Malawi Accelerated Research in Vaccines, Experimental and Laboratory Systems (360G-Wellcome-211433_Z_18_Z)

MARVELS 1 Respiratory infections are common, potentially vaccine-preventable causes of death. Despite dramatic progress in pneumococcal and influenza vaccination, much remains to be done, both to prevent mucosal disease from these pathogens and the complex effects of co-infections. As nasopharyngeal carriage provides the mode of transmission and the source of infection for pneumococcal disease, it is also an excellent point of intervention to prevent respiratory infections. MARVELS 1 will establish respiratory infection models in the human nasopharynx in order to answer 3 main questions: Which vaccines can prevent acquisition of pneumococcal carriage in Malawi? Which vaccines are most effective in vulnerable populations in Malawi, particularly those with substantial exposure to household air pollution, HIV, malnutrition? What are the critical mechanisms of respiratory tract defence that can be harnessed to develop an effective mucosal vaccine suitable for low and middle income country (LMIC) use? This programme of work will transfer our established controlled human infection models (MRC UK Programme grant) to Malawi in order to test vaccines in populations at risk of disease, determine mucosal immune responses, including those in co-infection and in risk populations, in order to accelerate vaccine discovery.