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Vaccinations can better fight superbugs

By Seth Berkley/Jeremy Farrar | China Daily | Updated: 2018-11-23 07:08
A Congolese health worker administers Ebola vaccine to a boy who had contact with an Ebola sufferer in the village of Mangina in North Kivu province of the Democratic Republic of Congo, August 18, 2018. [Photo/Agencies]

Whether you live below the poverty line in the slums of a city or work as a banker on Wall Street, drug-resistant "superbugs" are among the gravest threats to your health. But while the problem is ubiquitous, we are not entirely defenseless; in the race to prevent antimicrobial resistance (AMR), the world has a potent if underused tool: vaccines.

One epidemic currently plaguing Pakistan illustrates vaccines' potential. For two years, health professionals have been trying to contain an outbreak of extensively drug-resistant (XDR) typhoid. Unfortunately, diagnosing XDR typhoid is difficult, and doctors often prescribe antibiotics that are ineffective. This, in turn, prolongs the length and severity of the illness, and can lead to death.

But, we believe, doctors in Pakistan can prevent typhoid in the first place?

Gavi, the Vaccine Alliance, is helping to distribute a new vaccine, and if the immunization drive is successful, it will lead to a reduction in unnecessary antibiotic use, which is the main factor fueling the rise and spread of deadly superbugs everywhere.

Each year, some 700,000 people die from drug-resistant infections worldwide. And AMR, if not addressed, could make more infections untreatable, cancer therapies ineffective, routine surgeries impossible, and even childbirth unsafe.

We know vaccines help reduce AMR risk. For example, immunizations against bacterial brain and lung infections-such as childhood pneumococcal illnesses and Haemophilus influenzae type b, or Hib-have dramatically reduced the disease burden in the US and around the world, lowering the need for antibiotics in the process. Most important, while superbugs develop resistance to medications, they do not become resistant to vaccines.

Yet despite vaccines' effectiveness in the fight against AMR, we are not taking full advantage of them. For example, global coverage for the Hib vaccine is 72 percent but only about 44 percent of the world's children receive the complete course of the pneumococcal vaccine. Universal vaccination for the pneumococcal vaccine alone could reduce 11.4 million days of antibiotics for children below five.

So there is an urgent need to increase uptake of available vaccines-including for typhoid-and to develop new ones. For existing vaccines, the top priority should be to ensure universal access through expanded international coordination. A new report commissioned by Wellcome highlights vaccines could make greater positive impact on global health and AMR.

The World Health Organization has created a list of deadly pathogens that require new antibiotics, with those that cause salmonella, gonorrhea and shigella at the top. But vaccines are also needed to prevent these diseases in the first place. To accomplish that goal-and stave off AMR in the process-significantly more money must be spent on vaccine R&D. By increasing investments now, new vaccines will be available to help medical care providers stay ahead of superbugs.

Over the coming decades, demographic shifts, climate change and human migration, will compound AMR by making it easier for pathogens to spread. In fact, if the current trajectory is not slowed or reversed, by 2050 some 10 million people could succumb to drug-resistant diseases every year, costing the global economy $100 trillion. We have no time to waste in bringing new vaccines to the market.

More needs to be done to strengthen R&D for new diagnostic tools and antibiotics to treat drug-resistant infections, and similar attention must be paid to vaccine discovery, development and uptake.

Wellcome co-hosted a "call to action" event in Accra, Ghana, on Nov 19-20 to mobilize global action on AMR. Organized in partnership with the governments of Ghana, Thailand and the United Kingdom, as well as the United Nations Foundation and the World Bank, the event sought to translate disease-management commitments into viable AMR solutions.

When health professionals have the right tools to tackle AMR, millions of lives around the world will be saved. And when effective vaccines are used widely, superbugs will cease being so menacing.

Seth Berkley is CEO of Gavi, the Vaccine Alliance, and Jeremy Farrar is the director of Wellcome Trust, a global charitable foundation dedicated to improving health.

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