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Andrus J.K.,Pan American Health Organization | de Quadros C.A.,Sabin Vaccine Institute | Castillo Solorzano C.,Pan American Health Organization | Roses Periago M.,Pan American Health Organization | Henderson D.A.,University of Baltimore
Vaccine | Year: 2011

The challenge for regions embarking on measles elimination will be to maintain high population immunity with excellent vaccination coverage and high-quality surveillance. Meeting this challenge will be especially critical for dealing with importations of measles virus that will occur as long as the virus is circulating anywhere in the world. Implementation of measles elimination strategies will uncover the "hidden" disease burden of rubella and congenital rubella syndrome. As was the experience in countries of Latin America and the Caribbean (LAC), integrating the elimination of measles with the elimination of rubella will greatly enhance the capacity of countries to sustain progress in the reduction of measles mortality. Countries of LAC prioritized the routine national immunization program over short-term successes. While doing so, they have also encountered new opportunities to expand the benefits of disease control and elimination activities to other aspects of public health, most importantly towards improving health care for women and new borns and reducing inequities in health in the region's poorest communities. Implementation of similar strategies could lead to the global eradication of measles, rubella, and congenital rubella syndrome early this century, while strengthening routine immunization programs, and developing the capacity to introduce new and underutilized vaccines. © 2011 Elsevier Ltd. Source


Hotez P.J.,George Washington University | Hotez P.J.,Sabin Vaccine Institute | Ehrenberg J.P.,World Health Organization
Advances in Parasitology | Year: 2010

As local, national and international control and elimination efforts for the neglected tropical diseases (NTDs) expand, there is increasing recognition that the 11 Southeast Asian countries together with the People's Republic of China (P.R. China) account for a significant burden of global poverty and disease. Indeed, approximately one-third of the world's intestinal helminthiases, most of the food-borne trematode infections, one-half of the active trachoma infections and a significant number of cases of lymphatic filariasis (LF), schistosomiasis and arboviral infections occur in this region. Among the Mekong countries, active programmes of mass drug administration are in place for the control and elimination of LF, as well as morbidity control aimed at school-aged children at risk of intestinal helminths. However, treatment coverage for intestinal helminth infections remains low in the largest Southeast Asian countries and in P.R. China's poorest provinces. The food-borne trematodiases, especially liver fluke infections, remain highly endemic in northern Thailand, Lao People's Democratic Republic and four provinces of P.R. China where they are an important risk factor for cholangiocarcinoma, while schistosomiasis continues to be an important zoonosis in P.R. China and the Philippines, although the former country has embarked on an ambitious elimination strategy. Through a global network for NTDs, an innovative finance mechanism Is being created to control the most common neglected diseases across Asia. © 2010 Elsevier Ltd. Source


Nelson C.B.,Sabin Vaccine Institute | Mogasale V.,Korean International Vaccine Institute | Bari T.I.A.,EPI Programme Manager | Clemens J.D.,International Center for Diarrhoeal Disease Research
Vaccine | Year: 2014

Cholera is an endemic and epidemic disease in Bangladesh. On 3 March 2013, a meeting on cholera and cholera vaccination in Bangladesh was convened by the Foundation Mérieux jointly with the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B). The purpose of the meeting was to discuss the investment case for cholera vaccination as a complimentary control and prevention strategy. The performance of a new low cost oral cholera vaccine, Shanchol™, used in recent trials in Bangladesh, was also reviewed in the context of a potential large-scale public-sector vaccination program. Findings showed the oral vaccine to be highly cost-effective when targeting ages 1-14y, and cost-effective when targeting ages 1+y, in high-burden/high-risk districts. Other vaccination strategies targeting urban slums and rural areas without improved water were found to be cost-effective. Regardless of cost-effectiveness (value), the budget impact (affordability) will be an important determinant of which target population and vaccination strategy is selected. Most importantly, adequate vaccine supply for the proposed vaccination programs must be addressed in the context of global efforts to establish a cholera vaccine stockpile and supply other control and prevention efforts. © 2014. Source


Bethony J.M.,George Washington University | Cole R.N.,Infectious Diseases Research Institute | Guo X.,U.S. National Institutes of Health | Kamhawi S.,National Institute of Allergy and Infectious Diseases | And 7 more authors.
Immunological Reviews | Year: 2011

Summary: The neglected tropical diseases (NTDs) represent a group of parasitic and related infectious diseases such as amebiasis, Chagas disease, cysticercosis, echinococcosis, hookworm, leishmaniasis, and schistosomiasis. Together, these conditions are considered the most common infections in low- and middle-income countries, where they produce a level of global disability and human suffering equivalent to better known conditions such as human immunodeficiency virus/acquired immunodeficiency syndrome and malaria. Despite their global public health importance, progress on developing vaccines for NTD pathogens has lagged because of some key technical hurdles and the fact that these infections occur almost exclusively in the world's poorest people living below the World Bank poverty line. In the absence of financial incentives for new products, the multinational pharmaceutical companies have not embarked on substantive research and development programs for the neglected tropical disease vaccines. Here, we review the current status of scientific and technical progress in the development of new neglected tropical disease vaccines, highlighting the successes that have been achieved (cysticercosis and echinococcosis) and identifying the challenges and opportunities for development of new vaccines for NTDs. Also highlighted are the contributions being made by non-profit product development partnerships that are working to overcome some of the economic challenges in vaccine manufacture, clinical testing, and global access. © 2010 John Wiley & Sons A/S. Source


Keenan J.D.,University of California at San Francisco | Hotez P.J.,Baylor College of Medicine | Hotez P.J.,Sabin Vaccine Institute | Amza A.,University Abdou Moumouni | And 4 more authors.
PLoS Neglected Tropical Diseases | Year: 2013

Background:Lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminths, and trachoma are the five most prevalent neglected tropical diseases in the world, and each is frequently treated with mass drug administrations. We performed a survey of neglected tropical diseases experts to elicit their opinions on the role of mass drug administrations for the elimination of these infections.Methodology/Principal Findings:We sent an online survey to corresponding authors who had published an article about a neglected tropical disease from 2007 to 2011. Of 825 unique authors who were invited to complete the survey, 365 (44.2%) responded, including 234 (28.4%) who answered questions regarding one of the five most prevalent neglected tropical diseases. Respondents had varying opinions about the goals of programmatic activities for their chosen neglected tropical disease, with elimination or eradication identified as the most important goal by 87% of lymphatic filariasis respondents, 66% of onchocerciasis respondents, 55% of trachoma respondents, 24% of schistosomiasis respondents, and 21% of soil-transmitted helminth respondents. Mass drug administrations, other non-medication health measures, and education were generally thought to be more important for elimination than vector control, development of a new tool, or the presence of a secular trend. Drug resistance was thought to be a major limitation of mass drug administrations for all five neglected tropical diseases. Over half of respondents for lymphatic filariasis and trachoma thought that repeated mass drug administrations could eliminate infection within ten years of the initiation of mass treatments.Conclusions/Significance:Respondents for lymphatic filariasis, onchocerciasis, and trachoma were more enthusiastic about the prospects of elimination and eradication than were respondents for schistosomiasis or soil-transmitted helminths. Mass drug administrations were generally believed to be among the most important factors for the success of elimination efforts for each of the five neglected tropical diseases, highlighting the opportunity for integrating drug distributions. © 2013 Keenan et al. Source

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