Breakthroughs Blog: Vaccines

Photo: AVACYesterday, May 18, marked the observance of World AIDS Vaccine Day­­–an annual event to focus attention on the need for a vaccine to prevent HIV infection and AIDS. Although three decades have passed since HIV and AIDS were first identified, more than 1.5 million people still die from AIDS and millions of others contract HIV each year. Despite advances in treatment and prevention, for every three people put on treatment, four others contract HIV. An AIDS vaccine is an important part of a long-term strategy to end the AIDS epidemic. Today, more government institutes, nonprofits, academic research labs, and pharmaceutical and biotechnology companies than ever before are engaged in the global effort to develop a vaccine. The road ahead may prove long and bumpy, but recent breakthroughs in science and technology have boosted confidence that an AIDS vaccine is achievable and on the horizon. Sustained political and financial support is critical to translating this promise into a product. See the infographic below from AVAC for key numbers that indicate the progress that has been made toward the development of an AIDS vaccine.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. Two recent announcements occurred regarding US international collaboration on global health research and development (R&D). Earlier this week, the US National Institute of Allergy and Infectious Diseases and the Office of AIDS Research at the National Institutes of Health announced a collaborative project with the Indian Ministry of Science and Technology and Department of Biotechnology to fight tuberculosis in India as part of the Indo-US Vaccine Action Program. On Tuesday, the US Department of Health and Human Services and the European Commission released the first report of the Transatlantic Taskforce on Antimicrobial Resistance (TATFAR), which is a joint commitment by the US and EU to fight antimicrobial resistance. Dr. Lucas Otieno Tina—a physician and researcher at the Kenya Medical Research Institute/US Army Medical Research Unit-Kenya collaboration program—writes in AllAfrica.com about why he has spent his career working to develop a malaria vaccine. He also discusses the promise of the RTS,S malaria vaccine and his involvement in the clinical trials for the vaccine supported by PATH’s Malaria Vaccine Initiative. Last week, the NTD Roundtable—a group of global health partners committed to fighting neglected tropical diseases (NTDs) —hosted briefings in the US House of Representatives and Senate to discuss America’s leadership in the fight against NTDs and the need for greater NTD R&D. The briefings were attended by representatives from key House and Senate committees, the NGO community, and the African diplomatic corps. Among other topics, participants discussed the need for the development of new diagnostic tools and treatments for NTDs. TechCrunch reports about a grant from the Bill & Melinda Gates Foundation to Sure Chill Company in Wales, which has developed a way to store vaccines at a proper temperature without the need for an electrified or gas-powered refrigeration source. The technology reduces problems with vaccine distribution caused by vaccines that lose their efficacy without proper refrigeration.

In this guest post, Ambassador Michael W. Marine, CEO of the Sabin Vaccine Institute, writes about his organization’s 20th Anniversary Scientific Symposium event. In a fitting way to kick off World Immunization Week, several hundred people gathered Friday, April 25th to celebrate significant achievements in vaccinology over the past two decades and to examine solutions for overcoming remaining hurdles at the Sabin Vaccine Institute’s (Sabin) 20th Anniversary Scientific Symposium. Hosted at the Pan American Health Organization (PAHO) in Washington, DC, it was an energized room filled with visionary leaders from humanitarian and health organizations, nongovernmental organizations, pharmaceutical companies, and academia. Sabin’s President Dr. Peter Hotez opened the event by asking, “What do the next twenty years look like for product development and access to vaccine and medicines? What is the outlook for meeting ambitious global health objectives?” PAHO Director Dr. Carissa Etienne then highlighted the remarkable successes in the Americas for the past 20 years. By this March, “17 countries and territories … had added the rotavirus vaccine to their vaccination schedules, 28 had (introduced) the pneumococcal vaccine and 20 the [HPV] vaccine.” Country ownership is nearly complete, with “more than 95 percent of vaccines purchased with national funds.” Still, PAHO Member States are working to ensure that municipal vaccination coverage reaches 95 percent or higher everywhere. From left to right: Dr. Carissa F. Etienne, PAHO; Dr. Donald A. Henderson; Dr. Ciro de Quadros, Sabin; Dr. Anthony Fauci, NIAID; and Dr. Jon K. Andrus, PAHO. Credit: PAHO Dr. Ciro de Quadros, Sabin’s executive vice president, explained how Sabin “is guided by an unwavering belief: Lasting health solutions that benefit every person in a country can only truly be achieved when that nation supports health interventions out of its own budget; builds technical expertise; and maps its health priorities.” He added that in addition to quickening the pace of country and regional adoption of the Global Vaccine Action Plan (GVAP), “integration and cooperation are areas (where) we could all do better.” Via videoconference, Dr. Julio Frenk, dean of the Harvard School of Public Health, shared reflections on the evolution of global health and vaccination. He urged partners to consider how resources could be allocated more efficiently, prioritizing spending where there is the greatest need and where it will have the greatest impact. Dr. Seth Berkley, CEO of GAVI, explained its co-financing model, which “is about building ownership, building sustainability, and ensuring advocacy.” GAVI has notably “immunized 440,000,000 additional children and averted 6,000,000 future deaths.” Addressing vaccine research technologies, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID) at the National Institutes of Health stressed “the incomparable effects of vaccinology.” He shared some inadequacies of following natural immunity for diseases like HIV and influenza and how scientists are identifying new development techniques for vaccine-based solutions. Adding to the day’s excitement, Sabin’s Dr. de Quadros received PAHO’s highest honor, the Public Health Heroes of the Americas award. On behalf of PAHO, Dr. Etienne stated, “No single person has done more to extend the benefits of immunization in the Americas” than Dr. de Quadros, whose “vision, scientific acumen, undaunted courage, and boundless energy” played a central role in smallpox and polio eradication in the Americas, and the creation of PAHO’s Revolving Fund. Dr. Etienne commented that Dr. de Quadros is a “force for good in the region and in the world;” we at Sabin who work with him each day couldn’t agree more. Dr. de Quadros then chaired a panel focused on how organizations are advancing the GVAP: Dr. Jon Andrus, deputy director of PAHO, recognized that capacity development and assistance with “making evidence-based decisions,” for instance through PAHO’s ProVac Initiative, are essential. Dr. Mickey Chopra, chief of health at UNICEF, underscoring its importance noted “the critical window we have on the GVAP … If we succeed now, the trajectory will be completely different than if we fail.” Manufacturing capacity and technology transfers, along with sustainable financing, such as Sabin’s Sustainable Immunization Financing program, will accelerate progress. Dr. Julie Gerberding, president of Merck Vaccines and representing the International Federation of Pharmaceutical Manufacturers Association, spoke about the challenges facing manufacturers, such as competing priorities and shrinking research and development bases. She urged we “collectively think about and solve for” these issues. Dr. Mahendra Suhardono, marketing director at Biofarma representing the Developing Countries Vaccine Manufacturers Network, explained how the 40 manufacturers in this network are working to take action against many diseases. Dr. Lance Gordon, director for neglected infectious diseases in the Global Health Program at the Bill & Melinda Gates Foundation, commented on the Foundation’s commitment to tackling neglected tropical diseases (NTDs) and spotlighted the recent conference in Paris where $240 million was committed toward fulfilling the London Declaration. Delivering a powerful video message, Dr. Margaret Chan, director-general of the World Health Organization, stated, “countries must lead... they deserve to have the first say about priorities.” Despite a need to streamline and simplify programs, increase sustainable financing, and help people understand the value of vaccines, “the future of immunization looks bright.” This was truly a memorable event, and we hope that through continued collaboration and the commitment of our diverse partners, collectively, we can realize lasting improvements. As Morton Hyman, Sabin’s chairman, closed the symposium, he tasked us with asking ourselves, “how we can do better, how we can challenge the status quo and look at smarter, more collaborative, more efficient models to deliver the gift of good health to all people.” With 20 years of achievements behind us, Sabin looks forward to many years ahead filled with more success in reducing needless human suffering.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. Japan’s National Institute of Biomedical Innovation (NIBIO), GHTC member Aeras, and Create Vaccine Company have entered an agreement to collaborate on preclinical and clinical development of new tuberculosis vaccines. The partnership will advance vaccine candidates with the NIBIO technology through preclinical studies, with the goal of eventually testing candidates at clinical trial stages. According to SciDev, the UK Department for International Development (DFID)’s budget for research and development has fallen under the current government. DFID’s research budget in 2011-2012 was £11 million—or about US$18 million—below the £237 million that was available in 2009-2010, prior to the coalition government coming to power. In response to a US congressman, Roger Glass—director of the Fogarty International Center at the National Institutes of Health (NIH)—made the case for global health research supported by NIH. Glass writes: “In almost every branch of medicine, research overseas has allowed us to advance our discoveries faster, cheaper, and more efficiently than we ever could have at home. We are leaders in global health because we have been able to reach out and engage others to do studies that are locally relevant but can have clear implications for us at home. Global health research truly is the new frontier of science.” amfAR, The Foundation for AIDS Research has launched a new initiative—called Countdown to a Cure—aimed at funding a “broadly applicable cure for HIV by 2020.” The initiative plans to invest $100 million in cure research over the next six years.