WHO Internship Program

The Sealy Center for Vaccine Development (SCVD), in conjunction with the World Health Organization (WHO) headquarters, has developed a new internship program which we are planning to implement during calendar year 2014. The internship program will support two graduate students per year, with each student spending three months in Geneva, Switzerland.  

Successful applicants will be chosen by a combined SCVD and WHO selection committee. If selected, you will be living in Geneva and will be paired up with a mentor at WHO and a SCVD member to work on a defined project for a period of three months (most likely in either the Spring or Fall of 2014). This project will require your significant contribution to a team tasked with developing a report on vaccines and a specific infectious disease for the WHO. The SCVD will provide funds for your expenses plus your stipend while you are in Geneva. Interns may be required to take one or two (depending on your background) epidemiology courses prior to the internship. For academic purposes, it will be treated as a graded graduate course elective with credit.

There will be four projects available as follows (minor adjustments to the projects may be made to accommodate new developments in the field):

1. Global Influenza Program

Objective:
Within WHO Strategic Objective 1 'To reduce the health, social and economic burden of communicable diseases',  the overarching objective of the Global Influenza Programme is to strengthen global pandemic preparedness through improved quality and global coverage of influenza surveillance and response, improved understanding of health and economic burden of influenza, increased national preparedness for  pharmaceutical (vaccine, drugs and other supplies) and non-pharmaceutical interventions, expanded vaccines use/coverage, more rapid communication and information exchange between Member States, WHO Global Influenza Surveillance Network members, key partners and stakeholders.

Description:
Under the supervision of the team lead for influenza surveillance and monitoring and the overall guidance of the head of the Global Influenza Programme, the intern will support activities that directly relate to the monitoring of influenza activity at the global level.  These activities may include any or all of the following to varying degrees, according to the intern's interest and skills:

Knowledge and skills needed:
Undergraduate degree in sciences, some training in epidemiology and communicable diseases. Excellent analytical skills complemented by good interpersonal and presentation skills. Good level of computer literacy. 

Supervision:
Dr Anthony Mounts; Dr Julia Fitzner

2. Japanese encephalitis vaccine project

Objective: 
Develop a background paper and comprehensive data set on Japanese encephalitis (JE) vaccines currently registered for human use, as well as on candidates at advanced stages of clinical development.

Description: 
The landscape of JE vaccines has changed considerably over the past few years, as has the programmatic use of those vaccines. With more vaccines available and the prospect of GAVI supporting the use of JE vaccines in low-income countries, WHO will revise its current position paper on JE vaccination that was published in 2006 (WER, 25 August 2006).  The revision process will be assisted by an ad hoc group of experts, and it is expected that final draft recommendations for global JE vaccine use will be submitted to the WHO Strategic Advisory Group of Experts (SAGE) on Immunization for decision in November 2014. In conjunction with the revision of the position paper, several technical background documents will need to be produced.

Scope of work: 
Develop a technical background document on JE vaccines.  This document will compile product information of all commercialized JE vaccines in a tabular format supplemented by a narrative.  The document will be referenced, using peer-reviewed information, and if not available, company information and regulatory references.  Reference search strategies will be documented.  If needed, companies will be contacted directly. Confidential information will be compiled in an annex. A separate section will provide information on late stage JE vaccines (in phase 2 clinical evaluation or beyond).

Expected outcomes: 
A referenced document summarizing all relevant product information on JE vaccines and a succinct pipeline review.  The document will serve as background for the SAGE review and will be accompanied by a slide set and tables.  The potential to format this paper for journal publication will be considered.

Knowledge and skills needed: 
Training in biological sciences, basic understanding of immunology, familiarity with biologicals product development phases, basic understanding of epidemiology; training or experience in literature searches; good writing skills.

Supervision: 
First-level day-to-day supervision through Dr Kirsten Vaccine, Scientist, Initiative for Vaccine Research (IVR), second-level supervision through Dr Joachim Hombach, Senior Adviser, IVR.

3.  Leptospirosis project

Description: 
Leptospirosis is a significant emerging public health issue for which an international partnership has been launched, the Global Leptospirosis Environmental Action Network (GLEAN;http://www.glean-lepto.org/). GLEAN gathers international academic institutions and agencies.

The place of human vaccines in the control strategy is still to be defined, while animal vaccines are widely used without a clear rationale. Aside, the impact of the immunization of domestic animals on the incidence of the human disease is the subject of controversies.

The Pan-American Health Organization’s (PAHO) regional Technical Advisory Group on Immunization at its meeting July 2013 highlighted the importance of leptospirosis vaccination.

The topic could eventually accommodate two interns, one related to veterinary vaccine use, and one on human vaccines.

Supervision: 
Dr Eric Bertherat, Control of Epidemic Diseases

4. Meningitis vaccines project

Objective: 
Systematic review of the safety and efficacy from the randomized controlled trials and observational studies of childhood schedules using Meningitis C vaccines.

This evidence will be used as part of a wider project to inform adjustments of the current WHO position paper for meningococcal vaccines and will help inform an evaluation of the impact of vaccination programmes in the African meningitis belt.

Description: 
In most countries, Neisseria meningitidis is recognized as a leading cause of meningitis and fulminant septicaemia and a significant public health problem. The majority of invasive meningococcal infections are caused by organisms expressing one of the serogroup A, B, C, X, W135 or Y capsular polysaccharides. Meningococci of these serogroups have the potential to cause both endemic disease and outbreaks, but their relative prevalence varies considerably with time and geographic location. In the African meningitis belt, which is considered to have the highest annual incidence of meningococcal disease in the world serogroup A has been the most important cause of disease, although outbreaks caused by serogroups C and W135, and most recently by serogroup X, have also occurred. Although meningococcal disease frequently occurs as scattered, apparently unrelated cases or in small outbreaks, in some regions this endemic situation may alternate with devastating, unpredictable epidemics. This is the case in the African meningitis belt, which is the region in sub-Saharan Africa stretching from Senegal in the west to Ethiopia in the east. This region is inhabited by around 300 million people. During the dry season, from December to June, the incidence of meningococcal disease peaks and occasionally reaches rates of up to 1,000 cases per 100,000 inhabitants, as occurred during the explosive epidemics in 1996 and 2000–2001.

Currently available meningococcal vaccines include polysaccharide vaccines and polysaccharide-protein conjugate vaccines. Although purified capsular polysaccharide antigens elicit protective antibody responses, conjugate vaccines are more immunogenic and also induce immunological memory. Both polysaccharide and conjugate vaccines are available against meningococci of serogroups A, C, W135 and Y.

A MenA conjugate vaccine, intended for use mainly in the African meningitis belt, was licensed in 2010. The MenA conjugate vaccine has been used in large vaccine campaigns in Burkina Faso, Mali, and Niger and it is being progressively introduced in other countries of the African meningitis belt. WHO recommends that countries with high (>10 cases/100 000 population/year) or intermediate endemic rates (2–10 cases/100 000 population/year) of invasive meningococcal disease and countries with frequent epidemics should introduce appropriate large scale meningococcal vaccination programmes.

Scope of work:
The overall aims are to assess the relevant evidence to inform an update (if relevant) of the Meningococcal vaccines: WHO position paper. The objective of the review is to conduct a systematic review to evaluate the current evidence on comparisons of different schedules of Meningitis C vaccines for children/adolescents/ adults.

The revision process will be assisted by an ad hoc group of experts, and it is expected that final draft recommendations will be submitted to WHO SAGE for decision in November 2014. These recommendations will include guidance on two aspects: the current and anticipated impact of Meningitis A vaccination strategies and; on the immunization schedules and delivery strategies that are more appropriate to achieve low levels of susceptibility to Meningitis A among individuals of all ages living in the African meningitis belt.

In conjunction with this revision, several technical background documents will be simultaneously prepared including but not limited to epidemiology of Meningitis A in Africa and, evidence on the efficacy/effectiveness of various Meningitis A vaccine immunization schedules.

Expected outcomes: 
A referenced report of a systematic review on Meningitis C immunization schedules. The document will serve as background the SAGE review, and will be accompanied by a slide set and tables.  The potential to format this paper for journal publication will be considered.

Knowledge and skills needed:  
Training is required in biological sciences, basic understanding of immunology, basic understanding of epidemiology; training or experience in literature search; good drafting skills.

Supervision: 
First level day-to-day supervision is through Dr Ana Maria Henao-Restrepo, Medical Officer, Department of Immunization Vaccines and Biologicals.

We believe this program represents an outstanding career development opportunity for UTMB’s graduate students and will provide the successful interns with first-hand experience of global health planning and policy. SCVD will facilitate the application process and work with WHO on the project design and implementation.

For more information, please contact Drs. David Beasley (dwbeasle@utmb.edu), Gregg Milligan (gnmillig@utmb.edu) or Alan Barrett (abarrett@utmb.edu).