Published in The Lancet on May 14, “[t]he Global Enteric Multicenter Study (GEMS) … provides health and policy experts with evidence to pinpoint areas where research for new vaccine candidates is urgently needed to combat diarrheal diseases — the second leading cause of death among children globally,” and “[i]t also reveals other important opportunities for intervention,” Richard Walker, director of PATH’s enteric vaccine initiative, and Myron Levine, principal investigator at GEMS and professor at the University of Maryland School of Medicine, write in a Devex opinion piece. “The study tested for almost 40 pathogens and confirmed that just four are responsible for the majority of moderate-to-severe diarrhea cases: rotavirus, Cryptosporidium, Shigella and ST-ETEC, a type of E. coli,” they write, noting that there are already two vaccines against rotavirus, the leading cause of diarrhea. “In addition to rotavirus, it is critical to rally support for the development of vaccine candidates for the other three leading causes identified by GEMS,” they state.

“Developing and delivering vaccines for these top diarrheal disease pathogens will require stakeholders at all levels to advocate for the resources needed to create inexpensive, simple tools that can be implemented in low resource settings across sub-Saharan Africa and South Asia where the need is greatest,” Walker and Levine write, adding, “Advocates will also need to push for policy changes in these regions to expedite regulatory approvals and rollout of new vaccines.” They continue, “As health and policy experts debate the prioritization of investments for global health, they must remember that vaccines are one of the most powerful and cost-effective tools available to improve child health and advance our broader development goals. Now that we are able to better quantify and measure the burden of diarrheal disease, we can assess the impact of evidence-based decisions aimed at improving child health” (5/24).