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This is the first in a series of profiles to help IVAC partners and friends get to know our team. We thought we’d start with Lois Privor-Dumm, a long-time IVAC team member and Director of our Alliances and Information team. We caught up with Lois in between her busy travel schedule to chat about her background, her work at IVAC and what she likes to do in her spare time.

Tell us a bit about your background, what inspired you to work in global health, and how you ended up at IVAC.

Lois_PrivorDumm

Lois Privor-Dumm

I didn’t set out to work in global health, but I’ve always wanted to work internationally. I spent most of my career in the private sector and was fortunate enough to have the opportunity to launch Prevnar®, the first pneumococcal conjugate vaccine (PCV), in the U.S. and then help other countries around the world introduce the vaccine. I had worked with other vaccines and pharmaceuticals, but this experience, coming in direct contact with families impacted by pneumococcal disease, particularly meningitis, made a major impression. I saw the value that the vaccine had for countries that had introduced, but also recognized the severe disparities that existed in vaccine access around the world. I decided I could play a role in helping reduce those disparities. Although I was able to influence some change while working in pharma, I thought I could make a bigger impact by bringing my understanding of the industry and my marketing and operations experience to public health. I was fortunate to be working with experts on PCV, including Orin Levine, Mathu Santosham and Kate O’Brien, who recognized how my perspective – despite my non-traditional background for a public health career – could be beneficial. We shared the vision that new vaccine introductions did not need to see delays of 20 years or more between licensure and introduction in low-income countries, and helping devise and implement a plan to achieve this goal was very intriguing to me. 

So, I first joined Hopkins in 2005 as Director of Communications and Strategy on the Hib Initiative and soon after took on the role of Director of Access and Implementation, and later Communications, for the PneumoADIP. Our approach of addressing the needs of all stakeholders – countries, donors and suppliers – proved to be an effective way to achieve our vision, and we’ve been fortunate that we’ve been able to continue our mission through what is now IVAC. I consider myself very lucky to work with such a diverse, creative and talented team. I think it is the team and the way we work that has enabled us to work on some really tough challenges that have a big impact and achieve success.

I’m also a strong believer that there are always solutions and, at Hopkins, I value the opportunity to help facilitate those solutions, bringing both a manufacturer perspective and that of someone working with global health colleagues and country leaders. There’s been significant progress in vaccine access in the past decade or so, and I hope our work will continue to accelerate greater access and equity for vaccines and other interventions that make such a difference in peoples’ lives and contribute to healthier and more productive societies.

What projects do you work on at IVAC?

PrivorDumm_Nigeria_Vaccine_Summit

Lois Privor-Dumm and a group of children at the 1st National Vaccine Summit in Abuja, Nigeria in April 2012.

I lead the Alliances and Information team at IVAC, which includes projects covering advocacy and communications – both globally and in-country – as well as policy research and supply and access issues. I spend a great deal of time on our country-focused work, namely India, where we have been working to synthesize the evidence base and advocate for interventions for pneumonia and diarrhea at both the national and state level, and Nigeria, where we have helped analyze barriers and solutions to improve routine immunization and continue to provide technical support and encourage government accountability. I’m also excited that we’ve recently added country work with Pakistan.

Our work is varied, and there is never a dull moment. Our efforts have helped others become advocates and add their voice to important issues in child health. For instance, we’ve run advocacy workshops and collaborated with a network of trained experts to address child pneumonia and diarrhea in their countries. We support the efforts of experts including the ROTA Council, a dedicated council of scientific experts working to accelerate the introduction of rotavirus vaccines, and the Global Coalition Against Child Pneumonia. With the help of key partners, we established World Pneumonia Day to call for action on protection, prevention and treatment of the leading global killer of children. Our team also coordinates closely with IVAC’s Epidemiology and Economics & Finance teams to help communicate the results of their work and highlight the work of other researchers that relates to vaccines and child health.

Last but not least, I spend much of my time on our supply and access work, which is also very important. One of our more recent projects centers around primary container decision making and building awareness of how these seemingly straightforward decisions have significant impact on not only cold-chain space and procurement cost, but also wastage and other costs, vaccine coverage, and safety. We’ve developed a framework and have been working with various experts to help advocate for a more robust approach to considering all the implications of these decisions.

I’d be remiss not to mention, that none of this, of course, could be done without the great team of hard working and very capable individuals and students on the A&I team.

What have been some of your most rewarding or memorable experiences at IVAC?

One of my most memorable experiences was my first week at Johns Hopkins. I was working with the Hib Initiative and went to the Gambia and Bangladesh to film the BBC World Kill or Cure: Hib documentary, which highlighted the impact of the disease and efforts needed to bring a vaccine to developing countries. I remember meeting people at the labs and families that had been affected by meningitis and seeing how dedicated they were to finding the solution. I have great memories from that trip, for example touring the lab at MRC and then having tea with a family in the Gambia with little kids around very curious about all of our cameras. Bangladesh was no different, although it was tough seeing a child and her mother who did not know whether her daughter would survive the night or succumb to a severe case of pneumonia.

Another big moment was the first World Pneumonia Day in 2009 and seeing that kick off not only in the U.S. but probably more importantly around the world. That sense of pride continues when I see how many other people have taken up the cause. As we move into World Pneumonia Day’s fifth year, I am increasingly impressed by the level and volume of activities that take place – creating a global community of sorts. The fact that people are talking about antibiotic access, bringing new vaccines into countries, improving breastfeeding rates – it is very gratifying.

What is the most interesting place you’ve traveled to? Anyone who has seen your passport will know this will be a tough question to answer.

Yes, it is. Everywhere I’ve gone has been interesting. Large countries hold a lot of interest for me simply because of the level of contrast you see within the same country. I’m always struck by the disparities within the countries, but at the same time, the level of hope and generosity of those that don’t have much. I am fascinated by the diverse modes of transportation like the trucks that are brightly painted with “honk please” signs in India and Bangladesh, navigating the same roads as people walking with bundles of firewood on their heads or families piled three or four onto a small motorbike seat. In Nigeria I’ve been captivated by the people and the diversity of just about every aspect from dress to food, language and density of the population. And in some countries you’ve got such a long history that can’t help but impact you – Angkor Watt in Cambodia, Petra in Jordan, and slave quarters in Africa – it reminds me of how far the countries have come, yet how much more is still to be achieved.

Since you spend a lot of time in India and Nigeria, what similarities and differences do you see between the two?

India_National_Course

Lois Privor-Dumm and fellow participants at a national course on pneumonia and diarrhea prevention in Delhi in December 2012.

That’s a great question. I’d love to hear the perspective from those who live in one of the two countries. From my perspective though, they are similar in that they both have some wonderful, high caliber people. Both have large bureaucracies and complex environments, and I’m always impressed by

individuals who’ve been great champions of children who’ve successfully been able to navigate the environment and overcome some real barriers to getting things done. The real heroes are the ones who’ve been able to not just talk about change, but have been able to see things through, and there have been examples in both places. Another similarity is that health is very much a state subject, and implementation and sustainable change is highly dependent on the individual states. As different as priorities and ways of life are between these countries, the same can be said of individual states, and it is important to understand the priorities and players in each.

Both countries obviously have had to tackle an ongoing challenge of polio, and the related challenges and opportunities of an enormous vaccine effort. India has now gotten ahead of the curve with no cases of wild-type polio for the past two years. Nigeria still faces many challenges with polio, but has moved ahead to strengthen routine immunization and add new vaccines. 

One major difference may be in the way vaccines are portrayed in the press in each country. Although the dialogue is changing and more and more positive stories emerge surrounding vaccines, media in both countries still often like to report on sensationalist stories that do not hold scientific muster, and controversy reigns. Politicians and bureaucrats often do not recognize how political capital can be built by improving routine immunization. In Nigeria, although there are anti-vaccine sentiments, particularly surrounding polio in certain areas, health is an important issue, and leaders will take advantage of reporting on the steps they’ve taken to combat disease.

On a related note, what progress have you seen in vaccine access in India and Nigeria recently, and what do you expect to see in the next few years?

I think there is much more recognition in both countries that the systems must be strengthened, infrastructure for delivering polio immunization can be leveraged, and that a focus on bringing up routine immunization coverage will benefit new vaccines and vice versa. There has been a greater level of engagement at the state level, and I expect that this will become increasingly important moving forward. As states are implementers and must ultimately ensure that there is both adequate demand and supply, their engagement in the planning and decision-making process is key. Another area that should see improvement over the next few years is surveillance, not only to be able to measure the impact of the vaccines but also to be able to monitor any adverse events that may happen and to quickly determine if they are related to the vaccine. This has especially been a challenge in India, where activists and media have questioned whether adverse events are due to vaccine and have treated government assurances with suspicion. Good surveillance with baseline measures of child health statistics prior to introduction will make it easier to assess claims and address concerns that may be unfounded, as well as provide a basis for measuring the trends and impact that are so important to communicate to sustain public and policy maker support for vaccines.

On a personal note, when not traveling internationally, you split your time between Baltimore and West Chester. What do you like about each?

Yes, both places are great. West Chester is where I’ve lived for a long time, and where I spend a part of the week with my husband and dog. It is a historic city with brick sidewalks, and a small town where I’ve gotten to know a lot of people over the years. I consider it home, although I am originally from upstate NY. Baltimore is a great city. I love where I live in Fells Point, right by the water. I’ve got great colleagues and friends in the city, and the ability to walk to work is a huge bonus!

Do you have any interesting hobbies?

I like doing things outside, including spending time gardening, hiking and exploring different places old and new. But, there is no place I’d rather be than under the water diving (although on safari is a close second). I’ve been diving since 1992 and try to go every year. One of my favorite places is the South Pacific where you have just an amazing range of color and variety of marine life – sharks and eels and all sorts of different things. I think I like it because I’m an explorer at heart, and you never know what you’re going to find down there, and it’s a way to really relax.

What is the most recent book you’ve read?

I just read Cutting for Stone about a doctor from Ethiopia and am now reading Behind the Beautiful Forevers – Life, Death and Hope in a Mumbai Undercity. I like reading about places I’ve been or would like to go. I also have been reading some of the excerpts from an international thriller novel a friend of mine is working on publishing – can’t wait to see that in print.

Ok, just one last question. If you could have dinner with anyone, alive or dead, who would you pick and why?

That is a really tough question. Can I just throw a party?! I’d love to meet famous women who have made a difference – like Aung San Suu Kyi or, closer to home, Hillary Clinton. They are role models for how you can help change the world. And then there are people who I’m just starting to hear about who are doing some cool things with social innovation – not as well known of course, but just as inspirational. Coming from a business background, I’m interested in hearing about new ways to solve the world’s problems.

By Dr. Sachiko Ozawa

Evidence on the value of vaccines is essential for donors and government officials to see what their investment in vaccines buys. This value isn’t only about the health impacts we tend to think of – such as lives saved, illnesses prevented, and disability averted from vaccines. Vaccines also bring about broader economic benefits. Families avoid treatment costs and parents do not have to take off from work to care for sick children. Children may also have fewer missed school days, succeed better in school, and take on higher-paying jobs to support the country’s economy. In short, vaccines are likely to bring much value beyond direct health impacts.

Sachiko Ozawa

Sachiko Ozawa, PhD, MHS

Last week I participated on a value of vaccines panel at the GAVI Partners’ Forum that focused on just this idea. Raymond Hutubessy from the World Health Organization introduced the importance of valuing the full value of vaccines. I then presented the current evidence base including a recently published literature review from IVAC, which demonstrated that vaccines are cost-effective but highlighted the need to strengthen the economic data on vaccines. Till Barninghausen from the Harvard School of Public Health and Damian Walker from the Bill & Melinda Gates Foundation shared results from two case studies in South Africa and Bangladesh. These studies found that the measles vaccines can increase school attendance and improve school attainment (as measured by higher test scores), which may lead to a higher earning potential for these children.

We were pleased to have a truly engaged audience. The audience recognized that cost-benefit analyses that present the benefits of vaccines in dollar values are useful and needed, which is a contrast from the current norms to use cost-effectiveness data that assigns a dollar amount per DALY or disability-adjusted life year averted. An argument was made that just as interventions in other sectors could save lives, we need to present the benefits of health interventions in the same financial terms these sectors would use, in order to show the full return on investment. It was also noted that we are not done building the evidence base around the narrow benefits of vaccines. Therefore, a suggestion was made that we build economic evidence both at the narrow and broad levels concurrently. Another point made at the session was that many of these broad benefits may result not only because of vaccines, but because of a combination of health interventions that save lives and prevent illnesses. Audience members suggested looking into measuring the economic value of a package of interventions, or of a healthy child as a whole, in order to support efforts to advocate for investment in health vis-à-vis other sectors.

This successful panel and discussion led to an unexpected and truly exciting opportunity. Our panel was called upon by about 25 parliamentarians participating at the forum to give a separate presentation to this honorable group. This meant we could disseminate our work to the people who are actually advocating for vaccines in low- and middle-income countries. What an opportunity! We took to this occasion with enthusiasm and received feedback from the parliamentarians that confirmed they need evidence in dollar values to take to their ministers of finance. Many members of parliament in the room said they were glad to be armed with more evidence they can use to advocate for vaccines. We truly hope this type of engagement will continue with parliamentarians beyond this forum.

At IVAC we pride ourselves on being able to create, model and develop evidence that could be used in decision-making. Last week I witnessed that the evidence we develop indeed matters to audiences who use it to advocate for improvements in child health. Beyond the opportunity to share our evidence with parliamentarians and receive their feedback, I saw the economic evidence we developed put to use in advocacy materials such as an infographic created by the United Nations Foundation’s Shot@Life campaign.

One statement at the forum stuck with me: “Advocacy without evidence is just opinion.” I look forward to continuing to build the economic evidence that can be used by advocates – work that truly matters to saving children’s lives.

Sachiko Ozawa, PhD, MHS, is an Assistant Scientist with Johns Hopkins University Bloomberg School of Public Health and IVAC.

By Dr. Kate O'Brien

This week, IVAC staff have had the privilege to participate in the GAVI Alliance Partners’ Forum in Dar es Salaam, Tanzania. This could not be a more fitting choice of location, as a country that has shown remarkable leadership and commitment to vaccines for children. Yesterday (December 6th) marked the dual launch of rotavirus vaccine and pneumococcal conjugate vaccine in Tanzania, the second country to have undertaken such a dual launch (Ghana being the first).

The Partners’ Forum brings together in one place the truly remarkable range of partners that make up the Alliance including civil society organizations, UNICEF, WHO, GAVI-country representatives, donor country representatives, the Bill & Melinda Gates Foundation, vaccine manufacturers, the World Bank, the Pan American Health Organization (PAHO) and many others, coordinated in their efforts through the leadership of the Secretariat. IVAC, and numerous other technical and academic groups, are counted among these valued GAVI partners producing work that really does move the needle.

The theme of this Partners’ Forum is RISE, highlighting Results, Innovation, Sustainability and Equity – four themes that resonate for us at IVAC. I want to particularly focus on the results, without which there is nothing upon which to base innovation, nothing to sustain and nothing driving an insistence on equity.

Throughout this Forum we have seen the power of evidence to propel sound decision-making and commitments that are saving lives and reducing suffering around the world. We saw the power of pneumococcal conjugate vaccine disease impact data from Kenya where in just two years of vaccine use, vaccine type pneumococcal disease is becoming vanishingly rare. We also saw the compelling case for vaccines through the promise of over $150 billion of economic benefits gained over 10 years through improved health by vaccination. And we saw the reassurance of real-world performance and safety evaluations for rotavirus and pneumococcal vaccines in settings around the world where the vaccines are most needed.

Economics of Immunization

Photo Credit: Excerpt from Shot at Life's Economic Value of Vaccination Infographic. Based on Decades of Vaccine Economics (DoVE) research from IVAC showing that increasing access to coverage with new and existing vaccines can yield substantial health and economic benefits (Stack, et al. Health Affairs - June 2011).

These results meaningfully strengthen the foundation of evidence on which these vaccines stand. Speaking for themselves, these data bring renewed energy, commitment and resolve that the extraordinary effort by hundreds of thousands of community health workers, nurses and doctors to get these vaccines into children, on time for every dose, will indeed deliver results.

IVAC is proud to have collaborated with various organizations, both in country and internationally, to generate the results highlighted above. These particular studies are a great example of how we all stand shoulder to shoulder with our partners, and our partners’ partners, to make vaccines real for children, families and communities. Through the GAVI Alliance we have had the opportunity to work in trusted collaboration with PATH, CDC, Aga Khan University, University of Witwatersrand, Norwegian Institute of Public Health, KEMRI Wellcome Trust, WHO, PAHO, MRC Gambia, South Africa’s National Institute of Communicable Disease, and many other institutions on projects, studies, evaluations, trainings, and assessments that are all delivering directly on our shared vaccine mission.

This Partners’ Forum has been a focused opportunity to see compelling results make a difference. It is really happening. As we contemplate what it will take to assure every child is not just vaccinated but fully vaccinated, I urge us all to lean forward together in this effort to ensure change happens.

We at IVAC are committed to Rising to the Challenge with all of you.

Kate O’Brien, MD, MPH is Acting Director of IVAC. A pediatric infectious disease physician, epidemiologist and vaccinologist, she previously served as Deputy Director of IVAC. She also serves as Associate Director of the Center for American Indian Health.

In October, Dr. Kate O’Brien took over as Acting Director of IVAC. One of IVAC’s founders, she reflects here on how far the organization has come and her vision for the future, while also sharing a bit about her diverse career in global health.

You have been at Johns Hopkins University for more than 20 years. Can you tell us a bit about your background and how you ended up at IVAC?

When asked about my background, I find myself saying first and foremost that I am a Canadian, which helps explain who I am and why I do what I do. As a pediatric infectious disease physician, as well as an epidemiologist and vaccinologist, I’ve had the great fortune to work on meaningful problems and with remarkable people. Much of my training and career has been spent at Johns Hopkins where I first came to work as a pediatric intern in 1988. I also did my infectious disease training, and my Masters of Public Health at Hopkins. Following those formal training programs I joined the Centers for Disease Control in Atlanta as an Epidemic Intelligence Service Officer where my career direction was really set in motion, working on pneumococcus, Hib, and other bacterial diseases of childhood. Although over the years I’ve worked on many different pathogens and vaccines, all of that work has been held together by the concept of preventing disease in children, and specifically preventing disease through vaccines. For me an important notion is that throughout the developed world we have the incredible good fortune to live in communities with abundant resources. When it comes to children, vaccines are a social justice issue. Every parent, everywhere in the world wants their child to have a life of opportunity – it doesn’t seem fair, or just, that some kids have the benefit of receiving vaccines and others don’t, by the quirk of where they happen to be born. My work is about assuring not only that we have the best vaccines possible for preventing as much disease as possible, but also that the benefit of those life-saving vaccines should be available to all kids around the world regardless of where they were born, or whether their families can pay.

Kate O'Brien, Acting Director, IVAC

Dr. Kate O'Brien, Acting Director, IVAC

This is the foundation of IVAC and before that the PneumoADIP project, whose provenance is an interesting story. I had returned to Hopkins from CDC to work for the Center for American Indian Health on vaccine trials [Editor’s note: Dr. O’Brien continues to serve as Associate Director of the CAIH]. Soon after I returned, Orin also came back to Hopkins to join our group after he had spent time at the CDC and NIH. Soon thereafter, the RFP for the PneumoADIP was issued by GAVI; I remember sitting in my office with Orin discussing if I wanted to go in on this, to which I naively committed but warned him that I didn’t know what an “ADIP” was! We submitted a proposal setting out our ideas of how a set of activities could accelerate pneumococcal vaccine decision-making and were awarded the PneumoADIP grant. That was a really stimulating period of time and one that was transformative within the School by bringing together domains of science, finance and communication in a way that was not typical for the kinds of projects Johns Hopkins was doing at the time. Through that project we envisioned a place within the School that worked on vaccines from a multi-dimensional perspective and brought together skills and domains that go beyond the traditional science or academic ways of working. When the PneumoADIP project came to an end we embedded those principles into the founding of IVAC – to use the skills that we have within academia, of unbiased, rigorous, data driven decisions, always being clear as scientists that we allow the data to speak for themselves, and to bring those into the world of policy development and advocacy for vaccines.

You have had quite a varied career within public health. What inspired you to work in global health specifically?

Working in global health for me is really a social justice issue. Growing up in Canada, where the values of contributing to society are very strong, I hold as a guiding principle that all people are precious regardless of their station in life; children especially should not only have the opportunity, but they should also have the right to good health and the right to protection from preventable diseases. So for me the global health sphere is one that really speaks to my values, one that informs what I want to spend my working days doing, and how I want to contribute to society. From a personal perspective, it is a remarkable opportunity to constantly learn from others. It is also a career that demands humility – there are very few concrete “right” ways of solving problems, because there are just so many different ways people make decisions and contribute to health, and so many ways that communities and societies interact to make decisions for the collective good. In all those ways there is always a learning curve, always a way to feel enriched and a great sense of contribution. 

The global health landscape has really expanded in the past several years, and some would say that the space is now crowded. What makes IVAC stand out?

That’s a great question. There are some really clear things that make IVAC special in the global health arena. One is that IVAC is fundamentally seated within a university. Being in an academic setting means the fundamental characteristic of our work and approach is being balanced, agnostic and neutral – the pursuit of new knowledge, the revelations of new learnings, will always lead us in the direction of benefit and good decision making. This philosophy, that the data will speak for themselves, draws people to IVAC as faculty and staff who are committed to letting the evidence drive our efforts. The second thing that makes IVAC unique is that within the university, IVAC is really an unusual center; sitting within a single center are people working in diverse domains of vaccines where interaction with each other on a daily basis doesn’t usually happen. I think this was the incredible lesson of PneumoADIP – when you take people who are experts in financing, strategic vaccine supply, advocacy and communications, and you put them in the same space, thinking about the same problems as the epidemiologists, the vaccine clinical trialists, and the people who are scientifically driven, you end up with a learning space and leveraging of those skills well beyond the sum of the parts. You end up being able to look at problems in the vaccine space with solutions that were otherwise not imagined by any one group of people working on the problem. It is this multi-dimensional characteristic that is unique, and the emphasis and demand for excellence in all we do, which I think is what comes out of the academic atmosphere.

Kate O'Brien with child in Bangladesh

Dr. Kate O'Brien with a child in Bangladesh.

Along those lines, what have been some of the proudest moments at IVAC over the years?

There are many, but what come to mind are several tangible things. Going back to PneumoADIP days, a really proud moment was the launch by GAVI of the Advance Market Commitment for pneumococcal conjugate vaccines. PneumoADIP’s mission for five years was to figure out – in collaboration with the many global partners and country partners who all had views on and interests in this – whether or not pneumococcal vaccine should and could become a reality for the poorest kids around the world. So, the launch of the Advance Market Commitment was really one way when it all came together and became tangible; we knew we had reached a goal. There were many steps, some of them small steps and some of them really big steps, that culminated in an expression that global health decision makers, viewed the evidence as sufficient, credible and conclusive that pneumococcal conjugate vaccine was a product worthwhile to deliver to kids in the developing world and that there was a way of making that happen. So that was an incredibly proud moment and really felt like a culmination. 

Since then, each time a country launches pneumococcal vaccine it is a proud moment because it is an on-going living expression of the value of the work that we have been doing. It becomes something real for me that there are infants and children whose lives have been saved by those vaccines; of course we don’t know which kids they are but we know they are there.

Other proud moments come from the spirit and enjoyment of the people at IVAC and those we work with in partner organizations; there is real motivation by the mission and by the creativity and innovative way that we work. Events like World Pneumonia Day that bring pneumonia fighters to the streets of Washington or events like Pneumonia’s Last Syrah in New York where we sold wine to promote the prevention of pneumonia are really amazing – those are just not activities that the average pediatric infectious disease physician gets to spend time working on!

So looking to the future, what are your top three priorities for IVAC as we move into 2013?

My top priority for 2013 is to continue delivering the highest quality work for every project we’re are engaged in. This is the guiding core value of IVAC and we will continue to deliver the quality of work that we have always delivered.

The second priority is for IVAC to contribute meaningfully to new areas of work---that could be new projects within areas that we’re already engaged in, or completely new areas. Whether it is pneumonia etiology studies, impact evaluations of vaccines, economic and advocacy projects that help decision makers understand the best use of vaccines, or work on prioritization and implementation of those vaccines – there are many areas where IVAC can contribute its expertise to really important decisions.

The final and foundational priority is to assure that the people within IVAC continue to have a supportive atmosphere where their effort is valued and where they know that the work they are doing is making a difference.

Building on that and taking it forward, what does success look like for IVAC in the next five years?

That’s an easy one; success for IVAC is when, five years from now, there is a healthy IVAC. And what I mean by that is IVAC continues its contributions in the global health sphere with people who are working on topics that they feel are important and that the global health community is deriving value from that work. It’s really important that we not be rigid in what that looks like, instead we need to be flexible to address the needs of the community. A successful IVAC in the next five years is responsive to the needs that emerge to actually get vaccines where they need to be and demonstrate the value of those vaccines so they can continue to be supported.

Tell us a little bit about your family.

My husband is an adult infectious disease physician who also works in the global health sphere, but mostly in the domain of HIV/AIDs. We met while working in Haiti. We have two kids, Emma who is 15 and Jack who is 13. My extended family still lives in Canada so we spend a good deal of time there.

As some readers may know, you moved from the Washington, DC-area to Geneva last year. What do you and your family like best about living in Geneva?

Beyond the work we do here what we appreciate most is the incredible access we have to the  outdoors and the stunning beauty of this land. Everyone in our family really loves being in the mountains, being on a bicycle, taking a walk in the woods or through farmland, or skiing or ice-skating. Switzerland is such a small country, it means all of these things are close by. We love having the ability to enjoy this remarkable part of world for however long we are here.

We also really appreciate the opportunity to live in more than one language. Just having that lovely experience of coming into other cultures and into other peoples’ ways of living means we all can learn a lot about better ways of living.

What is the most interesting place that you have traveled to?

I knew you were going to ask me that!

We thought it might be Haiti, since that is where you met your husband.

I should say that, shouldn’t I? In fact Haiti is probably the most interesting place I’ve ever lived. It has an incredible mixture of cultures and histories, the European influence, the African influence – it is really a remarkable and unique culture. The art and the music that comes out of Haiti is phenomenal. It has a deeply troubling and in many ways tragic political history, but in spite of that there is a resilience and love that people have for their culture, for their country and for each other. Another place that is a favorite of mine is Jerusalem. It’s hard not be overwhelmed by the presence of history there.

One last question. You’ve had an amazing career – what are some of the highlights you’d like to share?

The greatest highlight has been the privilege to care for my patients…there are many kids and their families who have touched me in ways that they will never realize. I know this is a common experience for every physician, for every nurse, but it is true. There is far more that our patients give back to us than we can ever give to them, much as we try. The communities I’ve been able to serve are undoubtedly a highlight, in particular the Navajo and White Mountain Apache tribes who I’ve worked with for over 14 years, trying to address health disparities from vaccine preventable diseases. Those communities have a beauty and a history that is deeply humbling, showing us how little we really understand about life and spirit in this contemporary, modern, western society we live in. The other highlight is one that underlies everything, and that is the people I’ve worked with over the years. Those who know me know that beyond all else is my belief that in the end our work, our success, our joy, is always all about the people. Over the years I’ve had the most amazing mentors, colleagues, collaborators and students at Hopkins, at CDC, and at many other organizations around the world. In the end, it is always, all about the people.   

By Dr. Kate O’Brien

Kate O'Brien, IVAC's Acting Director

IVAC's Acting Director, Kate O'Brien

Today is a notable day for IVAC. We have transitioned from the leadership of Dr. Orin Levine, the founding director, who led the Center through its growth from a single project to a diverse portfolio of projects encompassing numerous vaccine access issues. We are beginning a new IVAC chapter, and I am proud to take the reins as Acting Director while the planning for a permanent Director progresses. Although this role for me at IVAC is new, the institution itself is not. My experience at IVAC includes the stages of visioning what we wanted the Center to be, choosing its name, developing our space from a concrete cavern to a place of warm collaboration, and growing its projects and staff.

IVAC is defined by its people and its partners. You are a dynamic, innovative, and dedicated group, focused on “moving the needle” toward improvements in child health and survival. Our long-term partners – organizations such as the GAVI Alliance, the Gates Foundation, CDC, PATH, Sabin Vaccine Institute, International Vaccine Institute, and fellow academic institutions and research centers around the world – have been central to the successes of IVACs work that aims to expand vaccine access to children in the places where it is most needed. We will continue to extend our efforts across disciplines and partners, guided by the mission of full vaccine access against leading causes of mortality and morbidity like pneumococcus, Hib, rotavirus, dengue, malaria and influenza.

I am very grateful for the opportunity to lead IVAC, an organization that will continue delivering the highest quality and impactful work it is known for. My aim in this next chapter of IVAC is to foster an environment where great work can continue to drive vaccine access, achieving milestones beyond what we believed possible at the beginning of IVAC. Working to collaborate with new partners, strengthen existing collaborations and providing our staff with the means to create and innovate, the work we do will remain firmly grounded in principles of excellence, objectivity, data driven decision making and advocacy using fresh, often unconventional, approaches.

I look forward to working with all of you in my new capacity, and eagerly welcome the discussions, directions and deliberations we are sure to have on the way to accelerating use of life-saving vaccines around the world.

Kate O’Brien, MD, MPH is Acting Director of IVAC. A pediatric infectious disease physician, epidemiologist and vaccinologist, she previously served as Deputy Director of IVAC. She also serves as Associate Director of the Center for American Indian Health.