An interview with Claire Dillavou, University of California, Los Angeles Earlier this year, Claire Dillavou of the University of California, Los Angeles was awarded $100,000 by the Bill & Melinda Gates Foundation through its Grand Challenges Explorations initiative*. Claire hopes to develop a compostable primary vaccine container that can reduce the environmental impact of vaccination campaigns in developing countries. She spoke to Op.ti.mize about her proposal and the challenges she faces. What gave you the idea for your proposal? I was in Ghana, out in the field in a remote location, and I came across all this rubbish left behind after an immunization campaign. It struck me that a lot of developing countries like Ghana just don’t have the infrastructure to dispose of this nonreusable trash in a way that isn’t detrimental to the environment and the people who live there. I thought that if we could deliver immunization campaigns in a way that isn’t damaging like that, that would be the greatest net gain for public health. Do you see this as a growing problem? As populations increase, more and more people will need to be vaccinated; meaning more rubbish from vaccine containers will be generated. So what we will have is less space available for landfills and dumps but more waste to deal with. With all the new vaccines about to be rolled out, waste management is becoming an increasing problem. Right now, we have all these plastics and glass in vaccine containers. Over time, the plastic degrades into the earth, which is particularly worrying in developing countries where much of the rural population’s water sources are shallow wells or rivers that are easily contaminated. Mass vaccination campaigns are projected to increase significantly in low- and middle-income countries over the next 15 years. Compostable vaccine containers will be a big step forward in addressing the burden of waste from these activities. Is this a neglected area of study? Low- and middle-income countries typically absorb waste management costs without proper quantification of the short- and long-term environmental and financial impact. These costs are largely invisible from donor agencies and vaccine manufacturers. Developing countries—the consumers of these vaccines—don’t necessarily have a voice in the research and development (R&D) agenda for the future of vaccines and so cannot address the issue. Politically and financially, at the moment it just doesn’t behoove any of the big players to invest more R&D in this area. What do you mean by “compostable?” The word “compostable” is frequently misused, as it connotes a material that meets specific standards outlined by American Standards for Testing Materials (ASTM) International. The guidelines specify three main things: biodegradability, meaning 60%–90% of your product is going to break down within 180 days; disintegration, meaning 90% of your product is going to break down into tiny pieces of 2 mm in size or less; and eco-toxicity, meaning that the breakdown of the product will not leave heavy metals that are toxic to the soil. Due to these specific definitions, there are very few materials known to meet the criteria. Compostable materials can be largely organic, so, for example, if you create the right organic compound, farmers could potentially use the vaccine container rubbish in their compost piles to help fertilize their land. Wouldn’t it be easier to use recyclable materials? Recycling represents an incremental change, as it still requires substantial human resources and planning to collect and transport waste to a single recycling point. This necessitates a good infrastructure and additional resources for petrol and vehicles for transport. Composting is a revolutionary solution because it reduces the impact of waste on local communities without these requirements. What will be your biggest challenge? Using compostable material to make a container is difficult enough. But it is even harder when you consider the complex makeup and different stability profiles of each vaccine. As a vaccine container can directly affect the vaccine it contains, the various materials used in compostable containers will have to be validated to ensure they don’t affect the potency of a vaccine over long periods of time under extreme temperatures. It may be that the container needs to be different for each vaccine to reflect their different stability profiles and to address issues of potential interactions. In my proposal, I’m focusing on one vaccine to create a prototype. Initially, I was going to focus on tetanus, because it’s the most stable vaccine under high and low temperature conditions. But now I’m thinking of focusing on the pentavalent vaccine, because although it’s not as stable as the tetanus vaccine (it needs to remain in the cold chain), it creates the most waste based on global demand. If we can show a proof of concept with pentavalent vaccine, other vaccines with a less sensitive stability profile should be easier. How will you go about finding a solution? We’re going to create and then test various compostable materials using a single vaccine as a prototype. Only low-cost, compostable materials—or materials expected to greatly reduce in price if the product is scalable—will be tested. This is a true experiment, as we don’t know if there are any compostable materials that can meet the stability profile of the vaccine. We will start by defining a set of criteria that need to be met for such an experiment. This includes assessing the eligibility of organic and inorganic materials, creating a target product profile, working with someone to build a prototype, and testing it to generate data to meet the WHO guidelines on stability evaluation of vaccines. We will also work with the manufacturers to identify relevant R&D that can help in this process. If you are successful, what happens next? If we can generate data that meet the WHO guidelines, the stability and potency of vaccine stored in the compostable container will need to be demonstrated in order to obtain a license for vaccine storage in that container. We could also demonstrate the compostable qualities of the container and how this affects waste management. This could be done by comparing the waste generated with and without the container during a vaccination campaign. Claire aims to complete her project by the end of 2013. For more information, please email [firstname.lastname@example.org]Claire Dillavou[/email]. *Grand Challenges Explorations is a US$100 million initiative funded by the Bill & Melinda Gates Foundation. Launched in 2008, over 600 people in 45 countries have received Grand Challenges Explorations grants. The grant program is open to anyone from any discipline and from any organization. The initiative uses an agile, accelerated grant-making process with short two-page online applications and no preliminary data required. Initial grants of US$100,000 are awarded two times a year. Successful projects have the opportunity to receive a follow-on grant of up to US$1 million. To comment, make sure you are logged in and click Reply.
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