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What We Do

CaT is a leader in the fight to control typhoid fever through increased access to life-saving vaccines.

Typhoid vaccines have primarily been targeted for use in the private or traveler’s markets and have not been widely supported for use at the country level. This means that the most vulnerable populations, such as infants and young children, do not have access to the vaccine.

CaT focuses on vaccine policy and raising awareness about the prevalence of typhoid and the need for vaccines. CaT aims to ensure that sufficient global typhoid immunization and financing policies are in place to enable the widespread use of typhoid vaccines in endemic areas and that these policies are supported at the regional and national levels.

Why It Matters

Up to one-third of the world’s population, most of whom are children, is at risk of contracting typhoid fever. Typhoid remains a very real threat in developing countries where many people lack access to clean water and basic sanitation, thereby exposing themselves to the conditions that enable typhoid to spread.

Unlike many other diseases prevalent in low- and middle-income countries, typhoid is preventable. Given that fundamental prevention strategies like good hygienic practices and access to clean water may be out of reach for many countries in the near-term, there is an even greater need for high-impact and cost-effective typhoid vaccines right now.

Our Priorities

In order to achieve the goal of increased access to typhoid vaccines, CaT targets its work in the following two areas:

1. Immunization Policy

The World Health Organization (WHO) recommends the use of the typhoid vaccines for endemic disease and outbreak control. Last updated in 2008, the existing WHO typhoid policy supports the use of two vaccines: an injectable vaccine called a Vi polysaccharide (Vi-PS) that can be used in children under age two, and an oral vaccine called Ty21a that can be taken by those over age five.

WHO’s current recommendation does not account for recent advancements in typhoid vaccine development. As of August 2013, a new injectable typhoid vaccine, called a Vi conjugate vaccine, was licensed for use in India. This vaccine addresses some of the weaknesses demonstrated by previous vaccines by offering long-term protection to adults and infants six months of age and older. Because of its life-saving potential, CaT is working to make conjugate vaccines broadly available by advocating for an updated WHO policy recommendation and vaccine prequalification, which helps ensure that medicines supplied to countries by procurement agencies meet acceptable standards of quality, safety, and efficacy.

2. Immunization Finance

The support of Gavi, The Vaccine Alliance (Gavi) will also be instrumental in enabling the introduction of typhoid conjugate vaccines in endemic areas of Gavi-eligible countries at an affordable price. As of Q3 2014, approximately eleven manufacturers are working on the development of a conjugate typhoid vaccine globally, and two vaccine manufacturers in India have acquired a marketing license for their conjugate typhoid vaccine. Both vaccines are currently being used in the private market but are not yet available for use in national immunization programs.

Gavi will open the next window for country support of new vaccines in the 2016 – 2020 funding cycle, and the typhoid conjugate vaccine is on the Gavi priority list for funding consideration. Gavi’s decision to support the use of a typhoid conjugate vaccine will be shaped by the WHO Strategic Advisory Group of Experts (SAGE) and a revised recommendation that includes typhoid conjugate vaccines, as well as the availability of a WHO prequalified typhoid fever conjugate vaccine.