This Safe, Cheap Typhoid Vaccine Could Be the Breakthrough the World Needs
The deadly disease still infects up to 20 million people a year.
For millions of people living in low- and middle-income countries, typhoid is an ever-present reality.
The deadly disease, which is spread through contaminated food and water, still infects up to 20 million people every year — and kills up to 160,000 people, many of them children.
And the need for an effective, affordable vaccine is greater now than ever, with climate change and urbanisation threatening to boost the spread of the disease through overcrowded populations, while resistance to antibiotic treatment is increasing.
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Now, however, the World Health Organisation (WHO) has offered a possible solution, by prequalifying the first conjugate vaccine for typhoid (TCV). It sounds complicated — but bear with us.
Being prequalified means the vaccine meets the quality, safety, and efficacy laid out by the WHO, which makes sure that vaccines used in immunisation programmes are safe and appropriate for the country’s needs.
It’s the vital next step needed to let UN agencies, such as UNICEF, and GAVI, the Vaccine Alliance, buy the vaccine for use in vaccination programmes in poor countries — predominantly in Africa and Asia, where the disease is rife.
GAVI has already approved $85 million in funding for doses to be given to children starting from next year.
The vaccine is important because it offers longer-lasting immunity than older vaccines, it requires fewer doses, and it’s the first that can be given to young children through routine childhood immunisation programmes.
Typhoid is a serious and sometimes fatal disease spread through contaminated food and water. As well as fever, fatigue, and headaches, symptoms can include abdominal pain, diarrhoea, and constipation.
The vaccine, called Typbar TCV, is made by Bharat Biotech of Hyderabad, India, whose research is supported by the Bill and Melinda Gates Foundation, the Clinton Health Access Initiative, and the Wellcome Trust, among other donors.
It has been tested and used in India since 2005, but in 2015, it was the subject of a “challenge trial” in Oxford, England.
Around 100 people — many of them students — volunteered to receive either the vaccine or a placebo, before swallowing live Salmonella typhi, the bacterium that causes typhoid.
The results, published last year in medical journal the Lancet, showed the vaccine to be 87% effective in preventing the disease. And anyone who fell ill during the trial was cured with antibiotics.
The vaccine now costs $1.50 a dose when purchased for developing countries, and the price will drop to $1 or less if donors order more than 100 million doses, reported the New York Times.
Although the approval was given by the WHO in December, it has only been announced this week. The prequalifying process included reviewing the evidence, testing the consistency of each batch of manufactured vaccine, and visiting the site where the vaccine is manufactured.
The Strategic Advisory Group of Experts (SAGE) on immunisation, which advises WHO, recommended the vaccine in October for routine use in children over 6 months old in countries where typhoid is endemic (or found regularly).
Another bonus of the vaccine is that its use should help to slow the alarming increase in resistance to antibiotic treatment, by cutting down the frequency of the use of antibiotics to treat typhoid.
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