Reaching 10 million children in Burkina Faso with typhoid conjugate vaccines

Typhoid is endemic in Burkina Faso. In 2021, the Global Burden of Disease study estimated that there were more than 97,000 typhoid cases annually in the country, with 75 percent occurring in children younger than 15 years old.

This disease burden may be even higher, because diagnosing typhoid is difficult: it shares symptoms with other common enteric diseases, and the gold-standard method for diagnosis—a blood culture—is expensive, requires specialized facilities that are scarce in some areas, and accurately detects typhoid only half the time. Because of these limitations, getting a clear picture of the national typhoid burden is often a challenge.

Additionally, recovery from typhoid is often long and difficult, keeping children out of school for weeks and placing a heavy economic burden on families and caregivers who must miss work and face high treatment costs.

The World Health Organization (WHO) recommends typhoid conjugate vaccines (TCVs) for use in all typhoid-endemic countries. Compared to previously available typhoid vaccines, TCVs provide longer-lasting protection, only require one dose, and are suitable for children younger than 2 years old, allowing for delivery through routine childhood immunization programs.

Since 2022, PATH has worked with Burkina Faso’s Expanded Programme on Immunization (EPI), WHO, and other partners to support the TCV decision-making and introduction process. As part of the Typhoid Vaccine Acceleration Consortium (TyVAC), PATH supports typhoid-endemic countries interested in TCV introduction that are eligible for support from Gavi, the Vaccine Alliance.

PATH supported data collection and analysis to get a clearer understanding of the typhoid burden in Burkina Faso, including data on key risk factors like drug resistance and water, sanitation, and hygiene indicators. PATH also co-organized a national forum on typhoid that convened various stakeholders including public health specialists, infectious physicians and surgeons, researchers, and other decision makers to assess the typhoid burden and the opportunity to introduce TCVs.

Following Burkina Faso’s decision to introduce TCV, PATH assisted with the application for Gavi support and collaborated with the Ministry of Health throughout every step of the campaign planning and introduction process, from advocacy, communications, and social mobilization (ACSM) activities to microplanning workshops and orientation meetings for political, religious, and administrative authorities. PATH also provided supportive supervision during the campaign, working to quickly address challenges as they arose and ensure that vaccines reached as many children as possible.

PATH has worked in more than 40 countries to help accelerate the policy pathway for vaccines and optimize vaccine introductions, partnering closely with immunization program managers, ministries of health, and other national stakeholders. PATH also brings specific experience related to typhoid, having supported all previous TCV introductions in Gavi-eligible countries in Pakistan, Liberia, Zimbabwe, Nepal, and Malawi.

PATH’s longstanding collaboration with the Burkina Faso EPI on other disease areas—not just typhoid—gave us a proven track record as a reliable partner and positioned us well to understand the broader context of public health priorities in the country.

“We’ve built collaboration, trust, and partnership with the Ministry of Health particularly the EPI beyond just typhoid,” said Dr. Ipyn Eric Nebie, Senior Program Officer at PATH’s Center for Vaccine Innovation and Access, who spearheaded this work in Burkina Faso. “We work together to improve all the immunization systems in the country.”

Additionally, PATH’s deep understanding of the common challenges and gaps associated with TCV introduction that other countries have faced enabled the team to apply those lessons learned in Burkina Faso. Our adaptable model allowed us to fill strategic gaps that lacked funding, such as ACSM activities. “When the EPI presented the gaps in technical assistance activities, I would say 80% were related to communications,” said Dr. Nebie. “It was the area that was least supported by other partners, but it ended up being the most critical area that PATH supported.”

From the earliest conversations to the conclusion of the introduction campaign, PATH took a hands-on approach, delivering local support to government stakeholders and partners in Burkina Faso. The PATH team provided technical assistance during critical workshops and meetings, from partnering on the first national typhoid forum in 2022 to the campaign launch in 2025 and afterwards. During the campaign planning process, PATH’s experience with TCV introductions enabled the team to raise potential issues and identify roadblocks before they occurred.

PATH provided critical support for ACSM activities: not only by developing a communications plan and promotional materials, but by brainstorming new strategies to generate demand for the vaccine. After hearing about needs identified by the EPI, PATH proposed a plan for “proximal advocacy” to engage regional and local leaders. PATH worked with the EPI to hold one-on-one meetings with governors from six regions. During these meetings, which were held at each governor’s local office, the team provided messages about TCV and recorded video spots with the governors to promote the campaign.

The individual meetings created momentum among the governors to promote the campaign—and even sparked some friendly competition to see whose region would boast the best-performing coverage numbers. “These discussions were catalytic,” said Dr. Nebie. “All the governors became ambassadors for the campaign—they held launches in regions where we hadn’t even planned them.”

Many of the governors visited vaccination sites throughout the campaign and asked for updates on coverage numbers daily. “This was the first time they felt intentionally included in planning,” said Dr. Nebie. “The success of the campaign became a source of pride for them. Having them champion the vaccine to their constituents played a significant role in the high coverage we saw throughout the country.”

Engaging with the governors and holding orientation meetings for other political, religious, educational, and administrative leaders helped create a cascade of involvement and support for the campaign. By identifying where gaps in campaign planning existed—in this case, demand generation and social mobilization—PATH stepped in to provide funding and support where it would be most impactful.

During the campaign itself, PATH’s supportive supervision was instrumental in ensuring that the campaign went smoothly and that teams reached as many children as possible with TCV. PATH worked with the EPI to manage and respond to reports of adverse events following immunization, as well as responding to rumors and misinformation in real time.

Burkina Faso’s TCV introduction campaign reached more than 10 million children aged 9 months to 14 years with TCV, providing them with safe, long-lasting protection from a potentially deadly disease. With a 103.2% national coverage rate, the campaign inspired an extraordinary level of support from all levels of the country—one that speaks to the success of ACSM activities around the vaccine.

Detailed microplanning, including a specific plan to deploy vaccines in hard to reach areas, enabled vaccination teams to reach children in all regions of the country. From aerial supply of vaccines in hard-to-reach areas to enlisting bloggers and influencers as spokespeople for TCV, innovative strategies helped generate demand for the vaccine while ensuring broad access. Following the campaign, TCV is now available for all children at their 9-month visit for routine immunization.

PATH is supporting Burkina Faso with follow-up activities from the campaign, including the documentation of best practices and lessons learned for future vaccine introductions. The introduction of TCV is expected to decrease typhoid cases in Burkina Faso, lighten the burden of disease for parents and caregivers, and lower health care costs associated with treating cases—ultimately freeing up resources for other health priorities.

PATH, as part of the Typhoid Vaccine Acceleration Consortium, supports typhoid-endemic countries interested in TCV introduction that are eligible for support from Gavi, the Vaccine Alliance. TyVAC is funded by the Gates Foundation. To learn more, visit www.takeontyphoid.org.