Global Network for Neglected Tropical Diseases

Our mission is simple: We are working to end global suffering and death from neglected tropical diseases through proven-effective, low-cost treatments.

The Global Network is fulfi lling this mission by raising the profi le of neglected tropical diseases and leveraging international resources to deliver treatments to the world’s poorest people.

What are NTDs?

Neglected tropical diseases (NTDs) are disabling, disfi guring and deadly diseases 1 impacting more than one billion people worldwide. These bacterial and parasitic infections are widespread among people in poor, rural communities—the majority of whom live on less than $2 per day. NTDs impair physical and cognitive development, cause adverse pregnancy outcomes, and limit adult productivity in the workforce. As a result, they cause billions of dollars in lost wages, all but ensuring that those at risk of infection remain trapped in a cycle of poverty and disease.

Soil-Transmitted Helminths (intestinal worms) Over 1 BILLION infected. Soil-transmitted helminths include ascariasis, hookworm, and trichuriasis. Transmission occurs with lack of access to clean water and sanitation. STHs in children cause anemia, vitamin A defi ciency, stunted growth, malnutrition, intestinal obstruction, and impaired physical and cognitive development.

LEADING THE FIGHT AGAINST DISEASES OF POVERTY Schistosomiasis (snail fever) Approximately 200 MILLION infected. Infection is caused by a blood-borne fl uke found in freshwater, which causes blood in urine or stool. This can lead to anemia and impaired growth and A low-cost, safe and development in children. In adults, life-threatening conditions of effective solution exists to end the suffering. For bladder cancer, kidney malfunction or liver and spleen damage approximately 50 cents may develop. 280,000 people die from schistosomiasis each year, per person per year we making it the most deadly of the NTDs. can treat seven of the most common NTDs – Onchocerciasis (river blindness) making the elimination Approximately 37 MILLION infected. Infection is caused by a of NTDs the “best buy” parasitic worm transmitted by bites from black fl ies. Symptoms in public health. include intense itching, disfi guring skin conditions and eye lesions 2 that can result in blindness.

Lymphatic Filariasis (elephantiasis) Approximately 120 MILLION infected. Infection is caused by a mosquito-borne parasitic worm that damages the lymphatic system, causing gross disfi guration and incapacitation from swollen limbs and thickened, rough skin. The larvae circulate in the skin, causing intense irritation.

Trachoma (blinding trachoma) Approximately 84 MILLION infected. The world’s leading cause of preventable blindness is a bacterial infection spread through fl ies, poor hygiene and direct contact with infectious discharge. Over time, the upper eyelid develops scar tissue, eventually turning inward and causing the eyelashes to scratch the cornea, resulting in blindness.

LEADING THE FIGHT AGAINST DISEASES OF POVERTY CONTENTS

I. From the Chair and President II. Our Advantage: A Network in Action III. Major Strides in NTD Control: Working to End the Neglect IV. Generating Global Momentum V. Looking Forward VI. Sabin Vaccine Institute VII. Financials

3

LEADING THE FIGHT AGAINST DISEASES OF POVERTY I. FROM THE CHAIR AND PRESIDENT FROM THE CHAIR Dear Friends,

The Sabin Vaccine Institute continues to evolve and adapt while envisioning a world free of preventable diseases. Our work commemorates the legacy of the great Dr. Albert B. Sabin, whose tireless efforts in the fi elds of vaccine development and global medical diplomacy improved the lives of many people. In this tradition, and in parallel with our other global health programs, I am proud of the signifi cant progress we’ve made since our energetic launch of the Global Network for Neglected Tropical Diseases in 2006. The success of the Global Network members’ incipient work in delivering a rapid-impact drug package for NTD control to communities throughout Latin America, sub-Saharan Africa, and Southeast Asia has already treated millions and has set the stage for a dramatic 4 improvement in the health of the world’s poorest people. In addition, the Global Network’s support of community-directed treatment distribution helps to ensure that programs are locally sustainable. The one constant in today’s world is change. As technology advances, diseases re-emerge or become resistant to existing treatments, and demographics shift. Amid this change, Sabin looks to remain at the forefront of the fi ght against preventable illness. As we continue to grow and adapt, we will not falter in our dedication to help the world’s poorest break out of the cycle of poverty and disease. I applaud the efforts of the Global Network and its members to create a synergistic approach to NTD control through new global partnerships. In doing so, they advance NTD control as increasingly innovative and cost-effective. I hope that, through this Annual Review, you receive a snapshot of all the wonderful work we are doing through the Global Network and its members. With your help and support, the Global Network can continue to extend its reach into the world’s most underserved communities.

Sincerely, Morton P. Hyman Chairman of the Board, Sabin Vaccine Institute

LEADING THE FIGHT AGAINST DISEASES OF POVERTY Dear Friends, FROM THE PRESIDENT

In the three years since we launched the Global Network at the Clinton Global Initiative, followed by a landmark donation from Legatum, we have experienced signifi cant growth as we deepen our commitment to fi ghting neglected tropical diseases around the world. Through the tremendous efforts of our Global Network members tens of millions of the world’s poorest people are currently receiving a low-cost rapid-impact package of essential NTD drugs, enabling them to break out of a devastating cycle of poverty and disease. As their name suggests, NTDs have traditionally been neglected by the international community. Over the past year, however, we have seen incredible momentum establishing NTDs as a critical policy issue in global health. We’ve witnessed world leaders taking action: President Bush called on the U.S. to invest $350 5 million to fi ght NTDs; UK government offi cials announced they will be contributing £50 million over the next fi ve years toward the control and elimination of NTDs; UN Secretary General Ban Ki-moon dramatically raised the profi le of NTDs at the UN Elders Meeting held in Atlanta; and for the fi rst time ever, the leaders of the G-8 put NTDs on the global health agenda. These exciting developments truly represent a paradigm shift in the way the global community understands and fi ghts NTDs. As we become more effective in our NTD control efforts—through expanded partnerships, greater outreach, and heightened public awareness and political momentum—we will come closer to eliminating poverty and allowing children and families to survive and thrive. In doing so, NTD control represents a key mechanism by which we can achieve UN Millennium Development Goals and targets. The Global Network 2008 Annual Review summarizes our programmatic and operational objectives and assesses the progress made in the past year. As we build on the tremendous momentum generated, we are delighted to work with you in continuing to end the neglect.

Sincerely, Peter J. Hotez, MD, PhD President, Sabin Vaccine Institute LEADING THE FIGHT AGAINST DISEASES OF POVERTY

II. OUR ADVANTAGE: A NETWORK IN ACTION

We take the word “network” seriously. The key to our success is two-fold: we leverage the strength and resources of our global partnerships and we combine them with an effective and inexpensive rapid-impact package that combats the seven most common NTDs.

We have found that investments work best when targeted directly at people in need. Through high effi ciency with minimal overhead, investments go fi rst and foremost to treating people suffering from NTDs. Our approach allows us to: In 2009, we will build on our network approach through the launch of an alliance 1. Coordinate with 7 of regional fi nancial and grantmaking platforms in Africa, Asia and Latin America. experienced global This innovative partnership model will leverage resources from the private and organizations in the public sectors to ensure that investments made result in treatments delivered. fi eld

Donors invest in the Global Network because their money goes directly to people 2. Partner with local who know how to effi ciently and effectively get the job done. We have member governments to create organizations across the globe with unparalleled expertise in NTD control efforts; sustainable solutions we utilize a unique community approach that empowers individuals to become 3. Leverage resources and directly involved in prevention and treatment efforts; and we collaborate with investments pharmaceutical donation programs that provide access to life-improving and 4. Empower communities life-saving treatments at no or low cost. 5. Raise awareness and increase overall health outcomes

LEADING THE FIGHT AGAINST DISEASES OF POVERTY In 1974, one in ten people RAPID-IMPACT PACKAGE: ONE OF THE “BEST BUYS” IN PUBLIC HEALTH in West Africa suffered from river blindness The rapid-impact package contains four drugs – delivered in combination – that (onchocerciasis). Over the next three decades treat the seven most common NTDs. The rapid-impact package needs to be given only a groundbreaking global health partnership emerged once a year at approximately 50 cents per person. It is the reason why to face this threat. The fi ghting NTDs is referred to as one of the “best buys” in public health. Onchocerciasis Control Programme (OCP) and Merck Most of the drugs needed to treat NTDs are donated by the pharmaceutical & Co., Inc’s MECTIZAN Donation Program came industry. These donations are valued at hundreds of millions of dollars each year together to provide ochocerciasis control and allow for the treatment of millions of people living with NTDs. medication free of charge in 1988. By 2002, OCP and A UNIQUE CONTRIBUTION TO GLOBAL HEALTH Merck had produced Unlimited quantity of albendazole for 8 unprecedented results in GlaxoSmithKline Albendazole Donation treatment of lymphatic fi lariasis. Over 600 West Africa – transmission million treatments provided thus far of the infection was halted in 11 countries, 600,000 cases Total quantity required for treatment of of blindness were prevented, Merck & Co., Inc. Mectizan Donation onchocerciasis and lymphatic fi lariasis. Over and 22 million West African 539 million treatments provided since 1988 children were born free 120 million doses provided thus far, totaling Pfi zer Azithromycin Donation from risk of contracting the $912 million disease. The program has Johnson & 50 million tablets per year for treatment of soil freed 25 million hectares Mebendazole Donation of arable land, enough to Johnson transmitted helminths in children feed 17 million people per 200 million tablets of praziquantel for Merck KGaA Praziquantel Donation year. This increased land schistosomiasis control 2008-2017 area, coupled with improved MedPharm Praziquantel at Reduced Price Schistosomiasis control for $0.20 per treatment workforce productivity post-treatment, has paved the way for an increase of $3.7 billion in agricultural productivity in the region.

LEADING THE FIGHT AGAINST DISEASES OF POVERTY A UNIQUE APPROACH “I work as a volunteer and with very limited means, but I’m very Global Network members and public-private partnerships devoted to NTD happy, when I realize that [so many] control collaborate with local governments, schools, healthcare systems and of our people participated in the deworming campaign” organizations to deliver medications to those suffering from NTDs. We have Marc Bahemukiyiki, Community Drug also learned that some of the most effective delivery solutions come through Distributor in Rutsiro, Rwanda community-led efforts. Community members elect local drug distributors, who are trained to deliver integrated treatment, teach prevention methods, and monitor progress. In doing so, community members are invested in NTD control and become an integral part of their local healthcare system. These efforts are self-sustaining, creating a positive impact on the economy, education, and health of communities. 9

LEADING THE FIGHT AGAINST DISEASES OF POVERTY “Deworming is the single OUR APPROACH LIFTS PEOPLE OUT OF POVERTY most cost-effective way of keeping children in school.” INCREASES ACCESS TO EDUCATION. NTDs infect over 400 million school-aged - Michael Kremer, Harvard children throughout the developing world. Treating their infections is the single most University economist cost-effective way to boost school attendance, opening the door to growth and learning for the next generation of workers, thinkers and global leaders. Hookworm alone results in an overall 40% reduction in STRENGTHENS WORKER PRODUCTIVITY. Global NTD control could contribute future wage earnings among hundreds of billions of dollars to developing economies worldwide through increased those infected. worker productivity.

It is estimated that, in India IMPROVES MATERNAL AND CHILD HEALTH. Treating parasitic infections cuts alone, each year lymphatic rates of sickness and death among mothers and children. This is achieved by greatly 10 fi lariasis causes a US $1.5 reducing the prevalence of anemia and malnutrition, which causes 35% of the global billion loss in gross national disease burden in children under fi ve. product. EMPOWERS COMMUNITIES. Supporting treatment campaigns that directly involve communities in their own health care ensures sustainable success through the energy and commitment of local volunteers.

LEADING THE FIGHT AGAINST DISEASES OF POVERTY A GREATER IMPACT FOR YOUR INVESTMENT: Working to Achieve the NTD CONTROL REDUCES DEATHS FROM MALARIA AND OTHER DISEASES United Nations Millennium Development Goals NTD control promotes and improves the effi cacy of immunizations, vitamin and · Eradicate Extreme bed net distribution, and maternal and child health programs. A comprehensive Poverty and Hunger three-year, multi-country study found that integrated interventions delivered · Achieve Universal through a community-based approach doubled the coverage rate for malaria Primary Education treatment and bednet usage when combined with treatment for river blindness · Promote Gender (onchocerciasis). For less than a 10% add-on cost, combining NTD treatment with Equality and Empower Women current malaria control efforts signifi cantly reduces anemia-caused morbidity and mortality. NTD control is also a critical component of achieving the United Nations · Reduce Child Mortality Millennium Development Goals. Realizing the MDGs will help lift the bottom billion · Improve Maternal Health 11 out of poverty and allow families and communities to thrive. · Combat HIV/AIDS, Malaria and other Diseases · Ensure Environmental Sustainability · Develop a Global Partnership for Map of geographic overlap of moderate- Development high hookworm infection prevalence and Co-infection distribution transmission of falciparum malaria. From None High hookworm Broker et al, 2004. High malaria Both

LEADING THE FIGHT AGAINST DISEASES OF POVERTY

III. MAJOR STRIDES IN NTD CONTROL: WORKING TO END THE NEGLECT “I have mentioned at least one “perfect storm” With over one billion people infected with NTDs, brewing on the horizon. I elimination efforts were seen as a huge task. Although believe that control of the neglected tropical diseases existing public-private partnerships had made—and represents the opposite: continue to make—great strides in combating disease, a “perfect rainbow”. We a new integrated approach was required. In most now see a whole spectrum countries, children and vulnerable populations were of opportunities that have converged in a most suffering with three or more NTDs simultaneously harmonious way. Safe and – a condition referred to as “poly-parasitism.” Combining resources, tools and powerful drugs are being 13 expertise through an integrated approach would allow more people to receive the donated or made available benefi ts of treatment at signifi cantly reduced costs. at very low cost. Integrated approaches have been To generate support for an integrated approach, a group of committed devised for tackling several organizations formed and launched the Global Network at the 2006 Clinton Global diseases at once…Research Initiative Annual Meeting. President Clinton remains an important advocate and continues to document the improvements in poverty has raised the profi le of these diseases, leveraging new investments for NTD reduction and economic control from the Bill & Melinda Gates Foundation, Legatum (a global investment productivity when these group) and others. Now, new advocates and donors are continually joining the diseases are controlled. A effort, building off of decades of success in NTD control and elimination. perfect rainbow really can end in a pot of gold.” Together, we are working to end the neglect. Dr. Margaret Chan, Director-General, World Health Organization Sixty-fi rst World Health Assembly

LEADING THE FIGHT AGAINST DISEASES OF POVERTY China initially targeted LF MAJOR STRIDES: ELIMINATING THE NEGLECT in the 1950s, because it was one of fi ve diseases LYMPHATIC FILARIASIS (ELEPHANTIASIS) has been successfully controlled in draining the country’s agricultural productivity. China, Thailand, Sri Lanka, Suriname, Solomon Islands, Trinidad and Tobago, Egypt, With commitment and will, Costa Rica and Korea. Since the program started in 2000, over 1.9 billion treatments China broke the cycle of LF have been delivered. In 2007 alone, 546 million people around the world were treated transmission by distributing drugs on a mass scale and to prevent transmission of lymphatic fi lariasis (LF), commonly known as elephantiasis. fortifying table salt with ONCHOCERCIASIS (RIVER BLINDNESS) has been eliminated as a public health DEC, an anti-parasitic drug. problem in ten West African countries, to the benefi t of some 60 million people. Before implementation, The Onchocerciasis Elimination Program in the Americas (OEPA), through active 330 million people were at risk of infection. As of 1994, fi nancial and technical partnerships, is on the verge of eliminating onchocerciasis China achieved elimination in the Americas. 14 of LF. SCHISTOSOMIASIS (SNAIL FEVER) prevalence in Egypt has been reduced from around 20% to less than 1-2% over the past two decades. China has also made substantial progress in reducing the burden of schistosomiasis. In the past four years, in Uganda, Burkina Faso, Mali, Niger and Tanzania, prevalence rates and intensity of infection rates have been reduced. TRACHOMA (BLINDING TRACHOMA) prevalence globally has been reduced from 149 million cases in 1997 to 60 million cases in 2008, through the implementation of the World Health Organization’s integrated strategy of surgery, antibiotics, facial cleanliness, and environmental improvement (SAFE Strategy). Oman, Morocco and Mexico have eliminated blinding trachoma thanks to socioeconomic development and the continued support of the WHO. Another 15 countries are applying the SAFE strategy successfully to achieve sustained elimination of blinding trachoma.

LEADING THE FIGHT AGAINST DISEASES OF POVERTY BUILDING ON SUCCESS

We measure success in the fi ght against NTDs at multiple levels. At the individual level, we succeed every time a child is dewormed or a community drug distributor is trained. In the fi eld, we succeed every time we kickoff a treatment campaign and train community workers to keep the campaign running. And on the global level, we see success when our efforts result in ending the neglect - improving the lives of millions who will then contribute to economic growth in their countries. Over the past year, funds raised by the Global Network and mobilized to our partners working in the fi eld have achieved dramatic results.

BURUNDI • The majority of the population of Burundi is at risk for 15 infection with NTDs, especially soil-transmitted helminths (STHs)

BURUNDI • Deworming campaigns, implemented by the Burundi NTD team with support from cbm, in partnership with UNICEF and the Burundi Ministry of Health, have treated over 5 million people; more than one million school-aged children and adults were treated for schistosomiasis; and 8,000 volunteers were trained in NTD prevention and treatment

EQUATORIAL GUINEA • An alarming 42.6% of children under fi ve are stunted for their age and 69.3% are anemic, both conditions are due

EQUATORIAL primarily to worm infections; 100% of the population is GUINEA at risk for malaria

LEADING THE FIGHT AGAINST DISEASES OF POVERTY • Recently-funded integrated mapping was conducted for the control of major NTDs—including onchocerciasis, lymphatic fi lariasis (LF), loiasis, schistosomiasis and STHs— and found that individuals in each of the 17 districts are simultaneously infected with at least three of these diseases

ETHIOPIA • The majority of the 80 million people living in Ethiopia are at risk for NTDs • A deworming campaign lead by the Center for Emerging Tropical Diseases and AIDS (CEMTA) at Ben Gurion University, in partnership with The Earth Institute, the 16 Regional Health Bureau and MedPharm, is underway in the city of Mekele targeting 250,000 children and adults through schools and health centers • CEMTA is also working with local NGOs to incorporate deworming into their work, targeting both people living with HIV/AIDS in Addis Ababa and residents of Ziway in the Rift Valley

HAITI • Over 26% of the population is infected with LF, and many are co-infected with STHs • The University of Notre Dame’s Haiti Program, in conjunction with the Centers for Disease Control and Prevention and the Haitian Ministry of Health, has treated a remarkable 1.3 million Haitians for NTDs

LEADING THE FIGHT AGAINST DISEASES OF POVERTY • Over three million Haitians are estimated to receive treatments in late 2008 for LF and STH – over 1/3 of the population – through funds mobilized by the Global Network

MYANMAR • 70% of children are infected with least one of the STHs; 44.5% of pregnant women are infected with STHs • A number of organizations, including the Global Alliance to Eliminate Lymphatic Filariasis, in conjunction with the World Health Organization and the national government, are working to relieve the people of Myanmar of NTDs • In 2007, the Global Network mobilized funds for the purchase of 12 million tablets of non-donated drugs to treat 17 4 million individuals for LF; this in turn inspired matching funds that provided for an additional 4 million people to receive treatment

NIGER • Schistosomiasis Control Initiative, in partnership with the World Health Organization, UNICEF, RISEAL, and International Trachoma Initiative, has successfully distributed treatment for all seven of the most common NTDs to approximately 8 million people; over 18,000 people were trained—most of them as drug distributors—as part of a widespread initiative to increase health care capacity • In 2008, the Global Network mobilized funds for 11 hydrocele surgeries for LF; a workshop on improving surgical procedures was also provided to 33 local doctors LEADING THE FIGHT AGAINST DISEASES OF POVERTY RWANDA • On average, 65% of Rwandan school children are infected with intestinal worms; in the Northern Province, the prevalence rates reach 80% RWANDA • Deworming campaigns, implemented by the Access Project, in partnership with UNICEF and the Rwandan Ministry of Health, have treated more than fi ve million people; more than 200,000 school-aged children and adults at risk were treated for schistosomiasis; and 3,000 volunteer community health workers were trained

TANZANIA • Tanzania is endemic with all seven of the most common 18 NTDs; all regions are infected with schistosomiasis and STHs, with prevalence rates above 80% in certain areas; LF is the leading cause of disability, with prevalence rates up to 45% • Since 2005, the national government and organizations such as African Program for Onchocerciasis Control, Global Alliance to Eliminate Lymphatic Filariasis, Helen Keller International, International Trachoma Initiative and Schistosomiasis Control Initiative have integrated control activities for the seven most common endemic NTDs • In 2008, the Global Network mobilized funds for the fi rst integrated deworming campaign for approximately 1.9 million school-age children in six endemic regions of Tanzania: Rukwa, Morogoro, Singida, Manyara, Kilimanjaro and Arusha

LEADING THE FIGHT AGAINST DISEASES OF POVERTY SIGNIFICANT PROGRESS, BUT MUCH WORK REMAINS The World Health Organization estimates that While great strides have been made in controlling NTDs, signifi cant and sustained approximately $222 million investments are needed from the public and private sectors to treat the world’s is needed over the next four poorest citizens. These investments will not only lift people out of poverty, they will years for the purchase of save lives. non-donated drugs alone. Research has demonstrated that controlling just one disease – chronic hookworm – would improve future wage earnings by an extraordinary 43%. Controlling and ultimately eliminating all of the major NTDs is one of the most effective and least expensive means of improving education, workforce participation, and global health.

MASS DRUG ADMINISTRATION COVERAGE IN 2007 19

STH/Schistosomiasis 93%

Lymphatic Filariasis 61%

Onchocerciasis 56%

0% 20% 40% 60% 80% 100%

At risk population treated Untreated

LEADING THE FIGHT AGAINST DISEASES OF POVERTY

IV. GENERATING GLOBAL MOMENTUM

The work of the Global Network and its members is certainly ground-breaking, but “It quickly became clear that we know that we cannot win the fi ght against NTDs alone. As we spread the word this story is not just about the staggering numbers of the about NTDs, we have been fortunate to learn from and work in a number of new world’s citizens overwhelmed public and private sector partnerships. Expanding our global network ensures that by HIV, AIDS, TB, and we are maximizing effi ciencies, synergizing efforts on the ground, and reaching malaria. And it’s not just the story about one billion more people in need. people who are affl icted The Clinton Global Initiative’s Annual Meetings are perfect examples of the with disabling, oftentimes ways in which we look to build partnerships and generate momentum. In 2008, stigmatizing, neglected Dr. Peter Hotez had the honor of being invited to speak alongside President Bill tropical diseases..... What 21 struck me, and what I Clinton and share the successes of the Global Network and its members with an think struck us all...that audience of CEOs, celebrities, and world leaders alike. these challenges are all interconnected.”

POLITICAL WILL IS GROWING President Bill Clinton

The Global Network has raised signifi cant international awareness of NTDs, garnering support for the importance of an integrated, sustainable treatment model with proven results. In early 2007, these efforts led to the mobilization of more than $100 million from the US Congress toward the distribution of the rapid- impact package – a combination of medications to treat the seven most prevalent NTDs – in nine countries. This fi ve-year program is successfully treating millions of people annually in sub-Saharan Africa alone.

LEADING THE FIGHT AGAINST DISEASES OF POVERTY Other American leaders US GOVERNMENT MAKES MAJOR NTD ANNOUNCEMENT have also come forward explaining the importance The Global Network successes, along with the signifi cant work of the NTD community of foreign assistance and and emerging international momentum, led the US government in 2008 to announce a poverty alleviation. $350 million commitment for the control and elimination of NTDs over the next fi ve years. Colin Powell recently Proposed funding would target seven major NTDs and provide integrated treatment for remarked, hundreds of millions in Africa, Asia, and Latin America. “I think we have to do

a lot more with respect UNITED KINGDOM BACKS US COMMITMENT, PLEDGES 50 MILLION POUNDS to poverty alleviation and In the spring of 2008, the United Kingdom joined forces with the US during the helping the needy people European Union Summit to pledge $1.62 billion to health and health care workers, of the world. We need to including a commitment to NTD control. Prime Minister Gordon Brown announced the increase the amount of United Kingdom’s support for NTD control initiatives and challenged other donors— 22 resources we put into our including G8 partners, foundations, and organizations—to contribute to global NTD development programs to control efforts. In September of 2008, the United Kingdom, through the UK Department help the rest of the world. of International Development (DFID), took another momentous step in the fi ght against Because when you help the NTDs by committing 50 million pounds (approximately $100 million US) toward NTD poorest in the world, you control efforts around the world.

start to move them up an G-8 HIGHLIGHTS NTDS ON GLOBAL HEALTH AGENDA economic and social ladder, At its July 2008 meeting, the leaders of the G-8 clearly stated that the world can no and they’re not going to be longer turn its back on NTDs, calling for sustained action over the next three to fi ve moving toward violence or years to fi ght NTDs. This marked the fi rst time that NTDs were a prime focus of the terrorism.” G-8 leaders’ discussions, helping to generate an important dialogue around their burden and control.

LEADING THE FIGHT AGAINST DISEASES OF POVERTY NTD AMBASSADORS

FORMER US DEPARTMENT OF HEALTH AND HUMAN SERVICES SECRETARY TOMMY G. THOMPSON In July 2008, Tommy G. Thompson, former Secretary of the Department of Health and Human Services and four-term Governor of Wisconsin, announced his new role as Global Ambassador for the Global Network. Secretary Thompson is representing the NTD community as an advocate on Capitol Hill and as a leader in global health. Secretary Thompson will also champion global medical diplomacy as a crucial part of the United States’ foreign and defense policies. In his new role as Ambassador, Secretary Thompson travelled to Rwanda to witness the devastating impact of NTDs and participate in a week-long treatment campaign that successfully dewormed nearly 5 million pre-school and school aged children and expectant mothers. 23

ALYSSA MILANO CONTINUES HER IMPORTANT WORK Actress and philanthropist Alyssa Milano—an Ambassador for the Global Network since 2006—has demonstrated impressive commitment to the cause of NTD control through her words and actions. She has discussed NTD control efforts in many public venues and has shown sustained fi nancial dedication to the issue. In her fi rst contribution, she donated $45,000 for the purchase of non-donated drugs in Myanmar, and this year she donated an additional $55,000 for the purchase of non-donated drugs in Haiti. Both donations have helped programs on the ground to reach millions of those infected who might not have otherwise received treatment.

LEADING THE FIGHT AGAINST DISEASES OF POVERTY The Loose Change concept was GRASSROOTS ACTION created by a Rotary member after reading a 2007 New York LOOSE CHANGE Times column by Nicholas The Loose Change Initiative is the Global Network’s grassroots fundraising and Kristof. In the article, Kristof explains the devastating awareness campaign, designed to give individuals the chance to make an impact impact of NTDs, and the fact on the lives of the world’s poorest people by simply donating the change in their that approximately 50 cents can provide treatment for a pockets. person for the seven most Our message is simple: a donation of just 50 cents can provide treatment for common NTDs for an entire year. Motivated by the enormous the seven most common NTDs to an individual for an entire year. Loose Change personal impact that such a participants convert nickels, dimes, and quarters into meaningful change by small sum of money can make, the Rotary member began organizing collection drives in schools, workplaces, or communities. Loose Change collecting pocket change from campaigns have been successfully completed by various groups including: his fellow Rotarians during 24 • Rotary Groups meetings – within the fi rst four weeks, he raised over $600. • High Schools • University Students • International Student Groups

LEADING THE FIGHT AGAINST DISEASES OF POVERTY 7

REPORTS FROM OUR LOOSE CHANGE LEADERS AROUND THE WORLD

ALEX HUDDELL—PENNSYLVANIA, UNITED STATES “When I fi rst learned about NTDs, I was shocked. I could not believe how many were suffering when a simple, inexpensive treatment exists. To raise awareness and funds for this worldwide crisis, I designed a t-shirt and sold it in my high school. The front of the shirt read “ONE IN SIX”, to show that one in every six people worldwide are affected by NTDs, and the back read “50¢ for seven cures” to explain the cost of treatment per person per year. The campaign was hugely successful! What amazed me was that the coins people gave during lunches amounted to $100 and the grand total raised was more than $1,300! Considering that there were only 1,300 students total in my school, the participation was incredible.” [Alex has since then raised an additional $1,100 from her church community.]

CHI CHI NWAFOR—HOKKAIDO, JAPAN “The Secretary General of the United Nations, during his discussion with students of Hokkaido University, emphasized the consequences of NTDs and how the youth should help to curb these 25 effects. Through our Loose Change efforts, I think we have done our best in disseminating the message of NTDs to the youth in Hokkaido, Japan.”

FLOOR TILMANS—THE NETHERLANDS “Our Loose Change Campaign at Leiden University raised about 60 Euros (approximately $100 USD). While that’s not much, it is enough to treat 200 people suffering from NTDs. More importantly, we have raised awareness about NTDs and the Global Network among the university community, so that’s good!”

EMILY MOODY—MINNESOTA, UNITED STATES “I was really happy with our campaign at the University Of Minnesota School Of Medicine! People were really interested in the campaign and in tropical diseases in general.” [Emily and her friends raised over $730.]

LEADING THE FIGHT AGAINST DISEASES OF POVERTY

V. LOOKING FORWARD

We are truly at a tipping point. Through our collaboration with communities, NTD experts, and global leaders, we are raising the profi le of NTDs around the world; individuals, communities, and global leaders alike are beginning to take action. We have seen signifi cant achievements, but much work remains.

With your help, we can end the neglect.

“Now, more than ever, we must be bold. In these times of crisis, when we 27 are tempted to look inward, it is precisely the time when we must move pursuit of the common good to the top of the agenda. Global solidarity is necessary and in the interest of all. Pursuing the common good will require addressing a set of global challenges that hold the key to our common future.”

UN Secretary-General Ban Ki-moon, October 2008

LEADING THE FIGHT AGAINST DISEASES OF POVERTY

VI. SABIN VACCINE INSTITUTE

HOME OF THE GLOBAL NETWORK FOR NEGLECTED TROPICAL DISEASES

The Global Network for Neglected Tropical Diseases is an initiative of the Sabin Vaccine Institute, whose mission is to reduce suffering from infectious and neglected tropical diseases. Founded in 1993, Sabin, a 501c3 non-profi t organization, builds bridges between leaders in science, academia, industry, and government to conduct research and create science-based solutions to worldwide health threats. Through its bio-medical and scientifi c perspective, innovative approaches and network of global partnerships, Sabin is working toward a world free of needless suffering. Sabin’s work focuses on research and advocacy to achieve the ultimate impact 29 of reducing suffering. In addition to the Global Network for Neglected Tropical Diseases, Sabin’s other research and advocacy initiatives include:

Vaccine Research & Development: (in partnership with The George Washington University) Human Hookworm Vaccine Initiative Schistosomiasis Vaccine Initiative

Vaccine Advocacy: Pneumococcal Awareness Council of Experts (PACE) Sustainable Immunization Financing Domestic and international symposiums

LEADING THE FIGHT AGAINST DISEASES OF POVERTY BOARD OF TRUSTEES Through the leadership of Sabin’s Board of Trustees and the expertise of our founding members, the Global Network has established itself as a world leader in the fi ght against NTDs. Without these dedicated individuals, the success of the Global Network would not be possible.

Morton P. Hyman Louis Z. Cooper, M.D. Chairman Professor of Pediatrics Sabin Vaccine Institute College of Physicians and Surgeons of Columbia University Ciro de Quadros, M.D., M.P.H. Executive Vice President Jeffrey A. Fuisz, Esq. Sabin Vaccine Institute Kaye Scholer LLP 30

Allan L. Goldstein, Ph.D. Lance Gordon, Ph.D. Professor and Chairman President & CEO Dept. of Biochemistry and Molecular Biology ImmunoBiologics Corporation The George Washington University Axel Hoos, M.D., Ph.D. Alan E. Greenberg, M.D., M.P.H. Group Director Professor and Chair Global Clinical Oncology Dept. of Epidemiology and Biostatistics Bristol-Myers Squibb Professor, Depts. of Medicine; Microbiology, Immunology, & Tropical Medicine Peter J. Hotez, M.D., Ph.D. The George Washington University President, Sabin Vaccine Institute Distinguished Research Professor The George Washington University

LEADING THE FIGHT AGAINST DISEASES OF POVERTY Kevin L. Reilly Adan Rios, M.D. Independent Director The University of Texas President (Retired) Health Science Center at Houston Wyeth Vaccines and Nutrition James Scott, M.D., F.A.C.E.P. Philip K. Russell, M.D. Dean, School of Medicine and Chairman of the Executive Board Health Sciences Human Hookworm Vaccine Initiative The George Washington University

H. R. Shepherd, D.Sc. Michael E. Whitham, Esq. Founding Chairman Whitham, Curtis, & Christofferson, P.C. Sabin Vaccine Institute

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LEADING THE FIGHT AGAINST DISEASES OF POVERTY TECHNICAL COLLABORATORS African Programme for Onchocerciasis Control Inter-American Development Bank Ben Gurion University of the Negev International Trachoma Initiative CBM Liverpool School of Tropical Medicine Deworm the World Pan American Health Organization The Earth Institute at Columbia University PhRMA/Global Health Progress The George Washington University Schistosomiasis Control Initiative Global Alliance to Eliminate Lymphatic Filariasis Task Force for Child Survival and Development Helen Keller International World Health Organization

GLOBAL NETWORK TEAM Peter J. Hotez, MD, Ph.D. Kari Stoever President Managing Director Sabin Vaccine Institute Clarence Daryl Edwards 32 Brian Davis Policy Director Chief Operating Offi cer Lindsay Wheeler Karen Palacio Research Associate Program Offi cer Suzanne Levy Erin Hohlfelder Fellow Program Coordinator

ADDITIONAL PROGRAM SUPPORT PROVIDED BY The Endeavor Group Home Front Communications LMW Strategies

LEADING THE FIGHT AGAINST DISEASES OF POVERTY SPECIAL THANKS TO OUR SUPPORTERS The work of the Global Network is greatly aided by generous contributions from foundations, corporations and private donors. We appreciate all of our supporters over the past two years and look forward to many more years of collaboration in the fi ght for global NTD control. • BILL & MELINDA GATES FOUNDATION • ANDREA AND CHARLES BRONFMAN PHILANTHROPIES • ROK CEFERIN • EXXON MOBIL • GENEVA GLOBAL • GOOGLE • DANIEL W. HILDRETH • MORTON P. HYMAN • LEGATUM • ALLAN LEWIS • MAJOR LEAGUE CENTRAL FUND • ERIN MALONEY • ALYSSA MILANO 33 • SUSAN PAINE P• P• hRMA/GLOBAL HEALTH PROGRESS • TIDES FOUNDATION • TIG GLOBAL • TOMMY G. THOMPSON • RICHARD WOLFENDEN • ROY ZUCKERBERG

SPECIAL THANKS TO THE PHARMACEUTICAL INDUSTRY In recent decades, the pharmaceutical industry has amassed an impressive track record of partnering with non-governmental organizations on large-scale treatment campaigns for NTDs. We would like to thank the following companies for their tireless commitment, which has enabled great strides in NTD control. • GLAXOSMITHKLINE • JOHNSON & JOHNSON • MEDPHARM • MERCK & CO. • MERCK KGAA • NOVARTIS • PFIZER INC. • SANOFI AVENTIS LEADING THE FIGHT AGAINST DISEASES OF POVERTY

VII. FINANCIAL REPORT

SABIN VACCINE INSTITUTE EXPENDITURE ALLOCATION

JAN 1, 2007 TO DEC 31, 2007 JAN 1, 2008 TO SEP 30, 2008 (INTERIM)

1% 6% <1% 5%

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93% 95%

Program expenditure General & administrative expenditure Fundraising expenditure

LEADING THE FIGHT AGAINST DISEASES OF POVERTY SABIN VACCINE INSTITUTE / STATEMENT OF ACTIVITIES January 1, 2008 to September 30, 2008* January 1, 2007 to December 31, 2007 Revenue and support $15,986,478 $16,608,260

Program services 10,531,304 11,568,628 Support services: General and administrative 520,944 11,568,628 Expenses Fundraising 34,544 108,623 Total supporting services 555,498 858,303

Total expenses 11,086,802 12,426,931

Change in net assets 4,899,676 4,181,329

Net assets, beginning (adjusted) 10,853,940 6,677,329

NET ASSETS, ENDING $15,353,616 $10,858,658

GLOBAL NETWORK / STATEMENT OF ACTIVITIES January 1, 2008 to September 30, January 1, 2007 to December 31, 2007 2008* Revenue and support $4,618,967 $2,968,466

Program services 3,141,184 2,278,190 Support services: General and administrative 0 0 Expenses fundraising 0 0 Total supporting services 0 0

Total expenses 3,141,184 2,278,190

Change in net assets 1,477,783 690,276 36 Net assets, beginning 676,522 (13,754) NET ASSETS, ENDING $2,154,304 $676,522

SABIN VACCINE INSTITUTE / BALANCE SHEET September 30, 2008* December 31, 2007

Current assets Total cash $11,649,929 $11,782,256 Total account receivable 7,790,384 212,770 Total other current assets 685,204 965,097 Assets Total current assets 20,125,516 12,960,123 Total fi xed assets (net of depreciation) 42,120 56,052 Total other assets 12,298 17,327

TOTAL ASSETS $20,176,934 $13,033,503

Current liabilities Liabilities Total accounts payable $1,072,612 $393,078 Total other current liabilities 3,345,816 1,773,877 Total current liabilities 4,418,428 2,166,955 Total long term liabilities 7,890 7,890

Liabilities & Total liabilities 4,426,318 2,174,845 net assets Net assets-unrestricted 1,438,807 927,022 Net assets-temp restricted 14,314,809 9,931,636

Total net assets 15,753,616 10,858,658

TOTAL LIABILITIES & NET ASSETS $20,179,934 $13,033,503

* Please note the 2008 fi gures are reported through the third quarter. LEADING THE FIGHT AGAINST DISEASES OF POVERTY