Giuseppe Ippolito

Giuseppe Ippolito is the Scientific Director (since 1998) of the National Institute for Infectious Diseases (INMI) “Lazzaro Spallanzani” in Rome and Director (since 2009) of  the WHO Collaborating Center for clinical care, diagnosis, response and training on Highly Infectious Diseases at INMI. He graduated in Medicine (summa cum laude) at the University La Sapienza in Rome in 1978, and in 1981 he obtained his specialty degree in infectious diseases (summa cum laude). In 1984, he obtained a second specialty degree in Dermatology at the University “La Sapienza”, Rome. He has also received a Masters Degree in Organization and Management of Health Institutions from the University of Tor Vergata, Rome, in 1997. Within the L. Spallanzani Institute Giuseppe Ippolito served in various positions (Registrar and Senior Registrar) in the Infectious Diseases unit during the 1980s. In 1985, he joined the “Latium Region” Regional Authority as head of the AIDS epidemiology unit.  In 1990 he was appointed Head of the AIDS Unit at INMI, and in 1993 he became Director of the AIDS Reference Center and the Unit for Infectious Diseases Epidemiology of the same institution; in 2000 he was appointed Director of the Department of epidemiology and pre-clinical research. Giuseppe Ippolito served as member of several National bodies established by the Italian Ministry of Health: National Commission on AIDS (1998-present); Scientific Committee for the Research Project on Antiviral Treatments for AIDS (1992-1996);   Scientific Committee for the Research Project on social and ethical aspects of AIDS (1994- 2002); Committee on Ebola and other Hemorrhagic fevers (1995-1996);  Scientific Committee for CJV disease (1996); Co-coordinator of the Technical Committee for the management of risks related to the intentional use of biological, chemical and nuclear weapons (2001-2004); Committee on SARS (2003-2005); National Task force for influenza A/H1N1 (2009-2010). He was also a member of the Scientific Committee for the evaluation of Projects of Industrial Research for the Italian Ministry of Universities and Research (2005-2009), and he is currently a member of the Scientific Committee of the department of Medicine of the Italian Research Council. He served on a number of international committees with the World Health Organization, the USA Centers for Diseases Control and Prevention, Health Canada, OECD, United Nations, NATO, G7+ Mexico -Global health Security Action Group, ILO, European Commission. He has served as advisor and evaluator for several research and policy bodies, including the European Commission and the European Center for Diseases Control.   In the last 10 years, he coordinated 8 EU-funded projects, and is currently coordinating 4, all in the field of Emerging and Reemerging infections, biosecurity, preparedness and response; he has also been a partner or leader of 6 additional EU projects. He is involved, as scientific coordinator, in international activities funded by the Italian Cooperation Office of the Italian Ministry of Foreign Affairs in Tanzania to strengthen the diagnosis and treatment of HIV/AIDS, tuberculosis, malaria, and emerging pathogens. Over the years, Giuseppe Ippolito's research interests have been focused on: the Surveillance and control of nosocomial and occupational infections; epidemiology and prevention of HIV, HBV, HCV, Tuberculosis; Emerging ad re-emerging infections; biodefense, biosecurity and biosafety; alert, preparedness and response. He has published as main author approximately 250 major papers (indexed by Index Medicus for a total Impact Factor of about 1300);  250  other peer-reviewed papers; 26 books, 30 book chapters, 44 reports and other publications for a general audience. In 1998, he received the Charles C. Shepard  Science Award from the Centers for Disease Control (CDC) for the study “A case-control of HIV seroconversion after percutaneous exposure”.

Global burden of infectious diseases: not just numbers

At the beginning of the third millennium communicable diseases continue to cause worldwide -mostly in developing countries- the death of several million people each year with the greatest impact on morbidity and life expectancy. Communicable diseases do not respect national borders and the failure of control measures in one country can put neighbours and global health at risk.

There is evidence that the impact of these diseases is increasing due to continuing and worsening levels of poverty, the effect of population growth, the increase in man-made and natural disasters resulting in displacement of populations, the behavioural changes, the emergence of resistance to anti-infectives, climatic changes and deteriorating sanitation. Infectious diseases can be partially controlled through improved living conditions and effective public health and education systems.

The Global Burden of Disease (GBD) Study, established since 1992, is an assessment for evidence-based decisions in public health. The term was coined by epidemiologists and economists to study international variations in the patterns of disability-adjusted life expectancy (DALYs) for the World Bank.

Among the top 10 diseases for mortality and burden, 4 are infectious diseases. The methods to estimate health gaps changed over the years as the number of conditions (diseases, injuries and risk factors) considered. The GBD now quantifies the burden of about 500 sequelae of more than 100 major causes of death and disability disaggregated by eight geographic regions and ten age-sex groups, with projections to 2020.

The goal of GBD is now to systematically collect data for assessment of health status; to ensure that all estimates and projections were derived, in an indipendent way, on the basis of objective epidemiological and demographic methods; to measure the burden of disease using a metric that could also be used to assess the cost-effectiveness of interventions (Disability-Adjusted Life Years, or DALYs)

The latest round of GBD (2010 study) is in progress and the results will be published in 2011. The report will be based on improved methods allowing full use of the increasing amount of health data, particularly from developing countries, and will include a comprehensive and consistent revision of disability weights.

The data of GBD represent a policy framework to provide information for a coherent, comprehensive and accelerated response to communicable diseases, securing adequate resources to produce better health outcomes towards a sector-wide approach, setting a broad policy framework and establishing longer-term partnerships.

Now the term Global Burden is largely used also outside the GBD study and several estimates of “Burden” have been performed for several communicable diseases.

Examples related to viral infections, methodological aspect, use of data and their integration with social and political information will be presented and discussed.