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Peter Hotez, M.D, Ph.D. Headshot

A New Malnutrition Vaccine for the World's Poor

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This post was co-authored with Remko van Leeuwen

When we think about the world's most pressing global health issues, usually diseases or conditions such as HIV/AIDS, malaria or influenza come to mind. But a report just released in the prestigious medical journal, Blood, reveals that anemia is now one of the most important causes of global illness, especially among women and children. These studies, led by Seattle's Institute of Health Metrics and Evaluation, determined that one-third of the world's population suffers from at least one form of anemia, which is responsible for almost 9 percent of all of the world's disability.

For people living in the poorest countries in Asia, Oceana, Latin America and Africa, a neglected tropical disease (NTD) called hookworm is one of the leading causes of anemia. Today more than 400 million people suffer from hookworm, making it one of the most common conditions among people living in poverty.

Hookworms are small worms that attach to the inner lining of the human intestine and suck blood. Infected people can harbor hookworms in their gut for years, eventually losing enough blood to develop moderate or severe anemia. As a result, they experience reduced oxygen delivery to the brain and other vital organs.

Children and pregnant women get hit the hardest.

A child with long-standing blood loss from hookworm experience profound mental and motor developmental delays. Children actually lose IQ points from their hookworm and ultimately are rendered less productive and functional as adults.

A pregnant woman with hookworm is more vulnerable to dying during labor and delivery because she has less blood to lose in the event she hemorrhages. Her baby is more likely to be born prematurely or with low birth weight, and therefore less likely to survive.

In fact, one-third or more of the children and women living below the World Bank poverty level are infected with hookworm resulting in a devastating disease burden from moderate and severe anemia. Our findings also show that these diseases disproportionately occur in the world's poorest Islamic countries -- nations such as Indonesia, Bangladesh, Mali, Nigeria, and several countries of the Middle East and North Africa.

The good news is that the Sabin Vaccine Institute's Product Development Partnership (Sabin PDP) is developing the world's first human hookworm vaccine, which could have a tremendous impact on the health, economic and social landscape of countries with high burdens of this disease.

With new support from the European Commission FP7 program, the Sabin PDP's hookworm vaccine development project is uniting critical academic, medical, and research partners to build on research and development efforts to-date. Known as HOOKVAC, this global consortium of partners from Belgium, England, Germany, the Netherlands, United States, and Gabon will further refine the manufacturing process for the vaccine, share technology and expand knowledge on NTD vaccines.

Ultimately, HOOKVAC will begin the first ever clinical testing of the vaccine in sub-Saharan Africa. Gabon's Lamberene Research Centre, linked to the prestigious Albert Schweitzer Hospital, will be leading clinical testing in African adults and children in Gabon, a country with a high burden of hookworm.

Our human hookworm vaccine has been referred to as an 'antipoverty vaccine' because of its potential ability to improve child development, pregnancy outcome, and the health and productivity of agricultural workers. By conquering a leading cause of anemia in the developing world, the vaccine could become a truly important global health intervention.

But because it is intended only for the most impoverished parts of the planet where hookworms thrive, the commercial market for the vaccine may not be attractive for the world's multinational pharmaceutical companies. For now, the human hookworm vaccine will be developed in the non-profit sector through HOOKVAC and other European and private support.

Dr. Albert Schweitzer once remarked: "The purpose of human life is to serve, and to show compassion and the will to help others." HOOKVAC is a great example of science in the service of humanity - a life-saving medical technology that could simultaneously lift the world's poorest people out of a vicious cycle of poverty.

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Peter Hotez MD PhD is the President of the Sabin Vaccine Institute and the Texas Children's Hospital Endowed Chair of Tropical Pediatrics at Baylor College of Medicine where he is also Dean of the National School of Tropical Medicine.

Remko van Leeuwen MD PhD is Director of Acquisitions at the Amsterdam Institute of Global Health and Development (AIGHD) Foundation and coordinator of the HOOKVAC consortium.