30 November 2016, Washington DC IFPMA Assembly 2016: Global Health V.2.0 Challenges in a Changing World

1. 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
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2. OUR COMMITMENT
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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.

3. 3
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

4. 2000-15
Millennium
Development
Goals
FROM THE MDGs TO THE SDGs
4
2016
Sustainable
Development
Goals

5. THE GLOBAL BURDEN OF DISEASE
STUDY
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6. 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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7. THE SCIENCE OF AUTISM
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8. PROGRESS ON MILLENNIUM
DEVELOPMENT GOAL 6
• 19 million lives saved from AIDS
• 30% reduction in Malaria
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9. GLOBAL HEALTH WHACK-A-MOLE
V.1.0
THE RISE OF THE NCDS
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Non-communicable
diseases
HIV/AIDS & Malaria

10. BURDEN OF DIABETES &
CARDIOVASCULAR DISEASE IN
AFRICA1990-2015
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11. “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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12. Ascariasis
Trichuriasis
Hookworm Disease
Schistosomiasis
Dengue and other
arboviruses
Food-borne
trematodiases
Lymphatic Filariasis
Onchocerciasis
Chagas disease
Leishmaniasis
NEGLECTED TROPICAL DISEASES:
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NTDs infect more than 1 BILLION of the world’s poorest people
Trachoma
Cysticercosis
Echinococcosis
Hansen’s Disease
Rabies
African Trypanosomiasis
Guinea worm
Yaws
Buruli ulcer
Mycetoma
Zika
Ebola
761.9 million
463.7 million
428.8 million
252.2 million
79.6 million
71.1 million
38.5 million
15.5 million
6.7 million
3.9 million
3.6 million
1.9 million
1.4 million
514,200
17,400
10,700
<1,000
Not determined
Not determined
Not determined
4 million
2,800

13. LYMPHATIC FILARIASIS
(ELEPHANTIASIS)
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“It’s quite a problem for me when I have
to stand at work for long periods.”

14. WORM INDEX & HUMAN DEVELOPMENT
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15. NTDs AND GIRLS & WOMEN
100 million
girls & women
Africa’s most
common
gynecologic
condition?
Female Genital Schistosomiasis
Zimbabwe
OR = 3 increase in HIV/AIDS
Kjetland et al. AIDS 2006
Tanzania
OR = 4 increase in HIV/AIDS
Downs et al. AJTMH 2011
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16. 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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17. NTD SCALE UP WITH THE
U.S. GOVERNMENT & DRUG DONATIONS
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18. >450 million People Rx
USAID NTD PROGRAM
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19. NOW WE’RE REALLY PLAYING
“GLOBAL HEALTH WHACK-A-MOLE”!
AIDS
TB
Malaria
Some NTDs
Childhood dz
NTDs V.2.0
Vector-borne NTDs
Zoonotic NTDs
Millennium
Development Goals
Sustainable
Development Goals
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20. 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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21. ANTHROPOCENE FORCES
PROMOTING NTDS
Poverty
Deforestation
Urbanization
and Human
Migrations
Climate
Change
Conflict and
Political
Destabilization
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22. 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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23. 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
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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.0002570
http://www.plosntd.org/article/info:doi/10.1371/journal.pntd.0002570

24. THE G20 + NIGERIA ALSO HOST 70%
OF THE WORLD’S NCDs
Diabetes
CVD
COPD
Cancer
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25. A NEW ERA OF NTD-NCD
CO-MORBIDITIES
• Diabetes + HTN
• Dengue
• Tuberculosis
• Renal disease +
Schistosomiasis
• CVD + Chagas disease
• AIDS + Leishmaniasis
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26. Ranking by GDP:
1. Brazil
2. Mexico
3. Argentina
CHAGAS DISEASE IN LATIN AMERICA
Ranking by Chagas:
1. Argentina: >1 million
2. Brazil: >1 million
3. Mexico: 1 million
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27. 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
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• Chagas
• Dengue

28. ZIKA MICROCEPHALY CASES
IN NORTHEAST BRAZIL
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29. POVERTY IN NORTHEASTERN BRAZIL
Salvador de BahiaRecife
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30. SPREAD OF ZIKA IN THE AMERICAS
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31. HOTEZ, PJ “ZIKA IS COMING”
The New York Times April 9, 2016
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32. POVERTY IN HOUSTON, TX
Houston’s Historic Wards
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Photos by Anna Grove

33. >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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34. CONFLICT & POLITICAL DESTABILIZATION:
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Ebola

35. CONFLICT & POLITICAL DESTABILIZATION:
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• Measles/Polio
• Leishmaniasis
• Schistosomiasis
• Brucellosis
• MERS CoV
• Dengue
• Malaria/TB
• Rift Valley Fever
ISIS-occupied Syria, Iraq, Libya, Yemen

36. 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

37. VACCINATING AGAINST THE
ANTHROPOCENE’S NTDs
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38. SABIN VACCINE DEVELOPMENT
PIPELINE
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Trichuriasis
Ascariasis
Leishmaniasis
MERS
Onchocerciasis
SARS
Chagas
Schistosomiasis
Hookworm
Discovery Preclinical Phase 1 Phase 2 & 3

39. A multivalent vaccine targeting
hookworm + schisto
Membrane
1 2 3 4
C
G
C
C C
C
G/A G/A
E/Q
E/Q
G/A
K
G/A F/Y
G
C
E/Q
P
W/F/Y
EC-1
EC-2
VACCINE TARGETING HOOKWORM AND
SCHISTOSOMIASIS CO-INFECTIONS
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40. U.S. SCIENCE ENVOY
PROGRAM
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41. 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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42. 42
“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

43. 43
Thank you!
Peter Hotez
President
Sabin Vaccine Institute
E: hotez@bcm.edu
Tara Hayward
Director, Resource Development
Sabin Vaccine Institute
E: tara.Hayward@sabin.org
T: 202-683-1881