Group A Streptococcus (GAS), Streptococcus pyogenes, is the biggest infectious killer that no one has heard of. The concerning global disease causes an estimated 18 million people to suffer, and 517,000 deaths with 1.8 million new cases annually. A great proportion of the disease lies in low- and middle-income countries, which makes it not necessarily a bigger problem, but a bigger priority. The greatest burden is due to rheumatic heart disease, but invasive GAS diseases also contribute significantly, together with acute rheumatic fever, rheumatic heart disease and post-streptococcal glomerulonephritis. GAS pharyngitis is a contributor to global antibiotic use.
There is a significant global need to reinforce current control strategies and develop new primary prevention strategies including vaccines. On 31 May 2017, the Executive Board of the World Health Organization (WHO) proposed a Resolution on ‘Rheumatic Fever and Rheumatic Heart Disease’ for adoption at the Seventy-first World Health Assembly in May 2018. Although many recombinants, multivalent vaccine candidates have been developed, there has been little financial investment beyond early-stage clinical studies, and no major manufacturer has a GAS vaccine program.
In line with its mission, Strep A Vaccine Global Consortium (SAVAC) is formed and convene representatives from the health sector to facilitate the development of GAS vaccine. The SAVAC is expected to enact and enable the R&D roadmap, and to create the public health value proposition with WHO. From development to delivery, the SAVAC will be a stepping stone on the way to an endless horizon of a safe, globally effective, and affordable GAS vaccine.