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.
The pneumococcus is the leading cause of pneumonia and is responsible for at least 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.
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. In order to help lower the price of these costly vaccines, particularly for high-burden areas, we are working with PATH and the Serum Institute of India to develop and introduce additional pneumococcal conjugate vaccines to the market.
Launch day for the MenAfriVac vaccine in Burkina Faso in 2010. (Photo © PATH / Gabe Bienczycki)
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.
MenAfriVac was first introduced in Burkina Faso in 2010. Initial data from more than 100 million administered doses in Sub-Saharan Africa suggests that it is effective in reducing meningococcal A outbreaks; the meningitis A bacterium has been nearly eliminated in vaccinated populations so far. Our strategy supports efforts to make MenAfriVac available to infants, to promote its inclusion in routine immunization programs, and to monitor the evolution of the disease and the potential need for meningitis interventions beyond this new vaccine.
Treatment Innovations and Delivery
Urgent work is needed to ensure that children who are sick with a severe respiratory illness receive appropriate care. Many children die because they are not able to receive appropriate care quickly. Children who do reach a provider might be misdiagnosed or not given the appropriate antibiotic, amoxicillin. Sometimes the provider might not recognize that the child’s condition is severe or that the child is at increased risk due to young age or malnutrition. In many instances, such cases require referral to a facility where supportive care interventions such as oxygen are available.
We work closely with other teams at the foundation to improve access to effective treatment for children with pneumonia, with a special focus on Nigeria, northern India, Ethiopia, the Democratic Republic of the Congo, and Pakistan—the countries with the greatest number of pneumonia deaths. Our work includes generating evidence to improve care for infants and children with pneumonia in limited-resource settings, advocating for policy changes and increased financial support to expand the availability of key treatment commodities (including amoxicillin DT, pulse oximetry, and oxygen), and demonstrating how appropriate pneumonia care reduces mortality in order to accelerate improvements in case management on a broad scale.
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. Unlike other causes of pneumonia addressed by our strategy, there is no existing vaccine for RSV. We support the development of maternal 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.
A health worker in Bihar, India, uses a Mobile Kunji device during a routine prenatal visit.
We aim to address gaps in data on influenza in 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.
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, which serve to protect pregnant mothers and their babies. We also support research to further understand the benefits of maternal influenza immunization on the developing fetus and work to develop 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 by decreasing chronic inflammation in the lungs. 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 exposure 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.