Issue link: https://tmcpulse.uberflip.com/i/323757
t m c » p u l s e | j u n e 2 0 1 4 23 people outside of the United States, it often comes down to doing the work that many pharmaceutical companies will not. "The vaccines that we are develop- ing are vaccines for the poorest people in the world," said Hotez. "Industry is not going to make these vaccines because they only affect people of extreme poverty. So it is really science for the poor. We make the vaccines that the drug companies can't make or won't make." "No one else is making these vac- cines because products developed for the poorest populations in the world generally have no commercial return on investment," added Bottazzi. "So usually those who really can commit to support those populations are either groups in the nonprofit sector, or the governments or the population itself." Through the PDP model, the Sabin Vaccine Institute and Texas Children's Hospital Center for Vaccine Development and the National School of Tropical Medicine are actively working on a number of vaccines for some of the major "diseases of the poor," including a human hookworm vaccine, now in clinical trials in Brazil and soon in Africa, a shistosomiasis vaccine that is about to start clinical trials, and new vaccines for Chagas disease, Leishmaniasis and Sever Acute Respiratory Syndrome (SARS). "A lot of university-based vaccine institutes call themselves vaccine insti- tutes because they do immunology with an interest in vaccines," said Hotez. "What's unique about us is we actually make the vaccines, and transition them from discovery, into the clinic. We are doing everything that a small to mid- size biotech company would do, but in Modeled after the Liverpool School of Tropical Medicine, and the London School of Hygiene and Tropical Medicine, the National School of Tropical Medicine has a fourfold mission, centered around research, training, clinical activities and public policy. While often found in tropical regions, where weather and environ- ment allow disease to spread by way of insects, soil or contaminated water- ways, the diseases Hotez and his team work with are not exclusive to any one region or climate. "People often think of these as sub-Saharan African diseases, but what we are finding is that the world has changed," said Hotez. "These are not just diseases of Africa, or develop- ing countries. This whole concept of developing versus developed countries, I like to say 'That's your father's global health.' That's not the way it is any- more. It's wherever you have poverty. It doesn't matter if that poverty is in Southern Mexico, Northern India, Northern Brazil, or the Gulf Coast of Texas. This is where you find tropical diseases. "We have a particular emphasis on diseases of the poorest regions in the western hemisphere. Not exclusively, though. We do projects in Africa and Asia, but particularly in Latin America," he added. "It is an important area of emphasis. In fact, the largest number of people living in poverty live in the state of Texas, so we have now found a sub- stantial burden of tropical diseases here in the United States, in the Gulf Coast." When addressing treatment and prevention of neglected tropical dis- eases like Schistosomiasis, caused by parasitic worms that affect 250 million the non-profit arena." Beyond developing vaccines, the National School of Tropical Medicine has core faculty working on other major areas of tropical medicine. Major programs in the epidemiology of vector-borne and zoonotic diseases, for example, are headed by Kristy Murray, DVM, Ph.D., an associate professor in the department of pediatrics where she is also associate vice chair for research. Murray's group has made important discoveries that include the first iden- tification of epidemic dengue fever in Houston, a new renal disease syndrome that results from West Nile Virus Infection, and the transmission of Chagas disease in southeast Texas. In addition, Rojelio Mejia, M.D., and others are leading efforts for the development of new diagnostics for parasitic infections. In the area of training, the National School of Tropical Medicine provides a unique Diploma in Tropical Medicine for physicians, physician assistants and medical students to recognize and understand how to identify and treat these diseases. Given the ease of international travel, it is critical that physicians have the skills to help isolate or possibly stop the spread of tropical diseases, particularly those transmitted through human contact. "Part of this arose out of the fact that when the dengue epidemic occurred in Houston, Dr. Murray found that not a single case was diagnosed by physi- cians," explained Hotez. "Physicians are not getting trained in most U.S. medical schools about these diseases —how to recognize them, how to diagnose them, and how to manage, treat and prevent them. Because they have always been thought of as problems unrelated to the United States. In fact, we find they are very much related. So we are really trying to expand our collaborations to include a lot of major universities in the area." Collaboration and strategic part- nerships are crucial to the success of the school. From running the Tropical Medicine Clinic and Travelers Clinic in conjunction with the Harris Health System and Baylor Clinic, to working with international researchers and governments on jointly developing vaccines, the tropical medicine team recognizes the incredible power of partnerships. They take that same approach in tackling issues of health policy. They are, among many other projects, currently working to introduce new legislation to Congress around tropical disease, and the distribution of packages of medicine that have so far reached over 250 million people worldwide. Hotez and Bottazzi hope to leverage these kinds of allies and resources to help carry their mission even further. "I am so grateful to the vision of Dr. Mark Kline, Baylor College of Medicine President Dr. Paul Klotman, Texas Children's Hospital Chief Executive Officer Mark Wallace, and Sabin Vaccine Institute Board Chairman Mort Hyman," said Hotez. "Our school is at the forefront of global health innovation, and the future looks very promising for tackling tropi- cal diseases," added Bottazzi. "Together with our strong partnerships within the Texas Medical Center, we will be able to serve as global health accelerators and bring new knowledge, new interven- tions and renewed access to care to the people in need, locally and around the world." when the dengue epidemic occurred in houston, dr. Murray found that not a single case was diagnosed by physicians. Physicians are not getting trained in most u.S. medical schools about these diseases…because they have always been thought of as problems unrelated to the united States. in fact, we find they are very much related. — Peter hotez, M.d., Ph.d.