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Innovation for the ‘Bottom 100 Million’: Eliminating Neglected Tropical Diseases in the Americas

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Hot Topics in Infection and Immunity in Children IX

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 764))

Abstract

An estimated 100 million people in the Latin American and Caribbean (LAC) region live on less than US$2 per day, while another 46 million people in the US live below that nation’s poverty line. Almost all of the ‘bottom 100 million’ people suffer from at least one neglected tropical disease (NTD), including one-half of the poorest people in the region infected with hookworms, 10 % with Chagas disease, and up to 1–2 % with dengue, schistosomiasis, and/or leishmaniasis. In the US, NTDs such as Chagas disease, cysticercosis, toxocariasis, and trichomoniasis are also common among poor populations. These NTDs trap the poorest people in the region in poverty, because of their impact on maternal and child health, and occupational productivity. Through mass drug administration (MDA), several NTDs are on the verge of elimination in the Americas, including lymphatic filariasis, onchocerciasis, trachoma, and possibly leprosy. In addition, schistosomiasis may soon be eliminated in the Caribbean. However, for other NTDs including hookworm infection, Chagas disease, dengue, schistosomiasis, and leishmaniasis, a new generation of ‘anti-poverty vaccines’ will be required. Several vaccines for dengue are under development by multinational pharmaceutical companies, whereas others are being pursued through non-profit product development partnerships (PDPs), in collaboration with developing country manufacturers in Brazil and Mexico. The Sabin Vaccine Institute PDP is developing a primarily preventive bivalent recombinant human hookworm vaccine, which is about to enter phase 1 clinical testing in Brazil, as well as a new therapeutic Chagas disease vaccine in collaboration with several Mexican institutions. The Chagas disease vaccine would be administered to seropositive patients to delay or prevent the onset of Chagasic cardiomyopathy (secondary prevention). Together, MDA and the development of new anti-poverty vaccines afford an opportunity to implement effective control and elimination strategies for the major NTDs in the Americas.

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Acknowledgements

The development of the human hookworm vaccine is supported by grants to the Sabin Vaccine Institute from the Bill & Melinda Gates Foundation, the Dutch Ministry of Foreign Affairs, and the Brazilian Ministry of Health. The feasibility studies for the development of the Chagas disease vaccine is supported by funds from the Carlos Slim Health Institute (Instituto Carlos Slim de la Salud) and the SouthWest Electronic Energy Medical Research Institute.

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Authors and Affiliations

  1. Sabin Vaccine Institute and Texas Children’s Center for Vaccine Development, Departments of Pediatrics and Molecular Virology & Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston, USA

    Peter J. Hotez, Michael J. Heffernan & Maria E. Bottazzi

  2. Laboratorio de Parasitologia, Centro de Investigaciones Regionales “Dr Hideyo Noguchi”, Universidad Autonoma de Yucatan, Merida, Yucatan, Mexico

    Eric Dumonteil

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  1. Peter J. Hotez
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  2. Eric Dumonteil
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  3. Michael J. Heffernan
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  4. Maria E. Bottazzi
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Correspondence to Peter J. Hotez .

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Editors and Affiliations

  1. Royal Children's Hospital, Dept. Pediatrics, University of Melbourne, Flemington Road, Parkville, 3052, Victoria, Australia

    Nigel Curtis

  2. Institute of Child Life and Health, UBHT Education Centre, University of Bristol, Upper Maudlin Street, Bristol, BS28AE, UK

    Adam Finn

  3. University of Oxford, Level 4,John Radcliffe Hospital, Oxford, OX3 9DU, UK

    Andrew J. Pollard

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Hotez, P., Dumonteil, E., Heffernan, M., Bottazzi, M. (2013). Innovation for the ‘Bottom 100 Million’: Eliminating Neglected Tropical Diseases in the Americas. In: Curtis, N., Finn, A., Pollard, A. (eds) Hot Topics in Infection and Immunity in Children IX. Advances in Experimental Medicine and Biology, vol 764. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4726-9_1

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