Our work focuses on seven priority initiatives: pneumococcus, meningococcus, diagnosis and treatment, strategic information and advocacy, RSV, influenza, and risk factors. While pneumonia affects people of all ages, our priority is children under age 5.
Pneumococcus is the leading cause of pneumonia and is responsible for 40 percent of cases in children under age 5. We work to broaden access to the two commercially available pneumococcal conjugate vaccines (PCVs) while also investing in the development, regulatory approval, and deployment of newer and improved vaccines.
Pneumococcal vaccine in cold storage at a facility in Nairobi, Kenya.
We have worked with the GAVI Alliance to implement the Advance Market Commitment for Pneumococcal Vaccines, an innovative financing mechanism that accelerates late-stage development and manufacturing of pneumococcal vaccines for developing countries.
The price of PCVs is relatively high compared to other vaccines in routine immunization programs in most countries. We address this challenge by supporting efforts to broaden the supplier base to reduce prices and by working with PATH and the Serum Institute of India to develop a low-cost PCV for India and other countries with a high burden of pneumonia.
In an effort to eliminate epidemic meningitis A in Africa, we support the Meningitis Vaccine Project, a collaboration that also includes PATH, WHO, African health ministers, and the Serum Institute of India. The project has developed an affordable vaccine called MenAfriVac—the first vaccine developed specifically for Africa—that provides lasting protection from life-threatening meningococcal meningitis, a bacterial infection of the fluid surrounding the brain and spinal cord.
Launch day for the MenAfriVac vaccine in Burkina Faso in 2010. (Photo © PATH / Gabe Bienczycki)
MenAfriVac was first introduced in Burkina Faso in 2010. Since then, more than 100 million people have received the vaccine, and it continues to be introduced throughout the “meningitis belt” in Sub-Saharan Africa. Our current investments will enable the use of MenAfriVac in infants and promote its inclusion in routine immunization programs in all countries in the meningitis belt.
Initial data suggests that MenAfriVac is effective in reducing meningococcal A outbreaks; the meningitis A bacterium has been nearly eliminated in vaccinated populations so far. We support continued studies and surveillance to monitor the evolution of the disease and the potential need for meningitis interventions beyond this new vaccine.
Diagnosis and Treatment
Urgent work is needed to ensure that children who are sick with a severe respiratory illness receive appropriate care. Many children die because their families do not recognize the symptoms or are unable to quickly get them to a healthcare provider. Children who do reach a provider might be misdiagnosed or not given the correct antibiotic therapy. If the illness has progressed to a level of severity that requires highly technical skills or equipment, those resources might not be available or accessible.
We work closely with other teams at the foundation to improve access to effective treatment for sick children, with a special focus on Nigeria, northern India, and Burkina Faso. Our decision to focus on these countries is based on the burden of childhood illness, readiness to innovate, and strong partner organizations. Our work includes educating caregivers on the signs and symptoms of pneumonia and increasing women’s autonomy to seek and advocate for care. We also invest in the development of tools to diagnose pneumonia quickly and to improve triage and referral systems for very sick children.
In countries where the Community Case Management approach is being used to train community members to deliver interventions for common childhood illnesses, we work to make such efforts more sustainable. We also work to improve the quality of care delivered by small-scale private providers, who are often the nearest healthcare option for many families in poor countries.
Strategic Information and Advocacy
We invest in the collection and use of high-quality data on the causes and global burden of pneumonia, which will contribute directly to vaccine development, better treatments, improved service delivery, innovation in diagnostics and treatment, and better reporting on causes of death.
We also work to raise the profile of pneumonia as a critical child health issue. Our priorities include ensuring sufficient funding for critical vaccines; supporting vaccine and child health advocates; and building political will at the global and country levels for evidence-based pneumonia prevention and treatment. We also seek to increase resources dedicated to immunization programs and to ensure government follow-through on important global health initiatives such as the Global Vaccine Action Plan for the Decade of Vaccines.
Respiratory Syncytial Virus
RSV is one of the most common causes of childhood lung infections, mainly in the first six months of life. We support the development of maternal and infant RSV vaccines. We also work to improve global data collection on mortality and morbidity related to RSV and on the long-term consequences of severe RSV infections. This information will help in evaluating the potential impact and cost effectiveness of RSV vaccines that are under development, as well as alternative prevention strategies.
We aim to address gaps in data on influenza in tropical and developing regions, assess existing strategies to stimulate demand for seasonal influenza vaccines, and ensure that pregnant women and young children in resource-limited settings can access affordable, effective vaccines.
Maternal influenza immunization has long been practiced safely in industrialized countries and could play an important role in reducing the burden of seasonal influenza in tropical regions by protecting pregnant women and the babies they carry.
Existing influenza vaccines are the basis of our maternal immunization strategy, which may pave the way for additional vaccines for pregnant women. We work with global partners to identify and address scientific, technical, regulatory, operational, and financial challenges to broadening maternal immunization efforts. We also support research to understand the benefits of maternal influenza immunization on fetal development and protection against illness.
In addition, we invest in the development of new and improved influenza vaccines for children under age 2.
Along with our efforts to broaden immunization against pneumonia and improve treatment, we work to reduce environmental risk factors. Adequate nutrition and breastfeeding—addressed as part of the foundation’s nutrition strategy—are key factors in ensuring that children’s immune systems are equipped to fight off infection.
Reducing indoor air pollution is also likely to lessen the risk of pneumonia. We invest in limited research to fill fundamental gaps in knowledge about the dose-response relationship between indoor air pollution and childhood pneumonia. We also support efforts to improve monitoring technology to measure personal particulate matter and to establish surrogate endpoints for subsequent clinical trials. Our work in this area will evolve as our understanding of the link between indoor air pollution and pneumonia grows.