Orin Levine

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Orin Levine is a recognized expert in the fields of international public health, child survival, and pneumonia. He is currently the Director of Vaccine Delivery at the Bill & Melinda Gates Foundation in Seattle, USA. In the past he was the Executive Director of the International Vaccine Access Center (IVAC), the Co-Chair of the Pneumococcal Awareness Council of Experts (PACE),[1] and is a 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. Additionally, he is currently president of the American Society of Tropical Medicine and Hygiene (ASTMH) Council on Global Health. He resides in Washington, DC.

Biography and Education[edit]

Orin Levine was born in Richmond, Virginia. He graduated with a bachelor's 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[edit]

After receiving his PhD, 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, 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. He's now at the Gates Foundation in Seattle.

As the executive director of the International Vaccine Access Center (IVAC),[4] Levine leads nearly 30 professionals with experience in epidemiology, economics, policy analysis, financing, and advocacy. The mission of IVAC is to accelerate global access to vaccines through the development and implementation of evidence-based policies. As a consultant who works both nationally and internationally, Levine's knowledge of epidemiology places him in high demand. Levine's professional memberships align with his special interests. Currently, he is a Steering Committee Member of Johns Hopkins Vaccine Initiative (JHVI), at the Johns Hopkins Bloomberg School of Public Health, and President of the American Society of Tropical Medicine & Hygiene's Committee on Global Health. He is also a Steering Committee Member of the Decade of Vaccines Collaboration, and the Co-Chair of the Decade of Vaccines Collaboration's Global Access Working Group.

Levine has authored over 100 peer-reviewed publications and book chapters. He also writes a regular blog for the Huffington Post on global health and vaccine-related issues, and appears regularly on radio, television, and in print as an expert authority on these topics.

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.[5] Pneumococcal and Hib pneumonia are preventable by vaccination, but these vaccines have not reached the children who needed them the most: those in developing countries. Levine's efforts, and those of PneumoADIP, are aimed at accelerating access to these life-saving vaccines so that children everywhere can benefit from them.

Two of his current 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[6] and the Accelerated Vaccine Introduction (AVI) Project, which is funded by the GAVI Alliance.[3] The purpose of PERCH is to achieve a greater understanding of the causes of pneumonia around the world. Better pneumonia surveillance is critical to the 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. Levine is also involved in dengue vaccines, acting as the lead at Johns Hopkins in the institution's involvement in the Dengue Vaccine Initiative, a consortium created to accelerate development and subsequent use of dengue vaccines.

Pneumonia Etiology Research for Child Health (PERCH)[edit]

Pneumonia is the leading infectious disease cause of death among children worldwide. Existing knowledge on the etiologies of childhood pneumonia is largely based on studies conducted in 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 diagnostic technologies is needed.

PERCH is a multi-center, case-control study of the etiology of severe and very severe pneumonia in children aged 1–59 months. With seven sites in Africa and Asia and a projected sample size of over 12,000 patients and controls, PERCH is the largest study of the etiology of pneumonia among hospitalized pediatric pneumonia patients in developing countries that has ever been undertaken. 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, and Zambia) and two in Asia (Bangladesh and 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 prior to the release 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[edit]

The mission of the Hib Initiative is to expedite and execute evidence-based 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 three strategic areas to support evidence-based decisions at the country level: coordination, communication and research.

PneumoADIP - The Gambia & Kenya[edit]

The Gambia[edit]

In conjunction with the Medical Research Council (MRC) in Gambia, the team 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-vaccination evaluation being conducted by MRC Gambia is a multi-year project.

Kenya[edit]

In conjunction with the University of Oxford, this team 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 being conducted is a multi-year project.

Serotype Replacement[edit]

This program was conceived to develop 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 in order to formulate a set of “best-practice principles” for pneumococcal disease surveillance in developing countries planning to introduce PCV. In this way, new data on pneumococcal vaccine impact may be collected and reported in ways that are useful in understanding the true effects of PCV. The 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[edit]

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[edit]

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[edit]

In addition to his academic publishing, 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 two BBC World documentaries on pneumococcal disease and 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, 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 Levine was featured in the Johns Hopkins Bloomberg School of Public Health magazine for his work on advancing vaccine access.

Awards[edit]

  • In 2000, 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 Levine as the first Dr. Robert Austrian Memorial Lecturer at the National Vaccine Research Conference.[7] 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. Austrian died in March 2007 at the age of 90.

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