Abstract
Recognizing that enteric fever disproportionately affects the poorest and the most vulnerable communities that have limited access to improved sanitation, safe water sources, and optimal medical care, the Bill & Melinda Gates Foundation has funded efforts to augment global understanding of the disease since the foundation’s inception. At the turn of the century, early efforts focused on characterizing the burden of disease in Asia and evaluating use of the available Vi-polysaccharide vaccines through the Diseases of the Most Impoverished projects at the International Vaccine Institute (IVI). More recent efforts have centered on supporting development of typhoid conjugate vaccines and expanding disease surveillance efforts into Africa, as well as generating a greater understanding of the clinical severity and sequelae of enteric fever in Africa, Asia, and India. The Typhoid Vaccine Accelerator Consortium is playing a critical role in coordinating these and other global efforts for the control of typhoid fever. Here, we outline the scope of support and strategic view of the foundation and describe how, by working through strong partnerships, we can realize a radical reduction of the significance of enteric fever as a global public health problem in the next 10 to 15 years.
Highlights
Recognizing that enteric fever disproportionately affects the poorest and the most vulnerable communities that have limited access to improved sanitation, safe water sources, and optimal medical care, the Bill & Melinda Gates Foundation has funded efforts to augment global understanding of the disease since the foundation’s inception
After an uncoordinated global approach over the last 2 decades [1], we have seen an unprecedented period of progress in the global public health goal of controlling typhoid fever in the past few years
It is critical that new epidemiology and burden data and evidence of the increasing threat of antimicrobial resistance be communicated to policy-makers in-country in order to facilitate informed decision-making regarding typhoid conjugate vaccine (TCV) introduction
Summary
A Global Agenda for Typhoid Control—A Perspective from the Bill & Melinda Gates Foundation. Recognizing that enteric fever disproportionately affects the poorest and the most vulnerable communities that have limited access to improved sanitation, safe water sources, and optimal medical care, the Bill & Melinda Gates Foundation has funded efforts to augment global understanding of the disease since the foundation’s inception. Based on the strength of new burden data from Africa and Asia, recent modeled burden estimates indicate that between 11 and 21 million cases of typhoid fever occur annually, with 145,000–161,000 deaths every year [2,3,4] These refined estimates, when coupled with promising clinical data of a TCV (Typbar-TCV) developed by Bharat Biotech International Ltd., Hyderabad, India [5], and licensure in India, helped solidify the World Health Organization (WHO) Strategic Advisory Group of Experts’ (SAGE’s) resolve to issue a recommendation for use of new TCVs in children aged >6 months in endemic countries [6]. Lessons learned from such efforts will ensure that country introduction strategies are designed and implemented appropriately
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