For one mother in Chandigarh, India, the impact of Strep A has shaped her life for almost a decade. What began as an infection progressed to rheumatic heart disease (RHD), one of the most serious complications of Strep A, leaving her with a chronic condition that can damage the heart valves and requires ongoing medical care.

Over time, she stopped her regular penicillin injections as her symptoms improved and concerns about side effects grew. It was only after enrolling at a local research site established by the Strep A Vaccine Global Consortium (SAVAC) that she gained a clearer understanding of her condition and agreed to restart treatment after a multi-year pause.

Her story highlights the urgent need for a Strep A vaccine to prevent avoidable suffering and serious disease, as well as the human impact behind SAVAC’s work. In India, IVI and its partners are building the foundation for future vaccine trials through hospital- and community-based surveillance—revealing the long-term burden of Strep A while directly connecting affected families with care.

IVI’s SAVAC team and representatives from the Postgraduate Institute of Medical Education and Research in Chandigarh. Credit: IVI

During a recent visit to the Chandigarh sentinel site, International Vaccine Institute (IVI) Director General Dr. Jerome Kim and Dr. Annette Kraus, IVI’s SAVAC project lead and Senior Research Scientist, met with her and other families to hear their experiences firsthand.

“Visits like this remind us why this work matters,” says Dr. Kim. “The surveillance program is not only generating important scientific evidence, it also creates connections between healthcare teams and the communities they serve.”

Chandigarh: a city of innovation and healthcare

Located in northern India, Chandigarh is known as “The City Beautiful” and is renowned for its modernist architecture, green spaces, and urban design.

Beyond its architectural legacy, Chandigarh is also a hub for healthcare and medical research. It is home to the Postgraduate Institute of Medical Education and Research (PGIMER), one of India’s leading medical institutions and SAVAC’s local partner for sentinel site activities.

The SAVAC team visits annually to strengthen collaboration and support research teams. This year’s visit came at an important moment for the Chandigarh site, where surveillance studies at PGIMER are now fully operational in both hospital and community settings.

“Over the last year, the team has grown from two people to 18 staff members, so it was a great opportunity to reconnect with familiar faces and meet new colleagues,” says Dr. Kraus.

“The dedication of the team is remarkable,” she adds. “The clinicians, laboratory staff, and social workers all play essential roles. The social workers, in particular, have developed strong relationships with families in the communities, which is critical for building trust and ensuring participants remain connected to care.”

Rheumatic heart disease: India’s ongoing burden

Chandigarh is one of four SAVAC sentinel sites worldwide, alongside sites in The Gambia, Malawi, and Fiji, selected to strengthen understanding of the global burden of Strep A and its complications.

Professor Madhu Gupta from PGIMER and Dr. Jerome Kim. Credit: IVI

India was chosen due to its historical burden of rheumatic heart disease, one of the most serious complications that can follow Strep A infection. Although greater antibiotic availability has contributed to reductions in new cases, RHD remains an important public health challenge.

At PGIMER, surveillance has already identified more than 1,000 patients with rheumatic heart disease through the hospital-based surveillance study. More than 600 participants are being monitored regularly for symptoms of pharyngitis and skin infections through the site’s community surveillance study.

“Many of these patients are not newly diagnosed,” Dr. Kraus explains. “Rheumatic heart disease can take decades to develop, and many patients require continued follow-up and treatment. Understanding this long-term burden, as well as the incidence of new cases, is essential when assessing the potential value of future Strep A vaccines.”

Sentinel site studies are generating data on Strep A disease patterns while strengthening the infrastructure needed for future vaccine clinical trials.

Preparing the world for a Strep A vaccine

SAVAC brings together experts in epidemiology, clinical research, vaccine development, and public health to overcome the barriers that have slowed Strep A vaccine development.

As the hosting institution, IVI coordinates SAVAC’s scientific strategy, partner engagement, and implementation activities, working with partner organizations including Murdoch Children’s Research Institute, The Kids Research Institute Australia, Harvard T.H. Chan School of Public Health, Shift Health, and the World Health Organization.

IVI’s Dr. Annette Kraus looking under the microscope at PGIMER facilities. Credit: PGIMER

Since SAVAC 2.0 launched in 2023, all four sentinel surveillance sites have become operational, conducting standardized hospital- and community-based surveillance. Additional workstreams are assessing the global Strep A vaccine pipeline, strengthening engagement with vaccine manufacturers, developing the business case for future vaccines, and supporting WHO efforts related to Strep A vaccine research and development.

Surveillance activities at all four SAVAC sentinel sites will continue through 2028, generating the epidemiological evidence needed to advance future vaccine development. At the same time, these sites are being prepared for potential clinical trials through investments in laboratory capacity, research systems, and clinical trial readiness.

For Dr. Kim, the visit highlighted the critical role of SAVAC’s sentinel sites in generating the evidence needed to advance Strep A vaccine research.

“By generating high-quality epidemiological data and strengthening clinical trial capacity, these efforts are helping to advance our understanding of Strep A and bring us closer to effective vaccines that could prevent disease in millions of people worldwide,” he adds.

Watch the video below to learn more about SAVAC and read about IVI’s work to advance group A Streptococcus vaccine development.