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Peter Hotez, Baylor College of Medicine
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IFPMA Assembly 2016: Global Health V.2.0 Challenges in a Changing World Peter Hotez, MD, PhD President, Sabin Vaccine Institute Texas Children’s Hospital Endowed Chair in Tropical Pediatrics Dean, National School of Tropical Medicine at Baylor College of Medicine U.S. Science Envoy @PeterHotez 1
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Transcript of Peter Hotez, Baylor College of Medicine
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IFPMA Assembly 2016: Global Health V.2.0 Challenges in a Changing WorldPeter Hotez, MD, PhDPresident, Sabin Vaccine InstituteTexas Children’s Hospital EndowedChair in Tropical PediatricsDean, National School of Tropical Medicine at Baylor College of MedicineU.S. Science Envoy@PeterHotez
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OUR COMMITMENT
Rid the world of vaccine-preventable diseases and extend the benefits of vaccination to everyone, regardless of where they are born.
Guided by the principles of equity, sustainability and country ownership, we carry on the crusade against preventable disease of our namesake, Dr. Albert Sabin.
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OUR WORK
Working to save lives and prevent suffering from infectious and neglected diseases:
Vaccine development
Introduction of new and under-utilized vaccines
Education and training
Advocacy
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2000-15Millennium Development Goals
FROM THE MDGs TO THE SDGs
2016SustainableDevelopment Goals
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THE GLOBAL BURDEN OF DISEASE 2013
Expanded use of vaccines• 83% reduction in measles deaths• 82% reduction in tetanus deaths• 57% reduction in diphtheria/pertussis deaths• 45% reduction in Hib deaths
Development of new vaccines• Pneumococcal disease (36% reduction in deaths)• Rotavirus (63% reduction in deaths)
2.5 million childhood lives saved through these initiatives
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THE SCIENCE OF AUTISM
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PROGRESS ON MILLENNIUM DEVELOPMENT GOAL 6
• 19 million lives saved from AIDS• 30% reduction in Malaria
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GLOBAL HEALTH WHACK-A-MOLE V.1.0
THE RISE OF THE NCDS
Non-communicable diseases
HIV/AIDS & Malaria
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BURDEN OF DIABETES & CARDIOVASCULAR DISEASE IN
AFRICA1990-2015
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“OTHER DISEASES”13-14 tropical infections:• Highly prevalent among the poor• Endemic in rural areas of low-income countries• Ancient afflictions• Chronic• Disabling (growth delays, blindness or disfigurement)• Stigmatizing• Poverty promoting
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AscariasisTrichuriasis
Hookworm DiseaseSchistosomiasis
Dengue and other arboviruses Food-borne
trematodiasesLymphatic Filariasis
OnchocerciasisChagas disease
Leishmaniasis
NEGLECTED TROPICAL DISEASES:NTDs infect more than 1 BILLION of the world’s poorest people
TrachomaCysticercosis
EchinococcosisHansen’s DiseaseRabies
African TrypanosomiasisGuinea worm
YawsBuruli ulcer
MycetomaZikaEbola
761.9 million463.7 million
428.8 million252.2 million
79.6 million
71.1 million
38.5 million
15.5 million6.7 million
3.9 million
3.6 million1.9 million
1.4 million514,200
17,40010,700<1,000
Not determinedNot determined
Not determined4 million
2,800
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LYMPHATIC FILARIASIS (ELEPHANTIASIS)
“It’s quite a problem for me when I have to stand at work for long periods.”
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WORM INDEX & HUMAN DEVELOPMENT
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NTDs AND GIRLS & WOMEN
100 million girls & women
Africa’s most common gynecologic condition?
Female Genital Schistosomiasis
ZimbabweOR = 3 increase in HIV/AIDSKjetland et al. AIDS 2006
TanzaniaOR = 4 increase in HIV/AIDSDowns et al. AJTMH 2011
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Ascariasis, Trichuriasis, Hookworm, Schistosomiasis, Lymphatic Filariasis, Onchocerciasis, Trachoma, Food-borne Trematodes
Hotez PJ et al. Lancet 2009
THE BOTTOM BILLION SUFFERS FROM MULTIPLE NTDs
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NTD SCALE UP WITH THE U.S. GOVERNMENT & DRUG
DONATIONS
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>450 million People Rx
USAID NTD PROGRAM
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NOW WE’RE REALLY PLAYING “GLOBAL HEALTH WHACK-A-MOLE”!
AIDSTBMalariaSome NTDsChildhood dz
NTDs V.2.0Vector-borne NTDsZoonotic NTDs
Millennium Development Goals
Sustainable Development Goals
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THE ANTHROPOCENE
The Anthropocene is a proposed epoch that begins when human activities started to have a significant global impact on Earth's geology and ecosystems.
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ANTHROPOCENE FORCES PROMOTING NTDS
Poverty
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POVERTY: “BLUE MARBLE HEALTH”
• Neglected diseases of the poor living amidst wealth
• A new framework for global science policy and the poverty-related diseases
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BLUE MARBLE HEALTH: The Poor Living Among the Wealthy (G20 + Nigeria)
WHO + GBD 2013• 73-78% Leprosy• 61-78% Chagas• 60-61% Dengue• 57-60% TB• 45-67% VL• 50-52% Helminths
• STH• Schistosomiasis• Lymphatic
Filariasis• OnchocerciasisG20 + Nigeria = 54% Population and 86% Global Economy
Hotez PJ (2013) NTDs V.2.0: “Blue Marble Health”—Neglected Tropical Disease Control and Elimination in a Shifting Health Policy Landscape. PLoS Negl Trop Dis 7(11): e2570. doi:10.1371/journal.pntd.0002570http://www.plosntd.org/article/info:doi/10.1371/journal.pntd.0002570
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THE G20 + NIGERIA ALSO HOST 70% OF THE WORLD’S NCDs
DiabetesCVDCOPDCancer
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A NEW ERA OF NTD-NCD CO-MORBIDITIES
• Diabetes + HTN• Dengue • Tuberculosis
• Renal disease + Schistosomiasis
• CVD + Chagas disease• AIDS + Leishmaniasis
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Ranking by GDP:1. Brazil2. Mexico3. Argentina
CHAGAS DISEASE IN LATIN AMERICA
Ranking by Chagas:1. Argentina: >1 million2. Brazil: >1 million3. Mexico: 1 million
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BRAZIL & BLUE MARBLE HEALTH
Introduction to Brazil
• Largest economy in Latin America
• 5th largest country by land mass & population
• 7th largest economy by nominal GDP
Poverty & Disease in Northeast Brazil
• Schistosomiasis
• Leishmaniasis
• Chagas
• Dengue
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ZIKA MICROCEPHALY CASES IN NORTHEAST BRAZIL
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POVERTY IN NORTHEASTERN BRAZIL
Salvador de BahiaRecife
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SPREAD OF ZIKA IN THE AMERICAS
HOTEZ, PJ “ZIKA IS COMING” The New York Times April 9, 2016
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POVERTY IN HOUSTON, TX
Houston’s Historic Wards
Photos by Anna Grove
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>12 Million Americans with NTDs:• Trichomoniasis 7 million• Toxocariasis 3 million• Chagas disease 1 million• Toxoplasmosis 1 million• Cysticercosis 0.2 million• Dengue 0.1 million
NTDS IN TEXAS & SOUTHERN UNITED
STATES
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CONFLICT & POLITICAL DESTABILIZATION:Ebola
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CONFLICT & POLITICAL DESTABILIZATION:
• Measles/Polio• Leishmaniasis• Schistosomiasis• Brucellosis• MERS CoV• Dengue• Malaria/TB• Rift Valley Fever
ISIS-occupied Syria, Iraq, Libya, Yemen
EMERGING VECTOR-BORNE DISEASE IN SOUTHERN EUROPE
Emerging Vector-borne Neglected Diseases in Southern Europe
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MalariaSchistosomiasis
Opisthorchiasis
West Nile Virus
Chikungunya
Dengue
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VACCINATING AGAINST THE ANTHROPOCENE’S NTDs
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SABIN VACCINE DEVELOPMENT PIPELINE
Trichuriasis
Ascariasis
Leishmaniasis
MERS
Onchocerciasis
SARS
Chagas
Schistosomiasis
Hookworm
Discovery Preclinical Phase 1 Phase 2 & 3
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A multivalent vaccine targeting hookworm + schisto
Membrane1 2 3 4
C
GC
C C
C
G/A G/A
E/Q
E/Q
G/A
K
G/A F/Y
GC
E/Q
P
W/F/Y
EC-1
EC-2
VACCINE TARGETING HOOKWORM AND SCHISTOSOMIASIS CO-INFECTIONS
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U.S. SCIENCE ENVOY PROGRAM
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CALLING ON THE PHARMACEUTICAL INDUSTRY FOR V.2.0
• NTDs V.2.0• Vector-borne NTDs
• Arbovirus infections• Chagas disease +
Leishmaniasis• Zoonotic NTDs
• Ebola• Coronavirus Infections
• NTDs + NCDs Co-Morbidities
• New Partnerships• CEPI/PDPs/DCVMNs• WIPO Re: Search• Diagnostics• Mhealth
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“A scientist who is also a human being cannot rest while knowledge which might be used to reduce suffering rests on the shelf.”
Albert B. Sabin
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Thank you!Peter HotezPresidentSabin Vaccine InstituteE: [email protected]
Tara HaywardDirector, Resource DevelopmentSabin Vaccine InstituteE: [email protected]: 202-683-1881
