Battle against Respiratory Viruses (BRaVe) initiative

Acute respiratory infections kill an estimated 3.9 million people per year. These infections are one of the top five causes of mortality worldwide and in many developing countries are the leading killer in children under five years of age.

WHO and UNICEF have developed a global action plan to tackle this problem through a combination of interventions to prevent and treat community-acquired pneumonia (CAP) in children. In the past decade, useful strategies have been implemented globally, including increased coverage with pneumococcal and Haemophilus influenzae type B (Hib) vaccines, to reduce the burden of acute respiratory infections and reach the Millennium Development Goal of halving childhood mortality.

More effort is needed to address viral respiratory infections. These infections affect all age groups, but particularly impact the very young, the elderly, and those with chronic medical conditions. In addition to increasing the risk of secondary bacterial infections, respiratory viruses are implicated in about half of CAP cases in children, over 90% of bronchiolitis cases in infants, and 85-95% of asthma exacerbations in children. In adults, it's implicated in 30-50% of CAP cases, 80% of asthma exacerbations, and 20-60% of chronic obstructive pulmonary disease (COPD) exacerbations.

Consequently, common respiratory viruses cause an enormous burden to health systems and economic costs to society in direct medical expenses and indirect productivity losses. Furthermore, emerging respiratory viruses, such as severe acute respiratory syndrome (SARS), H5N1 avian influenza, and pandemic (H1N1) 2009 represent threats to global health security.

Current pharmacologic interventions for respiratory viral infections are largely limited to vaccines and antivirals for influenza. While their use has provided important public health benefits and demonstrated the potential of such measures, no vaccines or therapeutics of proven value are currently available for most other respiratory viruses.

The aim of the Battle against Respiratory Viruses (BRaVe) is to address these challenges. The first steps will be to:

  • Identify gaps in knowledge and tools needed to develop effective interventions;
  • Articulate a research agenda reflecting public health research priorities to address these needs;
  • Increase research efforts to develop new preventive and treatment options, including those applicable in under-resourced settings, through engagement of stakeholders and implementation of this research agenda;
  • Foster multidisciplinary approaches to improve clinical management of acute respiratory infections.

[New] BRaVe review article

BRaVe Concept paper

BRaVe research agenda

BRaVe Call to action

Clinicians, scientists, and public health experts met in Geneva, on 6 and 7 November 2012, to identify crucial research needs in the battle against respiratory viruses.

To date, 48 experts from 23 countries have joined the initiative and signed the Call to action to urge responsible stakeholders to tackle respiratory viral infections.