
By Peter Hotez, MD, PhD
President, Sabin Vaccine Institute
No, you’re not looking at a screenshot from a Steven Spielberg horror film. That image of the white blob with teeth is a hookworm, an intestinal parasite that affects nearly one tenth of the world’s population, or almost all of the world’s poorest people (“The Bottom Billion”), and is the leading cause of anemia and protein malnutrition, particularly in pregnant women and children.
Hookworm is widespread in tropical and subtropical regions where the temperature of the soil is suitable for the growth of the hookworm larvae and many people live in abject poverty.
Hookworm larvae are found in human feces and transmitted to humans from contaminated soil through the skin, usually due to contact with contaminated soil or in some cases accidentally ingesting contaminated soil. Once inside the body, larvae are carried through the bloodstream to the lungs and mouth where they are swallowed, digested and passed to the small intestine. There, the larvae mature into half-inch-long worms which attach themselves to the intestinal wall and feed on human blood.
Currently, there are efforts underway to reduce infection rates including improving sanitation by building or increasing use of outdoor latrines; educating communities on the causes and symptoms of hookworm infection; and distributing annual doses of donated Albendazole or Mebendazole.
It’s devastating to visit the endemic areas of the world’s poorest countries, to see children with profound anemia and malnutrition from hookworm is truly tragic. I have been conducted research on hookworm infection for the last thirty years beginning when I was an MD/PhD student. It is my dream and hope to one day see this ancient scourge controlled or eliminated in the low-and middle-income countries of Africa, Asia, and the Americas.
In 2000, I established the Human Hookworm Vaccine Initiative (HHVI) to develop the world’s first-ever safe, affordable, vaccine against human hookworm infection. A hookworm vaccine would help alleviate the worldwide suffering of more than a half-billion infected people, 44 million of whom are pregnant women; and prevent disease in 3.2 billion people that are at risk, and, most importantly, it would provide immunity against the infection and ensure that fewer and fewer generations are susceptible to infection in the future.
October 9th, 2009
In President Barack Obama’s speech today, announcing that he will accept the Nobel Peace Prize, he remarked that “We cant accept a world in which more people are denied opportunity and dignity that all people yearn for the ability to get an education and make a decent living; the security that you wont have to live in fear of disease or violence without hope for the future.” At the Global Network, we are encouraged by this statement, because it reinforces that the Administration sees disease control as a critical global development strategy through which we can promote security and break the cycle of poverty and conflict.

President Obama delivers a speech acknowledging he will accept the 2009 Nobel Peace Prize. Photo courtesy of Stephen Crowley/The New York Times
A paper written by Sabin Vaccine Institute President Peter Hotez and Global Network Ambassador Governor Tommy Thompson titled “Waging Peace through Neglected Tropical Disease Control: A US Foreign Policy for the Bottom Billion” articulates this theme captured in President Obama’s statement today. The paper emphasizes that NTDs play a key role in destabilizing communities, which also exacerbates poverty. In order to heed President Obama’s “call to action” for a more peaceful world, then, we must work to control and eliminate NTDs and other global health problems around the world.
August 25th, 2009

Center for Disease Control lab tech Henry Bishop holding a mass of Ascaris lumbricoides worms, which had been passed by a child in Kenya, Africa. (Photo courtesy CDC-PHIL)
An analysis published today in
PLoS Neglected Tropical Diseases sheds new light on the toll that neglected tropical diseases (NTDs) take on sub-Saharan Africa (SSA), with an estimated
500 million people suffering from these debilitating and sometimes deadly diseases.
It is appalling that helminth infections and other NTDs are having such a devastating impact on the poor in sub-Saharan Africa, given that we have effective treatments to alleviate their sufferings, said Dr. Peter Hotez, co-author of the analysis, President of the Sabin Vaccine Institute, and Distinguished Research Professor at George Washington University. For $200-$400 million a year over five years, we could significantly reduce the burden of helminth infections and other NTDs from much of sub-Saharan Africa. Thats a minimal investment with maximum returns.
The authors note that NTDs in SSA may produce a level of disease equivalent to, or as much as, one-half and one-third of the regions malaria and HIV/AIDs disease burden, respectively, suggesting that the NTDs represent a formidable public health challenge in the region.
The authors also say that high priority must be placed on examining the impact that reducing helminth infections might have on malaria and HIV/AIDS. In many parts of SSA, helminths are co-endemic with malaria, worsening the course of the disease; in others, schistosomiasis causes genital lesions and may increase a womans susceptibility to HIV/AIDS.