Gary Michelson, Peter Hotez: Neglected Tropical Diseases Video Discussion
Our technical ability to treat neglected tropical disease and make vaccines to prevent them has outpaced our political, social and financial instruments. Dr. Peter J. Hotez and Gary K. Michelson discuss why this is and propose ways to overcome these obstacles.
Gary K. Michelson, Peter J. Hotez: Neglected Tropical Diseases Discussion
The Neglected Tropical Disease Problem
Peter Hotez of the Sabin Vaccine Institute was working on the treatment and development of vaccines for neglected tropical disease, recognizing them as the most, “most important diseases you’ve never heard of”, affecting over 450 million people. They are the most common afflictions of people living in poverty. 1.4 Billion of world’s poorest have no health care, are living on edge of starvation, and living below poverty level.
LA Times Article
In an effort to bring attention to this unmet medical need, Hotez published an Op-Ed in the Los Angeles Times in 2010 titled,“Diseases we can stop, but don’t”. In this article, he explained that some of the world’s most glaring health problems affecting impoverished girls and women are also some of the easiest to address. The article concluded by pointing out:
Peter Hotez: Controlling and eliminating neglected tropical diseases is one of the most effective and cost-efficient humanitarian interventions available today. It is also the surest way to maximize the impact of the new Global Strategy to address the plight of girls and women. 
Hotez had developed a low cost approach with a package of re-purposed medicines from pharmaceutical companies to help impact the world’s most common inflictions of poverty and was working on the development of vaccines to prevent them from happening in the future. He needed resources for these initiatives.
When Dr. Gary K. Michelson read this article, he was moved. So he took action. He looked up Hotez’s phone number, called his office and offered to help him address this problem.
Dr. Gary K. Michelson: When I was in medical school, I think we spent 15 minutes on neglected tropical disease, and they were nothing but oddities. To be hit over the head with a baseball bat… that there are 1.4 billion of the world’s absolute poorest, most destitute people who have no health care, who have no voice…. And they’re all living on the edge of starvation… below poverty level. The little bit of nutrition they’re having is being stolen by the worms that affect them. How can we, in the developed countries, allow that?
Challenges of Eradicating Neglected Tropical Disease
There isn’t a collective will to help eradicate these neglected tropical disease yet. Dr. Gary Michelson believes we need to raise the level of awareness about it.
The dollar amount is so modest, how could we not take this on? These are diseases we could stop, but don’t… Using existing medications, we could treat neglected tropical disease for only 50 cents per year.
These countries don’t have the resources to resolve these issues and vaccines take a long time to develop. Most investors do not have the patience to invest in something that takes so long.
Technical ability to make vaccines has outpaced our political, social and financial instruments to get them out there.
The Ebola vaccine was published in Nature magazine in 2003. It was considered an epidemic n 2014-1026. During that time, the US government through The Biomedical Advanced Research and Development Authority (BARDA), put up $100M to manufacture the Ebola vaccine, but it was too late. By the time the vaccines were ready, the outbreak was over and over ~11,000 people died, unvaccinated and unprotected. 
What It Takes To Get Attention
It’s not a new story, so media isn’t covering it. These are diseases we don’t hear about in developed nations and there hasn’t been a plighted celebrity to bring attention to it, such as the way Michael J. Fox did with Parkinson disease, and how Christopher Reed’s paralysis brought attention to spinal cord research.
If you believe it is the government’s duty to act on behalf of the people, then we need to pressure our representatives to do something more about this and help develop the vaccines.
The U.S. government investment in response to HIV has risen to more than $32 billion in FY 2017, with 17% of that money (approx. ~$6 billion) going to global treatment, even though there are only 35 million cases of HIV in the entire world. Compare that to 1.4 billion people who are afflicted by a neglected tropical disease, which only has ~$100 million dollars committed to it. 
Neglected Tropical Disease in the United States
Sabin estimates that ~12 million Americans are living with neglected tropical disease, such as Chagas disease and toxocariasis.
The National Health and Nutrition Examination Survey’s latest report, published in the journal Clinical Infectious Diseases, estimated that about 5 percent of the United States population — or about 16 million people — currently carry Toxocara antibodies in their blood, a sign they have ingested the eggs. 
Research by the SUNY Downstate Medical Center in Brooklyn, NY has found that Toxocariasis can cause cognitive and developmental delays in humans and Dr. Peter Hotez hypothesizes it may be responsible for the achievement gap noted among social and economically disadvantaged kids in the United States. There is no currently no gov’t funding allocated towards it. 
MMRF Philanthropy & Approach
Gary K. Michelson has generously donated funds to Sabin through the Michelson Medical Research Foundation. Dr. Michelson picked the most common, ubiquitous and important to treat, schistosomiasis and hookworm. Vaccines to treat both are currently in clinical trials.
Most individuals in developing nations suffer from one or both of schistosomiasis and hookworm.
Sabin is currently developing new vaccines for these disease and using re-purposed medicines from pharmaceutical companies to treat existing disease.
The Human Vaccines Initiative
Peter Hotez had been one of the earliest scientist highlighting the need to focus on vaccine development when he published an article in the Los Angeles Times in 2010 about it.
Since then, scientists across the globe have echoed the need to better understand the human genome and develop better vaccines to reduce the prevalence of all diseases. Now there is a robust effort to address vaccine research and development, beyond just the neglected tropical disease space.
In February 2014, The Human Vaccines Project [HVP] was formed by 35 leading global scientists from the public and private sectors. The Human Vaccines Project [HVP] is a global nonprofit that brings together leading stakeholders across academia, industry, governments and nonprofits. Their mission is to accelerate the development of vaccinations and immunotherapies against major global infectious diseases and cancers by focusing on the pre-competitive immunology research space and decoding the human immune system.
- (Featured Image) Dr. Gary K. Michelson and Dr. Peter Hotez discuss treatment of neglected tropical disease and the importance of vaccines during a Q&A at B’nai B’rith International from Vimeo [2016.12.09. 2016-12-09 B’nai B’rith GKM-Hotez Q&A. Vimeo]
- (Fig.I) Peter Jay Hotez, M.D., Ph.D. from Baylor College of Medicine [2018. bcm.edu]
- (Fig.II) Gary K. Michelson from Seth Casteel [2008.11.12. Seth Casteel Photography]
- (Fig.III) Chagas from Chagas Disease More Prevalent in U.S. Than Thought [2016.12.19. Nova PBS SoCal]
- (Fig.IV) Toxocariasis from IMU Researchers Evaluated Rapid Diagnostic Test for Toxocariasis in Humans [2015.10.29. International Medical University Malaysia]
- (Fig.V) Schistosomiasis from Prevalence Of Urinary Schistosomiasis Among Adults In Three Communities In Shonge, Shongom Local Government Area, Gombe State-Nigeria [2018.04.18. The Tao. Nigerian Biomedical Science Journal (NBSJ)]
- (Fig.VI) Hookworm from One billion affected by ‘neglected’ diseases [2017.03.16. Cosmos The Science of Everything. cosmosmagazine.com]
- Diseases we can stop, but don’t [2010.12.12. Los Angeles Times]
- Biomedical Advanced Research and Development Authority [2018. U.S. Department of Health and Human Services, Assistant Secretary for Preparedness and Response]
- U.S. Federal Funding for HIV/AIDS: Trends Over Time [2018. Kaiser Family Foundation]
- Parasites – American Trypanosomiasis (also known as Chagas Disease) [2018. Center for Disease Control and Prevention]
- Parasites – Toxocariasis (also known as Roundworm Infection) [2018. Center for Disease Control and Prevention]
- The Parasite on the Playground [2018.01.16. Laura Beil. The New York Times]
- SUNY Downstate Medical Center [2018. downstate.edu]
- Parasites – Schistosomiasis [2018. Center for Disease Control and Prevention]
- Parasites – Hookworm [2018. Center for Disease Control and Prevention]