Vietnam’s vaccine champion

PATH.org

September 24, 2018 by Katie Regan

Dr Le Van Be at IVAC_PATH/Hai Trinh.JPG

Dr. Le Van Be, director of the Institute of Vaccines and Medical Biologicals (IVAC) in Nha Trang, Vietnam, is driven by a childhood encounter with rabies to improve the health outcomes of the people of Vietnam. Photo: PATH/Hai Trinh.

Dr. Le Van Be, director of the Institute of Vaccines and Medical Biologicals, believes in the power of vaccines. And he is committed to seeing locally made influenza vaccine become a reality.

When Dr. Le Van Be was a child, a young girl in his town contracted rabies. Passed from an infected dog, the virus raced through her body, first bringing fever, headaches, and nausea, then eventually, hallucinations, paralysis, and death.

“I will never forget the way the rabies attacked her,” Dr. Be says quietly. “And how we could do nothing for her. That is why I decided to go to medical school. I went with hope I could help improve the health of my neighbors.”

The only treatment for rabies is vaccination shortly after exposure. Dr. Be, however, grew up in a very poor area of a poor province. At the time, acute medical care was a luxury, and preventative health care was limited. Medical school presented an opportunity, not just to improve his own fortunes, but to fight against some of the helplessness and unnecessary death that brush with rabies highlighted.

He focused on microbiology while at Hanoi Medical School, a concentration assigned by the school but that was perfectly suited to his future career in vaccine development.

Now the director of Vietnam’s state-owned vaccine manufacturer, the Institute of Vaccines and Medical Biologicals (IVAC), Dr. Be is working every day to ensure the health of not only his neighbors, but his entire country. In his 35 years at IVAC, Dr. Be has worked on vaccines against diphtheria, tetanus, pertussis, tuberculosis—even rabies.

“Vaccines are so important to prevent infectious diseases; there is nothing like them,” says Dr. Be. “Vaccines have the power to protect Vietnam, and the world, from so much sadness.”

Dr. Be is now focused on tackling a new disease: influenza. And he is nearly there; for the past decade IVAC has been working to develop and license vaccines against both seasonal and pandemic influenza. Licensure of a seasonal and a pre-pandemic A/H5N1 influenza vaccine candidate is expected by early 2019. This will be a critical achievement because Vietnam, a country of 92 million people, currently has no reliable, locally manufactured supply of influenza vaccine—an extreme vulnerability given the country has experienced deadly outbreaks of both A/H1N1 and A/H5N1.

“Vaccines are so important to prevent infectious diseases; there is nothing like them. Vaccines have the power to protect Vietnam, and the world, from so much sadness.”

— Dr. Le Van Be, director, Institute of Vaccines and Medical Biologicals (IVAC)

Dr. Be was of course always familiar with influenza, but it is to early-career exposure to global influenza vaccine manufacturing that he truly owes his interest. Learning about the methods used to develop influenza vaccines—and the surprising difficulty of creating a weapon against such a common infection—was fascinating to him. Even before IVAC began its own influenza journey, Dr. Be began exploring journal articles about the disease and following technology updates associated with vaccine development.

It became clearer and clearer over the years that Vietnam needed its own, sustainable supply of influenza vaccine. Even if Vietnam weren’t highly susceptible to pandemic, the capricious nature of influenza alone would be enough to worry Dr. Be.

“Influenza is among the microbes that cause the most trouble for scientists, because it is always changing,” says Dr. Be. “And when it changes it can grow out of control. We’ve seen that with A/H1N1 many times in the past; we have seen it take tens of millions of lives.”

Dr. Be can easily imagine the rabies scenario from his childhood playing out today with another group of children, in another province—except, this time the enemy is influenza. In fact, it probably already has. When the worldwide A/H1N1 pandemic struck in 2009, Vietnam waited for more than a year to receive imported vaccine while more and more people fell ill by the day; by the time the vaccine was available to Vietnam, the country no longer needed it because pandemic had ended. In a pandemic situation, vaccine shortages are not only likely; they are expected.

Vietnam has made efforts even in lieu of a vaccine, though. The country has strengthened its disease surveillance networks, outlined quarantine measures, and run numerous exercise simulations. These steps have helped—immensely—but they’re not enough without a vaccine.

Dr. Be also emphasizes the need for better disease awareness and education—particularly for health workers, who often don’t perceive the disease as serious. He noted there is a lot of mix-up between seasonal influenza and the common cold, which can cause people to ignore dangerous symptoms and let the disease spread unchecked.

“We won’t stop. We will keep working to improve our abilities, our technologies, everything.”

— Dr. Le Van Be, director, Institute of Vaccines and Medical Biologicals (IVAC)

Dr. Be has made it a personal mission to correct influenza misinformation whenever he encounters it. He carefully explains the basics: what influenza disease is, how it’s transmitted, how quickly and widely it can travel, the burden it places on a community, and how serious the consequences can be.

“I am honest with them,” he says. “I tell them, it doesn’t matter if you are young and strong. You can infect your family members. You can get very sick. You can even die.”

But overall, he is optimistic. IVAC’s has made incredible strides in the past ten years: from total naivety toward influenza vaccine development, to successful vaccines against A/H1N1, A/H5N1, A/H7N9, and seasonal influenza. IVAC has made such progress, in fact, the Vietnamese Ministry of Health recognized it for “contributing to the advancement of Vietnam’s national health,” says Dr. Be.

What does Dr. Be hope to see in the future? Sustainable influenza vaccine production. Increased manufacturing capacity. Heightened disease awareness and vaccine acceptance. And, critically, seasonal influenza vaccine’s incorporation into Vietnam’s national immunization program—which would allow the public to access the vaccine for free.

“But we won’t stop there,” says Dr. Be. “We will keep working to improve: our abilities, our technologies, everything.”

His conviction is not surprising. He is, after all, the same little boy who looked at disease and declared he would stop it.

And now, on the long and winding road of progress, it is important to pause and consider how far we’ve come. If an influenza pandemic happened today, is Vietnam better prepared than it was ten years ago?

“Oh, of course,” Dr. Be says with a smile. “Absolutely.”

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