For IDRI’s 25th anniversary, we asked friends, family and partners for their perspective about the mark IDRI has made through innovation and scientific discovery in the field of global health. Their views tell a story of impact and opportunity
Steve Reed, PhD
President, CEO & Founder, IDRI
“ IDRI sees itself as a champion of lost causes, taking on challenges that few others will.”
Corey Casper, MD, MPH
Chief Scientific Officer, IDRI
The real challenge for the global health ecosystem right now is that despite the global health community working for 40 or so years on solutions, we still haven’t hit on an ultimate model.
The basic problem is that if you’re relying on a market driven economy to develop new vaccines for neglected diseases, or even new vaccines for non-neglected diseases. And it’s not a favorable environment. So if you’re looking for a disease like leprosy, there’s 200,000 lepers on the planet, they’re in parts of the world that are impoverished, they’re in parts of the world that can’t invest large sums of money for a solution, so a market driven economy will never be able to quote unquote toll a vaccine for leprosy forward through development. That then relies on charity, it relies on grants, and that’s a system that I think is unstable. I
IDRI is unique. We are innovating a new model. We use grant funding from the federal government, charitable donations and foundation grants in ways that can be catalytic. And we think about ways in which new technology can empower vaccines that have potential economic returns, but also use that technology and those returns can empower vaccines that are not economically feasible.
The IDRI partnership model is also unique. We find ways to partner with big pharma, with local regional producers, with governments, with nonprofits, and act at the epicenter of that, to pull vaccines through the pipeline.
Gilla Kaplan, PhD
Senior Advisor, Bill & Melinda Gates Foundation
” It’s about the individuals that drive IDRI. It’s clearly Steve and his commitment to finding a solution for how to vaccinate against either leprosy or TB is a driving force. What’s interesting about IDRI is they are at the border between profit and not for profit. And it’s not a company: they don’t have to make an enormous income in order to justify the activity. Simply breaking even and getting the product funded to continue studying has been for a long time good enough to keep them engaged. I suspect that a lot of the bigger companies and the commercial entities that could have been involved have chosen to stay away. And the partnership with companies has been based on the assumption that this is going to succeed, which requires quite a lot of hard work. So it’s a personal commitment, it’s in their DNA.“
Marie-Paule Kieny, PhD
Former Assistant Director General, World Health Organization, Research Director, INSERM
QUESTION: What makes IDRI unique?
Dr. KIENY: There are very few private, not for profit institutions on earth, such as IDRI, dedicated entirely to combatting infectious diseases affecting some of the world’s most vulnerable populations. In addition, IDRI is not just a research laboratory in an industrialized country but has its feet on the ground in numerous countries where neglected tropical diseases are rife. And, this, in combination with IDRI’s outstanding research and product development capacity, has made a significant contribution globally. IDRI is a model for innovation.
IDRI has been one of these organizations focusing on the areas most neglected. And pushing projects forward. And we’ve learned from IDRI, that it is possible to do research and development differently without the need for profit.
I think one of the issues to move forward on is about a model in which there is more understanding by the public sector, by governments – that they need to put money on the table. That they cannot, at the same time, ask the industry to carry, financially, all the R&D. And at the end, come in and negotiate affordable prices. So, if we want to get out of this model where the return on investment on pharmaceutical companies is the highest of all sectors, higher than alcohol, higher than tobacco, and move to something which reflects the value of what is produced, and a more moral model, the governments will have to put money on the table.
Frank Prendergast, MD, PhD
Professor Emeritus, Mayo Medical School
” Where IDRI has excelled is that they made it their business to understand better than anyone else: the adjuvant. “Adjuvant,” the word means “help.” It’s something that helps. That has turned out to be the single most important feature in many ways in modern immune development, vaccine development. Everybody now recognizes this, but very few institutions succeed. In fact, this is where I say IDRI stands out. It is the best group in the world, in my view, for producing adjuvants. And not just for producing adjuvants, but for understanding the role of adjuvants, because no one adjuvant satisfies all the potential needs. You need a library of these adjuvants. They are dissecting out the science of adjuvants more effectively than anybody else in the world, so of course their impact, in my assessment, has been enormous.
IDRI’s role in the global health ecosystem will remain vibrant for a number of reasons. In fact, because the science is superb. It’s not just about developing a vaccine. The science is also about fundamental knowledge of immunology, and especially how immunology intersects with infectious disease of all types, but also with diseases like cancer, and the forays that have been made even into severe allergens. All those are branches of the immune response. The fine academic knowledge and expertise of the people at IDRI in immunology, not just in infectious disease per se and the organisms, is going to carry the institution very, very far. I don’t see anybody else challenging them for quite a while in terms of preeminence.“
President & CEO, American Leprosy Missions
By the late 1990s, it was clear that the multi-drug therapy for leprosy was doing a great job of curing the disease, but was not interrupting transmission. The immunological complexities of the disease made it difficult for people to imagine an effective, leprosy-specific vaccine ever being developed.
American Leprosy Missions (ALM) and IDRI shared a common board member, Dr. John Dawson. He challenged both organizations to take on this issue and see if the impossible could be accomplished. In October of 2001, the ALM board officially approved investing in a leprosy vaccine.
Dr. Dawson persuaded Steve Reed to take on investigating a leprosy vaccine, having seen the work that Steve had already begun doing in TB. In Brazil, Steve had seen firsthand how neglected diseases like leprosy ravaged people’s lives. Steve listened to Dr. Dawson’s proposal and entered into a partnership with ALM which still remains now, 17 years later.
IDRI, along with key staff like Dr. Malcolm Duthie, tirelessly pursued the testing and science necessary to develop a novel vaccine for leprosy. In 2017, after sixteen years of labor, the IDRI LEPVAX entered Phase 1 clinical trials in the United States. This is the first trial for a leprosy-specific vaccine in the history of the world.
Each year more than 250,000 people around the world are diagnosed with leprosy. In addition, it is estimated that more than four million people live today with disabilities caused by leprosy. The IDRI vaccine, LEPVAX, aims to impact both groups. IDRI’s leprosy vaccine can potentially interrupt the transmission of the disease. But, as important, it will be launched as a therapeutic because it appears to reduce nerve damage in those infected with leprosy.
As IDRI celebrates its 25th anniversary, American Leprosy Missions is proud to have been a partner for so many of those years. IDRI aspires to ensure that the neglected populations suffering from neglected diseases are not neglected from cutting-edge research for transformative drug and vaccine discovery. IDRI is a critical partner for American Leprosy Missions in reaching our goal of freeing the world from leprosy. After 25 years, IDRI has proven their commitment. May the next 25 years see many of their labors come to fruition.
Leslie Alexandre, PhD
President & CEO, Life Science Washington
” Washington State is blessed with several world-class research universities and institutions that have given rise to an impressive life science industry and contributed to solving some of the leading domestic and global health challenges of our time. IDRI stands out among these institutions for its mission to apply its research discoveries—and those of its collaborators—to the development of products to eliminate diseases of global importance. From its inception, IDRI has recognized that it is not enough to conduct innovative research; improving human health requires that the fruits of that research be translated into products accessible to peoples across the globe. IDRI and its incredible scientists have helped put Washington state’s life science cluster on the map with a pipeline filled with vaccines, drugs and diagnostics rivaling that of any large pharmaceutical company focused on infectious diseases. Moreover, IDRI’s commitment to motivating and preparing the next generation of scientists is helping to ensure our life science entrepreneurs have access to the pool of talent they require to start and grow companies here in Washington.“
Derek O’Hagan, PhD
Head of Global Discovery Support & New Technologies, GSK Vaccines
In global health, there can be a tendency to think that only the big pharma companies are capable of major technical advances. Steve Reed and IDRI have shown time and again that’s not the case.
Large companies have large budgets and conduct ground-breaking research. A key challenge though, is that such corporations have shareholders who need to see a return on their investment. Hence, their mission may not be entirely compatible with the need to serve the most disadvantaged people by comprehensively addressing diseases of the poor. IDRI has thrown itself into that gap with impressive programs on leprosy, schistosomiasis, and tuberculosis. They obviously have a different mission than the large companies, but it’s one that we all in the vaccine field can get behind and support.
I got to know Steve much better than before around 2010 when we were both on a Blue Ribbon Panel on Adjuvants that the National Institute of Health assembled. There was a real push then on work to protect against various infectious diseases. Specifically, there was a need for the creation of new adjuvants, the components that can be added to vaccines to make them more effective by boosting the immune response. With funding help from the NIH and others, Steve and IDRI made real progress on creating new adjuvants based on well-defined molecules and formulations.
Steve has always been a notable and respected voice in the field of adjuvants, as shown in his participation in the response to pandemic influenza in 2009. There was a lot of debate about whether we should utilize a particular type of adjuvant, called oil in water emulsions, because much older historical versions of emulsions did not have a great safety record. But a newer generation of emulsions based on degradable oils had shown a lot of promise in combating both seasonal and pandemic strains of the influenza virus. This was a predominantly European experience, which Steve helped to communicate globally and particularly within the US. Steve was an important voice in reassuring potential users, especially in developing countries, of the safety and effectiveness of these types of adjuvants, which was based on their accumulated clinical safety.
The same thing goes for IDRI’s search for an effective leprosy vaccine. What they have done is a remarkable achievement. It’s not a single technology — they were able to bring a number of elements together to really make a vaccine a possibility, including the ability to go out into the places where the product is going to be needed, conducting clinical trials and showing the therapeutic benefit. They bring the quality science that’s necessary to enable them to succeed in their mission.
I think IDRI is now really well positioned to meet challenges we face over the next couple of decades. In our field, we have seen some impressive scientific advances over the last 10 years or so and now we have to figure out how to capitalize on them for the benefit of everyone.
IDRI has a great ability to survey the field and try and identify those technologies that are out there and figure out how to make the most of them. I’m not sure of another organization that does this so comprehensively in terms of trying to bring the best science to bear in the public sector space, to protect against infectious diseases.
Co-Chief Investment Officer & Regional Market Director, Alexandria Real Estate
“ An important thing to think about is there are 10,000 known diseases and there’s 500 of which are treatable. So it’s daunting to think about all the real estate to roam. And all the work yet to be done. It’s just we haven’t scratched the surface yet on addressing all of these maladies, especially something like Alzheimer’s or opiod addiction – both with devastating consequences. So we’re particularly focused on trying to figure out ways to support companies to do the research. And a lot of times, that means bringing them into a cluster location where they can focus and interact with others.“
Stephen Hoffman, MD
Chief Executive & Scientific Officer, Sanaria
I’ve known Steve Reed, a fellow Weill Cornell Medicine (formerly Cornell University Medical College) alumnus through the American Society of Tropical Medicine and Hygiene for decades, and have been collaborating with IDRI for nearly 15 years. We both have worked on tropical infectious diseases our entire careers, and we have a shared vision and commitment to global health.
IDRI is extremely responsive and cutting edge in its work with adjuvants to help vaccines induce more potent and protective immune responses. We’ve been collaborating with IDRI on assessing adjuvants for products in both of our companies: Sanaria, working on malaria vaccines, and Protein Potential, working on recombinant proteins for malaria, SARS, and dengue, and vaccines for shigellosis, which causes a diarrheal disease deadly to children.
We have many challenges ahead of us in terms of developing vaccines for infectious diseases like malaria and tuberculosis, which causes so much morbidity and mortality worldwide. Progress is being made, but we have been moving forward more slowly than we would like, because the diseases we are trying to prevent with vaccine have proved to be very tough targets.
Why is it so difficult? We have vaccines for viruses. We have vaccines for diseases like typhoid fever, and tetanus, which are caused by simple bacteria. We don’t have any vaccines for parasites or for the more complex bacteria responsible for tuberculosis and leprosy, the focus of much of IDRI’s work. If you think about the scale of complexity, if a virus has a complexity of one and a bacteria a complexity of ten, a parasite has a complexity of a hundred or a thousand. This makes parasites extremely challenging targets for vaccine developers.
Furthermore, we have selected diseases which impact the least served, poorest people on our planet. Therefore, the resources (money) invested in solving these problems have been minimal to modest at best, compared to the resources that might be invested in solving problems from hair loss and balding to cancer.
During the terrible Ebola epidemic in West Africa four years ago, when the whole world responded out of compassion and fear, there were 11,000 deaths from Ebola. That’s a very sad and a terrible number, but every week and a half there are 11,000 deaths from malaria. The magnitude of the problem is no different for TB, IDRI’s major focus right now in terms of developing a vaccine and diagnostics. The world doesn’t see these problems on a daily basis and so the kind of resources, the kind of attention needed are not there.
One might also ask the question, why is it that so many people still suffer from diseases like TB, HIV and malaria, when we actually have drugs that work? We’re obviously not getting them to the people who need them the most in the right time period. If we could solve that, which may be facilitated by better technology to identify and diagnose these diseases. This is one of IDRI’s major areas of focus.
I have great hope that we will bring to bear new technologies, new approaches to solving millennia-old problems. However, hope for the new technologies and success in creating them won’t diminish the importance of fighting it out in the trenches in the way that the IDRI team has done for the last 25 years.
Robert Gallo, MD
Director & Co-Founder, Institute of Human Virology at the University of Maryland School of Medicine
“ Tremendous diagnostic progress in the future I would hope would be more for rapid, with greater field movement of diagnosis so that you get knowledge about when things happen quicker. And you can move on it.“
President, Washington Global Health Alliance
I arrived in Seattle in 2017 after a long career in legislation and policy in Washington, DC, and was excited to see what’s going on here. I knew of Washington’s reputation as a major player in global health, and I was anxious to see what was here.
Right away, I was impressed by how open people are here to sharing their work and information, and looking for ways to support each other. It’s refreshing. In DC the old axiom “knowledge is power” dominates the culture, making it tricky for people to be willing to share what they know. That could not be further from the case in Seattle and in this global health community. Here, we really are rooting for everybody to win.
That’s part of what we do here at the Washington Global Health Alliance, where IDRI is an important player. The Alliance was established in 2007 when there was a recognition that this region had become a powerhouse in global health but people were more likely to run into each other in Geneva or in New York or Boston than they were in Seattle. So the idea was to put together a platform for Seattle’s global health community to stay connected with each other. We believe in the power of relationships to drive ideas and collaboration. It’s so much easier to go further in our work when we know and trust others who may be in a different discipline or another organization. And we support each other. Steve Reed has modeled this approach here in Seattle for 25 years.
What’s next for the community? The next step is to better integrate with related disciplines — international development, life sciences, and economic sectors — that are not always fully incorporated into the global health sector. The next 25 years is going to be about bringing multiple sectors, multiple disciplines, multiple strengths to bear so we can lead the way in reaching the sustainable development goals. It’s ambitious, but it’s a vision that could lead to some really good progress.
There’s another side to the “we are rooting for everybody” culture that permeates Seattle’s global health community that is equally important. And that is our willingness to put ourselves out of business. The idea that we develop diagnostics and treatments here in the United States and carry them to other countries is outdated. We need to move the locus of research and education and training and delivery to the countries where we do the work.
Take just one local organization, Malaria No More. It started out focused on tapping into funding and political support in the U.S. for addressing malaria. It’s since expanded to the same thing in malaria-affected countries. Today, Malaria No More is providing technical assistance for parliamentarians and civic leaders who are developing goals, budgets, and strategies in countries where malaria is endemic. It’s a great model.
It is absolutely thrilling to be in this field at this time. We’re making so many discoveries and connections and we’re seeing results. IDRI’s vaccine candidates in tuberculosis and leprosy could dramatically change countless lives for the better. Of course there are setbacks. We are, for instance, worried about federal funding in global health right now. Some 69% of the work we do in global health here in Washington is funded by federal dollars, and the current Administration does not prioritize investments in global health. That’s disconcerting.
But it’s not uncommon to lose a little momentum or for the rate of improvement to slow. That happens. But this community is rich with expertise, experience, and compassion. We are far from done with our work.
Erik Iverson, JD
Managing Director, WARF
“ One of the lessons from IDRI is this: It has created a truly entrepreneurial and a pioneering spirit and nature of its activities. I think that’s what’s exciting and interesting to me about IDRI. First and foremost, it really is that balance between entrepreneurism and nonprofit and global health. There are very few organizations globally, certainly nationally, that are that hybrid between that nonprofit research institute and a company.
IDRI’s model is something that needs to be replicated many times over. I think it will actually be something that overtime changes the philanthropic landscape.“
Michel DeWilde, PhD
Sanofi Pasteur executive, retired
In its first 25 years, IDRI has discovered and brought to clinic several innovative vaccines against neglected diseases. And because of this IDRI is unique in the not-for-profit environment.
Adjuvants and formulations are core competencies of IDRI, equaled only in one or two other organizations. Because IDRI has always been out front – making its expertise broadly available – many other organizations have been able to progress their own programs.
Through partnering with a number of local organizations, the bases have been laid for future.
Yet, there have been challenges and lessons learned amidst IDRI’s first quarter of century of global work. IDRI’s “business model” is unique and has been very productive. The reliance on grants for funding has, however, shown its limitations. The limited availability of unrestricted funding has hampered IDRI’s ability to innovate beyond its already remarkable accomplishments.
What do I see for IDRI in the next 25 years?
IDRI will redefine its business model to ensure enough unrestricted fund to support innovation. This will provide a platform for its scientists to gain recognition as trend setters for science and for the organization, itself, to achieve significant global public health impact. Lastly, and possibly most importantly, IDRI will ensure that its current and future partnerships are managed so as to maximize opportunity on the global health stage.
As a nonprofit global health organization, IDRI (Infectious Disease Research Institute) takes a comprehensive approach to combat infectious diseases, combining the high-quality science of a research organization with the product development capabilities of a biotech company to create new diagnostics, drugs and vaccines. IDRI has a world-class portfolio of adjuvants and formulations, which are critical to making today’s vaccines effective. These are used in IDRI products and also licensed out to others around the world. Founded in 1993, IDRI has 125 employees headquartered in Seattle with more than 100 partners/collaborators around the world.