The fourth annual Global Health & Infectious Disease Conference focused on “Shrinking the Cure and Prevention Divide that Separates Populations from Life-Saving Drugs and Vaccines.”
Thank you to everyone who joined us to help make this event such a great success. Check out our Photo Album from the conference.
Experts offered talks on a diverse array of topics including HIV, implementation science, malaria, chikungunya, zika, PHARMA drug and vaccine donations, cancer drugs and global access. The event included a panel discussion, poster session, and lunch with the speakers.
Follow the links below to view videos of the presentations.
8:00 am: Registration and Poster Session
8:30 am: Welcome, David Perlmutter, MD and William G. Powderly, MD
8:35 am: George Kyei, MBChB, PhD, “Prospects for Curing HIV Infection”
9:10 am: Ingrid Basset, MD, MPH, “Implementation Science for Improving the Global HIV Care Cascade”
9:45: Break and Poster Session
10:15 am: Andy Wright, MSC, “The Role of the Pharmaceutical Industry in Global Health – A Perspective from GSK”
10:50 am: Andrew Hill, MD, “Treatment for cancer, HIV and viral hepatitis in the USA using low cost generic drugs – what could be done?”
11:30 am: Lunch
12:30 pm: Poster Session
1:30 pm: Rear Admiral Timothy Ziemer (Retired), “Transforming the Health, Well-being, and Livelihoods of Millions Across the Globe”
2:05 pm: Deborah Lenschow, MD, PhD, “The Emerging Threat of Chikungunya Virus- Understanding Disease Pathogenesis”
2:40 pm: Michael Diamond, MD, PhD, “Zika Virus: New Clinical Syndromes and its Emergence in the Western Hemisphere”
2:55 pm: Break
3:10 pm: Panel Discussion on Challenges and Opportunities of Global Health Implementation Research
3:55 pm: Awards & Closing Remarks, William G. Powderly, MD
Ingrid Bassett, MD, MPH
Associate Professor, Harvard University, Massachusetts General Hospital
Title: Implementation Science for Improving the Global HIV Care Cascade
Ingrid V. Bassett, MD, MPH is an Associate Professor of Medicine at Harvard Medical School and a practicing Infectious Disease physician at Massachusetts General Hospital. She also serves as the Director of Mentoring Services for the Harvard University Center for AIDS Research. Dr. Bassett established one of the first routine HIV screening programs in an outpatient department in Durban in 2005. She was among the first to document high acceptability and uptake of HIV testing but poor rates of linkage to CD4 count testing and antiretroviral therapy initiation in a multi-site study.
Dr. Bassett has also played an important role in assessing optimal TB screening strategies and the impact of TB on patient engagement in HIV care. These studies served as the foundation for the Sizanani Trial, a randomized controlled trial evaluating the efficacy of health system navigators for improving linkage to HIV care and TB treatment completion. Dr. Bassett is currently evaluating the clinical impact of a “Test and Treat TB” strategy using Xpert MTB/RIF screening on a mobile, community-based HIV screening unit in Umlazi Township, Durban.
Dr. Bassett graduated from Harvard Medical School and was an Internal Medicine Resident and Chief Medical Resident at Brigham and Women’s Hospital before training in Infectious Disease at the joint Massachusetts General Hospital/Brigham and Women’s Hospital program. She has garnered several awards for her research including Young Investigator Awards from the Conference on Retroviruses and Opportunistic Infections and the International AIDS Society, the Massachusetts Infectious Disease Society’s Maxwell Finland Award, and the 2015 HIV Medicine Association Research Award.
People diagnosed with HIV and promptly treated with antiretroviral therapy can live a near-normal lifespan. However, only 40% of people in need of antiretroviral therapy for HIV worldwide are on treatment. This talk will focus on the role of implementation science research as a mechanism for helping close the gap between “what we know” and “what we do” to improve HIV care from making the diagnosis to lifelong retention in care.
Michael Diamond, MD, PhD
Professor, Departments of Medicine, Molecular Microbiology, Pathology & Immunology Head, Division of Infectious Diseases, and Vaccine Development Center for Human Immunology and Immunotherapy Programs, Washington University
Title: Zika Virus: New Clinical Syndromes and its Emergence in the Western Hemisphere
Michael Diamond received his MD and PhD from Harvard University, and his post-doctoral and clinical training in infectious diseases and virology from the University of California, Berkeley and the University of California, San Francisco.
He is currently a Professor of Medicine, Molecular Microbiology, Pathology & Immunology at Washington University School of Medicine and the Co-Director of the Midwest Regional Center for Excellence in Biodefense and Emerging Infectious Disease Research.
Michael Diamond’s research focuses on the interface between viral pathogenesis and the host immune response, with special emphasis on humoral immune responses and the structural basis of antibody neutralization of several different enveloped RNA viruses.
Zika virus (ZIKV) had remained a relatively obscure flavivirus until a recent series of outbreaks accompanied by unexpectedly severe clinical complications brought this virus into the spotlight as an infection of global public health concern. In this talk, I will discuss the history and epidemiology of ZIKV infection, the emergence of ZIKV in the Western Hemisphere, newly ascribed complications of ZIKV infection including Guillain-Barré syndrome and microcephaly, and the prospects for the development of antiviral agents and vaccines. In addition, I will show new preliminary data on our studies to establish a mouse model of ZIKV pathogenesis using a contemporary virus strain with a tissue tropism relevant to disease in humans.
Andrew Hill, PhD
Senior Visiting Research Fellow, Department of Pharmacology and Therapeutics, University of Liverpool, UK
Title: Treatment for Cancer, HIV and Viral Hepatitis in the USA Using Low Cost Generic Drugs – What Could be Done?
Andrew Hill graduated from Oxford University and then studied at St Mary’s Hospital in London at the beginning of the UK HIV epidemic. He has a PhD from the University of Amsterdam.
He is currently a Senior Visiting Research Fellow at Liverpool University, specialising in treatment access issues. He has over 100 published papers, and is an advisor on HIV and viral hepatitis for the World Health Organization, the Clinton Foundation and UNITAID.
Fifteen years ago, it was shown that antiretrovirals for HIV/AIDS could be mass produced at very low costs. This led to treatment programmes which now supply drugs to over 15 million people with HIV worldwide. Similar analyses of drug production now show that viral hepatitis and certain cancers could also be treated at very low costs. Several key drugs to treat cancer, HIV and viral hepatitis will become generic in the USA within the next 5 years. There is the potential to expand treatment coverage for key diseases, while lowering overall costs of treatment.
However, costs of treatment in the USA are rising faster than inflation. Costs of the top 20 drugs in the USA are 3 times higher than the UK or Canada, despite similar Gross National Products. Access to generic treatments in the USA is limited by “pay for delay” schemes, secondary patents, large rises in drug prices and other issues. Medical bills are responsible for two thirds of bankruptcies in the USA.
For mass treatment with low-cost generic drugs to be successful in the USA, five key conditions need to be met.
- When any drug become generic, it should become available to publicly run health services at prices close to the cost of production, with an acceptable profit margin. These prices are freely available from India.
- Pharmaceutical companies should not be able to inflate prices of drugs after initial approval – this is the current standard in Europe.
- When a drug becomes generic and a low price established, the effects of this lower price on the value of other drugs should be evaluated. Higher prices for newer drugs may no longer be justified.
- Any secondary patent on a drug should be carefully evaluated for validity.
- Pharmaceutical companies involved in “pay for delay” schemes, bribery, false advertising or suppression of clinical trial results should pay fines which are also used to sponsor national treatment access schemes.
George Kyei, MBChB, PhD
Assistant Professor, Department of Medicine, Washington University
Title: Prospects for Curing HIV Infection
Born and raised in Ghana, Dr. Kyei obtained his medical degree from the University of Ghana Medical School. After internship at the Korle-Bu Teaching Hospital in Accra, he served as a family physician for three years at Manna Mission Hospital, an inner city hospital that cares mainly for the indigent and underserved. As a family physician in Ghana, he treated adults with hypertension, diabetes, tuberculosis and HIV; children with complicated malaria and sickle cell disease and women with complications of pregnancy, helping with difficult deliveries and performing C-sections. While working as a family physician, Dr. Kyei earned an MPhil degree from the University of Ghana where he characterized mycobacteria isolates causing tuberculosis in HIV and non-HIV infected patients. He immigrated to the US in 2003 and earned a PhD in molecular genetics/microbiology at the University of New Mexico, working on molecular aspects HIV/TB interactions in macrophages. Subsequently, Dr. Kyei moved to Washington University where he completed internal medicine residency, infectious diseases fellowship and postdoctoral studies joining the faculty in 2014. His lab at Washington University is focused understanding HIV persistence. Specifically, he is interested in the host factors that enable the virus to persist in patients in the face of anti-retroviral therapy and strong immune pressure. The goal is to identify and characterize therapeutic targets that will be useful for HIV cure.
Approximately 37 million people are afflicted with the human immunodeficiency virus (HIV) resulting in over 1.2 million deaths annually. Although anti-retroviral therapy (ART) can suppress the virus, recover immune function and improve patient outcomes, it does not provide cure. Patients need to take ART daily for the rest of their lives leading to compliance issues, emergence of drug resistance and medication side effects. Moreover, in the developing world, access to ART is limited. Even if every patient with HIV had access to ART, the cost going forward will be unsustainable. Hence there is the need to find a lasting remission or cure for HIV. The cases of the ‘Berlin patient’ and the ‘Mississippi baby’ have renewed enthusiasm about the prospects for HIV cure. The main obstacle to HIV cure from patients on ART is viral latency in resting T cells and other reservoirs that produce virus once treatment is interrupted. We will review the current state of the research on HIV reservoirs and discuss functional cure versus sterilizing cure. In addition approaches to cure such as ‘shock and kill’, DNA editing, immune therapies and bone marrow transplantation will be reviewed.
Deborah Lenschow, MD, PhD
Associate Professor, Departments of Medicine and Pathology and Immunology, Washington University
Title: The Emerging Threat of Chikungunya Virus- Understanding Disease Pathogenesis
Deborah Lenschow, MD, PhD is an Associate Professor of Medicine at Washington University where she is a practicing Rheumatologist and also serves as the co-director of the Physician Scientist Training Program. She graduated from the University of Chicago in 1998 obtaining both an MD and PhD in immunology. She then continued her training at Washington University in Internal Medicine followed by a Rheumatology fellowship and postdoctoral studies in the area of viral pathogenesis, joining the faculty in 2006. Her research program if focused on the area of host-pathogen interactions with an emphasis on understanding the type I interferon response through the analysis of interferon subtypes and the functions of downstream interferon induced genes. Recently, her research group has worked to understand the pathogenesis of the re-emerging alphavirus, Chikungunya virus. Through the utilization of patient cohorts, clinical samples, and mouse models her lab is working to identify the immune factors that regulate disease pathogenesis and to identify novel therapeutic targets.
Chikungunya virus (CHIKV) is an emerging mosquito-borne alphavirus that causes fever, rash, muscle pain and arthritis. Over the last decade, CHIKV has rapidly spread from Africa to the Indian Ocean region. In 2013, CHIKV transmission was documented for the first time in the Western Hemisphere and has since spread throughout the Caribbean, Central and South America, and into North America with greater than 1.5 million people infected. CHIKV targets the muscle and joints, causing a symmetric, debilitating polyarthritis. In a significant subset of patients it can also have a prolonged course lasting for up to 3 years, mimicking seronegative rheumatoid arthritis. The pathogenesis of CHIKV arthritis is poorly understood, including whether the development of chronic arthritis is the result of persistent viral infection or immune activation triggered by the virus after it has been cleared. To gain insight into disease pathogenesis we have characterized the immune phenotype of patients suffering from chronic CHIKV arthritis and have identified pathways of immune cell activation that are shared between CHIKV arthritis and rheumatoid arthritis. We are currently utilizing a murine model of CHIKV arthritis to better understand disease pathogenesis and to test the impact of therapeutic intervention on these immune pathways in the hope of developing potential future therapies.
Andy Wright, MSc
Vice President Global Health Programmes, GlaxoSmithKline, Brentford, UK
Title: The Role of the Pharmaceutical Industry in Global Health – A Perspective from GSK
Andy is currently Vice President of Global Health Programmes at GSK, leading the company’s portfolio of public health programmes to improve the health and lives of people in the developing world.
GSK is a research based pharmaceutical company that develops and makes available medicines and vaccines to improve human health. As part of the company’s commitment to the developing world, GSK donates medicines and makes grants, working in partnership with Non Governmental Organisations, private sector companies, the World Health Organization and country governments, to support programmes to increase access to healthcare. Key programmes include the donation of albendazole for de-worming of school age children, and the global elimination of the tropical disease that causes elephantiasis, product donations and grants to respond to humanitarian emergencies, and interventions to combat malaria. Other programmes address healthcare infrastructure through reinvesting profits into training of healthcare workers in Africa and other Least Developed Countries. The company also has a range of partnerships with private sector companies to address barriers to healthcare access, and a new strategic partnership with Save the Children.
Andy has a Bachelors degree in Civil Engineering and a Masters Degree in Project Management. Andy is a Chartered Engineer whose early career includes project management of capital projects within the petrochemical construction industry, roles in marketing and business development and project management consultancy.
The pharmaceutical industry contributes to global health by developing medicines and vaccines and making them available to patients. GlaxoSmithKline (GSK) is a research-based pharmaceutical company employing over 100,000 people, with a mission to improve people’s health to enable them to “do more feel better, live longer.” The company seeks to do this through its core business, and by pursuing flexible business models to extend its reach beyond people living in rich countries.
GSK conducts research and development into many diseases that affect people in rich countries, such as respiratory, oncology and HIV, but also those diseases that affect the poor, such as malaria, Ebola, and neglected tropical diseases. Flexible approaches to broadening access include adopting a flexible approach to intellectual property, opening laboratories for researchers, tiered and not-for-profit pricing, and granting licenses for ARV manufacture and sale. Vaccines are potentially the greatest health interventions available, and GSK is the world’s leading vaccine supplier with the majority of vaccines going to developing countries.
Another key area is Corporate Responsibility and global health programs which focus on reaching the poorest populations. GSK focuses on combating tropical diseases—malaria and NTDs—through the donation of albendazole, reducing child mortality, strengthening healthcare capacity through training frontline health workers, and programs to increase access to medicines.
A question often asked is why a for-profit company would invest in these areas? The presentation will describe how a commitment to developing world health makes business sense and supports the company’s long-term business goals.
Rear Admiral R. Timothy Ziemer, US Navy (ret)
U.S. Global Malaria Coordinator, President’s Malaria Initiative, USAID
Title: Transforming the Health, Well-Being, and Livelihoods of Millions Across the Globe
Rear Admiral Tim Ziemer leads the President’s Malaria Initiative (PMI), a historic U.S. Government initiative to reduce the burden of malaria and help relieve poverty in Africa. Appointed in June 2006, Rear Admiral Ziemer has served as the U.S. Global Malaria Coordinator for the past eight years, leading the Initiative across two Administrations. He has been recognized as “one of the most quietly effective leaders in public health.” As Coordinator, Rear Admiral Ziemer reports to the U.S. Agency for International Development (USAID) Administrator and has direct authority over both PMI and USAID malaria programs.
PMI is an interagency initiative led by USAID and implemented together with the U.S. Centers for Disease Control and Prevention (CDC) of the U.S. Department of Health and Human Services (HHS). It is overseen by the U.S. Global Malaria Coordinator and an Interagency Advisory Group made up of representatives of USAID, CDC/HHS, the Department of State, the Department of Defense, the National Security Council, and the Office of Management and Budget. In 2008, the Lantos-Hyde Act authorized the expansion of PMI, and, in 2009, it was included as a key component of the U.S. Government’s Global Health Initiative; it contributes significantly to the goal of ending preventable child and maternal deaths. Since its launch, PMI has contributed to the important reductions in malaria mortality that have been recorded among children under five in Africa.
Born in Sioux City, Iowa, Rear Admiral Ziemer was raised in Asia, the son of missionary parents serving in Vietnam. After graduating from Wheaton College, he joined the Navy, completed flight school, and returned to Vietnam during the war. During his naval career, Rear Admiral Ziemer commanded several squadrons, naval stations, and an air wing supporting the first Gulf War. Subsequent assignments included serving as the senior fellow with the Navy’s Strategic Studies Program at the Naval War College, and Deputy Director for Operations in the National Military Operations Center on the Joint Command Staff.
Prior to his appointment as U.S. Global Malaria Coordinator, Rear Admiral Ziemer was Vice President of the Arlington Institute, a nonprofit research institute specialized in strategic planning, and Executive Director of World Relief, a humanitarian organization.
Since 2000, global malaria deaths have dropped 66 percent among all age groups, and by 71 percent among children under five. More than six million lives have been saved, and a vast majority of the lives saved have been children. The increased application of proven interventions has helped to loosen malaria’s grip.
The year 2015 marks a decade of U.S. leadership in the global fight against malaria through, the U.S. President’s Malaria Initiative (PMI). Announced by President Bush in 2005, PMI started with three focus countries the next year. Today, PMI supports 19 countries in sub-Saharan Africa and countries in the Greater Mekong sub-region. Through PMI, the U.S. Government is supporting malaria-affected countries to reduce malaria-related mortality and substantially decrease malaria morbidity toward the long-term goal of elimination.
The story of U.S. leadership in the fight against malaria is one of immense success and progress. But as 2015 ends, and the dawn of a new post 2015 era begins, we must remember that we have a long way to go. In 2015, there were 214 million new cases of malaria and 438,000 deaths, with around 90 percent of these occurring in sub-Saharan Africa. The vast majority of deaths are children under the age of five. In Africa, a child dies every minute because of the disease.
Approximately 80 percent of malaria deaths are concentrated in just 15 countries, mainly in Africa. Taken together, these 15 high-burden countries have achieved slower-than-average declines in malaria incidence and mortality. In most of these countries, weak health systems continue to impede progress.
As we set our sights on malaria elimination, we stand to avert nearly 3 billion cases of infection and generate some $4 trillion in additional economic output over the next 15 years. A recent Economist cover story said eradicating malaria would “rank among humanity’s greatest achievements. But we must ensure political commitment and predictable financial resources necessary to carry us over the finish line.
As we were reminded during last year’s Ebola outbreak, if we are to tackle critical global challenges like Ebola or malaria, we need strong leadership — from individuals, communities and partner countries, to international partnerships — to fund, implement and track progress. It also takes U.S. leadership, with strong bipartisan commitment and support from Congress.
Event Sponsors: Supported by the Departments of Medicine, Molecular Microbiology, and Pathology and Immunology in the School of Medicine