These children are holding their immunization cards. One day, vaccines against ETEC could appear on this list.

I was looking at the group of people around me, our “market assessment team,” and wondering how such a diverse collection of people would come together to generate the analysis we needed. We were getting ready to prepare a report about the market potential of a vaccine for a serious disease that affects both vulnerable children in developing countries and travelers to these areas, including our military troops. The disease is enterotoxigenic Escherichia coli (ETEC), a leading cause of bacterial diarrhea. It is responsible for the deaths of 300,000 to 500,000 children each year and millions of bouts of trip-spoiling travelers' diarrhea.  

Our team was concerned about whether investments made in the travelers' diarrhea vaccine market could be leveraged to benefit the developing world, and whether commercial entities could gain from investing in this market. We were interested in helping investors from private and public sectors understand the benefits, risks, and opportunities of investments that may boost their bottom line, while bringing products and innovation to a world in need.

We assembled a team of experts on vaccines, manufacturing, diarrheal disease, marketing, travel and military medicine, vaccine programs, business, finance, and economics.  We also surveyed many others in these fields. However, coming from a business/financial perspective, I was uncertain about how such an assortment of talented but varied experts would effectively work together to create a credible market assessment. 

My concerns began to fade away after our first few team meetings. In one early discussion, the team had recently received market research data drawn from interviews with thought leaders in developing countries. These leaders were less concerned about the effectiveness of a vaccine specifically against ETEC, but rather wanted a vaccine that would decrease their overall burden of diarrhea, regardless of cause, by at least 10%. It was clear from everyone's reactions that this was an entirely new way of looking at the problem—or the solution. In another meeting, the business and marketing experts began to appreciate the immense challenges that face vaccine developers. I soon realized that we weren't here simply to contribute our individual expertise and compile it into a report. We were here to learn from each other and to create an integrated perspective.

I originally thought that everyone contributing their individual knowledge would be like throwing jellybeans into a jar, creating a colorful array of interesting information in one place. However, it was really more like making your favorite apple pie, where the individual ingredients blend together to create an even better final product.

I had the privilege of working with an immensely talented and diverse team that included members from PATH, BIO Ventures for Global Health, and the US Department of Defense, who, along with a cadre of outside experts, contributed to this work. You've heard it said, “The whole is greater than the sum of its parts.” This rings true when I think about the creation of the resulting market assessment report, which reflects not only the individual capacity of each contributor, but also the shared learning of the team. 

Read the complete report and learn more about the opportunities and potential markets that exist for low-cost and effective ETEC vaccines. The team found that ETEC vaccines may represent a moderate opportunity for industry investment, with an estimated annual revenue potential of more than US$600 million 10 years after global launch.

-- Debbie Atherly is a senior health economist at PATH

For more information:

-- Researchers are studying many promising vaccine candidates for diarrheal disease. Browse vaccine resources for an overview.

-- Add your voice to the ONE Campaign petition to invest in vaccines against the two leading child killers: pneumonia and diarrhea.

-- Join a Call to Action against diarrheal disease.

Photo credit: PATH