This year's report comes at a time when vaccine research is receiving increased interest and support from governments and international health agencies. A global effort to hasten vaccine development for diseases such as AIDS, malaria and tuberculosis is under way, as demonstrated in part by President Clinton's announcement today on the administration's new vaccine research initiatives.
"There is no more important goal of medical research than to prevent diseases from occurring in the first place," says Anthony S. Fauci, M.D., director of NIAID. "Our commitment to developing new and better vaccines to prevent the world's most serious infectious diseases has never been stronger, and The Jordan Report is a valuable resource for bringing scientists and policy makers up-to-date on this important endeavor."
The 20th century witnessed a revolution in immunology and saw the introduction of vaccines that led to the reduction or elimination of 21 infectious diseases. Smallpox has been eradicated, and polio is on the verge of being eliminated from most regions of the world. Routine immunizations now prevent childhood diseases such as measles, mumps, rubella and haemophilus influenza, and keep in check deadly illnesses like tetanus. Pneumococcal infections, previously common and potentially serious among infants, now can be prevented by a recently approved vaccine.
The past 100 years have also witnessed a change in vaccine technology. While the earliest vaccines contained weakened or killed versions of infectious organisms, or disabled forms of bacterial toxins, in the last two decades recombinant DNA technology has opened new avenues for vaccine design and development. More recently, the push to determine the genetic blueprints for all important disease-causing microbes has begun revealing more secrets of these pathogens, thereby exposing more targets for vaccine design.
The 173-page Jordan Report 2000, prepared by 24 scientists from NIAID with additional contributions from outside researchers, continues a tradition of providing a succinct vaccine progress report. The report offers a comprehensive overview of vaccine development against nearly 60 diseases caused by bacteria, viruses, fungi and parasites. Of these, AIDS, malaria and tuberculosis have received high priority status among government officials in the United States and abroad.
Each year, 500 million cases of malaria are reported to world health authorities. The disease kills 2.7 million people annually, including one child every 30 seconds across the globe. Malaria, spread by mosquitoes, is caused by the parasites of the genus Plasmodium. These parasites infect the liver and red blood cells, and can cause anemia and disorders of the brain, kidneys or lungs. The appearance of drug-resistant parasites and insecticide-resistant mosquitoes has redoubled the research community's search for a vaccine. Immunization remains difficult, however, because of the parasite's complex life cycle and because different Plasmodium species affect the body in different ways. The Jordan Report 2000 highlights recent advances in malaria vaccine research, including candidate vaccines that target different stages of the parasite's life cycle. Other experimental malaria vaccines include the relatively new technology of DNA vaccination. Additional studies seek to uncover new targets for vaccine development by determining the genetic blueprints for all malaria parasites.
AIDS continues to take a devastating global toll. At the end of 1999, the World Health Organization estimated nearly 34 million people worldwide were living with HIV/AIDS, and more than 16 million had died since the epidemic began. According to The Jordan Report 2000, "Development of a safe and effective vaccine against the human immunodeficiency virus (HIV) is critical to control the epidemic worldwide." This effort has faced many obstacles, including the wide global variation in HIV strains, lack of information on natural immunity to the virus, the absence of an ideal animal model, and multiple modes of HIV transmission. The Jordan Report 2000 reviews recent successes in overcoming some of these barriers and addresses all ongoing vaccine research. As with all the other infectious diseases, the report also highlights the contributions to vaccine efforts made by scientists studying the basic science of HIV infection.
Two billion people worldwide are infected with tuberculosis bacteria (TB), and two to three million die each year as a result. When one includes TB deaths among HIV-positive individuals, the disease kills more people than any other single infectious agent. Multi-drug-resistant TB strains are
becoming widespread, making an effective vaccine even more important. A TB vaccine has been available since the early 20th century, but its effectiveness is highly variable and unlikely to curtail the global epidemic. NIAID is working with other agencies to develop a better TB vaccine. "The challenge for the next few years," the report says, "is to rationally prioritize the plethora of vaccine candidates for human clinical testing and to design the necessary trials and infrastructure."
The Jordan Report 2000 addresses vaccine research aimed at preventing many other diseases, including foodborne bacterial infections, shingles, anthrax and dengue, and ongoing efforts to improve existing vaccines. Diseases are organized according to type and name, and are introduced with a brief overview prior to a detailed description of relevant vaccine research. The report contains appendices providing the status of all vaccines in development, plus trade names and licensing information where appropriate. The current recommended childhood immunization schedule and a list of more than 350 references are also included.
The report is available on the NIAID Web site or by writing to Jordan Report/NIAID OCPL; Bldg. 31, Rm. 7A50; 31 Center Dr., MSC 2520; Bethesda, MD 20892-2520.
NIAID is a component of the National Institutes of Health (NIH). NIAID conducts and supports research to prevent, diagnose, and treat illness such as HIV disease and other sexually transmitted diseases, tuberculosis, malaria, asthma and allergies. NIH is an agency of the U.S. Department of Health and Human Services.
Press releases, fact sheets and other NIAID-related materials are available on the NIAID Web site at www.niaid.nih.gov.