Coalition against Typhoid

Partnership Objectives

  1. Saving lives and reducing suffering by advancing typhoid vaccination in all settings.
  2. Defining the barriers for the adoption of typhoid vaccines in the communities where they are needed most.
  3. Defining the key activities that are needed to overcome the barriers for the adoption of typhoid vaccines.

In many areas, typhoid fever is misdiagnosed as malaria, dengue, or pneumonia due to non-specific clinical symptoms. In many areas, typhoid fever is misdiagnosed as malaria, dengue, or pneumonia due to non-specific clinical symptoms. Copyright Coalition against Typhoid

What are the health needs and challenges?

Typhoid fever is a severe bacterial infection spread through water or food contaminated with human waste. The bacterium that causes typhoid fever is Salmonella enterica serovar Typhi (S. Typhi). The disease causes high fever, flu-like symptoms, abdominal pain, constipation or diarrhea, rose-colored spots on the chest, and systemic illness that can result in severe morbidity or death. Typhoid fever impacts the lives of an estimated 21 million people a year, causing at least 200,000 deaths, predominantly among school-age and preschool-age children. The disease burden and global mortality rates from typhoid fever are comparable to other significant vaccine-preventable diseases, including rotavirus, Haemophilus influenzae B (Hib), and Hepatitis B. The disease is transmitted through the fecal-oral route and is most prevalent in areas without safe water and improved sanitation.

In many typhoid-high burden communities, reliable health care services, including accurate diagnostics and basic antibiotic medications, are limited. When healthcare services can be reached, low-cost, first-line antibiotics may not be effective.

Research indicates that multidrug resistant (MDR) typhoid strains have become increasingly common in typhoid-high burden communities, requiring new and more expensive antibiotics for treatment and increasing hospitalization rates for patients. Without appropriate antibiotic therapy, typhoid mortality can reach 20%. In 2014, 97% of typhoid cases resisted treatment from multiple drugs, an increase of 90% from 2010. 

Another issue affecting the treatment of typhoid is the lack of effective diagnostics. Delayed and inaccurate diagnosis and treatment result in increased costs and higher rates of serious complications and deaths. In many areas, typhoid fever is misdiagnosed as malaria, dengue, or pneumonia due to non-specific clinical symptoms. Currently, if left untreated, 20% of typhoid cases are fatal.

Prevention is key to stopping the cycle of typhoid transmission. Vaccines can help ward off typhoid infection in endemic environments, while improvements in water, sanitation and hygiene (WASH) infrastructure can help eliminate exposure to typhoid and paratyphoid bacteria. 

Description of partnership activities and how they address needs and challenges

By increasing disease burden knowledge and awareness and raising visibility of the World Health Organization’s (WHO) recommendations to countries and clarifying vaccination strategies, the Coalition against Typhoid (CaT) aims to prioritize typhoid on the global stage.

CaT is a global forum of scientists and immunization experts working to save lives and reduce suffering by advancing typhoid vaccination in high burden communities; populations affected by complex emergencies and natural disasters; and persons at risk for typhoid or its transmission as a result of their occupation or travel.

Activities of the CaT include:

  • Increasing typhoid fever awareness of the global, regional, and national epidemiology and disease burden
  • Promoting awareness of WHO’s recommendations on typhoid vaccination
  • Implement the typhoid vaccine in most endemic countries in 5-10 years
  • Encouraging GAVI’s prioritization of typhoid vaccines by providing data and modeling of disease burden and vaccination impact
  • Assisting countries to develop their vaccination strategies including: short term improvement such as good hygiene practices (eg. hand washing), long term improvements (eg. access to safe water and improved sanitation).
  • Securing adequate resources in to support all the activities above

Summary of impact and forward looking information

The Coalition against Typhoid attends and organizes multiple annual events and meetings to foster collaboration of CaT activities at regional, national and global levels. These events include the World Congress on Pediatric Infectious Diseases, the International Congress for Infectious Disease, the General Meeting of the Developing Countries Vaccine Manufactures Network and series of meetings with the best modelling experts in the world to review typhoid burden estimates and vaccine impact models. 

CaT continues to expand the number of its partners and assist in the coordination of in-country implementation programs and monitoring of typhoid vaccination programs. 

On 2 March 2015, Novartis announced the completion of a series of transactions with GlaxoSmithKline plc (GSK), including the divestiture of the Novartis non-influenza Vaccines business to GSK.


Typhoid and Water

Partnership information

Company(ies) Johnson & Johnson , Novartis

Partner(s) Aga Khan University, Agence de Médecine Préventive, Bharat Biotech, Bill and Melinda Gates Foundation, Center for Disease Control and Prevention (CDC), Clinical Research Unit at the Hospital for Tropical Diseases, Oxford University, Finlay Institute, Fogarty International, Fondation Mérieux, GAVI Alliance, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), International Vaccine Institute, Oxford Vaccine Group, PATH, Sabin Vaccine Institute, UNICEF, University of Maryland, University of Otago, US National Institutes of Health (NIH), Wellcome Trust, World Health Organization (WHO)

Type of Partner(s) Academia / Hospitals, Government, IGOs, NGOs, Other Business, PDPs

Therapeutic Focus Vaccine-Preventable Diseases

Disease(s) Typhoid Fever

Program Type(s) Prevention Programs - Vaccines, Research & Development - Development of Treatments, Research & Development - Pediatric R&D

Targeted Population(s) Children, People with low income, Youth

Region(s) East Asia & Pacific, Europe & Central Asia, Latin America & Caribbean, Middle East & North Africa, South Asia, Sub-Saharan Africa

Number of Countries 89

Country(ies) Afghanistan, Angola, Armenia, Bangladesh, Belize, Benin, Bhutan, Bolivia, Burkina Faso, Burundi, Cambodia, Cameroon, Cape Verde, Central African Republic, Chad, Comoros, Côte d'Ivoire, Democratic Republic of the Congo, Djibouti, Egypt, El Salvador, Eritrea, Ethiopia, Fiji, Georgia, Ghana, Guatemala, Guinea-Bissau, Guyana, Haiti, Honduras, India, Indonesia, Iraq, Kenya, Kiribati, Kosovo, Kyrgyzstan, Lao PDR, Lesotho, Liberia, Madagascar, Malawi, Mali, Marshall Islands, Mauritania, Micronesia, Moldova, Mongolia, Morocco, Mozambique, Myanmar, Nepal, Nicaragua, Niger, Nigeria, Pakistan, Papua New Guinea, Paraguay, Philippines, Rwanda, Samoa, Sao Tome and Principe, Senegal, Sierra Leone, Solomon Islands, Somalia, South Korea, Sri Lanka, Sudan, Swaziland, Syria, Tajikistan, Tanzania, The Gambia, Timor-Leste, Togo, Tonga, Turkmenistan, Tuvalu, Uganda, Ukraine, Uzbekistan, Vanuatu, Vietnam, West Bank and Gaza, Yemen, Zambia, Zimbabwe

Start Date 2011

More information Coalition Against Typhoid

Anticipated completion date 2015