Establishing a Maternal Immunization Readiness Network in Africa and Asia (MIRNA) to Identify, Characterize and Support the Platform, Policy, and Preparedness Requirements for the Introduction of Potential New Maternal Vaccines to Prevent Infectious Diseases.

January 13, 2025 | Ongoing Project | Reading time: 8 min

Introduction

KHRC is actively involved in ongoing efforts to improve maternal and infant healthcare through the Maternal Immunization Readiness Network in Africa and Asia (MIRNA). This consortium, involving countries across Africa and Asia, aims to provide evidence to guide the successful introduction and adoption of potential new maternal vaccines to fight infectious diseases caused by Group B Streptococcus (GBS) and Respiratory syncytial virus (RSV) in mothers and their infants.

Investigators

Prof. Kwaku Poku Asante, Dr. Samuel Afari-Asiedu, Mrs Irene Apewe Adjei, Ms. Theresa Afia Serwaa Tawiah, Mr. Kwame Kesse Adjei, Prof. Yeetey Akpe Kwesi Enuameh, Prof. Samuel Antwi Oppong.

Background

Maternal immunization (MI) is a promising approach to reduce the burden of maternal and infant morbidity and mortality and complements existing interventions in mother-infant care. New maternal vaccines are in clinical development for the prevention of respiratory syncytial virus (RSV) disease in infants and group B streptococcus (GBS) in neonates. As development of these vaccines progresses, programs will shift away from research and development towards implementation. Successful implementation of maternal vaccines will be key to reach the desired improvement in maternal, perinatal and infant outcomes for RSV and GBS, and reduce neonatal and infant mortality.

This success will be dependent on generating compelling evidence for adoption of MI in low and middle income countries (LMIC) and developing quality antennal care (ANC) delivery platforms which are well- integrated with the Expanded Program on Immunization (EPI). Identifying barriers to maternal vaccination access and uptake, mapping regulatory and financial mechanisms for new products, assessing the health system at different levels, establishing the evidence from a burden and cost perspective, supporting implementation, and understanding how to drive uptake need to be addressed well in advance of planned introduction. Cross-institutional and cross-country/regional collaboration will there be critical to the successful introduction, uptake and coverage of maternal vaccination in LMICs. A consortium of countries representing key regions in Africa and Asia has been established to ensure a unified approach to maternal immunization platform strengthening and facilitate early and successful adoption of new maternal vaccines after licensure.

Objectives

The study seeks to develop a comprehensive readiness agenda for maternal immunization (MI) concerning new vaccines in selected sub-Saharan African and South Asian countries

Methodology

A consortium has been established including partner institutions in Ghana, Uganda, Ethiopia, Kenya and Pakistan, coordinated by the University of the Witwatersrand in South Africa. Study activities is being conducted under five work packages;

1. Situational analysis of MI delivery pathways and care levels,

2. Synthesis of in-country burden of disease data and identification of systems to capture prospective disease data.

3. Synthesis of existing work on disease modelling and cost-effectiveness of products, identifying critical data gaps, and undertaking additional analyses as needed

4. Select, adapt and apply social science approaches to understand vaccine demand and hesitancy.

5. Stakeholder mapping and building communities of practice in partner countries and globally. This work will build on, expand and adapt previous efforts to advance MI programmes.

Expected Outcomes

The development of a Consortium of partner institutions in Africa and Asia will ensure a unified approach to MI platform strengthening and facilitate early and successful adoption of new maternal vaccines after licensure. The processes and learning from this study will contribute to a toolkit to support maternal immunisation acceleration in LMICs. Evidence generated will inform policy and decision-making bodies (e.g. Ministries of Health, National Immunisation Technical Advisory Groups) and provide the foundation for communication to professional bodies who are responsible for guiding recommendations.

Funder

Bill & Melinda Gates Foundation.

Collaborators

Prof Janan Dietrich, Prof Nellie Myburgh, Ijeoma Edoka, Jacqui Miot, Dr Clare Cutland, Prof Mark Jit, Dr Simon Procter, Sarah Malycha, Heidi Larson, Emilie Karafillakis, Kirsten Maertens, Dr Ranju Baral, Clint Pecenka, Tracey Goodman, Özge Tunçalp, Lisa Menning, Lisa Nogochi, Rosemary Njoku.

Collaborating institutions

University of the Witwatersrand (Wits) Vaccines & Infectious Diseases Analytics (VIDA) Research Unit (South Africa).

College of Health Science, Haramaya University (Ethiopia).

Kintampo Health Research Centre, Research and Development Division, Ghana Health Service.

Kenya Medical Research Institute, Centre for Global Health Research.

Aga Khan University and VITAL Pakistan Trust.

Makerere University College of Health Sciences (Uganda).

Study Duration: Two (2) Years

Start Date: January 2024

End Date: December 2025