Pakistan is the first country in the world to introduce World Health Organisation-recommended typhoid conjugate vaccine (TCV) in its national immunisation program.

In this big move, an India-made vaccine Typbar TCV, will play a significant role. About 1.2 crore doses of the vaccine have been supplied by Hyderabad-based Bharat Biotech for this initiative.

According to international reports, Pakistan is launching the project in Sindh province, which is the centre of an ongoing extensively drug-resistant (XDR) typhoid outbreak that began in November 2016.

Zafar Mirza, Special Assistant to Prime Minister Imran Khan on Health, said, “The government has planned a phased national introduction strategy with strong, coordinated support from global and local partners.”

With funding support from the Global Alliance for Vaccine Initiative (GAVI), the vaccine introduction will begin with a two-week vaccination campaign targeting one crore children. It will be introduced nationally in 2021, he said.

Bharat Biotech’s contribution

In January 2018, Typbar TCV became the world’s first conjugate vaccine prequalified by the WHO. That enabled the procurement and supply to UNICEF, GAVI, and Pan American Health Organisation (PAHO). The company announced a price of $1.50 per dose for procurement by GAVI-supported countries.

“In February 2019, the Pakistan government approached the Indian vaccine manufacturer through the GAVI Alliance to supply TCV,” Azra Pechuho, Health Minister of Sindh, told journalists, according to a report in The News, Pakistan.

She maintained that the Indian manufacturer had assured it would supply the vaccine in batches but the full consignment would be received in October 2019.

In the same month, the CMD of Bharat Biotech, Krishna Ella, had told media that the company had received a request from Aga Khan University, Karachi, to immediately despatch the vaccine. The company will also ship two lakh doses to Pakistan, he had said.

In late 2018 too, the company had donated one lakh doses of the vaccine to Pakistan, according to media reports.

After Pakistan, Liberia and Zimbabwe are also preparing to introduce TCV next year with support from GAVI. Several other countries too, are considering using this vaccine as they review data on the incidence of typhoid in their countries.

GAVI has allocated $85 million to support the introduction of TCVs, including Typbar-TCV, between 2019 and 2020.

Typhoid challenge

Typhoid is caused by the salmonella typhi bacteria, and is spread through contaminated food and water. According to WHO, every year nearly 1.2 crore cases of typhoid are reported globally. Death from typhoid is put at more than 1.28 lakh globally each year. And this is mostly reported among children and young adults in Asia and sub-Saharan Africa.

A typhoid conjugate vaccine offers a good solution to protect children from falling ill and from drug-resistant typhoid.