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.” DoD’s responsibility for the protection of military and civilian populations alike compels its interest in infectious disease prevention, and by extension, vaccines.

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 In recent years,

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 USAMRIID (Frederick, MD) BSL4 research facility “To investigate disease threats and develop effective medical countermeasures to protect and sustain U.S. troops” Chemical defense Biological defense

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 NAMRU-3 NMRCD Jakarta, Indonesia Cairo, Egypt Lima, Peru

U.S. Army AFRIMS USAMRU-K USAMRU-E Bangkok, Thailand Nairobi, Kenya 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 wrair.army.mil Links to Navy overseas labs wrair.army.mil Links to Army overseas labs