PATH’s Japanese Encephalitis Project helps millions get access to a lifesaving vaccine

In 2006, millions of Indian children lined the halls of village clinics, schools, and community centers, waiting their turn for a shot that would protect them against Japanese encephalitis, or “brain fever.” They were taking part in an unprecedented and far-reaching immunization campaign launched by the Government of India in response to a 2005 outbreak that killed 1,700 people, mostly children, and disabled thousands more.

The following year, the government’s campaign reached 20 million, bringing the number protected to more than 30 million kids. By the close of 2009, more than 60 million Indian children had been immunized, and the government expects to reach a total of 100 million by the end of 2010.

The successful vaccination campaigns in India were established with the assistance of PATH’s Japanese Encephalitis Project. Through this project, PATH and our partners have worked to build awareness of Japanese encephalitis throughout Asia and the Western Pacific Region where the disease occurs and to help countries introduce an affordable, lifesaving vaccine to protect against it.

A hidden toll

Japanese encephalitis (JE) has historically received inadequate attention partly because it’s virtually unheard of in the industrialized world. Hosted by pigs and wading birds and transmitted by mosquitoes, the virus that causes the disease mainly strikes poor rural communities in Southeast Asia and the Western Pacific. The World Health Organization (WHO) estimates that JE claims 10,000 to 15,000 lives a year. But because awareness is low and the disease is tough to diagnose, these figures may be gross underestimates.

Even less understood is the lifelong toll that JE takes on its survivors. Up to half of survivors can suffer neurological damage that will affect them for the rest of their lives. Shadow Lives, a short video produced by PATH, tells the story of three families’ experience with JE.

Partnerships for protection

The only way to effectively control JE is through vaccination. PATH and our partners consequently focused on providing technical support to JE-endemic countries working to make immunization routine. PATH collaborated with national governments in India, Sri Lanka, Nepal, Cambodia, Vietnam, and other countries, as well as with WHO and UNICEF, to equip policymakers with the tools they need to make appropriate decisions on JE control. We helped establish robust, sustainable systems for diagnosing JE, tracking its incidence, and modeling the cost-effectiveness of introducing vaccine.

We also helped identify an existing vaccine against JE—known as the SA 14-14-2 vaccine—that has been safely used in China for more than 20 years and conducted clinical trials that add to a growing collection of data on the vaccine. For example, we and our partners conducted studies to  determine whether the vaccine can safely be given at the same time children receive routine measles vaccination.

In addition to being proven safe and effective, JE vaccine must also be affordable for use in low-income countries. PATH negotiated with vaccine manufacturer Chengdu Institute of Biological Products to establish a special public-sector price—the only way developing countries can afford to bring the vaccine to poor children who are at highest risk. PATH also helped to support construction of a new manufacturing facility to ensure an adequate, stable, and affordable vaccine supply that meets international production standards.

Originally envisioned as a five-year effort, the JE Project largely completed its work to support country surveillance and clinical studies in 2009. Work to support WHO prequalification of the SA 14-14-2 vaccine and to provide technical assistance to the Government of India for vaccine introduction is continuing through 2011.

PATH and our partners envision a world where every affected country has the information and political will needed to effectively, efficiently, and safely control JE—and where every child at risk of JE infection is protected early in life by a safe, efficacious, and affordable vaccine.

Read more about PATH’s leadership in stopping Japanese encephalitis.