As Research!America prepares for our 24th Advocacy Awards Dinner, we want readers to learn more about our award recipients. Every Tuesday leading up to the March 11, 2020 event, we will post a short interview with our esteemed honorees.
Myron M. Levine, MD, DTPH
Associate Dean for Global Health, Vaccinology & Infectious Diseases, Center for Vaccine Development and Global Health, University of Maryland School of Medicine
When did you know you were an advocate for scientific research and innovation?
In progressive steps, during medical school, pediatric residency, infectious diseases fellowship, as an Epidemic Intelligence Service Officer of the Centers for Disease Control and Prevention, subsequently during post-graduate studies in tropical public health in London, and as a young faculty member at the University of Maryland School of Medicine, I increasingly affirmed a commitment to pursue research to prevent certain diseases that overwhelmingly afflict impoverished populations in developing countries. When this personal commitment was initially solidifying in the 1960s and early 1970s, enteric infections – the main focus of my research over the decades – constituted the number one cause of mortality among children less than two years of age in developing countries.
If you weren’t in your current field, what would you be doing?
From 1998 to 2002, I spent approximately one-third of my work effort as a consultant to the Rockefeller Foundation representing that Foundation as a member of an international Working Group that was crafting governance for a new entity that would succeed the Children’s Vaccine Initiative of the 1990s. I agreed to take on this external task in addition to my main responsibilities as Director of the Center for Vaccine Development at the University of Maryland School of Medicine. The new entity, the Global Alliance for Vaccines and Immunization (GAVI), had an initial launch within the United Nations agencies in November 1999, and, thereafter, had its full global launch at the World Economic Forum in February 2000. Following the launch of GAVI, I remained within the GAVI Working Group for two more years during which I initiated and served as Co-Chair of the GAVI Task Force on Research and Development. I played a key role in convincing the GAVI Board to accept the concept that research creating today’s vaccine candidates and immunization technologies leads to tomorrow’s new and improved vaccines for implementation to prevent disease. I thoroughly enjoyed these “GAVI years” (1998 to 2002) and considered this pursuing this endeavor full-time. However, I also still immensely enjoyed hands-on involvement in and direction of vaccine research. With reluctance, I elected to leave my GAVI responsibilities and concentrate on various exciting vaccine projects and epidemiologic research at the CVD.
If I were to have entered another field outside of medicine, it would likely have been as a historian or as a political scientist.
What do you consider your biggest career accomplishment?
As I look back on my career, there are three that stand out. One is the decades of collaboration that I had with the Ministry of Health of Chile in establishing a Typhoid Fever Control Program for the Metropolitan Region (Santiago) where typhoid was hyperendemic. I obtained external funding to support the typhoid control program that allowed us to undertake a series of public health research endeavors that provided the tools and knowledge to interrupt the amplified transmission of typhoid fever that was occurring. One of those tools, live oral typhoid vaccine Ty21a, was evaluated in four large-scale randomized controlled field trials involving approximately 500,000 Santiago school children. Those field trials assessed the safety, clinical acceptability and efficacy of the new typhoid vaccine and provided the evidence base for FDA licensure. Widespread vaccination of school children in Santiago with Ty21a, plus the government finally following our recommendation to outlaw the use of untreated sewage to irrigate vegetable crops during summer months, led to the elimination of amplified transmission of typhoid in Santiago.
The second accomplishment was the founding of the Center for Vaccine Development (CVD) at the University of Maryland as a multi-disciplinary, public sector academia-based entity with the mission of developing, testing and implementing vaccines to prevent certain enteric bacterial infections (such as cholera, typhoid fever and Shigella dysentery) that disproportionately afflicted children and adults in developing countries. This was an unusual undertaking for its time (mid-1970s) for an entity based within an academic institution.
The third accomplishment was to conceive, design, and coordinate the Global Enteric Multicenter Study (GEMS) funded by the Bill & Melinda Gates Foundation. This historic three-year case/control study and a one-year follow-on study (GEMS-1A), performed in seven sites including four in sub-Saharan Africa and three in South Asia, investigated the etiology of moderate-to-severe diarrhea (MSD) and of less-severe diarrhea (LSD) in children 0-11 months, 12-23 months and 24-59 months of age. GEMS also documented the nutritional consequences of these diarrheal episodes and assessed the risk of death over a 60-day follow-up. In total, 14,070 cases of MSD and LSD were enrolled along with 20,443 matched control children without diarrhea. The GEMS studies showed that although we tested for more than 40 specific etiologic agents of diarrhea, four pathogens were predominated, accounting for a large proportion of all pathogen-attributed diarrheal illness. These include rotavirus, Shigella, enterotoxigenic (encoding heat-stable enterotoxin) and Cryptosporidium. Both MSD and LSD stunted the linear growth of children compared to their matched controls without recent diarrheal episodes and MSD increased by more than nine-fold the risk of death over the ensuing 60 days compared to controls. Although the risk of death from MSD was significantly greater than the risk of death from LSD, within the population slightly more total deaths accrued from LSD because milder forms of diarrheal disease are collectively almost three times more common than MSD. Observations from the GEMS have guided interventions and investments to control diarrheal disease morbidity and mortality, including enhanced support for the development and implementation of vaccines to prevent pediatric diarrhea caused by rotavirus, Shigella, ETEC and Cryptosporidium.
What do others consider your biggest career accomplishment?
I suspect there are three: i) the field trials of Ty21a live oral typhoid vaccine performed among approximately 500,000 school children in Santiago, Chile; ii) establishing the Center for Vaccine Development and directing it for more than 40 years, and; iii) the design and coordination of the GEMS studies.
I’ve learned the most from…
Several mentors. Some mentors early in my career taught me invaluable lessons, not only about science but about life. These individuals include the late John B. Robbins, the late Samuel B. Formal, the late Richard B. Hornick and Eugene J. Gangarosa. My work ethic came from my father.
What advice would you give to your 20-year-old self?
Follow the professional and personal paths guided by your heart.