As WHO World Immunization Week 2014 draws to a close, the International AIDS Vaccine Initiative (IAVI), Aeras and the PATH Malaria Vaccine Initiative declare together: It’s time for AIDS, TB and malaria to go the way of smallpox and polio.
In 2012, the global death toll from AIDS, tuberculosis and malaria equaled the population of Connecticut.
Despite enormous progress in treatment and prevention, these three infectious diseases still bring death and misery to millions of people each year. We need new tools to erase them from the globe once and for all. In particular, we need vaccines.
Vaccines are among the greatest success stories in the history of public health. They have eradicated smallpox and nearly eradicated polio, save 3 million lives a year, and avert untold suffering and costs. They provide lasting protection, and can be distributed widely within broader public health campaigns and in places where healthcare infrastructures are limited.
How different tomorrow could look if vaccines joined the arsenals against these three global killers:
In 2012, HIV/AIDS killed 1.6 million people worldwide and infected 2.3 million others. Some 35.3 million people, including 3.3 million children, live with HIV worldwide. In east and southern Africa, 10.5 million children have lost one or both parents to HIV/AIDS. For every three people put on treatment, four others contract HIV. Even if sufficient funding materializes to maximize access to existing treatment and prevention, studies suggest that low- and middle-income countries will still see more than half a million new infections a year come 2050.
Adding and successfully implementing a 60-percent-efficacious AIDS vaccine could reduce new HIV infections by 25 percent in its first decade and by almost half in 25 years, averting up to 22 million infections.*
In 2012, TB killed 1.3 million people, including 530,000 children, and caused 8.6 million others to fall ill. TB is highly infectious, passed simply by breathing, and is a leading cause of death among people with HIV. One person with active TB disease can transmit it to 10-15 people and it is becoming more dangerous as it becomes increasingly resistant to available treatments.
Adding and successfully implementing a 60-percent partially efficacious preventive TB vaccine for adolescents and adults could avert 30-50 million new cases by 2050, plus an additional 7-10 million cases in infants.
In 2012, malaria killed more than 625,000 people, 90 percent of them in Africa and 77 percent of them children under age 5. Approximately 3.4 billion people live at risk of infection. Recent progress notably with bednets, drugs and sprays is threatened by growing resistance to drugs and insecticides.
Adding and successfully implementing a malaria vaccine with even modest efficacy has the potential to avert around 1 million total future deaths in Africa from 2015 – 2030, according to the GAVI Alliance.** Such a vaccine could have substantial health impact.
These three diseases have posed unprecedented challenges to the research and development of vaccines, but exciting innovation has been rising to push the world’s scientific frontiers.
Recent breakthroughs have brought critical lessons about the fast-mutating HIV; more than 30 vaccine trials are in progress, and others are being readied that build on 2009’s proof that a vaccine can help prevent HIV infection in people.
More than 12 TB vaccine candidates are undergoing clinical testing globally, and more than 25 preclinical candidates are under development.
The WHO reports nearly three dozen malaria vaccine approaches in various stages of clinical development worldwide. Additionally, an innovative partnership has helped to advance a vaccine candidate through Phase III clinical trials and toward submission to regulatory authorities later this year; scientists are already working on a second generation of vaccines.
Yet funding for this critical research and development is holding flat, at best. The steadfast commitment of the U.S. Government remains a beacon of hope for those who most need what this promising science will provide.
We can achieve a world that’s finally free of the enormous human and economic tolls wrought by HIV/AIDS, TB and malaria. We can do it with redoubled commitment. We can do it with sustained funding to support continued scientific innovation. We can do it – with vaccines.
*Modelling by IAVI, AVAC, and Futures Institute building on UNAIDS data and analyses