A shared interest in communicable disease control spurs international collaboration for vaccine development. The oral polio vaccine engendered collaboration between Soviet Union and United States scientists. In the Middle East and North Africa region neglected tropical disease vaccines research addresses shared interests. During Zika vaccine trials, vaccine candidate developers called for technical and regulatory harmonisation between Brazil, Russia, India, China and South Africa.
In Oceania, development of a group A streptococcal (GAS) vaccine, with rheumatic fever endpoint, is particularly important. The burden of GAS diseases is high and addressing disparities in rheumatic fever is a political issue. The Pacific Island Countries and Territories have twice declared rheumatic fever a public health priority, New Zealand has made major investments in rheumatic fever targets and Australia is developing an endgame for rheumatic heart disease.
The governments of New Zealand and Australia have already worked together to support the Coalition to Advance New Vaccines Against Group A Streptococcus (CANVAS) initiative. This kind of collaboration could be amplified by framing support for a GAS vaccine as a contribution to global development and strategic focus of foreign policy for Oceania. Vaccines are highly palatable political investments and with significant positive externalities. The return on investment in vaccine development is considerable; potentially greater than existing regional efforts in health and development investment. This review explores how clinicians, researchers, people living with GAS disease and civil society can make a compelling case for regional investment in the economic, scientific and political domains of GAS vaccine development.