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Why I fight pneumonia

June 29, 2016 by Mark Alderson

Immunization clinic in The Gambia. Photo: MRC Unit The Gambia/Aisha Sarr Ya Bajen

Families at an immunization clinic in The Gambia. Photo: MRC Unit The Gambia/Aisha Sarr Ya Bajen.

Mark Alderson won’t rest easy until he solves one of the biggest problems in global health: a vaccine against pneumonia.

Nearly a decade ago, I joined the fight against pneumonia. The reasons were compelling then and still are. But, what I witnessed one hot day in The Gambia continually reminds me why I stay the course.

I officially joined up when I signed on at PATH to lead a vaccine development project to fight the top cause of severe childhood pneumonia—pneumococcus. As an immunologist and vaccinologist, I was interested in solving the big problems in global health. And, as far as problems went, pneumonia was one of the biggest. In fact, it continues to kill more young children than any other infectious disease worldwide.

Our goal was to develop, license, and introduce lifesaving vaccines that are affordable and accessible for children in even the world’s poorest communities, where pneumonia hits hardest. Coming from an industry background, I found PATH’s approach to global health innovation appealing, uniquely positioned as a nonprofit organization using science to emphasize doing good rather than focusing on the bottom line. And PATH has one of the world’s largest vaccine portfolios and a comprehensive, lab-to-last-mile delivery strategy to accelerate their development, introduction, and scale-up.

A community clinic in The Gambia

A few years in, I traveled to The Gambia to meet with partners about a pneumococcal vaccine clinical study we were planning. One of our partners had just opened a new clinic in the town of Fajikunda where the study would take place. To celebrate, the community gathered for a public ceremony and I found myself lost in the crowd. Mothers and fathers came with their children. Physicians and nurses attended. Dignitaries gave speeches. All of them braved the scorching heat to show their appreciationnot just for the health services that the clinic would provide, but for the chance to participate in clinical research that could help solve problems they experienced on a daily basis.

They knew all too well what it meant to lose children to infections like pneumonia and understood what had to be done to protect their children. They saw that their participation in clinical trials to develop new vaccines could someday save lives in their community.

Standing amidst the crowd’s infectious enthusiasm, I felt my roots in our work grow even more. The importance of getting to the finish line in the fight against pneumonia seemed clearer than ever.

“ They saw that their participation in clinical trials to develop new vaccines could someday save lives in their community. ”
Isatu Conteh sitting on the edge of a small, hand-carved boat on the bank of a river.

Isatu Conteh, a parent who lost a child to pneumonia. Photo: PATH/Doune Porter.

Beyond the bottom line to the finish line

Pneumococcal vaccines for young children have been around for 16 years. They have been a critical part of the toolkit that has helped annual childhood deaths from pneumonia fall from nearly two million in the early 2000s to around 900,000 today. They only protect against some strains of pneumococcus, however, and are also relatively complex and expensive to produce. Traditionally underserved countries like The Gambia have only been able to gain access to these vaccines in recent years with the help of substantial donor assistance. Meeting needs in these communities over the long term will require reducing the inherent cost of the vaccines and broadening their protection. Doing so would also free up donor funds for other priorities, including other lifesaving vaccines.

Easier said than done though. Companies have to be willing to provide vaccines for less, risks have to be taken to advance technologies, and coordination is needed to ensure sustainable access for everyone.

On the road to affordable pneumococcal vaccines, our project is supporting clinical evaluation for a more affordable (US$2 or less per dose) version of the currently licensed conjugate vaccines that targets the specific strains of pneumococcus particularly affecting Africa and Asia.

The journey has had its ups and downs, but each milestone we achieve helps me see the finish line getting closer. Whenever I start to lose my way, I think back to the Gambian crowd’s hum of excitement. It was the sound of hope for a better future around the cornerif we stay the course.

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