Department of Health and HumanServices Secretary Tommy G.Thompson in November appointedretired Maj. Gen. Philip K. Russell, MD,founding president of the Sabin VaccineInstitute, as special advisor on vaccinedevelopment and production. Russell isan expert on virology who wascommander of the U.S. Army MedicalResearch and Development Command.

Russell is serving in the newly createdOffice of Public Health Preparedness,which is directed by renowned globalimmunization program administratorDonald A. Henderson, MD, and iscoordinating a national response topublic health emergencies. At theannouncement, Secretary Thompsonsaid, “Since arriving here nine monthsago, we have moved aggressively tostrengthen the department’s bioterrorismpreparedness and response. This is part

Philip K. Russell Named to New HHS Office of Public Health PreparednessHHS Sec. Thompson Taps Philip Russell and D.A. Henderson to Coordinate Public Health Emergency Response

of our ongoing effort to bring inAmerica’s most talented experts inbioterrorism as well as strengthen ourresponsiveness. We’re working hardevery day to build our capabilitieseven stronger.”

The deadly anthrax mailings last fallexposed the country’s vulnerabilityto biological terrorism and spurreddemand for technologies andmedicines that could be used tocombat such attacks. Russell’sappointment as special advisor onvaccine production and developmentrepresents the effort by federal healthofficials to strengthen and alignresources and expertise to defend thecountry against bioterrorism threats.Included in the government’s planningis an initiative to produce adequatesmallpox vaccine to immunize the nation,as a preparedness defense against such

Sabin Vaccine

The newsletter of the Albert B. Sabin Vaccine Institute —dedicated to disease prevention

R E P O R T

Continued on page 15

Volume V, Number 1Spring 2002

a bioterrorist attack. The governmentalso is seeking a full range of tools todefend against bioterrorism, includingsensors to detect biological and chemicalweapons, vaccines to provide immunityagainst disease agents, tests to diagnose

victims, and medicines to treat theinfected.

The Bush administration’s fiscal2003 budget proposal sets aside$5.9 billion to combat bioterrorism,

a 319 percent increase from the $1.4billion in the 2002 budget. It includes $2.4billion for research and development ofvaccines, diagnostic tests, therapies andother technologies; $1.2 billion toincrease the capacity of state and localhealth agencies to respond to bioterroristattacks; and $851 million to upgrade thefederal government’s ability to respondto such attacks.

Pictured from left at the Department of Health and Human Services are Office of Public Health Preparednessappointees Philip Russell, MD, and D.A. Henderson, MD. Photo by Deborah Demasse

IIIII nside nside nside nside nsideViewpoint: Conflict and Infectious Disease .. 2Chairman’s Message .................................... 3Hookworm Vaccine Initiative Review ........... 5Cold Spring Harbor Colloquium .................. 6Sabin Gold Medal Recipient Announced ..... 7Guest Report from TB Vaccine Meeting ....... 8Sabin Vaccine Institute Salutes .................... 9Book Review: Epidemics and History ......10SVI Cancer Vaccines Colloquium at Walker’s Cay ....................................... 12CDC Computer, “Albert” ............................ 13New Sabin Board Members .......................14Announcing Sabin Awards ......................... 15

www.sabin.orgwww.sabin.orgwww.sabin.orgwww.sabin.orgwww.sabin.org

The Sabin Vaccine Reportis published by the

Albert B. Sabin Vaccine Institute

Subscriptions are freePlease direct inquiries to:

SABIN VACCINE REPORT58 Pine Street

New Canaan, CT 06840-5408phone: 203.972.7907

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email: raymond.macdougall@sabin.orgEEEEEDITORDITORDITORDITORDITOR

Raymond MacDougall

SPRING 2002 SABIN VACCINE REPORT2

Did Contagion Help Fuel the Conflict in Afghanistan?The Relationship Between Armed Conflict and Serious Infectious Diseases

With the defeat of the Taliban regime inAfghanistan, Hamid Karzai, leader of theinterim Afghan government, faces thedaunting task of not only stabilizing a countrystill under siege and with a damagedinfrastructure, but also of remedying anappalling health crisis. Afghanistan has thedubious distinction of being the only non-African nation to be on the list of the 15countries with the highest child death ratefrom infection in the world. Its childhood andinfant mortality rates are comparable to oreven exceed the disease-ridden, poverty-stricken and war-torn African disasternations of Angola, Sierra Leone, Rwanda,and Somalia.

The vast majority of deaths in thesedevastated countries can be ascribed toinfectious pathogens that strike children withunderlying malnutrition. In Afghanistan, asin these stricken African nations, children donot receive their routine vaccinations. As aresult, infections such as measles, neonataltetanus, pertussis and polio are still majorchildhood killers in these countries.Outbreaks caused by measles, the singleleading killer of children worldwide, nowoccur regularly in Afghanistan. Afghanistanis one of only eight countries in the worldwhere polio is still found.

The situation facing Afghanistanrepresents an unfortunate and poignantmodel of the link between epidemicinfectious diseases and international security.A cross-disciplinary analysis suggests thatinfections may predispose a nation tobecome engaged in an armed conflict. Since1990, we found that nations such asAfghanistan and Angola, which suffer fromthe world’s highest rates of lethal childhoodinfectious diseases such as measles, tetanus,and pertussis, face almost 20 times the riskof becoming engaged in either civil war orinternational conflict than nations with a lowprevalence of these infections (EMBOReports [European Molecular BiologyOrganization], October 2001).

There are plausible explanations as to whyinfectious disease might promote conflict. Intheir January 2000 report, Contagion andConflict, Health as a Global SecurityChallenge, the Chemical and BiologicalArms Control Institute together with the CSISInternational Security Program identifiedseveral key factors leading to nationalinstability as a consequence of infectiousdiseases. This report, together with a recentCentral Intelligence Agency Report, TheGlobal Infectious Disease Threat and ItsImplications for the United States, makesa strong case for placing tropical and otherinfectious diseases on the map as significantglobal security threats.

This then leads to an obvious question ofwhether vaccinating against these infectionsmight promote stability and reduce thelikelihood for conflict. The observation thatmany of the world’s Islamic nations alsosuffer from the highest mortality rates fromchildhood infections, suggests that vaccinespossibly might have an indirect role inmediating conflict resolution. Vaccinediplomacy could be come an importanttheme in our nation’s nascent efforts atpromoting foreign relations with Pakistanand Afghanistan. Possibly one day, vaccinesmay have a role in helping to restorerelations with Iran and Iraq, and even future“axis of evil” nation states.

Recognition that Afghanistan is a disease-stricken region that more closely resembleswar-torn Angola than it does other Asiannations might serve as a useful foreign policyparadigm.

—by Peter J. Hotez, MD, PhD, FAAP

Peter J. Hotez, MD, PhD, is professor and chairof microbiology and tropical medicine at TheGeorge Washington University, and senior fel-low of the Sabin Vaccine Institute. He also is vis-iting professor, Institute of Parasitic Diseases, ofthe Chinese Academy of Preventive Medicine.

VIEWVIEWVIEWVIEWVIEWPOINTPOINTPOINTPOINTPOINT

AAAAASSOCIATESSOCIATESSOCIATESSOCIATESSOCIATE E E E E EDITORDITORDITORDITORDITOR

Veronica KornCCCCCOPYOPYOPYOPYOPY E E E E EDITORDITORDITORDITORDITOR

David Bedell

OOOOOFFICERSFFICERSFFICERSFFICERSFFICERS OFOFOFOFOF THETHETHETHETHE SVI B SVI B SVI B SVI B SVI BOARDOARDOARDOARDOARD OFOFOFOFOF T T T T TRUSTEESRUSTEESRUSTEESRUSTEESRUSTEES

H. R. Shepherd, ChairmanWilliam R. Berkley, Co-ChairmanMichael E. Whitham, Esq., Secretary/

Treasurer

SVI SSVI SSVI SSVI SSVI STAFFTAFFTAFFTAFFTAFF

Fran G. Sonkin, Executive Vice PresidentRaymond MacDougall, Director of

CommunicationsPaul J. Vilk, RPh, RAC, Vice President,

Program Management and RegulatoryAffairs, Hookworm Vaccine Initiative

David Bedell, Executive Assistant tothe Chairman

Veronica Korn, Research AssociateChristel Lane, Receptionist/Staff AssistantGboku Lumbila, Executive Assistant,

Hookworm Vaccine InitiativeEdward Smith, Information Coordinator

and LibrarianJean-Serge Valcourt, AccountingVanessa Santiago, Assistant to the

Executive Vice President

SVI ASVI ASVI ASVI ASVI ADVISORSDVISORSDVISORSDVISORSDVISORS

Philip K. Russell, MD, Senior Advisor tothe Chairman

Peter J. Hotez, MD, PhD, Senior Fellow& Chair, Scientific Advisory Council

William Muraskin, PhD, Sabin FellowPatricia Thomas, Sabin FellowNancy Gardner Hargrave, Development

Counsel

dedicated to disease prevention www.sabin.org 3

This brings me back to the sobering experience of September11. While awaiting results of a pre-operative spinal surgery exam,my physician broke the news that two planes had just crashed intothe World Trade Center towers. He then rushed to report to EinsteinMedical Center in New York City, to do what he could for the victims.

So, when I thought I had seen the worst, it was a shock to beconfronted by the senseless loss of life and security on our soil. Then,just as the nation seemed to be reckoning with the disasters in NewYork and Washington, we were further traumatized this past fall bythe spate of anthrax attacks. Such events create an indelible imageon our individual and collective impression of history.

Under these circumstances, the work of the Sabin Vaccine Institutetakes on even greater significance. The Institute has continuallyaddressed the need for vaccine development to counter the effectsof existing diseases. It also has supported increased vaccineproduction to protect us from biological agents that could fall intothe hands of terrorists. My message to the valued supporters,subscribers and constituents of the Sabin Vaccine Institute is thatyour continued support of our programs will be met with our equaldetermination to work toward disease prevention through vaccines.

Our fall colloquium at Cold Spring Harbor explored technologyaccess for making vaccines for the developing world, our springcolloquium at Walker’s Cay continued dialogue about vaccines forcancer and immunotherapy, we conducted a program review of theHookworm Vaccine Initiative in January, and during May, we’ll toasta Sabin Gold Medal awardee, Stanley Plotkin, in Baltimore, andrecipients of the Institute’s lifetime achievement award andhumanitarian award at our annual dinner in New York City.

These are some of the activities of the Sabin Vaccine Institute thatexemplify the efforts your support makes possible. Along with theeradication of smallpox and the great strides made against polio,the Institute’s programs are hallmarks of my historical survey of thepast three-quarters of a century.

Sincerely,

ChairmanSabin Vaccine Institute

This country is still recoveringfrom the terrorism andbioterrorism inflicted upon usthis past fall. We have seen, inresponse, remarkable human-itarianism and collectivemobilization to secure ourcountry from further acts ofterror and bioterrorism.

As the world has beenchanging around us, a series ofvivid life-changing memoriesfrom my own past has been castin a new light, evoking a sense of the importance of our history as anation and the way that each individual has a role to play in ourcountry’s recovery.

The first event that came to mind was the bombing of Pearl Harbor.I heard that shocking news on my way to chemistry lab when I wasa junior at Cornell. The attack on Pearl Harbor astounded mebecause it involved a sneak attack—not unlike the tactic used inSeptember. President Roosevelt called December 7 a date whichwill live in infamy and, until September 11, I don’t think we everimagined being struck again by an attack on such a scale.

The next defining event in my life was an extraordinary trip I tookduring the final years of my service in the U.S. Army aboard the SSTaos Victory in 1945-46. I had the unbelievable experience ofdelivering 5,000 French Foreign Legion Troops to Saigon, Vietnam.This period would later reveal itself to be a precursor to the VietnamWar two decades later, but the mission I was on remained unknownfor at least the next two years.

Three months later, in March of 1946, I found myself walking thestreets of Hiroshima, just six months after the United States droppedthe atomic bomb. The trip was part of my tour of the Far East tosave democracy. It was the most unbelievable and awful experienceof my life—seeing the destruction in Hiroshima. No one could beleft untouched by the experience of walking those streets—seeingthe children, seeing the destruction, seeing the twisted buildings.

Would youWould youWould youWould youWould youlike to read thelike to read thelike to read thelike to read thelike to read the

Sabin VSabin VSabin VSabin VSabin Vaccine Reportaccine Reportaccine Reportaccine Reportaccine Reportonline? Our newsletteronline? Our newsletteronline? Our newsletteronline? Our newsletteronline? Our newsletteris available in a PDFis available in a PDFis available in a PDFis available in a PDFis available in a PDF

format on our website,format on our website,format on our website,format on our website,format on our website,

www.sabin.orgwww.sabin.orgwww.sabin.orgwww.sabin.orgwww.sabin.org.....

Notable Quote—Disease has long been the deadliest enemy of mankind. Infectiousdiseases make no distinctions among people and recognize no borders.We have fought the causes and consequences of disease throughouthistory and must continue to do so with every available means. Allcivilized nations reject as intolerable the use of disease and biologicalweapons as instruments of war and terror.

—President George W. Bush, November 1, 2001

The Institute’s Mission Takes on Greater Significance, Especially Since September 11A Message from the Chairman

H.R. Shepherd, Chairman

SPRING 2002 SABIN VACCINE REPORT4

Russell and Osterholm Contribute to Dialogue at Alliance for Health ForumCapitol Hill Audience Hears Straight Talk on Bioterrorism

Sabin Board of Trustees membersMichael Osterholm, PhD, and PhilipRussell, MD, provided briefing remarksat a November forum on PotentialBioterrorism Threats, Existing PublicHealth Capabilities, and New Ap-proaches to Preventing Harm. The Capi-tol Hill briefing was organized by the Al-

liance for Health Reform and was mod-erated by Sen. Jay Rockefeller and Sen.Bill Frist, who are respectively chair andvice chair of the Alliance. Other mem-bers of the panel included LaurieGarrett, science writer for Newsday andauthor of The Coming Plague, and Mar-garet Hamburg, vice president for bio-

logical programs at the NuclearThreat Initiative.

The new attention being fo-cused on bioterrorism has a chill-ing effect, but according toOsterholm, “We can live withfear or in fear.” Faced with thestark reality of bioterrorism, headmon i shedthat govern-ment needs tomake publichealth a highpriority andthat, faced withthe knowledge of the ease andstealth of bioterrorism acts, ev-ery building should be protected.

According to Russell, thecountry’s preparedness against

Russell and Shepherd Address Young PresidentsVaccines Grab the Attention of Entrepreneur Group

bioterrorism contrasts with our readi-ness and swift victory in Desert Storm.“We are in the midst of a steep learningcurve,” he said. “We have a truly greatresearch capability, including the Na-tional Institutes of Health, the armedforces, and manufacturing, but the fed-eral government has not been success-ful in acquiring vaccines for defense.”He cited the need for a new cell-culturevaccine for smallpox and better diagnos-tics for the disease, for a second-gen-eration anthrax vaccine effective in justtwo doses, for a new plague vaccine anddiagnostic and treatment expertise, aswell as for acquisition of vaccine supply

to defend againstbotulism, tularemia,hemorrhagic fever,and encephalitis.

The clear messageof the briefing wasthat the nation as a

whole, and individual communities, mustbe prepared to defend againstbioterrorism threats, prevent them if pos-sible, and be prepared for effective re-sponses.

Philip Russell, MD, addresses Capitol Hill audience convenedby the Alliance for Health Reform on bioterrorism defense.

Photo by Bob Peavy

“We can live withfear or in fear.”

—Osterholm

Attendees at the Young Presidents’Organization Health and TechnologyDay, this past January in Norwalk,Connecticut, received a primer onvaccines and their role in combattingdisease and bioterrorism.

H.R. Shepherd, Sabin VaccineInstitute chairman, led a session onvaccines and Philip Russell, MD, SVIsenior advisor to the chairman andspecial advisor on vaccine devel-opment and production at the U.S.Health and Human Services Office ofPublic Health Preparedness, deliveredkeynote remarks.

Shepherd’s presentation drew uponthe experiences of the Sabin VaccineInstitute and his involvement in the

Institute’s research initiatives andadvocacy efforts over the past nineyears. He narrated a colorful andeffective slide presentation and madethe case for opportunities and initiativesthat will hasten new developments invaccine research.

Russell’s keynote address focusedon the role vaccines play in defenseagainst bioterror, including effortscurrently underway at the federal levelto strengthen our security withinvestment in vaccines.

A range of additional presentersincluded academic and medicalleaders, as well as senior executivesin the biomedical, pharmaceutical, andfinancial industries.

Vaccines Stage “Comeback”—TIME

The following SVI letter to the editorapplauded TIME for an article ondevelopments in the vaccine field.

A Hopeful SignA Hopeful SignA Hopeful SignA Hopeful SignA Hopeful SignYour article “Vaccines Stage A Comeback”[Staying HealthyStaying HealthyStaying HealthyStaying HealthyStaying Healthy, Jan. 21] summed it upperfectly: “Vaccines are the great preventionsuccess story of modern medicine.” Ratherthan a fading technology, vaccines are apresent wonder and, with new biotechnologydevelopments, will help conquer a widerrange of infectious diseases. A recent renewalof interest in the benefits of vaccines is ahopeful sign that researchers who arecontinuing to investigate the potential of newvaccines will receive public support and theinvestment needed to fuel their work andinspire even greater developments.

5

Human Hookworm Vaccine Initiative Conducts Program ReviewVaccine Experts from Around the Nation Provide Scientific Sounding Board for Hookworm Vaccine Progress Report

The Sabin Vaccine Institute’s HumanHookworm Vaccine Initiative (HHVI)convened a review meeting on January22 in Rockville, Maryland. The 40attendees represented the Sabin VaccineInstitute, The George WashingtonUniversity (GW), where the hookwormvaccine research is being conducted,and collaborators from a number ofexternal organizations.

Since receiving an$18 million awardfrom the Bill &Melinda GatesFoundation in the spring of 2000, theSabin Vaccine Institute has administeredthe grant supporting hookworm vaccineresearch led by Peter J. Hotez, MD,PhD, professor and chair, Departmentof Microbiology and Tropical Medicineat The George Washington University.Hookworm infection is one of the mostprevalent infections of humans—morethan one billion individuals harborhookworms in their intestines. Sometropical clinical investigators rankhookworm as the second mostsignificant parasitic infection of humans,next to malaria. Within developingeconomies, hookworm is a leading causeof anemia and malnutrition.

The HHVI program review providedan opportunity to assess the status ofthe research project to date and to planfor the coming months of activity. PhilipK. Russell, MD, Sabin Vaccine Institutesenior advisor, chaired the meeting andcalled for an open and frank discussionamong the participants. “It’s time to bringfolks together to look at the experienceover the last year on antigen discoveryand to receive scientific criticism of ourprogress where appropriate and a frankdiscussion on strategic decisions that willhave to be made over the next weeksand months.”

Hotez began his presentation with adescription of the global burden ofhookworm infection and a rationale fora hookworm vaccine. In providing atechnical description of the nature of

cussion and viewpoints for the ProgramReview included Ashley Birkett, PhD,Apovia, Inc.; Jane Halpern, PhD,Intellivax, Inc.; Walt Brandt, PhD, FilipDubovsky, MD, and Gina Rabinovich,MD, of the Malaria Vaccine Initiativeof the Program for AppropriateTechnology in Health; David Knox, PhD,Moredun Research Institute; Lee Hall,MD, National Institute for Allergy andInfectious Disease, National Institutesof Health; Lorenzo Savioli, MD, WorldHealth Organization; Ken Eckels, PhD,and Evelina Angov, PhD, of the WalterReed Army Institute for Research; andMichael Meagher, PhD, University ofNebraska–Lincoln.

A word of appreciation for the workbeing carried out by the HHVI team andthe support of collaborators at themeeting was conveyed by Sabin VaccineInstitute Chairman H.R. Shepherd, whosaid, “What you’re doing is veryimportant. But to me one of the mostimportant things is how it happened, howyou got all these diverse people together.It’s really a tribute to all the members ofthe team.” Shepherd put into perspectivethe evolution of the HHVI, from its rootsin Peter Hotez’ parasitology research,through its recognition by Philip Russellas an important vaccine researchproject, and to its being funded by theGates Foundation. “This has been oneof the greatest things I’ve experienced,”Shepherd said.

Peter Hotez, MD, PhD, describes progress to date in identifyingcandidate antigens for developing a human hookworm vaccine.

hookworm infection, Hotez provided acompelling case for a vaccine. Theinfective stage of the parasite is thelarvae, which pass through the skin, andare carried by the circulatory system tothe heart, then to the lungs, and are thencoughed up and swallowed. They dwellin the small intestine and over a periodof weeks or months and become adultblood-feeding hookworms. The only

effective method totreat hookworm isa n t h e l m i n t h i cchemotherap ies .

Yet, infestation typically recurs withinmonths of such treatments.

A brief overview of the HHVI and itscollaborators, many of whom were inattendance, was presented by Paul J.Vilk, RPh, RAC, vice president, SabinVaccine Institute Program Managementand Regulatory Affairs.

Hotez and members of his researchteam provided data on the antigendiscovery component of the vaccineresearch being conducted at GW.Reviewers were asked to consider thestrategy for choosing the best antigencandidate for the vaccine. In addition,they were asked to offer thoughts onaspects of developing the leadingcandidate and getting it into clinical trialsin a reasonable timeframe.

Process development strategies,manufacturing plans, and ultimate clinicaltrials were discussed during a livelyinterchange interspersed with questionsand debate.

The HHVI team at TheGeorge Washington Univer-sity is led by Hotez andincludes Ray Loomis; JamesAshcom, PhD; Zhan Bin,MD; Jeffrey Bethony, PhD;John Hawdon, PhD; KashiGhosh, PhD; Alex Loukas,PhD; Maria Elena Bottazzi,PhD; Idong Essiet; J.J. Feng;and Bernard Zook, DVM.

External attendees, whoprovided welcomed dis-

dedicated to disease prevention www.sabin.org

NEWS FROMNEWS FROMNEWS FROMNEWS FROMNEWS FROMTHE BENCHTHE BENCHTHE BENCHTHE BENCHTHE BENCH

SPRING 2002 SABIN VACCINE REPORT6

Sabin Vaccine Institute Convenes 8th Colloquium at Cold Spring HarborMaking Vaccines for the Developing World: Access to and Deployment of New Technologies

Making Vaccines for the DevelopingWorld: Access to and Deployment of New Technologies CSH 2001Participants are pictured, front row, from left: Melinda Moree, Lance Gordon, Regina Rabinovich,Philip K. Russell, Carol Nacy, Jerald C. Sadoff, Margaret Liu, Hannah Kettler, Peter Hotez, Edward Neiss,Sharon Hammer, Denis Panicali, Veronica Korn, Phyllis B. Moses, Noreen O’Connell. Back row, fromleft: Sarah Glass, Donald S. Burke, Richard Insel, Terry A. Young, Gordon Perkin, Mark Miller, RichMahoney, Brooke Mahoney, Don L. Douglas, Christian Shrivel, Walter Lee. Not Pictured: Margaret

Hammerschlag, Mike Levine, Lewis Miller.

The Sabin Vaccine Institute conductedits eighth colloquium on vaccine policyat the Cold Spring Harbor ConferenceCenter on Long Island this past October.“Making Vaccines for the DevelopingWorld: Access to and Development ofNew Technologies” provided 40scientific and public health leaders withthe opportunity to explore improvementsin cooperation on vaccine discovery,manufacturing, and delivery.

“An interesting mixture oforganizations is attempting to propel thedevelopment—and in the end, theutilization—of new vaccines for thebenefit of the entire world,” said PhilipRussell, MD, Sabin Vaccine Institutesenior advisor. “It’s a mixture of effortsall around the common theme of gettingthe next generation of vaccines into usein the world.” Russell chaired thecolloquium, which was organized byMelinda Moree, PhD, and ReginaRabinovich, MD, of the Program forAppropriate Technology in Medicine,Malaria Vaccine Initiative, and LanceGordon, PhD, CEO of VaxGen.

The next generation of vaccines willdepend upon highly specializedtechnologies, each with importantintellectual property considerations. Thecolloquium explored ways thatresearchers building vaccines forinternational public health initiatives canbenefit from the great resourcesavailable in the private sector.Participants considered mechanisms forjoint initiatives, potential reservoirs oftechnical knowhow, and novelapproaches to transfer technology fromthe industrial sector to the public healthsector, while protecting the intellectualproperty of developers.

The three-day meeting, set at one ofthe East Coast’s premiere scientificconference centers, featured a free flowof discussion based on the experiencesof participants representing academicinstitutions, federal laboratories, non-profit research entities, and industryorganizations. Five vaccine research

projects receiving support from the Bill& Melinda Gates Foundation wererepresented at the meeting.

While representing separate initiatives,the participants at the meeting share acommon perspective on the challengesfacing vaccine developers. Makingvaccines, says Rabinovich, requires “alot of hard work—they are not under arock waiting to be discovered.” Sheadded that the public health communityoperates differently than industrialmanufacturers, yet recognizes marketrealities. “We have a public healthmission. That doesn’t mean there is nota need or concern for how to maintain acredible market, or that there isn’t amarket for these vaccines—but it’s adifferent kind of market.” ParticipantCarol Nacy, of the Sequella GlobalTuberculosis Foundation, explained thatfor non-profit entities to acquire accessto vaccine technologies, the for-profitcompanies that own the technology mustsee a return on investment.

Accessing, evaluating, and utilizingmany new vaccine technologies for usein the developing world can best be doneby the large corporate manufacturers,indicated Russell. A consortium ofvaccine manufacturers in conjunction

with public sector vaccine research anddevelopment efforts could be veryeffective in solving common problemsthat all or most companies face and areespecially important to vaccine programsin the developing world.

According to Donald Burke, MD,director of the Center for ImmunizationResearch at Johns Hopkins University,non-profit vaccine developers sharecross-cutting vaccine research anddevelopment problems. These includeevaluation of novel routes and vaccinedelivery technologies that do not usesyringes and needles; identification andcertification of pilot production facilitiesfor platform technologies; assessment ofvaccine preservatives and stabilizers;selection and quality assurance of clinicalvaccine trial sites in developingcountries; and creation of contractualmechanisms to protect intellectualproperty while assuring long-term accessin poor countries.

Peter Hotez, Chair of the Microbiologyand Tropical Medicine Department atGeorge Washington University andPrincipal Scientist on the HookwormVaccine Initiative for the Sabin Institute

Continued on page 16

7dedicated to disease prevention www.sabin.org

Stanley Plotkin to Receive Sabin Gold Medal at May CeremonyRubella Vaccine Inventor to Receive Recognition

The Sabin Vaccine Institute will awardthe 2002 Sabin Gold Medal to StanleyA. Plotkin, MD, medical and scientificadvisor for Aventis Pasteur. The medalis awarded annually andrecognizes exemplaryleadership in the field ofvaccinology. The SabinGold Medal will bepresented to Dr. Plotkin ata ceremony at on May 7that the WyndhamBaltimore Inner HarborHotel. The event will beheld in conjunction with the5th Annual Conference onVaccine Research, ameeting of severalhundred of Dr. Plotkin’s fellow scientiststhat is co-organized by the Institute.

Dr. Plotkin developed the rubellavaccine now in use, and has workedextensively on a range of other vaccines,including polio, rabies, varicella andcytomegalovirus. He is a renownedexpert in virology. “Stanley Plotkin is anextraordinary figure in the field ofvaccinology and truly epitomizes thededication that reflects Albert Sabin’sgoal to conquer disease with vaccinesand immunization,” said H.R. Shepherd,chairman of the Sabin Vaccine Institute.“The Institute is proud to extend thishonor to a scientist and humanitarian ofDr. Plotkin’s stature.”

Dr. Plotkin joined Aventis Pasteur, oneof the world’s largest vaccinecompanies, in 1990 when the companywas known as Pasteur MérieuxConnaught. He attained the title ofemeritus professor from his prior facultymembership at the University ofPennsylvania. There, he was professorof pediatrics and microbiology andprofessor at the Wistar Institute, amedical research institute honored forthe discovery of vaccines, genetic, andmolecular therapies. He servedconcurrently as director of infectiousdisease and senior physician at theChildren’s Hospital of Philadelphia. For

two years, he was associate chairmanof the Department of Pediatrics at theUniversity of Pennsylvania.

Dr. Plotkin’s career included internshipat Cleveland Metropoli-tan General Hospital,residency in pediatrics atthe Children’s Hospital ofPhiladelphia and theHospital for Sick Childrenin London and three yearsi n t h e E p i d e m i cIntelligence Service of theCenters for DiseaseControl of the U.S. PublicHealth Service. In 1957,he investigated the lastknown outbreak of

inhalation anthrax in the United Statesprior to the events of 2001, and helpeddemonstrate the efficacy of the currentanthrax vaccine.

More than 500 ofDr. Plotkin’s articleshave been publishedand he has edited severalbooks including Vaccines, now thestandard textbook in the field. He waschairman of the Infectious DiseasesCommittee and the AIDS Task Forceof the American Academy of Pediatrics,liaison member of the AdvisoryCommittee on Immunization Practices,and chairman of the Microbiology andInfectious Diseases ResearchCommittee of the National Institutes ofHealth. His contributions have beenrecognized with the Bruce Medal inPreventive Medicine of the AmericanCollege of Physicians, the DistinguishedPhysician Award of the PediatricInfectious Diseases Society and theClinical Virology Award of the PanAmerican Society for Clinical Virology.

Stanley Plotkin, MD2002 Sabin Gold Medalist

Hotez and Goldstein Part of GW Collaboration in PanamaSVI Colleagues at GW Find Role in Tropical Diseases Institute Collaboration

Sabin Vaccine Institutescientific leaders Peter J.Hotez, MD, PhD, andAllan Goldstein, PhD,visited Panama last fall aspart of a delegation fromThe George WashingtonUniversity collaboratingwith the Panamaniangovernment on a Centerfor the Study of TropicalDiseases and GenomicStudies in Santiago deVeraguas, Panama. Hotez is chairmanof the GW Department of Microbiologyand Tropical Medicine; Goldstein ischairman of the GW Department ofBiochemistry and Molecular Biology.

The delegation met with PanamanianPresident Mireya Moscoso Rodriguezand signed a memorandum ofunderstanding regarding collaboration onthe center to be dedicated to investigatingthe major diseases of the CentralAmerican and Caribbean region.

“Together we will investigate themajor diseases of the region and identifya means to apply the new biotechnologyto this region,” Hotez said. Goldsteinadded that the agreement will also resultin providing new opportunities forstudents of Panama to continue theirmedical and scientific studies and forGW students, professors and physiciansto visit Santiago to “continue thedevelopment of this new and importantinstitute and medical center.”

Panamanian President Mireya Moscoso Rodriguez announcesmedical research and education collaboration with GW delegation,including, Peter Hotez, MD, PhD, and Allan Goldstein, PhD.

SPRING 2002 SABIN VACCINE REPORT8

More than 60 scientists convened thispast fall at the Tuberculosis(TB)Vaccine 2001 Conference inMontreal. The meeting was devoted toscientific issues in developing a betterTB vaccine and was hosted at McGillUniversity. Carol Nacy, president,Sequella Global Tuberculosis Foundation(SGTBF), welcomed the attendees to adiverse program, which ranged frombasic immunology to reports on new labtools and field studies, and of severalexperimental vaccines being developedas part of the SGTBF TB VaccineCollaboration, an effort supported by theBill & Melinda Gates Foundation.Immunology SymposiumImmunology SymposiumImmunology SymposiumImmunology SymposiumImmunology Symposium

An Immunology Symposium on“Detecting Vaccine Take and Efficacy”kicked off the conference. Robert North,Trudeau Institute (TI), discussedcharacteristic features of immunity to TBin the mouse model. The immuneresponse, with or without priorvaccination, inhibits MTB multiplicationafter three weeks, followed by stationaryinfection, but progressive lung pathologyand disease. He identified delay in thesecondary response after challenge invaccinated animals as a problem in onlypartially controlling infection, likening thisto TB-susceptible humans who makegood T-cell responses but fail to resolveTB infection and progress to disease.

Holden Maecker, Becton-Dickinson,described elegant cytokine flowcytometry techniques for measuring T-cell responses in chronic infections, andDavid Woodland, TI, discussed studiesof influenza immunity where the numberof memory T cells in the lung appearedto be important for protection againstchallenge. Susan Swain providedevidence that memory T cells originatefrom surviving effector T cells andaddressed the question of what regulatespersistence of immune memory;removal of antigen stimulation ofeffector cells appears important. MarkJenkins, TI, presented the concludingreport of the symposium on the location

of antigen-specific T cells after antigenstimulation. He recommeded that moreattention be paid to effector-memory Tcells in sites such as lung, GI tract, andsalivary glands rather than in lymphnodes and spleen.SessionsSessionsSessionsSessionsSessions

Sessions covered progress on clinicaltrials and related studies in the WesternCape region of South Africa. GregHussey, University of Cape Town, andLarry Geiter, SGTBF, are principalinvestigators of a large, multi-year studystarted in March 2001, comparing thesafety and efficacy of BCG vaccinegiven to infants by either thepercutaneous or intradermal route.There are already more than 2,000enrollments in the study. Theircollaborators at the RockefellerUniversity are developing methods todetect immune responses to infant TBvaccination to seek correlations withprotection. Reports of furthercollaborative work with South Africancolleagues covered field epidemiology,molecular epidemiology, and geneticepidemiology, all of which explore abetter understanding of TB in the regionin preparation for trials of new TBvaccines to better control this seriouspublic health problem.

In a session on experimental TBvaccines, Lew Barker, SGTBF,explained the foundation’s process forreviewing vaccine candidates andselecting those appropriate foradvancing towards initial human studies.Marcus Horwitz, UCLA, describedprogress towards Phase I human testingof his recombinant BCG (rBCG30)experimental vaccine, whichoverexpresses one of the importantextracellular proteins of MTB andprotects guinea pigs significantly betteragainst challenge than its parent BCGstrain. Barry Bloom, Harvard University,and William Jacobs, Albert EinsteinCollege of Medicine, reported twoinnovative approaches to developingsafe, live attenuated MTB experimental

Report of a Conference on TB Vaccines, Montreal, November 7-9, 2001Special to the Sabin Vaccine Report, by Lewellys F. Barker, MD, MPH, Chief Medical Officer, Sequella Global TB Foundation

vaccines that will deliver antigens missingin BCG. Anne DeGroot, EpiVax, Inc.,is applying bioinformatics technology toidentify MTB T-cell epitopes from theTB genome, and Martina Riegl,Intercell, Inc., is using the DeGrootfindings to advance a combination ofMTB epitopes and a T-cell adjuvanttowards initial human testing of achemically defined synthetic vaccine.Douglas Lowrie, Genomyc, Ltd., relatedan update of his work on a DNA-heatshock protein vaccine for use as animmunomodulator for preventing relapseand improving therapy of TB. DanielHoft, St. Louis University, reported hisclinical and lab studies of BCG vaccinein healthy adult humans, a prototype forinitial studies of new TB vaccines.

Rany Condos, NYU, opened the finalconference session with a report of herstudies of the human immune responsein the lungs of TB patients done on cellsin bronchoalveolar lavage fluid. WilliamBishai, Johns Hopkins, then discusseduse of the Lurie rabbit model to studyexperimental TB vaccines against theearly stages of TB when granulomas arefirst formed in the lungs, and BorisNikonenko, Sequella, Inc, talked aboutcharacteristics of the I/St mouse model,which mimic both exceptionalsusceptibility and exceptional resistanceto TB. John McKinney, RockefellerUniversity demonstrated use ofmolecular beacons to determine howMTB bacteria respond to their host inboth animal and human tissues. He foundstriking differences in mycobacterialgene expression responses betweenMTB in mouse lungs and human lungs,raising questions about the mouse as amodel for TB infection. David Sherman,Washington University, shed further lighton MTB latency with his studies ofinteraction between MTB metabolicstate and genetic control mechanisms.Understanding the latent stage of TB inhumans remains elusive but of highimportance in attempting to come upwith improved TB vaccines.

dedicated to disease prevention www.sabin.org 9

resulted in 55,000 reported cases and150 deaths, Carter and Bumpersfounded Every Child By Two in1991. For the past nine years, the

organization hasworked to ensure thatall children in Americaare immunized onschedule, from birth toage two, and thatimmunization deliveryis institutionalizednationwide. In recentyears, Betty Bumpersalso has worked on theglobal campaign toeradicate polio.

Betty Bumpers has dedicated herlife to issues affecting children’shealth. When she became the first ladyof Arkansas in 1970, the state had oneof the lowest immunization rates in thecountry. Bumpers spearheaded asystem for childhood vaccinations thatbecame a national model, andArkansas achieved one of the highestimmunization rates in the country atthe time.

After her husband’s election to theU.S. Senate in 1974, Bumperscontinued her work on immunizationwith the Centers for Disease Controland Prevention and Rosalynn Carter,whose husband was then governor ofGeorgia. Upon Jimmy Carter’s election

Sabin Vaccine Institute Salutes

Betty Bumpers, Co-founder, Every Child By Two

The Sabin Vaccine Report continues this regular column in our newsletter to salute individuals and organizationswhose innovation and dedication in promoting public health through immunization are worthy of a special mention.

as president in 1976, Bumpers andRosalynn Carter, led the federalgovernment’s first comprehensivechildhood immunization initiative in 1977,which was based on thesuccessful state program inArkansas. The efforts ofMrs. Bumpers and Mrs.Carter also led to nationwidelaws, requiring certainvaccinations before entryinto school. As a result ofthese laws, more than 95percent of American childrenare immunized by the timethey go to school.

In response to the 1989-1991 measles epidemic that

Betty Bumpers

January 25, 2002 was theculmination of a city-wide push in thenation’s capital to reach out to studentsin the public schools who were not fullyimmunized or lacked completeimmunization records. TheWashington, D.C. Department ofHealth provided a wide variety ofopportunities for students and theirparents to bring up to date theimmunizations and immunizationrecords prior to the well-publicizedcompliance date. Not the least of theseefforts were 24-hour immunizationclinics, along with publicized schedulesfor more than 25 immunization clinics,including mobil health units.Immunizations were provided free atthe sites.

The problem of unimmunizedchildren and children whose recordswere not up to date in the District wasbrought to the attention of the public afull year prior to the recent campaign.The public school system learned that

District of Columbia Department of Health, Education Work to Immunize School Children40,000 of the 68,500 students were notin compliance with immunizationstandards. Following efforts to informparents, 29,000 students remained outof compliance as of October 2001. Aspecial task force voted in November

Volunteerism Alive at the Sabin Vaccine Instituteolunteers have provided valuable contributions to the Sabin VaccineInstitute in recent months. The Institute extends its appreciation to thefollowing individuals who gave of their time:

to impose the January 25 deadline. Thelast weeks of the effort were calledOperation Final Push.

The success of the campaign washard won, but as of January 30, just2,800 students remained non-compliant.

Carolyn L. Kiel, Pleasantville,New York, entered library files intothe Institute’s database.

Border Crossing, an interdistrictHigh School program fromNorwalk, New Canaan, Wilton,Weston, Westport and Darien,Connecticut, dispatched studentswho helped organize the Institute’sphoto archives.

Robyn M. Frank-Smith, Stamford,Connecticut, helped update theInstitute’s mailing list, with contactsand addresses of scientificmagazines and newspapers.

George B. Holland, Danbury,Connecticut, helped fine-tune theInstitute’s library database, making ituser friendly for locating files,magazines, and books.

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Epidemics and History: Disease, Powerand Imperialism by Sheldon Watts (NewHaven: Yale University Press, 1997) isrequired reading for anyone aspiring tounderstand the history of infectious diseases.The footnotes alone, with their citation of thelatest articles and books on epidemicdiseases, make the book a w o r t h ypurchase. Dr. Watts writes in a simple andclear style, making the book accessible toboth experts and lay readers alike.

The chief strength of the book is that it looksat the history of epidemic diseases from thenon-Western-world perspective. It takes fairlyfamiliar material—the history of syphilis,leprosy, smallpox, cholera—and puts it in aradically different light, forcing the reader toconfront some unpalatable truths about therole of the West, including Western scienceand medicine, in aggravating rather thanalleviating infectious disease in the developingworld.

Traditionally, the Western image ofepidemic diseases is shaped by the belief thatsuch life-threatening ailments come fromsomewhere in the underdeveloped tropicsand endanger the lives of civilized folk inEurope and America. Our history books focusprimarily on the havoc wrought in the Westby such diseases, and put the suffering ofpeople in other regions into the background.Death from infectious disease is seen as thenormal state in foreign climes, unlike thesituation closer to home. For example, theBlack Death that devastated medieval Europealso decimated the populations of Asia andthe Middle East. The larger picture is notnormally dealt with except as backgroundmaterial for the “main event,” which takesplace in Europe. Watts takes a much broader

view and includes, for example, a fascinatingdiscussion of the effects of the plague in Egyptover a few-hundred-year period. The plaguein Egypt was not a short-term disaster, but anendless burden for which neither the culturenor government could find an adequatesolution.

Watts forces us to realize that diseasesoriginating “out there” were the result not somuch of the “natural” disease environment,bu t o f the ou tcome o f Wes ternintervention in the ecologyof those regions, with direunintended consequencesfor the native populations.The most striking example ofthis phenomenon is the caseof the so-called “IndianPlague,” cholera. It isgenerally assumed thatcholera was a massive killerin the Indian subcontinentbefore the Europeanscolonized South Asia. Theworldwide cholerapandemics in the early19th century are usuallyseen as a blight thatresulted from increasedinteraction betweenEurope and Asia—commerce andcolonization having brought “their problem”to the West. However, Watts emphasizes thereis no evidence that large-scale choleraepidemics existed in India before the early19th century. Rather, cholera appears to havebeen fairly localized in areas around the Bayof Bengal. It didn’t spread from its homeenvironment to the rest of the subcontinentuntil the British radically changed the social,economic, and ecological situation there. Inother words, it wasn’t “their disease” that wastransported to the defenseless West, but rathera limited local disease whose spreadthroughout India was facilitated by Britishactivity.

Of the many British innovations that Wattssees as causing the spread of cholerathroughout India, the two most strikinginterventions were the building of a railroadnetwork, which made it possible for infectedpeople to travel throughout the country whileincubating the disease, and the creation of asystem of large-scale irrigation canals, whichmade no allowance for the drainage of wastewater, nor for the fact that the canals wereused as privies by local residents. Theirrigation works helped to spread cholera farand wide. As a result, Watts takes the standardimage of cholera, which envisions a horridAsian plague that is spread to “innocent”Europeans who got in the way of someoneelse’s health problem, and replaces it with avision of a blundering British Empire that

creates havoc in India, andthen helpsspread thenewly emergentd i s e a s ethroughout theworld.

A major themeof Watts’s book isthe European rolein propagating newand deadlyepidemic diseasesthat make thetropical environmentmore dangerous forthe nativepopulations. This isnot the way thathistories of diseasehave traditionally

looked at East-West interactions. The book isfilled with instances where Westernintervention in African or Asian societieshelped create environments favorable todisease transmission, a situation far moremalign than what existed prior to theappearance of Westerners on the scene.According to Watts, the destructive effects ofWestern intervention on people’s health arenot exhausted in the spread of localizeddiseases throughout the newly createdcolonies. Independent of the West’s role inamplifying disease transmission was its partin creating a cultural vision of the disease and

Epidemics and History: Disease, Power and Imperialism—by Sheldon Watts

SPRING 2002 SABIN VACCINE REPORT10

The Sabin Report seeks to enrich the currentdialog on vaccine research and policy witharticle and review contributions. Opinionsexpressed in the articles are those of theauthors and do not necessarily represent theposition of the Institute.

Continued on page 11

[Hardback: ISBN 0-300-07015-2; Paperback: ISBN 0-300-08087-5]

dedicated to disease prevention www.sabin.org 11

its victims that further degraded nativepopulations. Watts argues that for each majorepidemic disease there is an intellectual“construct” that the Europeans devised thatmagnified the harms to indigenous peopleindependently of the biological effects of thediseases themselves. The most strikingexample of this is the “social construct” ofleprosy. As bad as the physical destructionthat the bacterium Mycobacterium lepraecauses in its victims, the socially constructedimage of the “leper” that Europeans carriedthroughout the world, was often moremerciless and degrading. In many cultures,those who suffer from leprosy are acceptedas full members of society. They move freely,marry, have children and carry on theirnormal lives. In the West, the erroneousidentification of Hansen’s Disease with thebiblical disease called leprosy, created amoral and emotional stigma leading to large-scale discrimination and segregation of theafflicted. Wherever Europeans went in theThird World they tried to “educate” thenatives to see leprosy through the emotionaland moral haze that European Christiansconfused with modern science. Whereverthese Western ideas took root, the lives ofpeople afflicted with the disease were madeinfinitely worse, since they were transformedin social pariahs and forcefully separatedfrom their communities.

Forcing the reader to confront a world inwhich the West caused more health problemsthan it solved is the major contribution of thebook, and the chief reason forrecommending it. Most of the material thatthe book is based upon is not original to theauthor, but rather a synthesis of the vast newresearch carried out in recent years. Wattsbrings it all together to paint a much broadercanvass than any other historian has yet done.

The author’s strength is to look at East-Westinteractions in a critical light and expose themany distortions that European and Americanethnocentrism introduces into historicalwriting. His weakness is to romanticize thevictims of Euro/American expansion, and toexaggerate the culpability of the West as a

cause of Third World problems. His tendencyto resort to snide anti-Western comments,simplistic class and cultural conflict models,and exaggerations of Western guilt is a realliability, and at times undermines the author’sown credibility.

It is difficult at points to continue readingthe book because of Watts’s seeming inabilityto credit almost any Westerner with analtruistic or humane motivation aboutepidemic diseases. Creating such straw mendoes nothing to help his argument. The factthat “tropical medicine” was developed inorder to make the tropics safe for white mento colonize, not for the benefit of the sufferingnative population, speaks for itself. That newscientific discoveries were used to protectcolonists, while natives were left to fend forthemselves, or to degrade the condition ofthe indigenous people—for example insegregating whites away from African childrenwho were stigmatized as the carriers ofmalaria infection—is horrible enoughwithout exaggerating the situation. But Wattstends to look for the worst, most self-servingreasons for white medical and scientificactivities. He usually emphasizes the mostracist, or dismissive comments by Europeanmedical and political spokesmen and leaveslittle or no space for the possibility of ahumanitarian concern coexisting with self-interest.

His image of the West doesn’t seemcompatible with real people and theircomplexities. In the same vein, his nativepopulations often seem like cardboardcharacters—but this time, unconvincinglybenign ones—except when they arecorrupted by Westerner influences.

What is especially frustrating in the book isthe author’s tendency to make moraljudgments and to do so even in cases wherethe participants lacked adequate knowledgeor means to carry out desirable actions. Wattson more than one occasion says that Westernscientists or policy makers “should haveknown” some factual piece of informationthat in fact they didn’t know at the time. Inother instances, he contends that they“chose” one scientific position over anothersimply because it was to their advantage. Forexample, according to Watts, despite RobertKoch’s work on cholera that showed thedisease was a microbe spread by water, the

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Continued from page 10

British authorities in India adopted the anti-infectious paradigm of Max von Pettenkofer.The Pettenkofer model allowed theauthorities to ignore the need for sanitaryreform and saved them the expense ofprotecting the native population. This kind ofreductionist argument that sees ideas assimple reflections of economic and socialpositions is not convincing. Nevertheless, thecontention that intellectual ideas aboutdisease are a direct cover for elite self-interestis a constant theme of the book.

An equal problem is Watts’s tendency tomorally condemn people for acts of omissionin cases where the lack of action seems tragicbut inevitable. For example, the author talksabout two sanitary officers in India in the late19th century who “adopted the thenrevolutionary idea that it was possible todesign preventive programs to improve theoverall health of India.” Such an idea wasdismissed by the British authorities becausethey contended that the problem went beyondthe government’s resources. The implicationin the book is that these human sanitaryofficers were right and the government actedimmorally and irresponsibly. But it begs thequestion of whether the government actuallyhad the resources to do what wasrecommended in the late 19th century. Doesthe Indian government have such resourceseven today? One must assume that Watts thinksthe answer is yes in both cases. If capitalistsignored the need to make a profit, colonialgovernments saw their mission as providingas much aid from the home country as poorcolonies needed, and the modern Indiangovernment put welfare above supporting itsmilitary establishment or serving otherpowerful political interests. However, in sucha situation, history becomes just an excusefor self-righteousness. The only fair questionis what was possible given the actualconstraints of real men in real societies. Itseems reasonable to make judgments wheregenuine opportunities existed and wereignored. But for Watts to sneer at a Britishofficial who had the audacity to say that nocapitalist would invest money in a project thatwould not produce a profit provides thereader with no insights about what could haverealistically been done to help the poor giventhe constraints of a capitalist imperial society.

Continued on page 12

SPRING 2002 SABIN VACCINE REPORT12

In a similar vein, Watts’s contention that theimperial powers helped create more virulentdisease environments by building railroads,canals, irrigation systems, and generallyunifying heretofore isolated areas, is anextremely important point. But the implicitand explicit blame that goes with thatobservation, ignores the fact that such diseaseenvironments were bound to be created bysomeone—native or foreigner—at somepoint in time, unless the Third World were tobe frozen in time. Of course, it is probablethat Watts would just dismiss homegrowngovernment unifiers that further theemergence of new diseases as corrupted

Western-clones, thus putting the blame backon those he is most comfortable judging. Allevil comes from “outside”—a mirror imageof the West’s ethnocentrism.

Unfortunately, perhaps Watts’s biases andjudgmentalism are the unavoidable price thatis paid for the insights that the author’s criticalperception produces. He sees the world fromthe perspective of the “other” and youinevitably get the distortions as well as thebenefits that flow from this. However, it wouldbe a pity if the major contribution that Wattsmakes to our understanding of the history ofepidemic disease were lost because onlypeople who enjoy Euro-American bashingbother to read it.

—by William Muraskin, PhDWilliam Muraskin, PhD, is a Sabin fellow and pro-fessor of urban studies, Queens College, New York.

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Continued from page 11

The Fourth Annual Sabin VaccineInstitute Colloquium on Cancer Vac-cines and Immunotherapy at Walker’sCay was convened this past March inthe Bahamas. Each year the colloquiumassembles prominent scientists in a“think-tank” environment for creativeand open exchange of ideas to deter-mine how to effectively translate recentadvances in molecular biology,genomics, and immunology into effec-tive cancer vaccines.

This year’s colloquium was organizedby Allan Goldstein, PhD, SVI boardmember and chairman of biochemistryand molecular biology at The GeorgeWashington University. Co-chairs of themeeting were Malcolm S. Mitchell,MD, professor of medicine, immunol-ogy and microbiology at the Hudson-Webber Cancer Research Center,Karmanos Cancer Institute; and Mar-tin Kast, PhD, professor of microbiol-ogy, immunology and pharmacologyand interim director, Oncology Institute,Cardinal Bernardin Cancer Center,Loyola University.

2002 SVI Cancer Vaccines & Immunotherapy Colloquium Returns to Walker’s CayMarch Colloquium Draws More Than 30 Participants, Including Leading Cancer Vaccine Scientists

This year’s meeting centered aroundfive areas of discussion: 1. the tumor’sdefense against the immune response,2. involvement of HLA-class II mol-ecules in tumor rejection, 3. strategiesfor immunization, 4. co-stimulatory mol-ecules, and 5. tumor antigens. Severalimportant papers on these topics pre-sented innovative research directionsthat forecast future breakthroughs intherapeutic cancer vaccines.

Though the island setting affords a re-spite from the typical day in the lab orwork setting, the meeting’s agenda wasjam packed. Each day of the collo-quium, up to 10 speakers presentedpapers, and participants delved into thecross-cutting presentations during dis-cussion periods. The design of the ses-sions provided for cross-cutting dialogwhich hopefully will stimulate the rapidtranslation of the most promising can-cer vaccine approaches into clinicaltesting. The Institute’s goal for the pro-gram is to provide a seed for innova-tive strategies and solutions in one ofthe most exciting and promising research

Proceedings of 2001Colloquium Published

movements in cancer today.President Nixon inaugurated Cancer

Control Month in 1969 from Walker’sCay, leading to a declaration of war oncancer. The colloquium is hosted byRobert Abplanalp, President Nixon’sfriend and confident, as well as by theSabin Vaccine Institute. Thecolloquium’s pleasant venue affordsparticipants the opportunity to returnfrom the meeting with fishing tales andrenewed motivation to pursue immuno-logical discovery.

As in year’s past, a proceedingsdocument will be compiled in the monthsfollowing this year’s meeting.

The proceedings of the 2001Sabin Vaccine Institute Colloquiumat Walker’s Cay is published. Lim-ited copies are available from the In-stitute upon request; a fee for post-age and handling is required. The 80-page document is an edited com-mentary encapsulating the presen-tations and discussion generated the2001 meeting.

dedicated to disease prevention www.sabin.org 13

“Albert” Computes Roadmap Toward Global Polio EradicationComputer at CDC Named for Albert B. Sabin to be Instrumental in Tracing Genetic Sequencing of Polio Virus

A powerful computer nicknamed“Albert,” in honor of Dr. Albert B. Sabin,is performing calculations that will assistresearchers at the Centers for DiseaseControl and Prevention (CDC) in theirpolio eradication efforts. Dr. Sabin’s oralpolio vaccine (OPV) is the foremost“weapon” in the battle to eradicate polio.The Albert computer resides at aspecialized polio reference laboratory atthe CDC where the genetic fingerprintsof the polio virus are being sequencedto identify remaining reservoirs of thevirus in the developing world. Albertperforms the calculations necessary toreconstruct the chains of poliovirustransmission. The computer houses thesequences of thousands of poliovirusesfound throughout the world; in effect,the genetic and virological history ofglobal eradication.

The CDC’s work is part of a largerpolio eradication campaign launched bythe World Health Assembly, thegoverning body of the World HealthOrganization (WHO), in May 1988.Global eradication of polio involved bothhalting the disease and eradicating thevirus that causes it—poliovirus. Theyear 2005 is the current date for thismonumental achievement, which can belikened to the 1977 eradication ofsmallpox.

Now almost 15 years later, the GlobalPolio Eradication Initiative, which isspearheading the effort, is still workinghard in a race to reach the last victim ofpolio. Along with the WHO and CDC,other partners cooperating in the globaleffort include Rotary International andthe United Nations InternationalChildren’s Emergency Fund. Thecoalition also includes nationalgovernments; private foundations suchas United Nations Foundation, and theBill & Melinda Gates Foundation; theWorld Bank; donor governments inAustralia, Belgium, Canada, Denmark,Finland, Germany, Italy, Japan, UnitedKingdom and the United States; andcorporate partners such as Aventis

Pasteur and De Beers. Volunteers indeveloping countries also play animportant part; ten million participatedin mass immunization campaigns lastyear, according to WHO.

In addition to funding large suppliesof oral polio vaccine, the CDC providesa wide range of technical expertise andlaboratory support for the polioeradication initiative. This includessupport for disease surveillance atglobal, regional, and national levels;investigating outbreaks of polio;assistance in the development andmonitoring of the polio laboratorynetwork; problem-solving throughepidemiological, operational, andlaboratory research; and funding forshort-term and long-term technicalsupport in key countries.

Polio is one of only a limited numberof diseases (others include measles andguinea worm disease) that can beeradicated. Polio can be eradicatedbecause the virus only affects humans;there is no animal reservoir; an effective,inexpensive vaccine exists (OPV);immunity is lifelong; and the virus canonly survive for a very short time in the

environment. Polio eradication is basedon the strategy and premise thatpoliovirus will die out if its human host isdestroyed through immunization. Thestrategy is similar to that used forsmallpox eradication in 1977; smallpoxis the only disease so far to have beeneradicated. Other diseases can becontrolled through immunization, but noteradicated. For example, tetanus and thebacterium that causes the disease,Clostridium tetani, is widespread in theenvironment and can surviveindependently from its human host.

The Albert computer is the CDC’sunique contribution to the globaleradication effort, due to its cutting-edgevirological surveillance capacity. Thisfunctionality is used to identify the strainof poliovirus involved and pinpoint itsexact geographical origin. Poliovirus cantravel quickly and cover long distances.An indigenous virus found in an area orcountry is one that may have circulatedin that area for a long time or may haverecently been imported. Determiningwhether the virus is indigenous orimported is necessary in deciding themost appropriate immunization strategy.

The web portal for the “Albert” computer system, which is being used at the CDC in their participation in theGlobal Polio Eradication Initiative.

INSTITUTEINSTITUTEINSTITUTEINSTITUTEINSTITUTENEWSNEWSNEWSNEWSNEWS

SPRING 2002 SABIN VACCINE REPORT14

The Sabin Vaccine Institute Boardof Trustees voted at its fall meeting toappoint two new board members,legislative advisor Mary Ann Chaffeeand development expert NancyGardner Hargrave.

Mary Ann ChaffeeMary Ann Chaffee is legislative

director and principal policy advisor toU.S. Senator Zell Miller. In a federalpublic service career spanning 20 years,she has worked on bills pertaining toMedicare, Medicaid, prescription drugbenefits, biomedical research, preventivehealth services, and vaccines. Shepreviously was policy advisor to formerSenator Dale Bumpers, when sheformulated the Senator’s agenda forsuch issues as government purchase andpricing of pediatric vaccines, childhoodimmunization, and global polioeradication. She holds a Master in PublicAdministration degree from HarvardUniversity’s John F. Kennedy School ofGovernment. There she receivedHarvard’s Women’s LeadershipFellowship. She also earned a Masterof Science degree from Case WesternReserve University, and a Bachelor ofArts from Ohio State University.

Nancy Gardner HargraveNancy Gardner Hargrave is an

independent development consultantwho provides capital campaign planningand management, major gifts, andfoundation and corporate relationsfundraising services primarily to non-profit scientific and health organizations.Her clients have included the CarnegieInstitution of Washington, the UnitedStates Institute of Peace, the NationalYouth Science Foundation, and the SabinVaccine Institute. She formerly servedfor 18 years with the National Academyof Sciences, departing in 1999 as

Institute Names New Board of Trustees MembersMary Ann Chaffee and Nancy Hargrave Elected at Fall Meeting

Director of Development. There, sheraised private funds to benefit theAcademy and its operating arm, theNational Research Council. She iscredited with leading a $36 millionendowment campaign, directing theAcademy Industry Program, andorganizing The Presidents’ Circle, asupport group of the National Academiesof Sciences and Engineering and theInstitute of Medicine. She holds aMaster of Arts from Indiana University

The “Plague Doctor” (a.k.a. DavidBedell, executive assistant to the chair-man) makes a Halloween appearanceat the SVI Board Meeing in Washing-ton. The costume is modelled after thatworn by doctors during plague epi-demics, composed of a mask resem-bling a bird’s beak and the cassok,both precautions in order to avoidcontagion while visiting the ill.

Members of the Sabin Vaccine Institute Board of Trustees gathered for the Fall 2001 meeting are, from left,seated: Philip Russell, MD, Nancy Hargrave, Heloisa Sabin, Carol Ruth Shepherd, and H.R. Shepherd(chairman); standing: Lewis Miller, Michael Whitham, Allan Goldstein, PhD, Michael Osterholm, PhD,MPH, and Mary Ann Chaffee.

Continued on page 15.

and a Bachelor of Arts from OhioWesleyan University.

Chairman of the Board H.R. Shepherdcalled the appointments of Chaffee andHargrave “a welcomed addition of talent

dedicated to disease prevention www.sabin.org 15

and energy” to the board. “Mary AnnChaffee offers valuable insight abouthow policy is being made on the Hill andNancy Hargrave has her finger on thepulse of the philanthropic community.The Sabin Vaccine Institute stands togain important guidance from each ofthese new members and I appreciatetheir dedication of time and servicetoward the advancement of vaccinepolicy and science.”

The Board Members’ dinner featureda timely speech on national bioterrorismthreats, presented by fellow boardmember and bioterrorism expert MichaelT. Osterholm, PhD, MPH, director ofthe Center for Infectious DiseaseResearch & Policy at the University ofMinnesota Academic Health Center. Dr.Osterholm is author of Living Terrors,which exposes the potential of biologicalinfectious disease agents as threats tothe nation’s public health.

Also serving on the Board of Trusteesare Co-chairman William R. Berkley,founder, chairman, and CEO, W.R.Berkeley Corp.; Heloisa Sabin, SVI co-founder; Maj. Gen. Philip K. Russell,MD, founding SVI president and senioradvisor to the chairman, special advisoron vaccine production and developmentfor U.S. Health and Human Services’Office of Public Health Preparedness;Allan L. Goldstein, PhD, chairman of theDepartment of Biochemistry andMolecular Biology at The GeorgeWashington University; Jane C. I.Hirsh, director, Sea Chain LLC; LewisA. Miller, president, Intermedica;Edward S. Neiss, MD, PhD, vice-chairman and CEO, AlmedicaInternational; Carol Ruth Shepherd,artist and photographer; Michael E.Whitham, Esq., Whitham, Curtis &Christofferson, PC; and Lawrence J.Wi l k e r , PhD president and CEO,ShowOnDemand, Inc.

SVI Board WelcomesNew Members

Board Member Michael OsterholmOffers Bioterrorism Insights

Continued from page 14.

Save the Date!Thursday, May 30, 2002The Albert B. Sabin Vaccine Institute’s 2002 Awards Celebration

H o n o r i n gJean-Pierre Garnier, Ph.D. Hon. Richard C. HolbrookeChief Executive Officer Former United States PermanentGlaxoSmithKline Representative to the United NationsHumanitarian Award Lifetime Achievement Award

The Pierre Hotel, New York City6:30 PM Reception - 7:30 PM Awards PresentationFor more information call (203) 972-7907

continued from page 1

In addition to his role as boardmember and senior advisor to thechairman of the Sabin VaccineInstitute, Dr. Russell is professoremeritus at Johns Hopkins School ofHygiene and Public Health,Department of International Health.He is the author of over 100publications on infectious diseases.

Russel l is board cert if ied ininternal medicine and retired in 1990from the U.S. Army as majorgeneral after a career in infectiousdisease research. His mil i taryassignments included director,Walter Reed Army Institute ofResearch, and overseas tours inPakistan, Thailand and Vietnam. Hereceived the Legion of Merit andDistinguished Service Medal.

Philip Russell Named to HHS Vaccine PostRussell is past president of the

American Society of TropicalMedicine and Hygiene and a fellowof the Infectious Disease Society ofAmerica. He served as specialadviser to the International Children’sVaccine Initiative and now serves onthe board of directors of theInternational AIDS Vaccine Initiative.He is a member of the StrategicAdvisory Committee of the Bill &Melinda Gates Children’s VaccineProgram and a consultant to the Bill& Melinda Gates Foundation.

According to Sabin VaccineInstitute Chairman H.R. Shepherd,“Philip Russell is an outstandingscientist who has been responsible forour success as an Institute. Thegovernment couldn’t be better servedfor the expertise the country needsat this time.”

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SPRING 2002 SABIN VACCINE REPORT

AAAAAPRIL 2002PRIL 2002PRIL 2002PRIL 2002PRIL 2002April 14-20, 2002

NATIONAL INFANT IMMUNIZATION WEEKCalling attention to the importance of proper

immunization for infants and toddlers. Communi-ties throughout the United States offer expanded

clinic hours, distributing information, holdimmunization fairs, and create new partnerships

with businesses and community groups.

April 29-May 2, 200236TH ANNUAL IMMUNIZATION CONFERENCE

Contact: Suzanne Johnson-DeLeonE-mail: msj1@cdc.govwww.cdc.gov/nip/nic

Denver, Colorado

MAY 2002MAY 2002MAY 2002MAY 2002MAY 2002

May 6-8, 20025TH ANNUAL CONFERENCE

ON VACCINE RESEARCH

Email: vaccine@nfid.orgwww.nfid.org/conferences/vaccine02

Baltimore, Maryland

May 13-16, 2002PHACILITATE VACCINE FORUM SPRING 2002

INTEGRATED STRATEGIES FOR VACCINE

RESEARCH, DEVELOPMENT AND SUPPLY

Email: david@phacilitate.co.ukParis, France

May 28-31, 200229TH ANNUAL GLOBAL

HEALTH COUNCIL’S CONFERENCE:GLOBAL HEALTH IN TIMES OF CRISIS

E-mail: conference@globalhealth.orgwww.globalhealth.org

Washington, D.C.

SABINSABINSABINSABINSABINCALENDARCALENDARCALENDARCALENDARCALENDAR

RETURN SERVICE REQUESTED

and the Gates Foundation suggested thata useful model for organizing ongoingdiscussion on the topic is the GreatNeglected Diseases (GND) Networkestablished in the 1980s. With annualmeetings, the network drew together themajor scientists working in each of theGND laboratories in the U.S. Throughscientific presentations, each member ofthe GND group was able to keep up withthe most up-to-date technologies as theymight apply to tropical infectiousdiseases. He suggested that the majorrecipients of Gates Foundationphilanthropy would also benefit from theestablishment of a similar networkmeeting, but one devoted to vaccinetechnologies.

A recommendation was made that theSabin Vaccine Institute conveneworkshops focused on specific vaccinedevelopment programs for thedeveloping world, barriers to progress,and solutions and best practices formoving them forward. As with any gooddialogue, the colloquium at Cold SpringHarbor provoked a number of newquestions that will feed an ongoing dialogfor future forums of this kind.

This fall meeting was the eighthcolloquium on vaccine policy hosted bythe Sabin Vaccine Institute since 1994.Previous colloquia focused on topicssuch as planning for the next generationof vaccines, vaccine development anddelivery in the era of managed care, theAIDS Vaccine Initiative, translationalresearch, vaccines for developingeconomies, and social venture capital forneglected vaccines. Proceedings of theprevious two colloquia are currently incirculation and available by contactingthe Sabin Vaccine Institute. Likewise, aproceedings document is being compiledfor release within the coming months.

Support for the meeting was providedby the Bill & Melinda Gates Foundation,which funds several vaccine initiatives,including the Hookworm VaccineInitiative of the Sabin Vaccine Institute.

Vaccine TechnologyCSH Colloquium Considers Access

from page 6

May 30, 2002SABIN VACCINE INSTITUTE’S

AWARDS DINNER

FACING THE CHALLENGE:DISEASE PREVENTION IN A TIME OF CRISIS

Email: sabin@sabin.orgThe Pierre Hotel

New York, New York

JUNE 2002JUNE 2002JUNE 2002JUNE 2002JUNE 2002June 2 - 14

THIRD ADVANCED VACCINOLOGY COURSE

Contact: Betty Dodet, FoundationMérieux

E-mail: bdodet@fond-merieux.orgwww.fond-merieux.org/enseignement/

ADVAC3a.htmlAnnecy, France

June 4 - 9THIRD WORLD CONGRESS ON VACCINES

AND IMMUNIZATION

Contact: Prof. Dr. Edouard KurstakEmail: kurstak@sympatico.ca

www3.sympatico.ca/kurstak/icwoOpatija, Adriatic Riviera, Croatia

JUNE 27 - 28RECENT ADVANCES IN

IMMUNO-INTERVENTION

Institut Pasteur EuroconferencesE-mail: euroconf@pasteur.fr

www.pasteur.fr/applications/euroconf/immuno

Paris, France