Dreams, sometimes, do come true
July 31, 2007 – Siena, a medieval treasure in the heart of Tuscany, seems a pretty sleepy city—except around the Palio, when droves of tourists converge there to watch the storied biannual horse race that is the soul of Sienese culture. On the first day of July this year, the usual summer tourists were joined by a small but significant group of public health officials, infectious disease experts and scientists from around the world who were equally enthusiastic about the Palio, but in town for an entirely different reason. They were in Siena to attend the first “Global Partnership for Vaccination” conference, a three-day meeting hosted by the Novartis Vaccines Institute for Global Health (NVGH). Their job: to give Novartis feedback on NVGH’s mission and its plans as it prepares to become an operational entity in the near future.
Our intentions were spelled out on the first day of the conference. The mission of the NVGH, the multinational group of attendees was told, is to find vaccines against neglected infectious and parasitic agents—like Protozoa, Metazoa, Cestoda, Trematoda—that exact a heavy toll on the developing world. To that end, it will take charge of the basic and translational research of vaccine development, through to perhaps the second phase of their clinical assessment. It will then hand successful projects over to any of a variety of partners, such as aid organizations and governments, willing to underwrite the last stages of their development and manufacturing, and see that the vaccines are delivered to the people who need them. “According to the WHO,” said Paul Herrling, Head of Corporate Research at Novartis, “infectious diseases alone carry 10 % of the global disease burden, mostly in poor countries of the developing world. Novartis has decided to make a contribution to address this problem by discovering and developing both small molecular medicines and vaccines for these mostly neglected diseases.”
Indeed, that recognition is what inspired Rino Rappuoli, Novartis Global Head of Vaccines Research, to develop the concept of the NVGH. Rappuoli had long been frustrated by the fact that while the technology exists to develop vaccines against some of the most devastating diseases of the world, the lack of a viable market for such innovations makes it impossible for drug companies to justify developing them to their shareholders. At the same time, poor countries lack both the funds and the expertise to develop such vaccines themselves. Yet bridging that gap is crucial to addressing some of the basic barriers to third world development. With the inception of Novartis Vaccines, Rappuoli saw an opportunity and, armed with slides and the data he had gathered over the past few years, made his case to Joerg Reinhardt, CEO of Novartis Vaccines and Diagnostics, and Novartis CEO Daniel Vasella.
Novartis has a longstanding commitment to corporate citizenship as evidenced by its numerous initiatives to fight diseases of poverty and improve access to medicines globally. Corporate citizenship is truly part of the DNA of Novartis and the NVGH appeared as a natural step to further encourage drug research for the third world.
Both Reinhardt and Vasella loved the idea of the NVGH and they joined a steering committee to oversee the development of the new institute. In August 2006, Novartis Vaccines and Diagnostics convened a conference in Siena, on the research and development of vaccines against neglected diseases. If there was any doubt that Novartis would put its considerable weight behind Rappuoli’s initiative, Dr. Vasella removed it when he announced during the conference that Novartis would soon establish what is now named the NVGH. But he also asked that the Institute’s board test its ideas on the people it would be working with around the world—the partners who would be crucial to the institute’s success—and incorporate their feedback into the institute’s operational plans.
The NVGH was incorporated in Siena on February 2, 2007, and recruited its first employee, Business Development Manager Mae Shieh, from the Novartis Institute for Tropical Diseases (NITD). NVGH is now hiring researchers and support staff, and looking for a CEO who will report directly to Herrling. This means that while NVGH will have access to all the technology and expertise available at Novartis Vaccines and Diagnostics’ Siena campus, it will function as an independent entity. It will also have its first laboratories, staffed with its first scientists, up and running this October.
The Institute builds on the model of the NITD, which is based in Singapore. Its focus will not be on those diseases, such as HIV/AIDS, that have already attracted considerable commercial interest. It will work in partnership with universities, research centers and other public and private organizations to discover and begin the development of vaccine candidates for only those ailments that are commercially neglected. And although its direct financial involvement will end there, it will work closely with partners from the outset to ensure that its vaccines reach the people who need them. These include donor organizations, such as the Gates Foundation, and the World Health Organization, which will help identify the geographic and medical areas where vaccines are needed. The Institute will also nurture relationships with governments of the countries where its vaccines will ultimately be used—vaccine distribution the world over is a highly centralized affair, in which all levels of government play a crucial role.
Conference attendees—who were invited, as suggested by Vasella, to provide feedback on the institute’s plans—validated these ideas. Many of the experts underscored the importance of NVGH engaging the leaders of recipient nations in its efforts, creating a demand for its products so that it wouldn’t need to push them on unresponsive governments. But several attendees also noted that NVGH could help many developing countries not only by finding novel vaccines but by improving those already on the market as well. They also raised questions about which diseases should be considered neglected, and offered several suggestions about how the institute should pick its targets. NVGH’s board will take their comments into account before it finalizes the institute’s mission. The attendees (who came from countries such as Mozambique, India and Brazil, among others) will wait for that mission to bear fruit, offer help where they can, and—inevitably—revisit the Palio frequently in their memories.