The IVI Newsletter - September 1995

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The International Vaccine Institute is an independent, international organization dedicated to capacity building for vaccine-related development and the promotion of international cooperation in the vaccine-related sciences. It is an initiative of the United Nations Development Programme (UNDP) and has received core start-up funding from UNDP and the Government of Korea.

The Institute will serve as an international resource for information and training in vaccine production technology, regulation, clinical/field trials and epidemiology, and research and development. It will not, itself, produce vaccines.

The Institute will conduct its programs through international collaboration and partnership with centers of excellence in vaccine-relevant fields. Through its various programs and projects, the Institute will seek to encourage and facilitate a regional network of partnership and cooperation.

The Secretariat for the International Vaccine Institute relocated from UNDP in New York to Seoul in January, 1995. The staff will be responsible for setting up the Institute's administrative, operational and programmatic infrastructure and for initiating its activities. The staff will work with the Board of Trustees to develop the Institute's long-term strategic vision and a work plan for its first years of operation.

The Board Nominations Committee, an independent committee appointed by UNDP to oversee the process of proposing founding members of the Board of Trustees, received a very enthusiastic response to its call for nominations.

The Committee [which consisted of Dr. Nyle Brady of the United States, Dr. S. Ramachandran of India and Dr. Hans Wigzell of Sweden] received a total of 67 nominations from 29 countries. The Committee proposed an eleven-member founding Board (Box on Pg. 2), and recommended that Prof. Barry Bloom, Weinstock Professor of Immunology and Microbiology at the Albert Einstein College of Medicine in New York, serve as its first Chairperson. UNDP, in concurrence with these recommendations, then invited the named individuals to serve on the Board.

The first meeting of the Board was held on April 20 and 21, 1995, at the United Nations in New York. Major items on the agenda included the draft Constitution of the Institute, the draft Strategic Plan, approval of the proposed workplan and budget, the process by which the Institute's Director General is to be identified, and the question of management of the Institute in the intervening period until a Director General is appointed. Minutes of the Board meeting are available from the Institute.

Institute staff, under the guidance of the Board of Trustees, is developing a Strategic Plan. To ensure that the Plan reflects the rapidly changing nature of the vaccine field and responds to the concerns of the international community, a wide spectrum of individuals is being asked for inputs. In particular, members of the CVI Meeting of Interested Parties (MIP) have been given a draft for comment. Their inputs will be integrated into the Plan. Institute staff will present the Strategic Plan to the Board for consideration at its next meeting in November. Copies of the current version of the Plan are available from the Institute.

As part of the process of developing the Institute's Strategic Plan, and of establishing a regional institutional network of collaboration, IVI hosted a consultation bringing together representatives of key institutions and agencies from 7 Asia and Pacific countries: Australia, China, India, Indonesia, Republic of Korea, Singapore, and Thailand. The consultation identified key regional concerns and issues that may best be addressed through pooling of resources, facilities and expertise. The participants shared their views on how best to establish the regional network, and also discussed the Institute's future role vis-a-vis the network. A report of the consultation may be obtained from the Institute.

IVI BOARD OF TRUSTEES

Prof. Barry R. Bloom, Chairperson

Weinstock Professor, Albert Einstein College of Medicine, USA

Dr. Geoffrey Schild, Vice-Chairperson

Director , National Institute for Biological Standards and Control, UK

Prof. Ruth Arnon,

Vice President for International Scientific Relations, Weizmann Institute of Science, Israel

Prof. Wan-Kyoo Cho

President, Korean Academy of Science and Technology, Republic of Korea

Prof. Chen Chunming

Professor and Senior Advisor, Chinese Academy of Preventive Medicine, China

Drs. Darodjatun

President Director, Perum BioFarma, Indonesia

Dr. Demissie Habte

Director, International Centre for Diarrhoeal Disease Research, Bangladesh

Dr. Maurice Hilleman

Director, Merck Institute for Therapeutic Research, USA

Dr. Lars Pallesen

Executive Director and CEO, Statens Seruminstitut, Denmark

Dr. Adolfo Martinez-Palomo

Director General, Center for Research and Advanced Studies, Mexico

Dr. V. Ramalingaswami

Professor Emeritus, All India Institute for Medical Sciences, India

Executive Secretary, ex officio, Children's Vaccine Initiative

Children's Vaccine Initiative Secretariat, World Health Organization, Switzerland

Representative, ex-officio, Government of The Republic of Korea

Director General, ex-officio (to be named), The International Vaccine Institute

by Dr. Bruce Gellin
National Institute of Allergy and Infectious Diseases, National Institutes of Health
Bethesda, Maryland, USA
Tel: 1-301-402-2126; Fax: 1-301-402-0208; e-mail: Bruce_Gellin@nih.gov

The NIH vaccine effort supports research directed at the development of vaccines and vaccine-related technologies that can be used to prevent infectious diseases, and "immunotherapeutic" agents that may help in the treatment of cancer and immunologic disorders. Through grants, contracts, and cooperative development agreements, NIAID currently supports over 400 projects related to the development of vaccines against infectious diseases.

NIAID has actively sought out research partnerships both in the United States and internationally with the goal of accelerating the process of vaccine development and evaluation that is necessary to bring these products into use. For example, the US-Japan Cooperative Medical Sciences Program has supported focused research toward the development of priority vaccines for countries of the Pacific Rim, including vaccines against hepatitis, acute respiratory infections, cholera and parasitic diseases.

Within NIH's overall mission of conducting research that will lead to improvements in the health of the population, NIAID's consistent commitment to basic research in molecular biology and immunology has led to an array of new technological developments that provides the framework for developing the next generation(s) of vaccines: vaccines that are ever safer, easier to deliver, and offer broader coverage of populations at risk. Technologic options that are being explored include recombinant DNA and polynucleotide vaccines, live vaccine vectors, subunit vaccines, new adjuvants and delivery vehicles.

In addition to broadening the spectrum of diseases which are "vaccine preventable," these new technologies should also greatly simplify the logistics of vaccine delivery. In the future, more vaccines will be given orally and fewer doses will be required as a result of combinations, delayed-release vaccines, and new adjuvants. For instance, an application of plant biotechnology offers new promise that genetically engineered plants and plant viruses could be the basis for oral "edible vaccines" of the future by building them into crops such as potatoes and bananas that are part of the diet. New products may minimize requirements for refrigeration and promise to reduce reliance on the cumbersome and expensive "cold chain" and allow significant improvement in the efficiency of developing country immunization programs.

The growing array of available and promising technologies highlights the need to accelerate the transition from vaccine research to development, evaluation and ultimate incorporation into immunization programs. To do this it is essential to continue to support and expand the research base that has brought us to this stage and to assure that concepts transform into useful products. Active and productive partnerships with industrial developers remains an NIAID priority. The recent rescinding of the "fair pricing clause" of the NIH's Cooperative Research and Development Agreements (CRADAs) should further lower the barrier to full industrial cooperation and accelerate the process of vaccine development. With the ultimate goal of improving health by preventing infectious diseases, this effort is designed to create the products that will most effectively do that job.

Editor's Note

The Children's Vaccine Initiative (CVI) is a partnership of agencies, organizations and corporations dedicated to ensuring the continued availability of high quality vaccines at affordable costs, and to developing new and improved vaccines. The United States National Institutes of Health (NIH), and particularly the National Institute of Allergy and Infectious Diseases (NIAID), is one of the principal CVI partners dedicated to vaccine research and development. This article, the first in a series on partner institutions of the CVI, provides a glimpse of future directions in vaccine research and development from the perspective of the NIH.

Results of Acellular Pertussis Vaccine Trials

Researchers in Italy, Sweden and the United States simultaneously announced, on July 13, 1995, the results of a major series of pertussis vaccine efficacy trials conducted over the last three years in Italy and Sweden. The results demonstrate that acellular pertussis vaccines are efficacious and relatively free from side-effects, and also raise important questions regarding the efficacy of whole-cell pertussis vaccines.

The two randomized, double-blind trials were supported by the US National Institutes of Health and aimed to determine the safety and efficacy of acellular pertussis vaccines. Such vaccines, first developed in Japan,
have been used since the early 1980s. While acellular pertussis vaccines are generally considered to be "cleaner" and less likely to cause adverse reactions than whole-cell vaccines, there has been much uncertainty regarding their efficacy.

The conventional wisdom has been that whole-cell pertussis vaccines are highly efficacious although they cause sometimes troubling side effects including fever, sore arms, swelling at the injection site, and prolonged crying. Their use over the last several decades has shown them to be safe and effective. Since introduction of these vaccines in the United States, for example, the incidence of pertussis has fallen steadily from more than 100,000 pertussis cases and thousands of pertussis-related deaths annually
in the 1940s (before whole-cell pertussis vaccines came into common use), to only 4,671 pertussis cases and 8 pertussis-related deaths in 1994.

Both the Italian and Swedish trials utilized DTP vaccines which contained either whole-cell or acellular pertussis vaccines. Controls were administered DT vaccine without any form of pertussis vaccine.

While whole-cell pertussis vaccines are composed of killed Bordetella pertussis bacteria, acellular pertussis vaccines consist of purified components extracted from the organism. Different acellular pertussis vaccines may contain different components. All of the acellular pertussis vaccines in the Italian and Swedish trials contained an inactivated form of pertussis toxin (PT) - either native or recombinant. During natural infection with Bordetella pertussis, PT and other bacterial products are believed to participate in damaging and killing the cells that line the human respiratory tract. Other cellular components that were part of some of the acellular pertussis vaccines tested include pertactin (PRN), filamentous hemagglutinin (FHA), and agglutinogens. These components may help the bacteria adhere to and colonize the respiratory tract during
infection.

The Swedish trial found that a two-component acellular pertussis vaccine containing PT and FHA (manufactured by SmithKline Beecham of Belgium) showed an efficacy of approximately 58%, while a five-component vaccine containing PT, FHA, PRN and two different agglutinogens (manufactured by
Connaught Laboratories, Ltd. of Canada) had an efficacy of 85%.

The Italian trial utilized two different three-component acellular pertussis vaccines, both containing PT, FHA and PRN. One product (manufactured by Chiron Biocine) contained recombinant PT while the other
(manufactured by SmithKline Beecham) contained native PT. Both vaccines had similar efficacies of approximately 84%.

Both trials showed that acellular pertussis vaccines are safe, and are less reactogenic than whole-cell pertussis vaccines.

A surprising finding in both trials was the lower-than-expected efficacy of the whole-cell pertussis vaccine used. The vaccine used in both trials came from the same lot (manufactured by Connaught Laboratories, Inc. of Swiftwater, Pa, USA), and showed an efficacy of about 48% in the Swedish trial and 36% in the Italian trial.

Contact: Dr. David Klein (Tel: 1-301-402-1663; e-mail: David_Klein@nih.gov)

Editor's Note

The efficacy of whole-cell pertussis vaccines has been variously estimated, from field observations and clinical data, to be in the 75-90% range. Further study is required to determine if the lower-than-expected efficacy findings in these trials are batch-specific or reflective of generally lower efficacy of whole-cell pertussis vaccines compared to acellular vaccines.

The results of these trials are likely to help accelerate the shift from whole-cell pertussis vaccines to acellular vaccines. Still, whole-cell vaccines are reasonably safe, effective, inexpensive, and less technologically demanding to produce than acellular vaccines. Many issues related to the use of whole-cell and acellular vaccines will need to be addressed in the near future, including a cost-benefit analysis of whole-cell versus acellular pertussis vaccines, and consideration of the implications of these results for immunization programs around the world. Several meetings are being planned in the coming months to consider these and other related issues.

[Contact: Dr. Roy Widdus, CVI Secretariat, Tel:41-22-791-4369, Fax:41-22-791-4192]

Diphtheria Outbreak in Commonwealth of Independent States (CIS)

A diphtheria outbreak in countries of the former Soviet Union caused an estimated 47,000 cases of diphtheria (with 1,700 deaths) in 1994. As many as 170,000-200,000 cases are projected in 1995.

The outbreak, which was initially associated with civilian adults working in military installations in Moscow and St. Petersburg, has spread quickly into the rest of Russia and the Central Asian Republics. Early efforts to target high risk groups for immunization failed to contain its spread. The outbreak has been associated with low immunization coverage, arising from a lack of availability of vaccines in the Central Asian Republics
following the break-up of the Soviet Union. While Russia itself appears self-sufficient in vaccines, international assistance, coordinated by UNICEF and WHO, is being organized to procure and supply the vaccine needed to meet short term needs of the Central Asian Republics as part of the strategy to contain the epidemic.

Sources: Asiaweek, July 8, 1995 & Dr. Nicholas Ward, GPV/WHO (Tel: 41-22-791-4798; Fax: 41-22-791-4192)

Malaria Vaccine Trials

SPf66, a synthetic vaccine against Plasmodium falciparum developed by Dr. Manuel Patarroyo of the Institute of Immunology in Bogota, Columbia, was found in 1991 to provide almost 40% protection in an at-risk Columbian population. This was the first time that a vaccine showed even minimal protection against malaria, and created a major international stir when it was first reported. A second trial conducted in 1993-94 in the Kilombero valley of southern Tanzania, where malaria infection occurs with a much higher intensity than in Columbia, reported an efficacy of about 31% in reducing the incidence of malaria in children aged 1-5 years. SPf66 is currently also undergoing trials in the Gambia and in Thailand. Results are expected to be announced by the end of this year.

The fact that SPf66 appears to provide some protection against malaria has given impetus to efforts to develop an even more efficacious vaccine. The World Health Organization anticipates that several alternative candidate vaccines against Plasmodium falciparum will undergo clinical trial in the next 3-4 years. Even if a vaccine with sufficient efficacy to merit mass immunization is developed, its use is likely to need to be integrated with the use of anti-malarial drugs, insecticide-impregnated bednets, and environmental management approaches.

References: SCN News, Number 12 (1995). Malaria Vaccine Tested in Tanzania; and 12th Programme Report of the UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (1995).

Dr. Roy Widdus joins CVI Secretariat

Dr. Roy Widdus was appointed as the Coordinator of the Children's Vaccine Initiative (CVI) in April, 1995. Dr. Widdus, formerly the interim director of the National Vaccine Program Office at the United States Public Health Service, will work under the direction of Dr. J-W Lee who is concurrently Executive Secretary of the CVI and Director of WHO's Global Programme for Vaccines and Immunization (GPV).

Dr. David Magrath Retires

Dr. David Magrath, who served as Chief of Biologicals at WHO and also as the Secretary of the CVI Task Force on Quality Assurance, retired from WHO in December, 1994. Dr. Magrath has been succeeded at Biologicals by Dr. Ellwyn Griffith. Dr. Magrath helped develop a concept for regional cooperation and collaboration that has been instrumental in inspiring IVI's regional network building efforts. We wish Dr. Magrath a happy and fulfilling retirement.

The following statement was recently issued by the Global Programme on Vaccines and Immunization (GPV), WHO:

News has recently surfaced that the World Health Organization is promoting the use of tetanus toxoid vaccines in the Philippines, Mexico, Nicaragua and Tanzania which have been laced with an infertility drug derived from human chorionic gonadotropin (hCG). This news is not true.

Tetanus toxoid vaccine is used to protect infants, yet to be born, from neonatal tetanus, a disease which kills up to 40 infants for 1000 live births in some areas. The disease strikes infants in the first month of life and has a mortality rate of up to 85%. It is characterized by convulsions and respiratory arrest. The tetanus toxoid vaccine is given to pregnant women and other women of childbearing age, so that the immunity they develop is passed on to their infants prior to birth to protect them during the first 30 days of their lives. WHO recommends that five doses spaced at appropriate intervals are necessary for protection throughout a woman's childbearing years.

The tetanus toxoid vaccines used in immunization campaigns in these and other countries are produced by recognized manufacturing facilities, and have been certified as safe and efficacious by the governments of the countries in which they are produced. In addition, the manufacturers and relevant government authorities have provided WHO with written statements that these vaccines contain no substance which will interfere with conception or pregnancy.

The source of the reports appears to be the results of tests carried out on tetanus toxoid vaccine in the Philippines which suggested the presence of trace amounts of human chorionic gonadotropin (hCG) in the vaccine. However, these results were due to false positive reactions. An appropriate test methodology shows no hCG in the vaccine.

The tragedy of the situation is that these reports, and false and misleading publicity that has arisen from them, has caused tetanus immunization campaigns to be cancelled. This means that many infants will die from neonatal tetanus whose lives could have been saved by the tetanus toxoid vaccine. Dr J-W Lee, Director of WHO's Global Programme for Vaccines and Immunization, stressed that "women must be immunized with tetanus toxoid vaccine to protect their unborn children against neonatal tetanus."'

Contact: Dr. Julie Milstien
GPV/WHO (Tel: 41-22-791-3564; Fax: 41-22-791-4192; e-mail: milstienj@who.ch )

Editor's Note

We asked Dr. Milstien if it was known why the false positive results had occurred. According to her, "The tests used were pregnancy test kits which are based on ELISA or RIA. They are not appropriate for use with alum-adsorbed vaccines, and as far as we know, no attempt was made to remove the alum. Also, most of these kits, despite saying their cutoff value is 2-5 mIU/ml, are not reliable below 25 mIU/ml. The 'positive' values were in the range of 5-7 mIU/ml, results characterized to be of no biological significance by the testing laboratories themselves.When the vaccines were tested by the US FDA, The Human Co. in Hungary, and others, results were below the cutoff of the tests."

Dr. Milstien added,"The summary of these findings is that, without exception, when interpreted by independent laboratories, including those in the Philippines that conducted the test that started the rumor, all tetanus vaccine samples have proved negative for hCG or any other substance likely to reduce fertility."

What do the collapse of a major department store in Seoul, polluted klongs in Bangkok, and poor quality control/quality assurance of vaccine and pharmaceutical production in many developing countries have in common? Lots - when considered from the viewpoints of risk transition and risk perception.

Risk transition refers to the changing pattern of risks to which individuals are exposed as societies become more affluent and developed. "Traditional" risks (arising from exposures to infectious diseases and natural environmental factors) tend to decline rapidly with development. On the other hand, "modern"risks (associated, for example, with exposure to industrial pollutants, road-traffic accidents, or shoddy construction) tend to follow an inverted "U"-shaped curve - rising initially as societies begin their development process, peaking as newly industrializing economies "mature", and then declining with further development.

Individuals tend to vary greatly in their perception of risk - some would consider a risk of death or disability of 1 in 10 as reasonable, others would consider a risk of 1 in a million as too much. Response to risk exposure tends to vary with personality, culture, socio-economic status, and education, among other factors. As societies become more developed, rising affluence and education tend to be coupled with growing awareness and concern regarding the potential consequences of exposure to risk.

Unfortunately, growing awareness tends too often to come about as a result of negative experiences. Hence, the collapse of the department store, the polluted klongs, and adverse reactions due to administration of unsafe vaccines have almost seemed to be inevitable experiences before growing public outrage and media pressure lead to appropriate investment in putting in place safety standards and regulations aimed at ensuring safe and high quality outputs.

It is to be hoped that the International Vaccine Institute, working closely with its Children's Vaccine Initiative and regional institutional network partners, can, at least in relation to the production and use of vaccines and other pharmaceuticals, help accelerate greater recognition of the need for quality control and effective regulatory capability in developing countries. -GSS -

The National University of Singapore (NUS), in collaboration with the National Science and Technology Board (NSTB), is keen to make Singapore a regional center of excellence for clinical trials and epidemiology. Towards this end, and to help ensure that trials are organized and conducted along internationally accepted lines, NUS has started a program to train and certify researchers in Good Clinical Practice (GCP). NUS and NSTB are interested in the possibility of expanding the program to include scientists and clinicians from around the region.

Contact: Prof. Edmund JD Lee
Department of Pharmacology, National University of Singapore, Singapore 0511
(Tel: 65-772-3269; Fax: 65-773-0579)

The International Vaccine Institute and the United Nations Industrial Development Organization (UNIDO) are collaborating to organize training workshops on vaccine production management and on quality control/quality assurance.

The Workshop on Vaccine Production Management is aimed at helping to strengthen managerial capabilities in relation to vaccine production in developing countries. In addition to financial, personnel and administrative issues, the workshop will consider such priority management concerns as the economic feasibility of production versus procurement, issues in maintenance and upgrading of facilities and staff, and the potential of research and development to contribute to quality vaccine production. The workshop will be held at the Sino-Danish Post-Graduate Training Center in Beijing, China, in Spring 1996.

The Workshop on Quality Control/Quality Assurance and Good Manufacturing Practices will be held at the facilities of Perum Bio Farma in Bandung, Indonesia, in Summer 1996.

Contact: Dr. Gurinder Shahi, Coordinator - Operations Development
International Vaccine Institute
(Tel: 82-2-872-2801; Fax: 82-2-872-2803)

Dr. Zoltan Csizer, Senior Adviser
Pharmaceutical Industries Unit, United Nations Industrial Development Organization (UNIDO)
Vienna, Austria (Tel: 43-1-211-31-3948; Fax:43-1-230-9615)

The International Vaccine Institute, working in close collaboration with the US National Institute of Allergy and Infectious Diseases (NIAID), is interested in exploring the possibility of regional cooperation in surveillance and monitoring of Hemophilus influenzae B (HiB) and pneumococcal infection-related mortality and morbidity.

These infections together are thought to account for as much as 50% of mortality related to acute respiratory infection and are also major causes of meningitis and deafness (one of the more common late sequellae of bacterial meningitis). Surveillance would allow the determination of the relative importance of these infections in the region and would subsequently enable monitoring of the effectiveness of vaccines against these diseases as they are introduced. HiB vaccine is available, either alone or in combination with DTP. Conjugate pneumococcal vaccines, which are expected to be immunogenic in infants, are undergoing clinical testing in the United States and are anticipated to become available as early as 1997. Since there exist as many as 84 pneumococcal serotypes, another benefit from surveillance (in particular, molecular epidemiology and serotype surveillance) could be to ensure that vaccines are "matched" to the relative frequency of the different serotypes in each country or region.

Those who have experience in HiB/pneumo epidemiology and surveillance and are interested in sharing the results of their investigations, or in participating in a collaborative effort, are invited to write to the Institute.

This year marks the 100th Anniversary of the death of Louis Pasteur, and 1996 is the 200th Anniversary of Edward Jenner's first use of the cowpox virus to prevent smallpox. These occasions are being commemorated around the world.

Smallpox was a major cause of death in the 18th century. In Jenner's time, it was treated by inoculating healthy individuals with pustular material from those who had mild cases of the disease - with sometimes fatal consequences. Jenner observed that his patients who had been exposed to cowpox, a much milder disease than smallpox, showed no reaction to these inoculations. To confirm this observation, he inoculated an eight-year-old boy with cowpox pustular material in 1796; six weeks after the boy's reaction, Jenner reinoculated him with smallpox pustular material and observed that there was no reaction to the smallpox inoculation. The wide-spread application of Jenner's discovery of cross-protection between cowpox and smallpox led to a rapid reduction in the incidence of smallpox in Europe in the 19th century, and eventually, to its eradication in the 1970s.

Pasteur is generally recognized as the founder of modern microbiology and immunology. He is credited with many major scientific advances including proving the germ theory of disease, inventing the process of pasteurization, and developing vaccines for rabies and other diseases.

The International Vaccine Institute is planning to organize a two-day International Symposium in Fall, 1996, to commemorate Pasteur's Centennial and Jenner's Bicentennial. The meeting, tentatively entitled "Vaccines for the Developing World: Priorities, Concerns and Opportunities", is expected to bring together scientists and public health professionals from around the world to address future directions and challenges in the vaccine and immunization science arena. An announcement regarding the meeting will be made in a later issue of this newsletter.

Prof. Seung-il Shin, formerly the Senior Health Advisor to UNDP with responsibility for conducting the feasibility study for the IVI, has been asked by the Board of Trustees for the International Vaccine Institute to serve as the Institute's Project Leader and Chief Executive Officer. Prof. Shin will oversee the early operations of the Institute until its first Director General is appointed. An American citizen, Dr. Shin received his graduate training in biochemistry and cell biology at Brandeis University, and postdoctoral training in genetics at the University of Leiden in The Netherlands and in immunology at the National Institute of Medical Research in London. He was also a member of the Basel Institute for Immunology in Switzerland, before serving for 14 years as a professor of genetics at Albert Einstein College of Medicine in New York. Subsequently, Dr. Shin co-founded and served as the chief executive officer of a U.S.-based biotechnology company specializing in the development of diagnostics and biologicals including vaccines. Dr. Shin's group played a key role in the industrial development, field testing and eventual global usage of a hepatitis B vaccine. He joined UNDP in 1992.

Dr. Richard Mahoney, who joined the IVI staff in January, 1995, serves as Director of Institutional Development, taking responsibility for overseeing institution-building and the development of the Institute's strategic plan. A founding member of the International Task Force on Hepatitis B Immunization, Dr. Mahoney serves as Secretary. He was involved in all aspects of Task Force work including model immunization programs, technology transfer, and relations with private industry. He has been involved in the launching of the Children's Vaccine Initiative (CVI) serving as member-secretary of the CVI Task Force for Strategic Planning and as a consultant to the CVI Task Force on Situation Analysis. Dr. Mahoney, an American, holds a PhD in physical chemistry. In the 1970s, he was a program officer with the Ford Foundation and was one of the founders of PATH, a major international non-governmental organization dedicated to international health. He served as Vice-President at PATH prior to joining the IVI staff.

Mr. Sae-Joong Kim is the Institute's Director of Planning and Administration. Mr. Kim is responsible for the Institute's personnel and financial management. He also serves as the Institute's senior officer responsible for coordinating the construction of the Institute's permanent facilities in collaboration with the Government of Korea and the Seoul National University, IVI's host institution in Korea. Mr. Kim comes to the Institute after a distinguished international career with a major Korean conglomerate, and has lived and worked in Jakarta, London, New Delhi and New York.

Dr. Gurinder Shahi, formerly Health Planning Officer at UNDP, serves as the Coordinator of Operations Development. He is responsible for coordinating the establishment and operation of the Institute's regional network of collaboration and partnership, and for establishing the information dissemination services of the Institute. He will also coordinate the Institute's training programs. A native of Singapore, Dr. Shahi is a physician with a PhD in toxicology, and a Masters degree in Public Health (International Health Policy and Management). In 1992, he was awarded the Warren Weaver Fellowship by the Rockefeller Foundation. Prior to joining UNDP and the Institute, he lectured for several years at the National University of Singapore. He has also served as a consultant to several international agencies and non-governmental organizations.

Ms. Sun-Young Min, the Institute's Administrative Secretary, holds a degree in French Literature and speaks several languages including English, Korean, French and some Japanese. She has worked in Seoul and the USA and has translated 2 books from English into Korean. She also practices yoga.

The Institute is in the process of establishing an internet node which it hopes will be running by the end of 1995. When available, it will be possible to access the Institute's database on the information superhighway.

Through a World Wide Web page, the Institute will provide access to a range of documents and data, and to other vaccine-relevant resources on the Internet. In time, as the Institute's capabilities grow, electronic meetings and video conferencing (with affiliate centers of the Institute) are to be anticipated. Also, as a research institution which will come into its prime with the dawning of the 21st century, the Institute is committed to taking a leadership role in promoting the use of multi-media as an educational tool to complement vaccine-relevant training and capacity-building activities of the Institute.

The Institute is establishing a database of agencies and institutions in Asia and beyond with an interest in vaccine science and technology development. The database will include agencies and institutions in such categories as: vaccine production and production technology, quality control and quality assurance of vaccines, regulatory and policy concerns, epidemiology (including post-introduction monitoring and surveillance, and the conduct of clinical and field trials), vaccine introduction and utilization, and research and development of new and improved vaccines.

To have your agency or institution listed on the database, simply write to the Institute with the following information: name of institution and relevant department(s), name(s) of principal scientists, contact information (including mailing address, telephone and fax numbers, and e-mail addresses), areas of vaccine-relevant interest, and copies of any publications that may be of interest.

There exist a number of potentially useful vaccine- and health-related services which may be of interest to those who have internet access. Two resources readers may wish to explore include:

HealthNet provides a mechanism for linking up those concerned about health-related issues in developing countries. For further information, send an e-mail message to: info@usa.healthnet.org

ProMED is an information hotline program to "identify and rapidly respond to unusual outbreaks of infectious diseases in order to provide help to affected areas and to prevent spread .... not only to the region of origin but to the entire world". Access to its electronic conference can be obtained by simply sending an e-mail message to: promed-request@usa.healthnet.org

The IVI Newsletter is planning to introduce several additional features in future issues including:

A series on on-going activities and plans for vaccine-relevant science and technology development in countries in Asia and the Pacific is planned. Countries to be featured include: Australia, Bangladesh, China, Japan, India, Indonesia, Malaysia, Myanmar, the Democratic People's Republic of Korea, New Zealand, the Philippines, the Republic of Korea, Singapore, Thailand, and Vietnam.

The IVI Newsletter plans to provide a forum for constructive discourse in the international vaccine science and technology development arena. Thought-provoking and original insights and observations which deal with issues of common concern are particularly welcome.

The IVI Newsletter has been designed with you, the reader, in mind. We hope to provide useful, pertinent information that you can use. Your feedback, advice and inputs can help us serve your interests and needs better - so write and tell us what you think!

The International Vaccine Institute is so new that it does not yet have a logo. We are open to any ideas and suggestions for that perfect logo.

So why not let your creative juices flow? You might get a flash of inspiration, for example, while you are doodling' at office meetings. Or you might want to challenge your children to see what brilliant ideas their fertile young minds can come up with.

If you do come up with a possible winner or a great idea you want to share with us, simply write, fax or e-mail it to us. Your contribution might well find its way onto IVI stationary!

The IVI Newsletter will post information regarding meetings, conferences, and workshops which may be of interest to scientists and policy-makers in Asia.

The IVI Newsletter is published by the International Vaccine Institute. It seeks to provide timely, useful information pertinent to scientists and policy-makers with an interest in vaccine science and technology development. It is distributed free of charge.

The IVI Newsletter is interested in your views and perspectives. Readers wishing to submit suggestions, comments, letters to the editor, information regarding activities or events, or articles to be considered for publication may contact:

The Editor
The IVI Newsletter
The International Vaccine Institute
Seoul National University Campus
Shillim-Dong Kwanak-Ku, Seoul, Korea 151-742
Tel: 82-2-872-2801; Fax: 82-2-872-2803; e-mail: webmaster@ivi.org

To be placed on the mailing list or to make address corrections, write to the Newsletter Circulation Desk.

Publication of this issue of The IVI Newsletter has been supported by grants from The Asia Foundation, the Republic of Korea, Quintiles (an international contract-research organization), and the United Nations Development Programme.

Institute News	The Editor's Opinion	Reader's Corner
Vaccine R&D: a glimpse into the future	Training Opportunities	Meeting Planner
News and Views	Future Activities	Information and Acknowledgements
CVI News	Who's Who at IVI
The Truth About Tetanus Toxoid	InterNetworking