Preventing the next Pandemic: Vaccine Diplomacy in a time of Anti-Science Peter Hotez MD PhD Texas Children’s Hospital Endowed Chair in Tropical Pediatrics Dean, National School of Tropical Medicine at Baylor College of Medicine University Professor, Baylor University Hagler Institute of Advanced Studies, Texas A&M University @PeterHotez 1 Under 5 Child Deaths 2000-2017 GBD 2017 Sebastiao Salgado 2000 2017 ‐ Measles 478,727 ‐ Measles 83,438 (-83%) ‐ Pertussis 138,048 ‐ Pertussis 86,091 (-38%) ‐ Tetanus 105,333 ‐ Tetanus 18,623 (-82%) ‐ H. flu 86,104 ‐ H.flu 36,185 (-58%) ‐ Diphtheria 10,413 ‐ Diphtheria 2,914 (-72%) Page 2 xxx00.#####.ppt 5/7/2020 1:49:32 PM Incidence of Hib in USA 3 Global Elimination of Polio & Measles 4 New Global Anthropocene “Hot Zones” of Vaccine- Preventable & Neglected Tropical Diseases NTDs Where political instability combines with climate change, urbanization, deforestation, or antiscience Texas &Gulf Arabian Coast Peninsula China and Philippines Central Africa’s Latin Un-Wars America 5 War, Political Collapse, Climate Change, Urbanization • Arabian Peninsula • Venezuela 6 War, Political Collapse, Climate Change, Urbanization • Africa Un-Wars • Texas + Gulf Coast 7 SHIFTING POVERTY: “Blue Marble Health” • Neglected diseases of the poor living amidst wealth • A new framework for global science policy and the poverty-related diseases 8 COVID19 and the G20 Nations • 2-3 million cases • United States • Spain • Italy • France • Germany • UK • China • Turkey 9 Tissue Expression of ACE2: Heart, Lung, Adipose, Gastrointestinal Tract https://medium.com/@yuanhe716/tissue-specific-expression-and-genetic- regulation-of-sars-cov-2-receptors-ace2-and-tmprss2-d75d76bf45fb Page 10 xxx00.#####.ppt 5/7/2020 1:49:33 PM SARS CoV2-COVID19 Vaccine Approaches Page 11 xxx00.#####.ppt 5/7/2020 1:49:33 PM Texas Children’s Hospital Center for Vaccine Development 12 Texas Children’s CVD • Low Cost • Our Portfolio • Global Health Vaccines • Schistosomiasis • Hookworm • Recombinant protein vaccines • Onchocerciasis • Technology transfer to LMICs • Leishmaniasis • Building vaccine development • Chagas disease capacity in LMICs • Coronavirus infections • SARS and SARS 2 • MERS 13 COVID-19 in Latin America, India, Africa 14 Global Coronavirus Vaccine Initiative 15 Vaccine Diplomacy 16 Roll of Antiscience 17 The Rise of Antiscience WHO and “Vaccine Hesitancy” 80,000 measles cases 2018, >100,000 measles cases 2019 18 20 Years of ‘Vaccine Hesitancy’ 1998-2018 19 TEXAS NON-MEDICAL VACCINE EXEMPTIONS (2003-2019) 64,176 56,738 52,756 44,716 40,997 38,197 32,616 28,432 22,910 19,050 12,633 9,606 10,404 2,314 2,722 6,991 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 to to to to to to to to to to to to to to to to 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 20 Heat map of counties with >400 kindergarteners with NMEs in 2016 to 2017 Vaccine Hesitancy in USA Olive JK, Hotez PJ, Damania A, Nolan MS (2018) Correction: The state of the antivaccine movement in the United States: A focused examination of 21 nonmedical exemptions in states and counties. PLOS Medicine 15(7): e1002616. The Antivax 4-Headed Monster: 1) The Media, 2) The Political Machine, 3) Deliberate Predation, 4) War on Women 22 Vaccine Scientist, Pediatrician, Autism Dad 23 Science and Public Engagement 24 Epic Struggle Mass Treatment, 21st Century Forces Vaccines & Biologicals, Poverty, Climate Change, Vector Control War, Political Collapse, Technologies Urbanization, Antiscience 25.