously address pneumonia and diarrhea to protect health, prevent illness, and treat affected children.

Child health programs at every level must address diarrhea and pneumonia together for lasting impact. Both are needed to make progress toward achieving the Sustainable Development Goals (SDGs) and implementing the United Nations Global Strategy for Women’s and Children’s Health. Integration of diarrhea and pneumonia solutions can provide children everywhere with a healthy start and a better future for their families and communities.

To see how the 15 countries with the highest burden of childhood pneumonia and diarrhea deaths are doing in their efforts to meet GAPPD targets and end these preventable deaths, read the International Vaccine Access Center (IVAC)’s 2021 Pneumonia & Diarrhea Progress Report Card. Notable highlights in the 2021 report include improved diarrhea scores in India and the Democratic Republic of Congo thanks to rotavirus vaccines and in Chad thanks to improved zinc coverage and breastfeeding rates.

This is a question of equity. Poor children in low-income countries are most at risk of death from pneumonia or diarrhea but much less likely to get the interventions they need… We know what to do.

- Dr. Mickey Chopra, Lead Service Delivery Specialist, World Bank

Using these solutions together makes them work better:

Vaccines WASH Breastfeeding & Nutrition ORS & Zinc Research & Development