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Immunization campaigns save lives but create environmental concerns, particularly in low-income countries. Claire Dillavou offers a potential solution.
Claire Dillavou was in a remote location of Ghana as a World Health Organization consultant for the country’s yellow fever vaccine program when she came across a slew of trash. There were empty vials, needles, and packaging, remnants of a previous immunization campaign. “It struck me that a lot of developing countries don’t have the infrastructure to dispose of this non-reusable trash in a way that isn’t detrimental to the environment and the people who live there,” Dillavou recalls.
A former Peace Corps volunteer with considerable experience working as an epidemiologist in low-income countries, Dillavou was used to questioning things she saw in the field that didn’t make sense to her, and she began asking senior members of her team why these life-saving public health campaigns couldn’t be accomplished in a more environmentally friendly way. They agreed it was a problem worth addressing, then informed her of funding being offered for such big ideas through the Bill & Melinda Gates Foundation’s Grand Challenges Explorations initiative. In April 2012, just five months before Dillavou would enter the Fielding School’s PhD program in the Department of Epidemiology, she learned she had received a $100,000 grant for her project, Biodegradable Primary Vaccine Packaging for Developing Countries.
Dillavou points out that immunization campaigns are projected to grow significantly in low- and middle-income countries over the next 15 years as populations increase and new vaccines are introduced. This will generate substantially more glass, plastic, and rubber waste from vaccine containers at a time of diminishing space for landfills and dumps. The burden is particularly great in low-income countries, which typically must absorb the waste management costs with little consideration of the short- and long-term environmental and financial impacts. “These countries don’t have a voice in the research and development agenda for the future of vaccines,” Dillavou says. “And at the moment it just doesn’t behoove any of the big vaccine manufacturers to invest more in this area.”
Dillavou hopes to help change that mindset with her study. With a UCLA professor of chemistry and biochemistry, Dr. Thomas Mason, she has identified materials that can be used to form packaging with properties that make it both biodegradable and adherent to the rigid World Health Organization requirements for ensuring that vaccines remain stable under all conditions. With three-dimensional printing technology, Dillavou redesigned the packaging of a prototype vaccine to use space and material more efficiently, minimizing costs and waste. Mindful of the need to entice vaccine manufacturers to invest in the new technology, Dillavou has paid close attention to cost issues - focusing on materials that are either inexpensive or expected to greatly drop in price if mass-produced.
Not unexpectedly, Dillavou has encountered challenges in executing her plan, particularly given the complex makeup and stability profiles of each vaccine. “It’s easy to see why industry hasn’t invested in this technology - glass vials are cheap, easy, and they work,” Dillavou says. “But this is an environmental burden for low-income countries. I can’t say whether biodegradable packaging will take off, but I am more convinced than ever that it’s a good idea, both for vaccines and more broadly.”