SABIN INSTITUTE Partnering for a Healthier World

1 TABLE OF CONTENTS 02 Letter from the Chairman and CEO 03 Message from the President

05 The Sabin Story 06 Why We Fight Diseases of Poverty 08 2010 in Review 11 Measuring Success

Program Updates 12 Vaccine Advocacy and Education 16 Vaccine Development 20 Global Network for Neglected Tropical Diseases

Profiles 24 Profile 1: NTD Vaccine Development 26 Profile 2: Ending the Neglect in Burundi 28 Profile 3: Financing in Cambodia

30 Our Partners 32 Board of Trustees and Staff 34 Financials 36 Sabin Scholar Awards and Appointments 37 In Memoriam

To reduce needless human suffering from vaccine- preventable and neglected tropical diseases by developing new , advocating for increased use of existing vaccines, and promoting expanded access to affordable medical treatments. 2 Sabin Annual Report 2010 1 from the from the Letter Chairman and CEO Message President

Dear Sabin Supporters: Sabin’s Vaccine Advocacy and Education initiative Dear Friends: Relocating the vaccine program to TMC will allow advances policies that improve access to vaccines our team of a dozen scientists and support staff to We are pleased to present the Albert B. Sabin Vaccine which prevent transmission of a multitude of As you will read in the pages that follow, 2010 was embark on new collaborations for vaccine discovery, Institute’s 2010 Annual Report and to share with infectious diseases. Spurred on by our Sustainable particularly notable for our efforts to control and delivery, and testing, at a world-class institution you our most significant developments since our last Immunization Financing program, seven of 15 ultimately eliminate neglected tropical diseases, the in a major gateway city to . Both the letter. As this report makes clear, the breadth and target countries increased their immunization budgets most common afflictions of the world’s poorest and vaccines will undergo scope of Sabin’s three principal programs have grown and nine countries began writing new immunization billion people. clinical development and ultimately industrial significantly as we continue to play a leadership financing legislation. The Coalition against scale manufacture in , and we plan to develop role in the global fight against vaccine-preventable Typhoid, a new program launched in 2010, quickly In the area of research and development, our vaccine a vaccine in Mexico. and neglected tropical diseases (NTDs). became a major resource for countries seeking to development program and PDP—the Sabin Vaccine develop implementation policies and secure funding Institute Product Development Partnership—advanced In the area of policy and delivery, our Global Network While progress continues to be made in bringing new for World Health Organization (WHO) prequalified three new “anti-poverty vaccines” to combat NTDs. for Neglected Tropical Diseases, under the direction vaccines and treatments to the market, there remains typhoid vaccines. The two components of our human hook- of Dr. Neeraj Mistry, continues to make great progress a large gap in getting life-saving interventions to worm vaccine were successfully manufactured and in elevating the profile of these conditions, and we the world’s poorest people. Millions of children still Another core initiative, the Global Network for we submitted regulatory filings in the U.S. and look forward to revealing some innovative approaches die each year because they are not being vaccinated. Neglected Tropical Diseases, expanded its advocacy Brazil prior to anticipated clinical testing in Brazil. to “get the word out” about these conditions in the Nearly 1.4 billion people remain trapped in poverty, and resource mobilization for integrated NTD treatment Our will also soon be manu- coming months. At the same time, Dr. Ciro de Quadros in part because they do not have access to medicines programs, also known as mass drug administrations factured and we launched efforts to make a new leads an incredibly effective effort to expand global —many of which are donated by pharmaceutical or MDAs. Through MDAs, for approximately $0.50 per Chagas disease vaccine. We continue to be deeply access of all major childhood vaccines as well as firms—that offer effective treatment against the seven person, we can treat and prevent up to seven grateful to the Bill & Melinda Gates Foundation and to ensure that the “decade of vaccines” meets its most prevalent NTDs. To avoid drug resistance NTDs for a year. Working with a range of international the Brazilian Ministry of Health for their unwavering ambitious targets. problems in the future and provide definitive, long- partners, we developed regional funds that will support of the , now joined with term solutions, vaccines for some of these diseases efficiently channel donations to NTD control programs a major co-investment from the Dutch Ministry of With the move of the Sabin vaccine development labs must be developed. Sabin exists to bridge these gaps in , Latin America, and the Caribbean. Foreign Affairs. For the schistosomiasis vaccine, the to Houston, I will also become the founding Dean of by providing poor and underserved communities ongoing support of the Blavatnik Family Foundation, a new National School of Tropical Medicine, the first around the world with better access to vital medical To further these initiatives and programs, we formed and Mort and Chris Hyman, and now the National of its kind in the United States, at Baylor College of treatments and vaccines. an affiliate in the United Kingdom, Sabin Foundation Institute of Allergy and Infectious Diseases of the U.S. Medicine. I invite you to come and visit our labs in Europe. Its leaders will focus on expanding awareness National Institutes of Health, has been absolutely Houston, Texas and enjoy one of the most culturally Sabin continues to pioneer the development of and support of the Sabin mission throughout Europe. critical. We are equally grateful for the new support of vibrant and international cities in the U.S.! low-cost vaccines to prevent human hookworm, the PDP by the Carlos Slim Health Institute in Mexico schistosomiasis, and other diseases. Our unique Sabin plays a unique and vital role in providing to begin efforts for a new therapeutic vaccine for Warmest regards, vaccine product development partnership (PDP), which solutions to the health burdens of the world’s poor Chagas disease and related . involves collaborators from across the globe, including and we will remain at the forefront of the fight against Brazil, Australia, and , recently grew in stature diseases of poverty. We truly appreciate your Our expansion into additional vaccines beyond and scope through a new affiliation with Baylor College generous contributions, which are the foundation of hookworm and schistosomiasis coincides with the of Medicine (BCM) and Texas Children’s Hospital our success, and look forward to working with relocation of our vaccine development laboratories Peter J. Hotez, MD, PhD (TCH), which now host the PDP. The addition of these you to overcome these global challenges in the years to Houston, Texas. In September 2011, our product President, prestigious institutions and their financial support will to come. development laboratories moved to a state-of-the- enable us to significantly expand our capacity to art, 20,000 square foot facility at the Feigin Center develop and deliver vaccines for a range of diseases Sincerely, of Texas Children’s Hospital and Baylor College affecting the poorest people around the globe. of Medicine, located in the renowned Texas Medical In addition, our partnership with these two world- Center (TMC), the world’s largest medical center. renowned institutions provides an important link Morton P. Hyman Michael W. Marine Texas Children’s Hospital and Baylor College of between our research and treatment initiatives and Chairman of the Board Chief Executive Officer Medicine will become major investors in the Sabin the BCM/TCH network of pediatric centers of of Trustees Vaccine Institute PDP. excellence across Africa.

2 Sabin Annual Report 2010 3 The Sabin Honoring a lifetime of scientific achievement by pioneering new Story health solutions for the world’s poor.

In 1993, the Albert B. Sabin Vaccine Institute was diseases by working with leading health agencies, founded in honor of one of the most influential pharmaceutical companies, and senior government scientists of the 20th century. Over time, Sabin grew officials to expand the demand for and reduce the into a leading advocacy and scientific organization price of these lifesaving vaccines. Ultimately, dedicated to developing lifesaving vaccines and governments must prioritize immunization policies expanding access to existing vaccines and medicines and adopt measures for programs to be for the poorest people around the world. paid out of their own national budgets. To help meet these sustainability goals, Sabin works with Since its inception, Sabin has placed a premium low-income countries to strengthen and pay for on the value of partnerships for addressing complex immunization programs themselves. challenges. Our three main programs —the Sabin Vaccine Institute Product Development As researchers, scientists, and advocates, we Partnership, the Global Network for Neglected Tropical understand that making a positive impact on global Diseases, and Vaccine Advocacy and Education— health outcomes requires time, but we are still driven fulfill distinct, yet complimentary, missions to achieve to make a difference now. So we are exploring new better health for the world’s poor. We work closely channels of communication to tell the story of NTDs with a wide range of entities—including global and encourage diverse groups to collaborate on policymakers, development agencies, program solutions. We are encouraging government leaders implementers, and academic institutions—to deliver to increase funding and to consider new approaches effective and sustainable health solutions. to financing immunization programs. And we are continually expanding our partnerships to ensure that Our mission has evolved over the past 18 years a multitude of perspectives are considered. to meet the emerging needs of a rapidly developing world still plagued by preventable diseases. It is in this way that we honor the legacy of Dr. Sabin We remain focused on creating the first vaccines while continuing to deliver on the promise of a for devastating diseases that affect over a billion healthier future for millions of people around the world. people living in poverty. While those vaccines are in development, we expanded our scope of work to include advocating for and facilitating the use of existing drugs to treat the seven most prevalent neglected tropical diseases (NTDs). This allows us to meet immediate human needs until new vaccines can be developed.

Far too many children die each day from diseases that can be prevented. From the first day Sabin opened its doors, we have championed increased access to Dr. Albert B. Sabin existing vaccines for a range of deadly yet preventable

4 Sabin Annual Report 2010 5 Why we fight diseases At a cost of approximately 50 cents, per person per year, we can provide protection from seven of poverty of the most common NTDs for an entire year.

Diseases of poverty are aptly named: they affect people living in extremely poor conditions and trap people in a cycle of poverty because they leave children unable to learn and undercut adults’ ability to work productively. They disproportionately target infants and young children, prevent children from ever reaching their full potential, and keep mothers from having healthy pregnancies. When pneumococcal virus, or typhoid, or schistosomiasis strikes a child or parent, a family is destabilized. When these diseases occur at endemic levels, as they frequently do, the development of an entire nation can stall.

We believe that access to vital medicines and vaccines should be a basic service that governments Sustainable results require an unwavering, long-term guarantee for their people; and that populations commitment to see the end of these diseases. We free from the burden of preventable diseases know most can be controlled and eventually eliminated are better equipped to focus successfully on building for a relatively low cost and in a period of time that is their societies. measured by years, not decades or lifetimes. We also have emerging evidence that the effects of treating The tools to fight many of the worst diseases NTDs can have widespread positive impact on efforts already exist, but tragically remain out of reach for to reduce the rates of of HIV/AIDS, many of those who need them. Sabin works with and tuberculosis. global partners at the highest levels of government, business, and society to break down the logistical Our job is to educate, eliminate barriers, and lead and financial barriers to delivering existing lifesaving scientific discovery on behalf of nearly two billion vaccines and treatments. We leverage the generosity people still affected by NTDs and vaccine preventable of partners who have diseases. Our goal is to help them achieve a life donated billions of dollars of NTD medications by worth living. encouraging national governments to undertake The Sabin Vaccine Institute PDP annual, low-cost mass drug administrations (MDAs) is a one-of-a-kind organization. to treat and eliminate NTDs as a threat. Its science is absolutely novel We also fill a critical market gap by pioneering the and unique, and the potential of research and development of new, affordable vaccines its work to impact public health to prevent the NTDs with the highest health burden. in the world’s poorest countries is unparalleled.

Physician-in-Chief Texas Children’s Hospital 6 7 1. 2010 Summary of our In Review accomplishments 1.

1. 1. We pushed boundaries by We increased funding for fighting DISEASES OF POVERTY by Encouraging more than 50 countries to introduce pneumococcal vaccines Raising nearly $20 million in new funding for 1. 1. into their national immunization programs vaccine development, advocacy for vaccine 1. access, and expansion of NTD treatment Creating a major advocacy program programs around the world to promote universal access for typhoid vaccines Creating and expanding regional funds in Africa and Latin America and the Caribbean Making significant progress in the

1. development of a schistosomiasis vaccine Leveraging $2.18 million through partners and two hookworm vaccine , such as the Inter-American Development registering one with the U.S. Food and Drug Bank, Fundacion , and University

1. Administration for Phase 1 clinical trials of Notre Dame, directed to control programs in Latin America Supporting NTD control programs in 1. Rwanda and Burundi that delivered more Helping to persuade the U.S. government 1. than 16 million treatments during to raise NTD funding from $25 million in 2009 1. mass drug administration campaigns1. to $65 million in 2010

We connected with We spread the word through 1. 500,000 web site visitors and posted 535 news articles 415 blog entries 13 broadcast appearances 10 op-eds 4,600 Twitter followers 1. 21 journal articles

71 panel/key speaking opportunities We expanded our impact by cultivating Nearly 200 meetings with global More than 100 partners policymakers

Operational or program partnerships in 40 countries

8 9 MEASURING Among the key milestones SUCCESS we are working toward are:

Reducing the global prevalence of typhoid fever, Encouraging greater integration between pneumococcal disease, meningococcal disease, neglected tropical disease (NTD) control and other human papillomavirus, pertussis, polio, measles, health programs such as water and sanitation, HIV/ rotavirus, and rubella AIDS and malaria prevention programs

Achieving World Health Organization Raising $250 million from G8/G20 prequalification for at least two typhoid vaccines governments and other sources to support NTD mass drug administration Promoting the creation of a supply and distribution system for two, first-ever vaccines to be Developing and institutionalizing regional introduced over the next several years funding mechanisms in Africa, Latin America and the Caribbean, and Asia Successfully implementing vaccine immuni- zation finance legislation and funding mechanisms in Supporting ongoing pharmaceutical donation 15 pilot countries programs for vital NTD medicines and ensuring the effective use of these critical donations Bringing vaccine candidates for human hookworm, schistosomiasis and other NTDs through phase 3 The partnership developed over clinical trials, licensure, and large scale manufacture the last few years between the Global Network and PAHO and the Increasing the level of awareness of the adverse Inter-American Development Bank impact of NTDs and what can be done to control has led to significant gains for a them among general populations and policymakers number of Latin America’s most Promoting the creation and execution of national vulnerable populations. Together government, multi-year plans for NTD mass drug we have supported several administration in all endemic countries countries to design and carry out needed surveys for NTDs in neglected communities, map and model diseases, develop national integrated plans of action for NTDs and obtain deworming tablets to help keep many young children healthier and in school.

Regional Advisor for Parasitology and Neglected Tropical Diseases Pan American Health Organization (PAHO) 10 Sabin Annual Report 2010 11 VACCINE Rubella virus... ADVOCACY AND Text to come Saving lives through better EDUCATION access to existing vaccines Speakers at the 9th International Rotavirus Symposium in Rubella Virus, US Department Johannesburg, South Africa organized by Sabin Vaccine Institute of Health and Human Services

Following on a century of steady advancements in Our Vaccine Advocacy and Education program is medical and vaccine science, the Bill & Melinda Gates one of the only groups in the world bringing leaders Foundation has heralded the next ten years as the together to tackle the complex issues that prevent “Decade of Vaccines,” underscoring the imperative to vulnerable populations from receiving the vaccines extend access of low-cost, effective vaccines to all they need to live healthy, productive lives. We serve populations. At Sabin, we believe access to vaccines as an independent, honest broker as groups with is a basic human right, on a par with access to different agendas seek common ground for the sake safe drinking water. We capitalize on a rich history of of better vaccine policies. vaccine expertise to advocate at the highest levels of government, in the private sector, and among civil We focus our advocacy and education attention society, to develop sustainable access to lifesaving on diseases that already have proven vaccines vaccines for all people. available, but which are not currently accessible to those who need them. Among these diseases are typhoid fever, pneumococcal disease, menin- gococcal disease, human papillomavirus, pertussis, polio, measles, rotavirus, and rubella. Together, these diseases account for more than three million preventable deaths annually.

Dengue fever is another focus area. No vaccine for dengue presently exists, although the disease affects more than 100 countries worldwide and imposes a significant economic burden on governments and individuals. No drugs are available to prevent or treat dengue infections, making the need for a widely accessible vaccine all the more urgent. Several dengue vaccines are in development, and Sabin is leading the advocacy work of the Initiative to prepare governments for their swift introduction to affected communities.

Beyond preventing high levels of mortality, morbidity, and disability, controlling these diseases helps communities lift themselves out of poverty by ensuring that kids stay healthy and in school, and parents stay productive. Eliminating the threat of disease also strengthens political stability and greater social justice, two crucial elements of vibrant societies.

12 Sabin Annual Report 2010 13 In response to a major gap in advocacy for typhoid During 2010, seven of the SIF countries increased vaccines, the Bill & Melinda Gates Foundation their immunization budgets and nine countries awarded Sabin a three-year, $3 million grant to serve began writing new immunization financing legislation. as the secretariat for the Coalition against Typhoid Passing this legislation will ensure that immunization (CaT), a global forum of health and immunization budgets are protected by law. experts dedicated to improving access to low-cost typhoid vaccines in poor communities around Though there has been progress with immunization the world. financing, much remains to be done. By 2010, the 15 SIF pilot countries were financing just $11 of the $30 We at Sabin believe it is important to challenge needed to provide a child with the basic immunization the existing, heavily donor-dependent immunization package. The SIF program will focus increasingly in financing practices followed by many national the coming years on implementation—taking the best governments in the developing world. We do this practices to scale and finding local capacity to build by taking a “bottom-up” approach, working with solutions on a country-specific basis. national government officials, parliamentarians, and the domestic private sector through our Sustainable Immunization Financing (SIF) program. We encourage governments to use their immunization programs as vehicles to improve their budgeting and financial management capacities. The SIF program documents and disseminates best practices and arranges peer exchanges among the 15 SIF pilot countries.

Bill Gates, David Oshinsky, Pulitzer Prize-winning author of “Polio: An American Story,” and Dr. Ciro de Quadros, Sabin’s Executive Vice President

In 2010, the Vaccine Advocacy and Education team led efforts to create greater attention on the 2011 Highlights: prevention of pneumonia and diarrheal diseases. Vaccine Advocacy and education The Pneumococcal Awareness Council of Experts (PACE) hosted a symposium for officials from the In collaboration with the Coalition against Typhoid The SIF program held its first International Eastern Mediterranean region to increase access to (CaT), the World Health Organization (WHO) Colloquium in Addis Ababa, Ethiopia, where more pneumonia and diarrheal disease vaccines. At this granted prequalification for the first . than 100 delegates representing ministries of health conference, country representatives agreed on the This is a major advancement toward universal access and finance from 18 African, Asian, and Latin need for the region to form a funding mechanism and for typhoid vaccines, as it allows the United Nations American countries convened to discuss sustainable pledged to work together to develop one. PACE Children’s Fund (UNICEF), other UN agencies, immunization financing strategies, initiatives, also played a key role in successfully advocating to and the Pan American Health Organization (PAHO) and achievements. make pneumococcal vaccines available at affordable Revolving Fund to procure the vaccine. WHO prices throughout the developing world. Since prequalification also is a prerequisite for GAVI In partnership with Universidad Peruana Cayetano PACE’s inception in 2006, over 50 countries introduced Alliance support. Heredia, Sabin convened a two-day training session pneumococcal vaccines in their national in Lima, Peru, for 30 global health journalists from immunization programs. The Dengue Vaccine Initiative was officially 17 countries in the Americas. launched to focus on introducing and maintaining In August 2010, in conjunction with Fogarty a pipeline of vaccine candidates. The DVI is a International Center of the U.S. National Institutes consortium consisting of the International Vaccine of Health, the Bill & Melinda Gates Foundation, and Institute, the WHO, the International Vaccine Access Brazil’s Fundação Oswaldo Cruz (FIOCRUZ), Center at Johns Hopkins University, and Sabin Sabin convened a 30th anniversary symposium on Vaccine Institute. smallpox eradication to discuss the global campaign and how its lessons and legacies relate to current global health priorities.

14 Sabin Annual Report 2010 15 VACCINE Pioneering NTD DEVELOPMENT vaccine development

Sabin’s vaccine development program marked clinical trials later in the year. In addition to the work its 10-year anniversary in 2010. More than one billion completed on Na-GST-1 in 2010, significant progress people around the world live at risk of hookworm was made in developing the manufacturing process and schistosomiasis infection. Typically, those affected of a second hookworm vaccine antigen, Na-APR-1. by these diseases are among the planet’s poorest Of note, cell banks were produced to manufacture people, providing little financial incentive for traditional this antigen in tobacco plants in collaboration with vaccine makers to tackle these problems. In 2000, the Fraunhofer Center for Molecular Biotechnology. Sabin led a group of committed organizations from around the world to form a product development Because its victims are among the poorest people in partnership (PDP) to fill this gap. the world, hookworm disease remains unknown to many in developed economies even though it affects In its first decade, the Sabin PDP established itself as nearly 600 million people. Hookworm is an intestinal a leader in the adaptation of the PDP model for parasite that causes internal loss leading NTD vaccine production of “anti-poverty vaccines.” to iron-deficiency and protein , The PDP has leveraged world-class clinical testing particularly in pregnant women and children. and process development resources from such Chronic in children contributes partners as FIOCRUZ and Instituto Butantan in Brazil; to physical and intellectual impairment, learning James Cook University in Australia; London difficulties and poor school performance. Hookworm School for Hygiene and Tropical Medicine in the United is a serious global concern contributing to an Kingdom; The Institute for Parasitic Diseases, estimated 43 percent reduction in future wage earnings Chinese Centers for Disease Control and Prevention; in affected areas. and The George Washington University in the United States. Recently we made a major expansion to In December 2010, the Sabin PDP was awarded a the PDP through an affiliation with Baylor College of four-year grant in the amount of 5.9 million euros ($8.5 Medicine and Texas Children’s Hospital, where million) from the Dutch Ministry of Foreign Affairs to our product development labs will be located as continue development of a hookworm vaccine. The of September 2011. The move includes a $40 million Sabin Vaccine Institute is confident that this grant commitment over ten years by Texas Children’s and continued support from many other organizations Hospital and Baylor College of Medicine. and individuals, including the Bill & Melinda Gates Foundation and the Brazilian Ministry of Health, will one In 2010, the PDP completed preparation of an day result in a safe, low-cost, and effective vaccine Investigational New Drug (IND) application for the for hookworm. Na-GST-1 hookworm vaccine antigen. Sabin submitted the IND application for the Na-GST-1 vaccine to the U.S. Food and Drug Administration (FDA) in January 2011 and will begin Phase I

Magnified hookworm

16 Sabin Annual Report 2010 17 While working toward a vaccine to prevent hookworm The Sabin PDP is developing a promising vaccine disease, the program also adapted its novel approach antigen identified as Sm-TSP-2 that will target 2011 Highlights: for other diseases afflicting poor people around the the main cause of intestinal/liver schistosomiasis, Vaccine Development world. Using the PDP blueprint, Sabin also conducted mansoni. We completed production work to develop vaccines to prevent schistosomiasis of antigen cell banks and are transferring the Relocated the laboratories of Sabin Vaccine Utilizing plant-based expression technology, Sabin and malaria in 2010, and advanced a Chagas disease manufacturing technology for this vaccine to two Development from The George Washington University collaborated with iBio, Inc. and the Fraunhofer vaccine initiative. partners: Instituto Butantan in Brazil and Aeras in to Baylor College of Medicine and Texas Children’s Center for Molecular Technology to successfully the United States. Hospital. The move and the accompanying budget manufacture the Na-APR-1 hookworm vaccine, Schistosomiasis, like hookworm, causes anemia, support of $40 million dollars over ten years which will be tested in an animal toxicology study impairs physical growth, and limits cognitive Vaccine development is a process that can take represent a major, new investment to develop vaccines in the second half of 2011 and will enter clinical development. It also can cause severe damage to the many years to produce a safe and efficacious for the world’s poor. The priorities are to continue our trials in 2012. internal organs of its victims. It is estimated that candidate for human use. The past several years cutting edge work on hookworm and schistosomiasis over 200 million people around the world are afflicted marked a period of tremendous exploration and vaccine development. The first new targets will be Received a two-year, $12 million grant from the by schistosomiasis. discovery for the Sabin PDP team. As a result, to accelerate the Sabin PDP’s work on a vaccine for Bill & Melinda Gates Foundation (BMGF) to fund we are on the path to delivering the world’s first Chagas disease. continued development of the Na-GST-1 and vaccines for hookworm, schistosomiasis, and Na-APR-1 hookworm vaccines through Phase 1 Chagas disease. clinical trials. Prior to this grant, BMGF had funded our hookworm vaccine research from 2000 to 2010.

Freshwater snails carrying the parasite Schistosoma

18 Sabin Annual Report 2010 19 global network FOR Neglected Promoting mass drug Tropical Diseases administration for NTDs

Imagine feeling as though you have just donated a Many of those afflicted by NTDs are children—half a pint or two of blood, every day for the rest of your life. billion in all. Many others are young girls and pregnant Or that you are slowly losing your eyesight because women. Generation after generation of people living your eyelashes are curling inward and scratching your in the poorest parts of the world who are unable corneas with every blink. What would it feel like to to escape poverty because NTD-induced anemia saps go through life with limbs so swollen that you are no the strength needed to be productive students or longer able to use them? workers, or because they are physically disfigured and debilitated. The reality is that nearly one in six people around the world suffer from these and other life-altering Established in 2006, the Global Network for Neglected symptoms caused by the seven most common Tropical Diseases (Global Network) advocates highly neglected tropical diseases (NTDs). NTDs are a cost-effective and proven mass drug administrations group of 17 parasitic and bacterial diseases that (MDAs) to treat and prevent NTDs. Over the past year, together are a greater health burden than malaria we have strengthened our partnerships with country One of the Global Network’s most important a visionary roadmap for corporate and philanthropic and tuberculosis, and rival that of HIV/AIDS. governments, international non-profit organizations, activities focuses on the creation of regional funding engagement to deliver multi-sectoral solutions and major pharmaceutical corporations to expand mechanisms in our three priority regions—Latin that can set Africa on the path to NTD control. It Another reality: we can treat and prevent the the availability of these MDAs to those who need them. America and the Caribbean, Africa and Asia—to expands the pool of financiers of NTD control projects seven most common NTDs for approximately $0.50 deliver programmatic funding in support of MDAs in a beyond donor countries and traditional funders. per person per year. more cost-effective and impactful way. We established The END Fund began with the goal of raising $100 the Latin America and the Caribbean (LAC) NTD million to provide effective interventions that reduce Initiative, a partnership between the Global Network, the prevalence of the seven most common NTDs the Inter-American Development Bank (IDB), in sub-Saharan Africa. Over the next several years, it and the Pan American Health Organization (PAHO), will provide the capital resources needed to address that supports projects which are integrated the region’s NTD burden as well as the technical and community-based. These projects go beyond capacity to collaborate with national governments immediate curative measures to include long-term and health and development organizations operating solutions that tackle the social and environmental on the ground to bring scalable treatment options determinants of disease transmission, including to those at risk. improved access to clean water and sanitation systems. In 2010, the LAC NTD Initiative designed In addition, the Global Network expanded its eight projects in five different countries (Brazil, operations into Asia last year by laying the groundwork Guyana, Haiti, Mexico, and Guatemala). These for targeted and deliberate multi-regional funding projects will close the gaps in health equity among and advocacy efforts. We began a relationship with indigenous communities, while working toward Deworm the World in India that promises to deliver NTD elimination. significant opportunities for collaboration in 2011 and we strengthened our partnership with the World In Africa, we partnered with Geneva Global, a private Health Organization’s (WHO) Western Pacific philanthropy consultancy with a founding commit- Regional Office and South-East Asia Regional Office ment from Legatum Foundation to establish the End in support of deworming and lymphatic filariasis Neglected Diseases (END) Fund. The END Fund is elimination efforts.

20 Sabin Annual Report 2010 21 The Global Network also supports programs to In our broader advocacy efforts, we strengthened ensure that country-led efforts to control NTDs are the Global Network’s outreach strategy to the implemented at the national level. In May 2010, U.S. Congress, the White House, and targeted G8 ongoing national NTD control programs in Rwanda and G20 countries. Over the past several years, and Burundi successfully completed their third our advocacy efforts have contributed to the year of operations, accounting for the delivery of 16.5 establishment of the U.S. Agency for International million treatments during MDAs that year alone. Development’s NTD Program, the inclusion of The drug deliveries, which were conducted during the NTDs in President Obama’s Global Health Initiative, Mother and Child Health Week campaigns, reduced and the 70 percent increase in drug donations disease prevalence and intensity in both countries. commitments from the pharmaceutical industry. In Rwanda, the overall average cost per child treated was an estimated $0.14, while the overall cost Fighting NTDs continues to be acknowledged as per anemia case prevented was estimated to an important aspect of reaching the Millennium be $5.13, just one indicator of the value of MDAs as Development Goals (MDGs) and was recognized in an inexpensive and highly cost-effective health the United Nations 2010 MDG Summit’s official intervention. Due to the project’s high return on outcome document. Additionally, through briefings investment, funding for both programs was extended and special events, one-on-one meetings with for another year. decision-makers, expanded online communications, and targeted global health correspondence, we During the same period, we partnered with four made the case for controlling and eliminating NTDs WHO regional offices to support the development of to nearly 200 key policymakers in 2010. Despite national plans for NTD control in Asia, sub-Saharan the severe economic downturn, the U.S. government Africa, and the Americas. These plans provide a increased its spending on NTD control in 2010 to critical framework for coordinating various disease- $65 million, up from $25 million in 2009. specific efforts at the country level and with the implementing organizations. Furthermore, they serve as a forecasting tool to access drug donations and as the basis for proposals to present to potential donors.

2011 Highlights: Global Network The [NTD] disease burden has been easy to ignore, as it affects The United States Congress approved $77 million This project is co-funded by the Chiapas State people with little political for the USAID NTD Program, reflecting the highest Government, FEMSA Foundation and the LAC voice and low visibility on national funding level for NTD control and elimination by NTD Initiative, and will treat more than 132,000 and international agendas. The the U.S. government since the inception of people at risk for NTDs over the next year. the program. immense suffering caused by these Released a white paper entitled “A Call to Action: diseases is often endured in Coordinated with the Burundi and Rwanda Addressing Soil-transmitted Helminths in Latin silence, accepted as an inevitable Ministries of Health to transition mass drug America and the Caribbean,” directed to regional consequence of being poor… administration programs to government control, policy makers and public health advocates. Today, instead of waiting for these providing NTD treatment to over eight million diseases to gradually vanish, people over the past four years. a community of partners is deliberately vanquishing them. Some Launched the first demonstration project of the of the recent progress, viewed Latin America and the Caribbean (LAC) NTD against such a long and notorious Initiative in Chiapas, Mexico. history, is stunning.

Director-General of the World Health Organization 22 23 Sabin continues to make significant progress in its efforts to develop the first vaccines for human Profile 1 ntd Vaccine hookworm and schistosomiasis, two diseases that together plague hundreds of millions of people. Our product development partnership (PDP) fills an d evelopment important market gap by collaborating with world- class research and development institutions to create ultra low-cost vaccines for poor populations.

December 2005 Na-APR-1 July 2007 Na-GST-1 March 2008 Sm-TSP-2

EXPLORATORY STAGE: Na-APR-1, an adult-stage hookworm protein, Na-GST-1, an adult-stage hookworm protein, Sabin Vaccine Institute begins work on a candidate 2-4 years. selected as second candidate vaccine antigen selected as candidate vaccine antigen vaccine antigen, Sm-TSP-2, against schistosomiasis, Goal: identify natural or synthetic antigens. against hookworm. against hookworm. discovered by scientists from the Queensland Institute of Medical Research.

MANUFACTURING: June 2011: November 2009: 4th Quarter of 2011: Manufacture of Na-APR-1. Manufacture of Na-GST-1. Scheduled manufacture of Sm-TSP-2.

PRIMARY SAFETY STUDY (TOXICOLOGY): August 2011- February 2012: July-December 2010: 2011-2012: Planned primary safety study for Na-APR-1. Conducted primary safety study for Na-GST-1. Planned primary safety study for Sm-TSP-2.

INVESTIGATIONAL NEW DRUG (IND) APPLICATION: 2nd Quarter 2012: January 2011: 4th Quarter 2012: Application required by the FDA in order to begin Planned IND submission for Na-APR-1. Sabin Vaccine Institute submits IND application Planned IND submission for Sm-TSP-2. clinical testing. The IND application describes the for the clinical development of the Na-GST-1 manufacturing and testing processes, summarizes hookworm vaccine. the laboratory reports, and animal testing, and describes the proposed .

Once the IND application has been approved, the vaccine undergoes three phases of testing. PHASE 1 clinical TRIALS: 4th Quarter 2012: September 2011: 2nd Quarter 2013: This first attempt to assess the candidate vaccine Planned Phase 1 Clinical Trial of Na-APR-1. Planned Phase 1 Clinical Trial of Na-GST-1 in USA. Planned Phase 1 Clinical Trial of Sm-TSP-2. in humans involves a small group of adults, usually September 2011: between 20-80 subjects. Goals are to assess the Planned Phase 1 Clinical Trial of Na-GST-1 in Brazil. safety of the candidate vaccine and determine the type and extent of the response.

PHASE 2 clinical TRIALS: 2016: 2016: 2014: A larger group of several hundred individuals Planned Phase 2 Clinical Trial of Na-APR-1 Planned Phase 2 Clinical Trial of Na-GST-1 Planned Phase 2 Clinical Trial of Sm-TSP-2. participates in Phase 2 testing. The goals of (co-administered with Na-GST-1). (co-administered with Na-APR-1). Phase 2 testing are to study the candidate vaccine’s safety, immunogenicity, and potential to have a biological impact on infection (also referred to as a “proof-of-concept” study).

PHASE 3 clinical TRIALS: 2018: 2018: 2016: Conducted within a much larger group of Planned Phase 3 Clinical Trial of Na-APR-1 Planned Phase 3 Clinical Trial of Na-GST-1 Planned Phase 3 Clinical Trial of Sm-TSP-2. thousands to tens of thousands of people. (co-administered with Na-GST-1). (co-administered with Na-APR-1). Testing for safety as well as efficacy.

24 Sabin Annual Report 2010 25 Profile 2 ending the neglegt in burundi

The prevalence rate of intestinal worms has decreased significantly; schistosomiasis decreased from 6.4 percent to 3.6 percent, bringing it below the public health hazard level. Trachoma has been mapped and the International Trachoma Initiative, along with other partners, is considering the provision of sight-saving interventions. In addition, thousands of community health workers and laboratory technicians have been trained to identify NTD infections and administer drugs to fight them.

Burundi, lush and green, is known fondly as “the Land Burundi’s government was central in this effort, of a Thousand-and-One Hills.” A decade of violence paying for the salaries and office space of the Burundi that began in 1993 shattered the nation, claiming NTD team; not taxing the imported drugs; adopting 300,000 lives and displacing nearly one million people. a national NTD policy; and developing a five-year Poverty rates rose, with the number of people plan with the goal of controlling and eliminating NTDs living on less than a $1 per day increasing from 35 in Burundi. Going forward, these efforts will percent in 1992 to more than 67 percent in 2005. Not strengthen the government’s ability to control NTDs unexpectedly, NTDs thrived in this environment. with less donor assistance. The partners are also By 2005, in some districts, schistosomiasis and hook- addressing the lack of access to clean water and worm affected over 40 percent of the population. adequate sanitation, both significant problems in With the notable exception of the African Programme Burundi and the main cause of high re-infection rates. for Control (APOC), which worked With a government committed to NTD control and with the Ministry of Health to control onchocerciasis elimination, millions of Burundians have the promise (aka river blindness), Burundi lacked the needed of a better future. systems and infrastructure to treat NTDs. For Burundians like village chief Leonard Madina, In 2008, with funding from the Legatum Foundation, NTD treatments provided a new lease in life. an alliance formed between the Global Network, the When he returned to Burundi’s Rutana Province at Ministry of Health, CBM International, Geneva Global, the end of the civil war, the country’s health system and the Schistosomiasis Control Initiative to build on was in shambles. He was soon suffering from APOC’s ongoing efforts. The partnership implemented the debilitating symptoms of onchocerciasis, which “Before the medicine, people the nation’s first mass drug administration (MDA). scarred and distended his legs, causing him couldn’t work and cultivate the In the initial year, more than 1.8 million Burundians tremendous pain and preventing him from wearing fields. Thanks to the medicine, received medicine to treat NTDs, many for the first time. the rubber boots he needs to work in the rice the community is back to work, and we are moving forward.” fields. Today, thanks to the help of community health After three years, seven integrated MDAs (campaigns workers, Chief Madina and his fellow farmers have Leonard Madina, providing , bed nets, micronutrients, and received the NTD treatments they need to allow Village Chief, Rutana Province other medicines), and more than three million people them to support their families. treated, Burundi has achieved remarkable milestones.

26 Sabin Annual Report 2010 27 Profile 3 immunization financing in Cambodia

The SIF program engages countries through a high-level advocacy process. Advocacy begins with parliamentary briefings where elected officials learn from their counterparts in other governments how their own national immunization program is performing and how it is currently financed. Advocacy often extends to regional officials who prepare and manage provincial immunization budgets. Sabin sustains collective action through frequent peer exchanges in which key counterparts share best practices with each other.

Examples of these best financing practices include quarterly analysis and reporting of immunization program expenditures, legislation earmarking new revenue sources for vaccines, and the development Sabin’s Vaccine Advocacy and Education program of national immunization trust funds. has developed a niche expertise in the area of immunization program financing. Using an approach During 2010, Cambodian government officials and that leverages collective action, the Sustainable parliamentarians attended three Sabin-sponsored Immunization Financing (SIF) program engages briefings along with their counterparts from Nepal and leaders in ministries of health, ministries of finance, Sri Lanka. Each event generated a resolution calling parliaments, and the private sector to develop on the governments to increase and safeguard immu- sustainable financing solutions for national immuni- nization financing. The parliamentarians subsequently zation programs. The goal is to reduce external introduced the resolutions in their home parliaments. Prior to the Sabin/SIF initiative, dependencies and assure country ownership of Each country is currently crafting supporting Cambodia health officials rarely the programs. legislation. In addition, Sabin sponsored a series of met with members of Parliament provincial briefings where Cambodian parliamentarians to discuss immunization policies. As the number of recommended childhood vaccines learned firsthand how the immunization program is Now we see increased collective increases and the number of children continues financed and managed. action between leaders in to grow, countries face a corresponding increase in the ministry of health, ministry immunization program costs. Current vaccine prices According to Cambodia’s national immunization have not decreased substantially and additional program manager, Dr. Svay Sarath, Ministry of Health of finance and Parliament, which valuable vaccines are entering the market. Low-income officials were hesitant to meet with parliamentarians. has led to a more effective governments have three choices: let their populations The SIF advocacy work changed this. Today, understanding of the importance get sick, remain dependent on external aid, or find Cambodian Ministry of Health, Ministry of Finance, of immunization. sustainable domestic financing. and parliamentarian counterparts are working together to find their best sustainable immunization financing solutions. Cambodia National Immunization Program Manager 28 29 Our success is the direct result of the individuals have provided to Sabin generosity, insights and leadership Vaccine Institute as we seek to OUR of our global partners. We appreciate provide life-changing health solutions the collaboration and support to millions of people worldwide. PARTNERS that the following organizations and

Aeras Edmond de Rothschild Inter-American Development Bank Oxford University Clinical U.S. Centers for Disease Control Foundation [United Kingdom] Research Unit at the Hospital for and Prevention African Programme for International Emerging Infections Tropical Diseases [Vietnam] Onchocerciasis Control Eisai Co., Ltd. [Japan] Program [Nepal] U.S. National Institutes of Health Oxford Vaccine Group Aga Khan University [Pakistan] The Emory Global Health Institute International Trachoma Initiative U.S. National Institutes of Health, at the University of Oxford Fogarty International Center Agence de Médecine Préventive FEMSA Foundation [Mexico] International Vaccine Access [United Kingdom] [France] Center at the Johns Hopkins United Nations Children’s Fund Fraunhofer Center for Molecular Pan American Health Organization University Baylor College of Medicine Biotechnology The United Nations Foundation PATH MVI International Vaccine Institute Bharat Biotech [India] Fundação Oswaldo Cruz [Brazil] United Nations Relief and Works [South Korea] Pfenex Agency The Bill & Melinda Gates Fundación Mundo Sano James Cook University [Australia] Pfizer Inc. Foundation [] United States Agency for Johnson & Johnson Philippine Foundation for International Development Blavatnik Family Foundation GAVI Alliance Vaccination [The Philippines] Kraft Foods Universidad Peruana Cayetano The Campbell Family Foundation Geneva Global, Inc. Price Family Foundation, Inc. Heredia [Peru] Legatum Foundation Carlos Slim Health Institute George Link Jr. Charitable Trust [United Arab Emirates] Public Health Development University of Cincinnati [Mexico] The George Washington and Research Center, Integrated Liverpool School of Tropical University of Jordan [Jordan] CBM International University School of Medicine and Rural Health Development Training Medicine [United Kingdom] Health Sciences Center [Nepal] University of Kansas Center for Research and London School of Hygiene Advanced Studies of the National GlaxoSmithKline [United Kingdom] The Rockefeller Foundation University of Notre Dame and Tropical Medicine Polytechnic Institute [Mexico] Governments and Parliaments of [United Kingdom] Rotary Club of Kathmandu-North University of the Witwatersrand Center for Vaccine Development at Cambodia, Cameroon, [Nepal] [South Africa] Mectizan Donation Program the University of Maryland Democratic Republic of the Congo, Sanofi Aventis University of Yucatan [Mexico] Ethiopia, Kenya, Liberia, Nepal, Merck & Co, Inc. Center for Vaccine Development Mali, Nigeria, Madagascar, Sanofi Pasteur Wellcome Trust [Mali] Ministry of Foreign Affairs, Rwanda, Senegal, Sierra Leone, [United Kingdom] Government of the Netherlands Schistosomiasis Control Initiative Changing Our World Sri Lanka, and Uganda at Imperial College, London Wellcome Trust Sanger Institute Ministry of Health, Kingdom Chiapas State Government Government of the Municipality [United Kingdom] [United Kingdom] of Jordan [Mexico] of Recife [Brazil] Serum Institute of India The World Bank National Institute of Parasitic Children Without Worms Helen Keller International Diseases [China] Shantha Biotech [India] World Health Organization Covington & Burling The Horace W. Goldsmith Nepal Paediatric Society [Nepal] The Social Investment Consultancy World Health Organization Foundation Crucell [United Kingdom] Regional Office for Africa Novartis International AG Morton and Chris Hyman Deworm the World [Switzerland] Task Force for Global Health World Health Organization iBio, Inc. South-East Asia Regional Office Dubai Cares [United Arab Emirates] Novartis Vaccines Institute for Texas Children’s Hospital IMA World Health Global Health [Italy] World Health Organization The Earth Institute at Columbia U.S. Army Walter Reed Institute of Western Pacific Regional Office University Instituto Butantan [Brazil] Research

30 Sabin Annual Report 2010 31 The Sabin Vaccine Institute is grateful for the activism and generosity of its Board of Board of Trustees, composed of senior international leaders in business, civil trusteEs service, academia and philanthropy. staff

As of July 2011 Marc Shapiro Executive Leadership Program Leadership Non-Executive Chairman of Morton P. Hyman Chase Bank of Texas; Chairman Michael W. Marine, Sabin Vaccine Institute PDP Chairman of the Board of Trustees of Ambassador (Ret.) Baylor College of Medicine. Chief Executive Officer Maria Elena Bottazzi, PhD Louis Z. Cooper, MD Director, Product Development Former President of the American Alisa Swidler , MD, PhD Baylor College of Medicine Academy of Pediatrics Chair, President and Director of Sabin Texas Children’s Hospital The Walkabout Foundation Vaccine Institute PDP Allan L. Goldstein, PhD David Diemert, MD, FRCP(C) Professor in the Department of Peter L. Thoren Ciro de Quadros, MD, MPH Director, Clinical Trials Biochemistry & Molecular Biology at Executive Vice President of Executive Vice President and The George Washington Access Industries Director of Vaccine Advocacy Marva Loblack, MS, MBA University School of Medicine and Education Director, Quality Assurance Michael E. Whitham & Regulatory Rt Hon Baroness Helene Hayman Secretary and Treasurer Neeraj Mistry, MD, MS Immediate Past Lord Speaker Founding partner of the law Managing Director, Global Global Network for Neglected of the House of Lords, United firm of Whitham, Curtis, Network for Neglected Tropical Diseases Kingdom Parliament Christofferson & Cook Tropical Diseases Michelle K. Brooks Axel Hoos, MD, PhD Heloisa Sabin Brian Davis, CPA Director, Policy Medical Lead in Immunology/ Honorary Trustee Chief Operating Officer Oncology at Bristol-Myers Squibb Richard J. Hatzfeld Director, Communications Kevin L. Reilly Former Chairman of the Board of Marcia de Souza Lima, MD VaxGen, Inc. Director, Programs and Operations Gary Rosenthal Partner in The Sterling Vaccine Advocacy Group, L.P; Chairman of and Education the Board of Trustees of Texas Children’s Hospital Ana Flavia Carvalho, MBA, MPH Associate Director Philip K. Russell, MD Past Chairman Mike McQuestion, PhD, MPH Major General, U.S. Army Director, Sustainable Medical Corps (Ret.) Immunization Financing

Christopher B. Nelson, PhD, MPH Director, Coalition Against Typhoid Secretariat

32 Sabin Annual Report 2010 33 FINANCIAL Condensed Statement Condensed Statement STATEMENTS of Activities of Financial Position For the years ended December 31, 2010 and December 31, 2009 For the years ended December 31, 2010 and December 31, 2009

Revenue and Support 2010 2009 Assets 2010 2009

Grants, contributions and Cash, equivalents other support received $21,345,296 $17,128,901 and other current assets $14,182,529 $6,488,582 Future portion of grants Investments 12,593,629 16,009,324 as of year-end 36,667,534 38,309,326 Other assets 39,067 54,728 Investment income 25,207 94,650 Total assets $26,815,225 $22,552,634

TOTAL 58,038,037 55,532,877 Liabilities and Net Assets Expenses Accounts payable and accured expenses 2,937,947 2,889,732 Program services 15,282,994 18,441,527 Other liabilities 682,715 664,556 General, administrative and fundraising 1,891,292 1,731,244 Total liabilities 3,620,662 3,554,288

TOTAL 17,174,286 20,172,771 Unrestricted net assets 1,806,523 1,987,911 The financial statements Temporarily restricted net assets 21,388,040 17,010,435 presented have been Excess of revenues, summarized from Sabin's commitments and audited financial statements. Total net assets 23,194,563 18,998,346 support over expense $40,863,751 $35,360,106 Total liabilities Sabin’s full audit report, completed by Rogers & Co, and net assets $26,815,225 $22,552,634 LLP, is available at Sabin's Board of Trustees and executive leadership are fully www.sabin.org. committed to responsible and effective stewardship of donor funding. For the second consecutive year, Sabin received Charity Navigator's highest rating possible for consistently executing our mission in a fiscally responsible way.

2010 functional expense allocation: 2010 program expense allocation:

% 11% 89 41.5% 26.3% 32.0% 0.2% Program Services General, administrative Sabin Vaccine Vaccine Advocacy Global Network Other programs and fundraising Development and Education

34 Sabin Annual Report 2010 35 Sabin Scholar The following represent some of the appointments Awards and and awards that Sabin received and conferred Appointments since 2009.

Sabin’s prominence in the field of vaccine and dR. Ciro de Quadros global health advocacy is recognized in part by the honored by the Pan awards and appointments that our leadership American Health receives and through the presentation of the Sabin Organization and the Gold Medal, which we award each year to the Spanish Royal Academy scientist whose peers believe best reflects Dr. of Medicine ’s lifelong work of developing vaccines to meet humanitarian needs. Dr. Ciro de Quadros received a special award by the Pan American Health Organization (PAHO) at the Sabin President Dr. 50th annual meeting of the PAHO Directing Council. Peter Hotez selected The award recognized the public health contribu- to lead the American tions Dr. de Quadros has made in the Americas and Society of Tropical his involvement in the creation of PAHO’s Revolving Medicine and Hygiene Fund for Vaccine Procurement. Additionally, Dr. de Quadros was presented with the Premio Carlos Dr. Peter Hotez was elected President of the IV for Research in Public Health award by the Royal American Society of Tropical Medicine and Hygiene Academy of Medicine of honoring his work (ASTMH), one of the world’s leading organizations in the development and promotion of activities promoting global health through the prevention and related to improving public health and progress of IN MEMORIAM control of infectious and other diseases affecting biomedical research. poor communities. Additionally, Dr. Hotez was The Sabin Vaccine Institute said appointed as a member of the National Institutes of goodbye to a dear friend and leader Health (NIH) Council of Councils and was awarded  Sabin Gold Medal Award early in 2011 when our founding the Abraham Horwitz Award for Excellence in chairman, Dr. H.R. Shepherd, Leadership in Inter-American Public Health by the  Dr. John D. Clemens, Director- passed away. Pan American Health and Education Foundation General of the International (PAHEF). Coupled with his guest speaking oppor- Vaccine Institute (IVI), became This report is dedicated to his legacy. tunities as the John Ring LaMontagne Lecturer the 16th recipient of the Albert at the National Institutes of Health and the Stanley B. Sabin Gold Medal Award. Dr. Clemens is a Plotkin Lecturer at the Fondation Merieux, these world-renowned expert in vaccine development honors and appointments highlight the breadth of and evaluation in developing countries and is best Dr. Hotez’s contributions in developing solutions to known for leading the first efficacy trial of an oral diseases of poverty. vaccine against cholera at the International Center for Diarrheal Disease Research in Bangladesh. During the cholera study, Dr. Clemens discovered that the was highly effective at protecting women and children and that the vaccine provided “,” representing two revolutionary breakthroughs. He has also conducted studies of vaccines against numerous other diseases, including typhoid fever, tuberculosis, measles, and Japanese encephalitis, throughout Asia, Africa and the Americas.

36 Sabin Annual Report 2010 37 sabin vaccine institute 2000 Pennsylvania Ave NW Suite 7100 Washington, DC 20006 www.sabin.org www.globalnetwork.org

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