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Never heard of GBS? Well, defeating it can save babies’ lives

Wednesday May 17 2017
keith

Dr Keith Klugman

As Africa gathered at the beginning of May for the World Economic Forum on Africa, there were many successes to celebrate. There was also a need to discuss plans to mitigate challenges we expect the continent to face in the coming decade. It was inspiring to see so many fine minds come together behind a common goal, and fascinating to hear about the different ways people propose to overcome the hurdles ahead.

But my favourite bit of news from the week is something you may have missed. On Tuesday May 2, the Biovac Institute, a South Africa-based manufacturer, announced with PATH, an international health organisation, that they have joined forces to develop a new vaccine for Group B Streptococcus (GBS).

This project makes Biovac the first African company to attempt to develop a GBS vaccine specifically designed to protect mothers and babies in sub-Saharan countries where the disease is most prevalent.

A viable solution to prevent GBS before babies are even born would be a huge boon to child health – not just in Africa, but in other regions of the world as well. While GBS isn’t exactly a household name, it is one of the leading killers of newborns. In some parts of the world the mortality rate from GBS is as high as 38 per cent, and in South Africa there are 2.38 cases of GBS per 1,000 live births.

Moreover, an estimated 1 in 4 pregnant women is a carrier of the GBS bacterium. Even babies who survive the illness can often be left with lifelong disabilities.
Infant mortality, especially in sub-Saharan Africa, is nebulous and largely mysterious.

There’s still a lot we don’t know about why kids are dying. We’re lucky that when it comes to GBS, we actually do know quite a bit. For instance, we know approximately how many deaths are caused by GBS, and we know that it can infect children any time immediately after birth or in the first month of life. This information, on its own, cannot stop deaths from GBS, but it can give us a pretty good idea of where to start to prevent it and what questions to ask.

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As Sue Desmond-Hellmann, the CEO of the Bill and Melinda Gates Foundation, is fond of saying, “You can’t fix what you can’t define.”

We know, for instance, that giving antibiotics to mothers can prevent the onset of GBS for the baby during the newborn period. But this method is not effective at protecting against GBS when the infant is slightly older.

Biovac’s proposed solution to this problem is a vaccine that would be given to pregnant women, who would then pass on the immunity to their children. This would be revolutionary for GBS.

The early weeks of life are a crucial period where infants are going unprotected. It’s too early in a child’s life to administer vaccines directly, but too late for the protection of antibiotics given to the mother to be in effect. We have seen vaccines for flu, for example, have protective effects using this same approach and are optimistic that we will see the same type of results for GBS.

Of course, ideas and projects as ambitious as this one don’t come overnight, and no one can come up with them alone. First and foremost, the South African government, specifically the Department of Science and Technology, has been working to develop the infrastructure to host a research and innovation hub for decades now. They recognised early on that innovation would be crucial to solving previously intractable problems like this one for child health.

None of this would be possible without the resources and effort that have been dedicated to growing the country’s network of top-quality universities and an advanced cadre of researchers and entrepreneurs.

But even given that, developing and manufacturing vaccines is a hard, complicated business. That’s why it’s so important, even for leading scientists, to partner with organisations that are already working on vaccines.

Biovac’s partner PATH has one of the world’s largest vaccine development portfolios, and expertise in the full range of research that will make this development possible. In addition, Inventprise, a biotechnology start-up in Seattle, will provide technical support to this project in the early stages.

Inventprise has experience developing the kinds of vaccines that can pass from pregnant mothers to children, and its role will be to ensure that Biovac has all the resources it needs to develop the kind of vaccine it envisions – one that is specifically targeted to address GBS in sub-Saharan Africa and similar regions.

This partnership is the exact type of project the Bill and Melinda Gates Foundation likes to fund: One where babies lives are saved, the public and private sectors come together to solve an old problem in a new way, and where local expertise can shine. We’re honoured to be able to support this project and can’t wait to see how many lives are saved because of it.

Dr Keith Klugman is director for pneumonia at the Bill and Melinda Gates Foundation.

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