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New Zealand to lead rheumatic fever vaccine search


New Zealand to lead rheumatic fever vaccine search

AUCKLAND: A trans-Tasman research coalition between New Zealand and Australia is undertaking a unique global project to accelerate the development of a vaccine for rheumatic fever, which disproportionately affects Māori, Pacific Islanders, Australian Aboriginals and Torres Strait Islanders.

The Coalition to Advance New Vaccines for Group A Streptococcus (CANVAS), is a new initiative funded by the governments of New Zealand and Australia.

This work arose from a discussion between University of Auckland Faculty of Medical Health and Sciences Dean, Professor John Fraser and Prime Minister John Key, who then brought Australia into the partnership with help from his Chief Science Advisor, Professor Sir Peter Gluckman.

Professor Fraser will lead a team in New Zealand in partnership with an Australian team led by Professor Jonathan Carapetis, to evaluate and accelerate development of a preventive vaccine selected from three vaccines already in development overseas.

Health Minister Tony Ryall welcomes this collaboration that complements the Government’s existing investment to combat rheumatic fever, including the Rheumatic Fever Prevention Programme.

“Reducing rheumatic fever is a priority for the Government. We have invested more than $65 million over six years to combat this preventable illness, including supporting the development of a vaccine. This agreement shows just how seriously the Government is taking the fight against rheumatic fever,” he said.

“The entire approach is unique, from the Prime Minister’s personal commitment to the complicated issues surrounding rheumatic fever, to the collaboration with three separate organisations already developing vaccine candidates,” says Professor Fraser.

In New Zealand, Māori and Pacific Islanders make up most of those with rheumatic fever, which can progress to scarring of the heart valves and sometimes death. It is most common in the North Island. The disease delivers a heavy burden on families, the community and health services. Professor Fraser describes our rate of rheumatic fever in New Zealand as ‘appalling’.

Kaitaia GP and 2014 New Zealander of the Year, Lance O’Sullivan, focuses on improving the health of Māori and children in the Far North.

"The possibility of developing a vaccine to reduce the burden of Strep A disease is truly exciting. We know the power of vaccination programmes and strengthening our population’s ability to combat infection is overall a far more efficient approach than treating the complications of disease. This trans-Tasman approach is an important step to support the provision of equitable health outcomes for all.”

CANVAS will evaluate three existing vaccines from three different countries via a partnership that transcends the usual commercial barriers. The University of Auckland’s commercial arm, Auckland UniServices Ltd, will oversee intellectual property management and negotiation with commercial partners.

“When you already have candidates in development overseas, it makes sense not to reinvent the wheel, but to see whether they will work in our particular local setting or if one can adapt them to meet local needs,” Professor Fraser says.

However, developing a vaccine for rheumatic fever still poses significant challenges.

Professor Fraser describes Group A Streptococcus (the bacteria that causes rheumatic fever) as tricky, with up to 200 different strains, meaning any vaccine must have good coverage against most strains circulating in the community.

“Vaccines for certain infectious diseases are not as commercially rewarding as other therapeutics. Anything more than a dollar a dose is too expensive for public health, hence, it’s difficult to get vaccine development through big pharma and most vaccines developed in the last 15 years have emerged through a combination of government, private and philanthropic investment,” says Professor Fraser.

The Maurice Wilkins Centre, a New Zealand Centre of Research Excellence focused on discovery and development of new medicines, also plays a major role in this collaboration as one of the world’s proven players in finding solutions for serious human diseases.

A successful vaccine would change the way we treat rheumatic fever.

“Instead of $30,000 plus for heart surgery, it will be a few dollars for a vaccination with a significant and measurable reduction in personal, community and national health costs,” says Professor Fraser.

The governments of New Zealand and Australia have committed initial funding of NZ$1.5m each to support genomics, laboratory-based work and a health-economics analysis over the first 18-month stage. Based on performance and results, the governments may commit further funding to support subsequent clinical trials and vaccination.

Professor Fraser views the New Zealand/Australia collaboration as merely a start.

“Rheumatic fever is a major third-world health issue. If we successfully engineer a vaccine for New Zealand and Australia, we then know it can be done for areas such as sub-Saharan Africa and South America, where the disease is an even worse problem.”


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