The urgency to prevent typhoid is increasing. These children were vaccinated with TCV in Zimbabwe, protecting them from typhoid

Prioritizing TCV introduction in Africa: Time for decision-makers to act with urgency

As another year draws to a close, policymakers, researchers, and partners are convening in South Africa to discuss typhoid, TCV, and the work that remains to combat this disease. Despite several years of sustained progress, including new prequalified vaccines, additional data, and four Gavi-supported TCV introductions, many challenges remain. Drug resistance, climate change, and migration persist and threaten typhoid control progress, raising the urgency to act. Increasing resistance to final line antibiotics remains one of the greatest threats to public health. Additionally, the Africa region is grappling with other significant health impacts linked to climatic shocks. These shocks can have long-term health consequences. As we collectively look toward 2023, there is no better time for decision-makers to prioritize TCV introduction to save lives.

Gathering to share data

During this exciting week in South Africa, several different meetings are occurring to discuss typhoid research, burden, and country introduction support. Partners and decision-makers from all over the world will share their experiences with typhoid prevention and control. The Scientific Advisory Process for Optimal Research on Typhoid burden of disease (SAPORT) team will meet to address ongoing challenges with typhoid prevalence, incidence, and drug resistance data. They will also discuss ways to improve the quality of future reports of these data. The SAPORT meeting is a valuable connection among researchers to understand what data are available and can influence discussion and decision-making.

A small team will also meet to discuss how best to standardize the reporting of typhoid prevalence and incidence data. Enhancing the QUAlity and Transparency Of health Research (EQUATOR) will look to tackle some of the pernicious challenges with standardized, comparable typhoid burden data across countries.

The final, and largest, meeting will bring together nearly 100 stakeholders from dozens of countries to discuss typhoid and TCV introduction progress in Africa. The first Africa Regional Typhoid Meeting will bring together key decision-makers from ministries of health, immunization programs, and multilateral partners, alongside regional and international partners and research institutes. The two-day meeting will be a valuable opportunity to learn about progress in the region. It will also allow decision-makers to strategize about the data and support needed to continue the typhoid control momentum.

Learning from country experiences

Specifically, the regional meeting will provide an opportunity for stakeholders and national policymakers to discuss TCV introduction and share early experiences. Policymakers from Liberia and Zimbabwe—the two countries that have introduced TCV so far—will speak about their early adoption experience and why they chose TCV as a high government priority. Researchers and partners will reiterate the data that show TCV is an efficacious and cost-effective public health tool.  Countries that have started TCV introduction discussions will have an opportunity to ask questions and strategically plan how best to engage with donors and partners.  The value of peer-to-peer conversation, sharing experiences, and learning from each other cannot be underestimated.

Continuing the momentum in Africa

The time for TCV introduction is now. The policy landscape is in place for country decision-makers. WHO recommends TCV in countries with a high burden of typhoid and/or drug-resistant typhoid. Gavi provides support to eligible countries for TCV introduction.  The looming challenges of drug-resistance, climate change, and increased urbanization raise the urgency for action. This meeting provides a timely opportunity for decision-makers to learn more about the potential of TCVs. Nearly 50 million children have been vaccinated with TCV and we need to continue the momentum in the Africa region. This week’s shared data, discussion of learnings, and connections made will be invaluable as we work to increase typhoid control progress in 2023.

Photo: Children walk together following vaccination with TCV during the introduction campaign in Zimbabwe. PATH/Kundzai Tinago.