Pakistan has become the first country in the world to introduce typhoid conjugate vaccine (TCV) into its routine immunisation program through a campaign in Sindh. The government of Pakistan is launching the vaccine in Sindh province in response to an outbreak of typhoid since November 2016. The launching ceremony of the typhoid vaccine introduction was held at a local hotel in Karachi, jointly presided over by Special Assistant to Prime Minister on Health Dr Zafar Mirza and Sindh Health Minister Dr Azra Fazal Pechuho. Senior officials from Ministry of National Health Services, Regulations and Coordination and provincial department including director general health, national program manager EPI, national coordinator EOC, director general health, Sindh, director EPI, Sindh also attended. While sharing his remarks at the launching ceremony, Dr Zafar Mirza said, “Children are disproportionately affected by typhoid and its associated complications, and we strongly believe that TCV will help protect our children against the potentially fatal disease. Starting with Sindh province, where the need is most urgent, the government of Pakistan has planned a phased national introduction strategy with strong, coordinated support from global and local partners.” In 2017, 63% of typhoid cases and 70% of typhoid deaths in Pakistan were among children younger than 15 years of age. To prevent these deaths, the phased introduction will begin with a two-week campaign targeting 10.1 million children of nine months to 15 years of age in more than 460 urban union councils of Sindh province with funding support from Gavi, the Vaccine Alliance. This will include 4.7 million children from Karachi. As the campaign needs to reach older children, schools will play a major role. Following the campaign, the vaccine will be given to nine-month old infants as part of routine immunization at EPI centers in all parts of the province. “Typhoid is a highly contagious disease that spreads more quickly and easily when people live in crowded neighborhoods with weak water and sanitation infrastructure. Beginning the vaccination in urban areas is critical in preventing the disease among the communities most at risk,” said Dr Azra Fazal Pechuho. “Typhoid is preventable. Prevention through vaccination is one of the most effective interventions to reduce typhoid infections. The TCV campaign will be conducted from 18 to 30 November in Sindh and will be followed by TCV being a part of the routine immunization program in December,” she added. The TCV is a one-dose vaccine injected intramuscularly, that is low cost, has higher efficacy, and is expected to provide long-lasting immunity in adults, children, and infants older than nine months of age. UNICEF Representative in Pakistan Aida Girma said, “We applaud the government of Pakistan for prioritizing immunization of children at risk of typhoid. Their phased national introduction plan for TCV will ensure that the vaccine will reach the children most at risk first.” “Before the discovery of antibiotics, typhoid would kill as many as one in five people who contracted it,” said Dr Seth Berkley, CEO of Gavi. “The rise of extreme drug resistant typhoid risks bringing us back to levels of mortality not seen since the 19th century, posing a risk to all of us. That’s why typhoid conjugate vaccine is so important and why the government of Pakistan deserves praise for being the first to introduce this lifesaver into its routine immunization program,” he added.