A COMMENT FROM THE COORDINATOR
November 12, 2018 is World Pneumonia Day.
- World Pneumonia Day (WPD) 2018 is just around the corner! Be sure to check out our Events section to see WPD events happening near you.
DEEP BREATHS: BLOGS FROM PIN MEMBERS
Towards Elimination of Pneumococcal Disease
by Mark Alderson, Director of the Pneumococcal Vaccine Project at PATH, photos by Lauren Newhouse (PATH) and Mark Alderson (PATH)
Pneumococcal conjugate vaccines (PCVs) have now been introduced into many countries throughout the world, including in nearly 60 Gavi supported countries where these vaccines have markedly reduced childhood pneumococcal disease (including pneumonia). Despite this considerable success, two major challenges remain for global pneumococcal disease control—ensuring that PCVs are sustainably affordable for low- and middle-income countries (LMICs) and addressing disease caused by non-PCV serotypes.
Financial support provided by Gavi, the Vaccine Alliance and other donors has been instrumental in helping low-income countries (LICs) afford PCVs; however, many middle-income countries ineligible for Gavi assistance have struggled to afford them. A looming concern is that the same will happen for LICs when they graduate from Gavi support. We need inherently lower-cost PCVs to fill this gap. Competition from developing-country vaccine manufacturers (DCVMs) has solved this problem for other vaccines, but PCVs present unique manufacturing, clinical, and regulatory challenges that have thus far slowed DCVM entry into the PCV market. Fortunately, a number of DCVMs may now be on the brink of PCV licensure and World Health Organization prequalification—offering hope for competition and more efficient manufacturing processes that sustainably lower PCV costs for LMICs.
The other challenge is that non-vaccine serotypes have emerged to cause considerable residual pneumococcal disease in many areas where PCVs have been introduced. One proposed strategy for addressing this gap is to increase the number of PCV serotypes from the current 10 to 13 up to 15 to 24. This approach is challenging for LMICs, however, due to PCV manufacturing complexities and increased costs associated with adding serotypes. Moreover, continued serotype replacement is likely and the overall value of adding more serotypes remains to be determined. Another strategy is to develop vaccines based on common pneumococcal protein antigens to either replace or supplement PCVs. Although this strategy has shown some initial promise, considerable clinical and regulatory challenges remain and difficulties in demonstrating a clear-cut protective benefit in early-stage clinical trials leave many questions as of yet unanswered.
Is there a solution? Natural immunity to the pneumococcus involves immune responses to both the polysaccharide antigens used to make PCVs and to common pneumococcal proteins. For this reason, the best strategy may be to combine these approaches, either by adding proteins to PCVs or by using common proteins as the carrier for PCVs. The latter approach has less regulatory challenges and, as such, may be our best shot for a more comprehensive global pneumococcal disease control strategy. Overall, progress to date against pneumococcal disease is an inspiring testament to what is possible, but we must continue to pursue strategies for addressing remaining gaps so that no child dies of this preventable disease, anywhere.
PNEUMONIA INNOVATIONS NETWORK MEMBER AND PARTNER UPDATES
Up your impact for World Pneumonia Day 2018
This year, we want your World Pneumonia Day to be more impactful than ever before! Here are 10 things you can do to make your contribution to World Pneumonia Day 2018:
- Participate in one of the WPD-related events: (1) On November 12, the University of Edinburgh will host a World Pneumonia Day Symposium, (2) On November 13, IVAC will host an event with the United Nations Foundation's Shot@life campaign in DC, and (3) on November 13, CSIS is hosting an Innovations to Improve Vaccine Equity event in DC.
- Read and share two new pneumonia-related reports that are being released: (1) "The Missing Piece: why continued neglect of pneumonia threatens the achievement of health goals” from JustActions and Development Initiatives using Global Burden of Disease 2017 data, courtesy of the Institute for Health Metrics and Evaluation (IHME), and (2) “Pneumonia and Diarrhea Progress Report” (this link is for the 2017 version) from IVAC using WHO/UNICEF data to measure select country progress to the GAPPD child pneumonia targets. You will be able to find both reports on the stoppneumonia.org website in early November.
- Promote the annual unveiling of 10 new “PneumoniaFighters! Hidden Heroes Fighting a Silent Killer”, and share their stories on social media using #PneumoniaFighters. Browse earlier champions here: PneumoniaFighters!: Hidden Heroes Fighting a Silent Killer. The new list will be revealed on November 12.
- Register and/or submit an abstract for a pneumonia-related device to the 4th WHO Global Forum on Medical Devices, which will take place from 13-15 December 2018 in India.
- Start sharing your own pneumonia-related content NOW using #stoppneumonia, #everybreathcounts, and #pneumoniainnovations and connect your work in pneumonia to the larger efforts to increase vaccine coverage (#vaccineswork #gotlife), leverage more domestic spending for children’s health (#InvestInHealth, #thegff), expand universal health coverage (#UHC #HealthforAll), and shift the focus to primary health care (#PrimaryHealthCare #PHC). Focused action on pneumonia will help all of these efforts achieve their goals.
- Stay tuned for a November announcement from Unitaid regarding their RFP for a better tools for integrated management of childhood fever. This work hold the promise of accelerating development of next generation diagnostic tools that can help countries reduce childhood deaths from malaria and pneumonia, better target medicines, and reduce risks of antimicrobial resistance.
Exciting publications coming your way
Keep your eyes open for several exciting publications scheduled for release before or on WPD 2018:
- To be released ahead of WPD 2018: The International Vaccine Access Center at Johns Hopkins Bloomberg School of Public Health will be releasing its ninth annual Pneumonia and Diarrhea Progress report.
- To be released in JAMA Pediatrics, November 12, 2018: Placebo versus amoxicillin for non-severe fast-breathing pneumonia in Malawian children aged 2-59 months: a double-blind, randomized controlled non-inferiority trial
- To be released in The Lancet Global Health, November 12, 2018: A hundred years after the 1918 influenza pandemic - the role of bacterial vaccines in prevention of pandemic and seasonal influenza mortality
Kevin Watkins delivers impactful speech on pneumonia at Social Good Summit 2018
At this year's Social Good Summit, Kevin Watkins sets out the case for tackling pneumonia, and the reasons the disease has been ignored for so long.
"The battle against pneumonia is one that we can win, but we have to wake up."
Watch the full speech here and share the YouTube link within your networks and on twitter using the hashtags #everybreathcounts, #2030NOW, and #PNEUMONIA.