icddr,b, better known locally as the 'Cholera Hospital', has made many innovations including its landmark innovation of ORS that has saved an estimated 50 million lives globally since its inception in 1960.
This centre of excellence of the Global South is celebrating 60 years of its service to mankind throughout 2020. The Daily Star (DS) had an exclusive interview with icddr,b Executive Director (ED) Professor John D. Clemens recently where he was asked critical questions to understand the international organisation's history, successes, challenges, major innovations, future directions and commitment to humanity in the days ahead.
DS: Would you please tell us about icddr,b from a historic perspective?
ED: The year 2020 marks a major milestone in the history of icddr,b. About 60 years ago on December 5, 1960 the then South East Asian Treaty Organisation (SEATO) established a small laboratory in Dhaka named Cholera Research Laboratory (CRL) to be operated under the National Institutes of Health (NIH), USA at the very onset of the seventh cholera pandemic. The laboratory was also known as CRL or Pak SEATO CRL or PSCRL. Later in 1978, it became International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) through a Government Ordinance followed by a meeting at World Health Organisation (WHO) headquarters in Geneva in 1979.
DS: icddr,b does claim it has saved 50 million lives globally with ORS. What is the basis of the claim?
ED: During the late 1970s, the WHO estimated that there were 500,000,000 (five hundred million) episodes of diarrhoea in children under 5 years of age each year, resulting in roughly five million deaths from diseases like cholera annually.
In 2007, Fontaine, Garner, and Bhan estimated that more than 50 million children have been saved by oral rehydration therapy (ORT) between 1982 and 2007 – that is on average of 2 million lives a year.
Based on these estimates the number of children saved from 1982 until 2019 by ORT could be more than 70 million. Whatever the exact number of lives saved is, it would not be an overstatement to say that many adults would not be alive today if not for the discovery of ORS earlier called ORT.
DS: icddr,b has been holding the glory of anti-diarrhoeal treatment. What are icddr'bs' other major innovations except for ORS?
ED: In 1970, our scientists, working with US CDC, US NIH and WHO, demonstrated that widely used whole-cell injectable cholera vaccines, the only cholera vaccines available at the time conferred low, short-lasting protection. Subsequently 26th World Health Assembly in 1973 recommended against countries' requirements for travellers from developing countries to present a certificate of vaccination against cholera, saving billions of dollars. And the WHO recommended against the use of these cholera vaccines in public health programmes for the control of cholera.
In 2015, icddr,b scientists, working with scientists at the University of Melbourne, invented ultra low-cost bubble-CPAP for treatment of severe pneumonia in children. This has a potential to save thousands of infants from premature death. Large scale trials are underway in Bangladesh and in Ethiopia. Recently, WHO has recommended the use of bubble-CPAP for treating Covid-19 positive children suffering from pneumonia.
These are only a few of the contributions made by icddr,b amongst other widespread contribution to science.
DS: icddr,b is a donor-funded international organisation. What is your plan to make it a self-sustaining organisation within the next 10 years?
ED: icddr,b's annual budget is around USD 70 million, about 70% of this comes from research funding. Other revenue comes from core donor funding and from our clinical diagnostic services. Last year we provided free-of-charge treatment to more than 280,000 patients. We are grateful to Bangladeshi companies, and to the Bangladeshi public through our "hospital appeal campaign" for their continued support to our hospitals and will welcome their support in future too. We are also working to grow our endowment fund and welcome contributions from every walk of life. During the pandemic, many Bangladeshi corporations and individuals came forward to help us in saving lives at our hospitals.
Donors play a very important role in the development, growth, operations and sustenance of icddr,b. Steps are underway to raise our revenue through new initiatives of self-sustenance that include increasing our endowment funds, as well as an exciting new Contract Research Organisation that will be able to conduct clinical trials of products under development by local and international pharmaceutical companies. We look to local philanthropists and also to the corporations to support our Hospitals and Endowment Funds with their CSR budgets.
DS: What are the major events you have planned to celebrate your organisation's 60 years?
ED: Our 60 years' celebration started with the Asian Conference on Diarrhoeal Disease and Nutrition (ASCODD) 2020 in late January. We have had a plan for several stakeholder engagement events throughout the year but due to the COVID-19 pandemic we have revised our celebration programmes and relied on online engagement.
2020 is not only special for icddr,b but also for the nation as Bangladesh celebrates the birth centenary of Bangladesh's founding father Bangabandhu Sheikh Mujibur Rahman. A tree plantation campaign will be led by our Staff Welfare Association planting 100 saplings in celebration of Bangabandhu's birth anniversary.
icddr,b has launched a research grant opportunity for female scientists in Bangladesh called Mujib100 Research Grant for Women (RGfW) on this occasion, which we believe will encourage Bangladeshi female researchers to build their career in science.
DS: Thank you.
ED: You are welcome.