IVI co-sponsored an international meeting with the Merieux Foundation and the World Health Organization on “Typhoid fever – a neglected disease: towards a vaccine introduction policy”.

The meeting, held in Annecy, France April 2-4, was seen as a critical step in getting vaccination against typhoid fever – which still kills an estimated 200,000 or more persons world-wide each year – on the global health agenda.

The meeting drew 50 participants from 19 countries, representing research and academic institutes, ministries of health, multi-national and developing country vaccine producers, and donor agencies (including the Bill & Melinda Gates Foundation and the GAVI Alliance). Several of the world’s leading experts in typhoid fever and typhoid vaccines participated in the meeting.

Children wait in line to be immunized against typhoid fever in a school-based trial vaccination campaign in Jakarta, Indonesia in February 2004. The campaign was conducted as part of IVI’s DOMI Typhoid Program. 

The purpose of the meeting was to reach consensus on the continued importance of typhoid fever as a cause of illness and death in developing countries – especially among children, drawing upon recent data from typhoid field studies conducted in five Asian countries through the IVI’s Diseases of the Most Impoverished (DOMI) Program (Learn more), as well as from other research studies and experiences. A further aim was to develop an action plan to increase the visibility of the disease and to make typhoid vaccination a higher priority within the global health community.

Dr. Tikki Pang of WHO gave the keynote lecture, entitled, “An overview of the global problem of typhoid fever and licensed vaccines available as public health tools”.

Presentations covered:  

§ an update on the magnitude of the disease and its economic consequences

§ trends in antibiotic resistant typhoid

§ country experiences with typhoid vaccination using new-generation vaccines, including demonstrations conducted through DOMI using the injectable, single-dose Vi vaccines, clinical trials in Chile using the oral live attenuated Ty21a vaccine, and China’s own experience with Vi vaccination

§ Production and supply of modern typhoid vaccines

§ Possible delivery and financing mechanisms for typhoid vaccines

§ Challenges in typhoid vaccination, including school-based delivery.

In Working Group discussions, participants developed a plan to present the case for typhoid vaccination to the WHO immunization program’s Strategic Advisory Group of Experts (SAGE) in November, with the expected outcome of an updated WHO recommendation for the introduction of typhoid vaccination in endemic countries. Efforts to get modern typhoid vaccines pre-qualified by WHO were also seen as critical to their broader use.

Participants felt that the choice of typhoid vaccine, age at vaccination and delivery strategies (school- or community-based) should be left to the countries, based on local data and conditions. Participants also recommended implementing typhoid vaccination along with improvements in community water and sanitation, conducting additional disease burden studies and vaccine pilot projects, and considering a variety of options to finance the introduction of typhoid vaccines.