Building Vaccines for the 'Bottom Billion'

  • by Portia Crowe (new york)
  • Monday, June 20, 2011
  • Inter Press Service

In a recent article co-authored by economist Jeffrey Sachs, Hotez explains that neglected diseases like schistosomiasis and hookworm geographically overlap with HIV/AIDS, malaria, and tuberculosis. He points to the massive global effort to fight the more notorious afflictions, and notes the possibilities for operational synergies in fighting NTDs as well.

This August, Hotez will have the opportunity to advance his ambitions when he serves as the founding dean of a new School of Tropical Diseases at the Baylor College of Medicine, or BCM, in Houston, Texas.

Already president of the Sabin Vaccine Institute, a Washington-based non-profit research institute focusing on the 'diseases of the poor', Hotez will also head its vaccine development programme, which is relocating to the BCM and Texas Children's Hospital.

'We'll be in the heart of an entity called the Texas Medical Center, which is the world's largest medical centre,' Hotez told IPS. 'It's like a small city.'

A pediatrician by training, Hotez will also head a new section of BCM's pediatrics department focusing on tropical diseases.

Hotez's work is fairly uncommon, largely because NTDs affect what he calls the world's 'bottom billion' — a demographic that cannot afford expensive, innovative research and with no capacity for remuneration.

'We make the vaccines the industry cannot or won't make because they only affect the world's poorest people,' he said.

Funded by the Bill and Melinda Gates Foundation, the Carlos Slim Institute of Health, and the Dutch and U.S. governments, Sabin's scientists incorporate cost-efficiency into the design of their products with low-cost technology, processes, and procedures.

'It's a whole different mindset for making a vaccine,' Hotez said.

'Our cost-effective analysis people tell us often that we should try to make these for under a dollar a dose, so we actually design that into the construction of the vaccine,' he explained, noting the tactic was 'something you would not find in the major pharmaceutical companies'.

But Hotez's work does not stop at vaccine research and low-cost development. In 2006, he co-founded the Global Network for Neglected Tropical Diseases to raise awareness, political will, and funding for the fight against NTDs.

'The idea is that it's not only about research and development, but there's medicines that are out there which could be made more widely accessible,' he said.

The network is working with the United States Agency for International Development (USAID) to create rapid-impact packages for as little as 50 cents per person, annually.

The benefits of these packages, and the 'anti-poverty vaccines' developed at Sabin Institute, are two-fold: they provide economic returns along with improved health.

'These are vaccines to prevent diseases that actually cause poverty because of their impact on child health and worker productivity,' Hotez said. By helping prevent these diseases, the vaccines will have long-run impacts on household productivity and national economies.

In 2011 Health Affairs article, Hotez wrote that 'a push to develop new vaccines would stimulate innovation and indirectly provide economic return,' and he identifies big banking enterprises like the African Development Bank as potential sources of financing.

Anti-poverty vaccine development could have another major benefit. Beyond improved personal health and national economic prosperity, the vaccines' greatest impact could be enhancing global peace, according to Hotez.

He described the 'back-channel diplomacy' that surrounded the discovery of the oral polio vaccine by Albert Sabin, the institute's namesake. The technology was developed cooperatively with the Soviet Union at the height of the Cold War, and tested primarily on Soviet school children.

'So I've asked the question,' he said, 'how do you franchise that? What are the modern lessons that we can have for what we call vaccine diplomacy today?'

Some of the world's highest rates of NTDs are found in Islamic countries, from schistosomiasis in Indonesia to leishmaniasis in Iran. With this in mind, Hotez is exploring the possibility of developing vaccines in partnership with these countries.

'Wouldn't it be great to do this jointly and to really incorporate science diplomacy into our U.S. foreign policy?' he asked.

For now, Hotez may have enough on his hands — heading Sabin's vaccine development programme, BCM's tropical disease pediatrics programme, and the college's newest school. It will be no small feat; the school is the first of its kind in the United States.

But, said Hotez, 'I think that's one of the exciting parts of this move.'

© Inter Press Service (2011) — All Rights ReservedOriginal source: Inter Press Service

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