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Ann-Mari Svennerholm works to develop a vaccine against malnutrition

In high season at the large diarrhoea hospital in Dhaka, thousands of patients must be cared for on bunks under make- shift tents. This is where the poorest lay, those who do not have access to clean water and food. The children are the hardest hit.

In the autumn and spring, when rain or drought worsens the water quality, Dhaka, the capital of Bangladesh, is struck by epidemic outbreaks – forcing the diarrhoea hospital to temporarily expand outdoors. Many patients have cholera, but even more have been struck by ETEC (enterotoxigenic E. coli). According to WHO this disease is behind 400 million cases of diarrhoea and 300,000 deaths of children under five each year.

“All of us have E. coli bacteria in our intestines. But ETEC can grow in the upper intestines and form a choleralike poison causing severe diarrhoea. In Bangladesh and many other countries, ETEC diarrhoeal disease is a huge problem,” says Ann-Mari Svennerholm, who has devoted much of her research life to the subject.

Close collaboration with Bangladesh
Ann-Mari Svennerholm regularly travels to Bangladesh where she, together with researchers in Dhaka, works intensively to develop a vaccine against ETEC.

“The poverty is enormous in our field. Many people don’t have proper toilets or clean drinking water and an incredible number of children have diarrhoeal diseases. However, many are committed and positive to doing something about it, and it’s not difficult to get mothers and children involved in our studies,” says Ann-Mari Svennerholm.

Promising results
The new vaccine has been developed and re ned for more than a decade. A working solution is now close.

“The initial tests have gone very well. The most recent version we’ve developed is free of side effects and will provide protection against up to 80 percent of all ETEC infections – so we are feeling very optimistic. Now we’re preparing an extensive study in Bangladesh. We begin by vaccinating adults and then the lower age groups, finally testing on our main target group – children under the age of two years,” says Ann-Mari Svennerholm.

Research further challenged by economics
How can a sickness that affects millions of people around the world still not have a cure? Why isn’t there a vaccine on the market already? According to Ann-Mari Svennerholm, the reason is a combination of research and financial challenges.

“It’s difficult to create immunity against all different types of E. coli bacteria and we have worked for a long time to develop a mix with exactly the right components. Furthermore, intestinal immunity is a challenge in itself. This is not a vaccine that you inject into the blood, but a drinkable vaccine that should stimulate cells in the intestines to form antibodies. And that’s a complicated process."

“Another challenge is getting the financiers and pharmaceuticals industry to invest money in a vaccine that’s not primarily for a market in western society – and yet an effective ETEC vaccine could also be very useful for travellers to ETEC-exposed countries.”

Vaccine against malnutrition?
The researcher who succeeds in developing a good vaccine can make a huge difference in people’s lives. This is something many researchers dream of. For Ann-Mari Svennerholm there is a further dimension to vaccine research.

“The latest research shows that repeated diarrhoea is a common cause of malnutrition – in most places more common than a shortage of food. So if we can develop good vaccines, for ETEC in particular, we can also reduce malnutrition, and that really is something to dream about,” concludes Ann-Mari Svennerholm.

Ann-Mari Svennerholm

PhD at University of Gothenburg, 1975. Professor of Infection and Immunity in 1988.

Selection of appointments and distinctions

  • Member of the Royal Swedish Academy of Sciences
  • Chair of the WHO Committee for Diarrhoeal Vaccine Research and Research Council of Norway’s programme for global health
  • Board appointments for the International Vaccine Institute and International Centre for Diarrhoeal Disease Research

Contact Information

Contact details for
Ann-Mari Svennerholm

Page Manager: Pontus Sundén|Last update: 8/8/2018

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