Orin Levine

Dr. Orin Levine is a recognized expert in the fields international public health, child survival, and pneumonia. He currently acts as the Executive Director of the International Vaccine Access Center (IVAC), the Co-Chair of the Pneumococcal Awareness Council of Experts (PACE),^[1] and is an Associate Professor at The Johns Hopkins Bloomberg School of Public Health in the Department of International Health.^[2] He is also an adjunct assistant professor of Epidemiology at The Rollins School of Public Health at Emory University in Atlanta. He resides in Washington, DC.

Biography and Education

Orin Levine was born in Richmond, Virginia. He graduated with a Bachelors degree from Gettysburg College in Gettysburg, Pennsylvania. He continued his studies at The Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland where he received a PhD in epidemiology.^[1]

Research

After receiving his PhD, Dr. Levine spent 5 years working for The Centers for Disease Control and Prevention(CDC) in Atlanta. There he served first as an Epidemic Intelligence Service officer and then as a staff epidemiologist in the Respiratory Diseases Branch. He then spent 3 years working at the National Institutes of Health in Bethesda, Maryland.^[1] In 2003, he joined the Department of International Health at the Johns Hopkins Bloomberg School of Public Health, and started (with Katherine O'Brien) the PneumoADIP, a small, focused organization dedicated to accelerating access to pneumococcal vaccines for the world's poorest children.^[3] In the past 6 years, Dr. Levine and the PneumoADIP team have successfully competed for and been awarded over 100 million dollars in research grants from the GAVI Alliance and the Bill & Melinda Gates Foundation.

Dr. Levine has authored over 70 original articles and book chapters. Dr. Levine's research has predominantly been focused on the two most common causes of fatal pneumonia, S. pneumoniae and H. influenzae type b. Pneumonia kills over 2 million children each year and >98% of these deaths occur in developing countries.^[4] Currently pneumococcal and Hib pneumonia are preventable by vaccination and yet these vaccines have not reached the children who needed them the most, those in developing countries. Dr. Levine's efforts, and those of PneumoADIP, are aimed at accelerating access to these life-saving vaccines so that all children, everywhere can benefit from them.

Two of his current major research projects are: Pneumonia Etiology Research for Child Health (PERCH) which is funded by a 43 million dollar grant from the Bill and Melinda Gates Foundation^[5] and the Accelerated Vaccine Introduction Project (AVI) which is funded by the GAVI Alliance.^[3] The purpose of PERCH is to come to a greater understanding of the causes of pneumonia around the world. Better pneumonia surveillance is critical in a global fight against this disease. The purpose of AVI is to accelerate access to life-saving pneumococcal and rotavirus vaccines for children in the world's poorest countries.

Pneumonia Etiology Research for Child Health (PERCH)

Pneumonia is the leading cause of death from infectious disease for children world-wide. Existing knowledge on the etiologies of childhood pneumonia is largely based on studies from the 1980s and 1990s. With expanded use of new pneumonia vaccines and changes in host and environmental factors, a new evidence base that harnesses novel technologies for diagnosis is needed.

PERCH is a multi-center case-control study of the etiology of severe & very severe pneumonia in children aged 1-59 months. Over two years, PERCH will enroll approximately 6,500 hospitalized cases with WHO-defined severe and very severe pneumonia. Approximately the same number of community-based controls will be enrolled to assess the community prevalence of pathogens as well as known and unstudied risk factors for pneumonia. Seven research sites were selected to be representative of areas where most of the severe pneumonia cases in children are expected to occur in 2015. There are five sites in Africa (Gambia, Mali, Kenya, South Africa, Zambia) and two in Asia (Bangladesh & Thailand). The study will be carried out using standardized clinical and laboratory methods and techniques, in combination with innovative diagnostic and specimen collection methods. The data will be analyzed using advanced statistical methods and their interpretation will be considered in advance of knowing the specific microbiologic results.

More information on the study protocol and the PERCH project is available at http://www.jhsph.edu/ivac/perch.html

The Hib Initiative

The mission of the Hib Initiative is to expedite and sustain evidence-informed decisions regarding the use of Hib vaccination, in order to prevent childhood meningitis and pneumonia. The Hib Initiative strategic plan provides a roadmap to fulfill this mission, and focuses on 3 strategic areas to support evidence-based decisions at the country level: coordination, communication and research.

PneumoniADIP - The Gambia & Kenya

The Gambia

In conjunction with the Medical Research Council (MRC) in Gambia, the project will coordinate and perform a range of surveillance and research activities designed to determine the burden of pneumococcal infections among and demonstrate the impact of pneumococcal conjugate vaccines on children and adults in the Upper River Division in The Gambia. The surveillance and post-vaccine evaluation conducted by MRC Gambia is a multi-year project.

Kenya

In conjunction with the University of Oxford, the project will coordinate and perform a range of activities designed to estimate the total reduction in disease burden attributable to programmatic use of pneumococcal conjugate vaccine and to evaluate the efficacy of the vaccine following introduction into the routine childhood immunization schedule. The pneumococcal surveillance and post-vaccine introduction evaluation conducted is a multi-year project.

Serotype Replacement

The project aims to undertake an evidence-based, rigorous, and transparent process for collecting, analyzing and interpreting the evidence for pneumococcal serotype replacement and placing it in this larger context. The approach is to develop hypothesis-driven analyses and to evaluate them on the basis of comparable data from different settings and also aims to formulate a set of “best-practice principles” for pneumococcal disease surveillance in developing countries planning to introduce PCV so that new data on pneumococcal vaccine impact are collected and reported in ways that make them useful for understanding PCV effects. The project’s process of determining the proportionate role of serotype replacement in post- pneumococcal conjugate vaccine nonvaccine-serotypes invasive pneumococcal disease changes will provide a framework for countries to evaluate their own data and make decisions related to their PCV immunization program.

LEAP: Evaluation of the Binax NOW® S. pneumoniae test for use in blood of pneumonia and sepsis patients in low- and middle-income countries

The project aims to evaluate the utility of the Binax NOW® S. pneumoniae immuno-chromatographic test, for diagnosing pneumococcal pneumonia and sepsis in low- and middle-income countries. Detection of pneumococcal pneumonia and sepsis is limited by the poor sensitivity of existing diagnostic methods, hindering accurate measurement of disease burden where the Binax NOW® test may enable the identification of additional pneumococcal cases among patients with pneumonia and sepsis.

LARI: Landscape Analysis of Routine Immunization in Nigeria

The project aims to identify the key supply- and demand-side bottlenecks to routine immunization coverage in Nigeria and determine drivers of low coverage and inequalities. Specific aims include to describe the landscape and status of previous and current routine immunization strengthening programs in Nigeria and to identify context-specific opportunities and strategies for improving immunization service access and delivery, utilization, uptake and demand.

Advocacy

In addition to his academic publishing, Dr. Levine appears frequently as an expert in print, on the radio, and on television. He has authored and/or co-authored Op-Eds that have appeared in publications around the world. His television appearances include 2 BBC World documentaries on pneumococcal disease and its prevention by vaccination, and news interviews on BBC World, BBC News, Al-Jazeera (The Pulse), South African Broadcasting Corporation, and Arirang (South Korea). His work on pneumonia research and prevention has been profiled in the New York Times (see New York Times Article: A Campaign to Get a Disease Some Respect). On August 4, 2009, Dr. Levine was featured in an episode of the "Kill or Cure series" on BBC World. This episode, called "Saving Lives" (http://www.rockhopper.tv/programmes/262/), focused on efforts to increase access to pneumococcal vaccines through an initiative called the Advance Market Commitment (http://www.vaccineamc.org). Click here to access all the episodes of Kill or Cure on the Rockhopper.tv website (http://www.rockhopper.tv/programmes/18/). Most recently Dr. Levine was featured in the Johns Hopkins Bloomberg School of Public Health magazine for his work on advancing vaccine access.

Awards

• In 2000, Dr. Levine was awarded the CDC's Iain Hardy award for his outstanding contribution to the control of vaccine-preventable diseases.^[1]
• In 2008, in light of his outstanding achievements in pneumococcal disease and its prevention, the National Foundation for Infectious Diseases selected Dr. Levine as the first Dr. Robert Austrian Memorial Lecturer at the National Vaccine Research Conference.^[6] The lecture is named for Dr. Robert Austrian, former chair of medical research at the University of Pennsylvania, who developed the first multivalent vaccine against pneumococcus bacteria. Dr. Austrian died in March 2007 at the age of 90.

References

1. ^ ^{a b c d} Sabin Institute
2. ^ JHSPH
3. ^ ^{a b} PneumoADIP
4. ^ The Forgotten Killer of Children
5. ^ Global Health Council
6. ^ Bio-medicine

Videos

• Powerful 5 Minute Video Produced by PneumoADIP about the Toll of Pneumococcal Disease
• The Pulse Al Jazeera 10 Minute Report on Pneumococcal Disease and Vaccines
• A 25 Minute Video for the BBC Series Kill or Cure (Pneumococcus) Produced by Rockhopper
• A 25 Minute Video for the BBC Series Kill or Cure (Haemophilus Influenzae Type b) Produced by Rockhopper
• A 25 Minute Video for the BBC Series Kill or Cure (Title: Saving Lives) Produced by Rockhopper
• From Survival TV, The Struggle to Breath produced by Rockhopper
• Survival TV Briefing Room with more Videos and Podcasts about Pneumonia Including some by Orin Levine
• Interview with Orin Levine on Global Health TV

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• PBS NewsHour interview about PCV introduction in Nicaragua and the potential of the vaccine to improve health in the country. The story features commentary from Johns Hopkins Bloomberg School of Public Health's Orin Levine and GAVI Alliance's CEO Seth Berkley.

External links

• PneumoADIP
• New York Times Article: A Campaign to Get a Disease Some Respect
• Dr. Levine's JHSPH Faculty Page
• The GAVI Alliance
• The World Health Organization Accelerated Vaccine Introductions Page
• Pneumonia: The Forgotten Killer of Children
• The Bill and Melinda Gates Foundation
• The Pneumococcal Awareness Council of Experts
• World Pneumonia Day
• Baltimore Sun Article The Right Fight
• Rwanda: President Meets Pneumococcal Vaccine Sponsors
• New Funding Strategy Will Bring Pneumococcal Vaccine To Developing Countries
• PERCH
• Pediatric Supersite
• Dr. Orin Levine of Johns Hopkins Bloomberg School of Public Healthdebunks 5 common myths about pneumonia in his latest blog post onThe Huffington Post

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