Every four minutes, one child dies of pneumonia-causing diseases in India, before even reaching his fifth birthday.

Caused by Streptococcus pneumoniae and Haemophilus influenzae B or HIb -- two infamous bacteria -- pneumococcal disease are killing 140,000 Indian children every year.

According to a new study, every year, 1.2 million children under age five die from these infections.

Published in the `Lancet' medical journal on Saturday, the study found that in 2000, an estimated 14.5 million cases of pneumococcal disease such as pneumonia and meningitis were reported worldwide, most caused by Streptococcus pneumoniae with 826,000 deaths among children under five.

Besides India which recorded the greatest proportion of global pneumococcal cases -- 27% --, four other Asian countries featured on the list of top 10 nations with the greatest number of pneumococcal deaths in children aged 1-59 months. They were: Afghanistan, China, Pakistan and Bangladesh.

HIB, on the other hand, caused 8.1 million serious illnesses worldwide and 371,000 child deaths every year.

Here too, India tops the 10 countries list with the highest estimated number of HIb deaths in 2000. While India recorded 72,000 deaths, China saw 19,000 casualties, Afghanistan 14,000, Pakistan 13,000 and Bangladesh 12,000 deaths. Unfortunately, safe and effective vaccines exist to provide protection against both diseases. However, India is among many countries which are yet to start using the vaccine in its national immunization programme.

In 2000, only the USA had initiated routine use of pneumococcal vaccine. By August 2008, this expanded to include 24 high and two upper-middle income countries but did not include any from Africa or Asia, the regions with the highest numbers of pneumococcal deaths and cases.

According to the study, these 26 countries accounted for less than 0.2% of global childhood pneumococcal deaths in 2000 and the children in these countries, on average, had a 40-fold lower risk of pneumococcal death than the children in countries not yet using the vaccine.

Kate Brien, primary author of the pneumococcal study from Johns Hopkins Bloomberg School of Public Health, said, "The need for vaccination and treatment is particularly urgent in Africa and Asia, which together account for 95% of all pneumococcal deaths."

"Prevention of pneumococcal and HIb cases and deaths is imminently achievable, but countries must demonstrate the political will to prioritize prevention," said Orin Levine, executive director of PneumoADIP at the Johns Hopkins Bloomberg School of Public Health.

India, however, is finally waking up to the threat. The health ministry will soon take to the Cabinet for final approval the proposal to introduce a pentavalent vaccine (5X1) in its national immunization programme.

The vaccine, that received a go-ahead from the ministry's Expenditure Finance Committee (EFC) in June, will combine DPT (diphtheria, pertussis, tetanus) with Hepatitis B and Haemophilus Influenza Type B (HIb) that causes pneumonia and meningitis.

The ministry will first launch the vaccine in five states -- Himachal Pradesh, Kerala, Tamil Nadu, Jammu and Kashmir and Karnataka -- all of which have high routine immunization rates (80%-90%). An estimated 90.63 lakh children will be vaccinated with this five-in-one shot in the five states between 2009 and 2011. This will cost nearly Rs 408 crore.

The vaccine is expected to cost the government a little less than $2 per dose. At present, 85 countries across the world are using pentavalent vaccines.