Latest articles about typhoid

The issue

More than 11 million people are infected with typhoid every year, mainly in low-income countries.

Typhoid fever is a life-threatening disease caused by the bacterium Salmonella Typhi. It is mainly transmitted through contaminated food or water. Symptoms include prolonged fever, headache, nausea, loss of appetite, constipation and sometimes diarrhoea. If typhoid is not treated, it can kill up to 30% of those who are infected.

Disease burden

While improvements in living conditions and increased access to antibiotics have largely eliminated typhoid from industrialised countries, it remains a serious threat in low-income countries.

Typhoid affects 11-21 million people each year, causing 128,000 to 161,000 deaths - mainly in sub-Saharan Africa and South Asia. Almost a third of all cases are among children under five, highlighting the importance of being able to prevent the disease in young children.

Antibiotic resistance

With appropriate antibiotic treatment, the case fatality rate of typhoid can drop to less than 1%. However, in recent years there has been an alarming increase in antimicrobial resistance of Salmonella Typhi. Drug-resistance is spreading across Asia and Africa, posing a serious threat to public health.

The emergence of drug-resistance could stall efforts to control the disease and force a shift of focus towards prevention rather than treatment, mainly through immunisation and improved access to safe water, sanitation and hygiene.

Vaccine-preventable

Typhoid conjugate vaccines, in combination with increased access to improved sanitation and clean water, can significantly reduce the spread and burden of typhoid fever around the world.

In October 2017, WHO recommended the introduction of typhoid vaccine for children over six months in endemic countries. It also recommended catch-up vaccination when feasible and appropriate, prioritising children and adolescents up to 15 years of age.

Gavi’s response

Gavi prioritised typhoid conjugate vaccines in 2008, as part of the vaccine investment strategy, but did not make a financial commitment due to the absence of a suitable vaccine. Following the WHO prequalification of a newly available typhoid conjugate vaccine at the end of 2017, and the release of SAGE guidance on the use of typhoid conjugate vaccines, Gavi opened a funding window for the vaccine.

Find out more about applying for vaccine support

Gavi prioritised typhoid conjugate vaccines in 2008, as part of the vaccine investment strategy, but did not make a financial commitment due to the absence of a suitable vaccine. Following the WHO prequalification of a newly available typhoid conjugate vaccine at the end of 2017, and the release of SAGE guidance on the use of typhoid conjugate vaccines, Gavi opened a funding window for the vaccine.

Find out more about applying for vaccine support

Investing in typhoid vaccines is closely aligned with Gavi’s mission and strategic goals.

  • Almost a third of all cases are among children under five years of age.

  • While high-income countries have virtually eliminated typhoid, it still common in low-income countries. Typhoid vaccines can help bridge this equity gap.

  • Through our market shaping efforts, we can help to improve supply of the vaccine and encourage new manufacturers to enter the market – increasing healthy competition.

2018 was the first year in which countries could apply for Gavi support through a new window for typhoid conjugate vaccine (TCV). Gavi funding is available for routine immunisation and for catch-up immunisation at the time of introduction as appropriate to a country’s epidemiologic context. Pakistan was the first country to apply for routine support, partly in response to the widespread transmission of an extensively drug-resistant strain of salmonella typhi. Pakistan will be the first country to introduce TCV with Gavi support and their introduction is planned to begin in 2019. Zimbabwe was also approved for TCV support for use against a drug-resistant typhoid outbreak in Harare. The TCV outbreak response campaign was planned for early 2019 and will represent the first non-research use of TCV in sub-Saharan Africa an increasing number of countries have indicated interest to introduce TCV, and we expect demand to increase in the coming years. 

More effective vaccine

Previous typhoid vaccines were not effective in children younger than two years, and only provided short-term protection. The new typhoid conjugate vaccine promotes a stronger immune response. As a result, it provides longer-term protection and can be effective in children as young as six months.

High routine immunisation coverage with the new typhoid conjugate vaccine can play an important role in controlling this deadly disease. The use of the vaccine will also help the global community to understand its impact on antimicrobial resistance, as well as to identify appropriate immunisation strategies.

Gavi support

In line with WHO recommendations, Gavi provides support for nationwide introduction of TCV into the routine immunisation schedule through vaccine co-financing and depending on the country context, a targeted one-time catch-up immunisation of up to 15 years of age based on local typhoid epidemiology. We fund the vaccine itself, as well as injection supplies and a grant to cover introduction costs. 

Support for typhoid conjugate vaccines was Board-approved in late 2017 and the application window opened mid-2018. Since then three countries have applied for support, which includes a request for TCV use in response to an outbreak. The first Gavi-supported introduction began in 2019.

Latest articles about typhoid

4 November 2022

“It’s difficult, but we’ll find a way”: a new vaccine against typhoid rolls out in a flood-devastated province of Pakistan

Armed with vials of Typhoid Conjugate Vaccine, health workers in Balochistan are doing what they can to protect children threatened by a pincer movement of global crises: antimicrobial resistance on the one hand and climate change on the other.…

26 October 2022

Dial-a-vax: Pakistan’s 1166 helpline has answers for the country’s vaccine questions

Is my child eligible for the new typhoid conjugate vaccine? I’m living in a flood-zone and I’m spiking a fever. Can my baby get immunised against COVID-19? In Pakistan, a multilingual government helpline funnels information-seekers straight to a…

15 August 2022

New TCV data from Malawi highlight longer-term immune response

Strong immune response data provide even more evidence that typhoid conjugate vaccine offers lifesaving protection to African children.

26 July 2022

Could vaccines save us from antimicrobial resistance?

Each year around five million people die from antimicrobial resistant infections. Vaccines could help, but the current vaccine pipeline is insufficient.

4 July 2022

‘Global response’ needed as typhoid evades antibiotics

Drug-resistant typhoid has spread worldwide from South Asia – study. ‘Very few antibiotics left are effective against typhoid’ – lead researcher. Researchers say global response is needed.

14 April 2022

Vaccine reaches Nepal’s provinces just in time for typhoid season

Nepal’s government has kicked off a major typhoid conjugate vaccine (TCV) campaign, also introducing this lifesaving vaccine into the country’s routine immunisation programme.

11 April 2022

Celebrating Nepal’s typhoid conjugate vaccine introduction

The introduction of typhoid conjugate vaccine in Nepal is a great step forward in keeping children healthy and protected from typhoid.

16 September 2021

Now we know: typhoid conjugate vaccines are highly effective in African children

A study in Malawi found that TCVs are 84% efficacious among children 6 months to 15 years of age – the first such evidence among African children.

13 August 2021

TCV is 85% efficacious and urgently needed for Bangladeshi children

New study finds TCV prevents 85% of cases among vaccinated children in Bangladesh, which has one of the highest typhoid burdens in the world.

18 June 2021

The tragedy of Typhoid Mary

Mary Mallon was branded a public menace and incarcerated after typhoid outbreaks across New York City were linked to her presence in the kitchen. Was she unfairly demonised?

10 June 2021

Tackling typhoid in Zimbabwe: “We have to be sure for ourselves that the water is safe”

After a devastating typhoid outbreak swept through Bulawayo, Zimbabwe, a new, more effective vaccine is bringing hope.

3 February 2021

The next step: Lifesaving typhoid conjugate vaccines reach Punjab province, Pakistan

Punjab province introduces typhoid conjugate vaccine, taking the next step in protecting children from typhoid in Pakistan.

16 December 2020

More typhoid conjugate vaccines, more impact

A second typhoid conjugate vaccine has achieved WHO prequalification and others are in development. More vaccines will help increase access to TCVs.

19 November 2020

One step closer to untreatable typhoid

The continued emergence and spread of drug-resistant typhoid make infections more difficult to treat. Life-saving vaccines are urgently needed to prevent it and to limit its spread.

24 September 2020

Keep focus on emerging infections, Disease X: analysts

Biggest funders of emerging infectious diseases R&D are also biggest recipients. Ebola and Zika experienced R&D spike in wake of epidemics. US is losing global leadership role in the field.

24 September 2020

Typhoid: immunising against antimicrobial resistance

Typhoid fever is increasingly resistant to the main antibiotics used to treat it. Gavi is supporting a new vaccine to help control this deadly disease – and fight antimicrobial resistance.

Last updated: 22 Sep 2022

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