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U.S. Department of Defense Drug and Vaccine Development LT Mazie Barcus U.S. NAMRU 2 Jakarta, Indonesia DoD Force Health Protection Tenet • “The most valuable, most complex weapons system the U.S. Military will ever field are its soldiers, sailors, airmen, and marines.” • “New and emerging infectious diseases will pose a rising global health threat and will complicate U.S. and global security over the next 20 years.” • “These diseases will endanger U.S. citizens at home and abroad, threaten U.S. armed forces deployed overseas, and exacerbate social and political instability.” Why is the DoD involved in Infectious Disease Research? • Up until WWII, deaths due to infectious diseases outnumbered those due to combat injuries • Potential for naturally occurring infections to play pivotal role in deployments • Frequent deployments to geographic regions with endemic infections U.S. Army Hospital Admissions During War 90 80 70 60 Wounds Injuries Diseases 50 40 30 20 10 0 WWII Korea Vietnam Persian Gulf Some DoD Infectious Diseases Highlights • • • • • • • 1962: isolated rubella virus 1970: meningitis vaccine 1970: antimalarial mefloquine developed 1986: hepatitis A vaccine developed 1997: PCR-based detection of camplobacter 1997: oral camplobacter vaccine 1998: first induction of immune response against malaria in humans with a DNA vaccine • 2002: completed sequence of malaria parasite and anopheline genome (Science and Nature) Military Infectious Disease Research Program (MIDRP) • Development of products to protect deployed warfighters against naturally-occurring infectious diseases – – – – Vaccines Drugs Vector control products Diagnostic tests • Peer-reviewed program for proposed research • Advanced development managed by USAMMDA and usually done with commercial partners Examples of 2001 Vaccine-related Research • • • • • • • • • • Malaria vaccines Prevention of diarrheal diseases Flavivirus vaccines Malaria genome project Hepatitis virus vaccines Meningococcal vaccines Vaccine delivery systems Hemorrhagic fever vaccines Rickettsial diseases Prevention of HIV Global Network of Research Facilities OCONUS Medical Research Units Central Coordinating Hub Germany WRAIR NMRC Egypt Thailand Kenya Indonesia Peru Central Hub • Joint Army-Navy Medical Research Institute – Naval Medical Research Center (NMRC) – Walter Reed Army Institute of Research – 5 major research areas • Infectious diseases • Combat casualty care • Operational medicine • Chemical defense • Biological defense – USAMRIID (Frederick, MD) BSL4 research facility • “To investigate disease threats and develop effective medical countermeasures to protect and sustain U.S. troops” Research Support • Active duty military, civilians • Technology Transfer – CRADAs, medical transfer agreements, patent licenses • Universities, private industries, research foundations • Civilian sector involvement – Small Business Innovative Research Awards – Dual-use Science and Technology Agreements • Government and Non-government Organizations – NIH (funding, HIV research, NIAID) – CDC (disease outbreak investigations, vaccines) – WHO (reference laboratories) • Base for development of technology Overseas Laboratories • Testing of infectious disease technology • Emerging, re-emerging, and naturally occurring infectious disease surveillance • Technology transfer to host nation • U.S. Military, Foreign Service Nationals, local contractors • Convergence of purposes: diseases of military importance are those of concern to host nation public health • Hosted by Ministry of Health or Military U.S. Navy NAMRU-2 Jakarta, Indonesia NAMRU-3 Cairo, Egypt NMRCD Lima, Peru U.S. Army AFRIMS Bangkok, Thailand USAMRU-K Nairobi, Kenya USAMRU-E Heidelberg, Germany (behavioral sciences) Summary • Limited private sector involvement • Convergence of purposes with military • National Security – Protection of U.S. Personnel abroad – General global and economic development Some Useful Websites • nmrc.navy.mil – Links to Navy overseas labs • wrair.army.mil – Links to Army overseas labs