Professor Kim Mulholland
MB BS FRACP MD
of Child Health and Vaccinology
I am an Australian paediatrician with subspecialty training in immunology, respiratory medicine and epidemiology. I have spent much of my career working in the developing world, particularly Sudan and Gambia, and more recently in Fiji, Mongolia and Vietnam. I entered the vaccine research field with a series of trials of Hib vaccine in Gambian infants and pregnant women. This work culminated in the Gambia Hib trial (1993-96).That study demonstrated the power of large vaccine trials to inform us about the contribution of an organism, in that case Hib, to the overall burden of pneumonia. In the subsequent years, while working for WHO, I was involved in the design of most pneumococcal or Hib vaccine trials undertaken in the developing world, and in the establishment of clinical, radiological and microbiological standards for pneumococcal vaccine trials. Currently I share my time between LSHTM, where I have been one of the leaders of the Hib Initiative, and the Murdoch Childrens Research Institute in Melbourne. The countries where I am most active in are as follows:
For over a decade my team has been working on vaccines and vaccine preventable diseases in Fiji. The pneumococcal work lead directly to the decision of the Government of Fiji to introduce 10-valent pneumococcal conjugate vaccine in 2012. The work has provided important insights into the dosage regimens for pneumococcal vaccines, and much of the evidence behind WHO's forthcoming recommendations on pneumococcal vaccines. In Fiji we have also developed new methods for assessing long term immunity to pneumococcus, based on B-call assays. We are currently undergoing a detailed evaluation of the impact of the vaccine in Fiji.
Similarly, our work on the epidemiology of cervical cancer lead to an initial round of HPV vaccination there and a decision to introduce HPV vaccine in 2013. We have built a research component into our evaluation of that vaccine, looking particularly at levels of immunity among girls who were incompletely vaccinated in the first round with Gardasil, and then revaccinated with Cervarix.
Typhoid continues to be a major problem for Fiji. Working with the Ministry of Health we helped to organize an international meeting in August 2012 that lead to a multifaceted control program that is being implemented by the Ministry with help from our group and others. I am leading a multi-institutional group investigating this issue. I am supervising a PhD student investigating the fascinating link between the health of natural water sources and typhoid transmission and epidemiology.
For over 3 years my group has been building a comprehensive pneumococcal vaccine research program in Vietnam. The cornerstone of that program is a large Phase 2/3 trial comparing different schedules of the two pneumococcal conjugate vaccines - PCV10 and PCV13 in Ho Chi Minh City (funded by NHMRC, Australia). Our partners there are the Pasteur Institute, and together we have begun establishing state-of-the-art pneumococcal immunology and epidemiology.
I am an investigator on a GAVI Alliance funded project working in partnership with WHO and the Mongolian Ministry of Health. The primary objective is to evaluate the impact of PCV introduction on the incidence of radiological pneumonia among under-5 children in four large districts of Ulaanbaatar.
In collaboration with Professor Cissy Kartasasmita of Universitas Padjadjaran (UNPAD) in Indonesia, I am leading a new research project to acquire baseline information on pneumococcal carriage that will help inform the design of (PATH-wSP) efficacy trials.
In Melbourne I lead the Pneumococcal Group at the Murdoch Childrens Research Institute, located within the Royal Children's Hospital. There we have a number of laboratory based projects in the field of pneumococcal vaccine evaluation, immunology and microbiology. The largest is the Gates funded PneuCarriage project, lead by Dr Catherine Satzke. The project has established a global system to evaluate available methods to study pneumococcal carriage. The results were published at the end of 2013, and findings have contributed to changes in the field. We will work with the leading group(s) and the Gates Foundation to apply the methodologies to the monitoring of serotype replacement in developing countries that are introducing pneumococcal vaccine.
In Darwin I am a Board Member on the NHMRC-funded Centre of Research Excellence in Ear and Hearing Health of Aboriginal and Torres Strait Islander children. In 2017, I was awarded the Peter Wills Medal from Research Australia for my efforts in promoting Australian health and medical research internationally.
I continue to play a role in Gambia, assisting with the Child Survival Program and the Pneumococcal Vaccine Evaluation project. I am currently Investigator on a pneumococcal vaccine impact study and a member of the Directors Advisory Board of the Medical Research Council Laboratories.
Pneumococcal and Hib vaccine work - I continue to work with WHO on appropriate schedules for these vaccines. The Radiology Working Group that I was responsible for establishing in 1997 and the Pneumococcal Carriage Group are both being revived and I am playing a role in that process.
Pneumonia - I have been one of the originators of the Global Action Plan for Pneumonia, which has been endorsed by the World Health Assemble and is now providing a focus for pneumonia work in many countries. I continue to be involved in the design and implementation of that project. With Dr Martin Weber I have written and published a book on "Pneumonia in Children - Epidemiology, Prevention and Treatment" in 2016.
Overall my interests are focused on child health, child rights and child survival.
I am directly involved in teaching in the areas of child survival, epidemiology, tropical nursing, tropical medicine, vaccinology and health policy.
I am involved in the evaluation of the following vaccines: pneumococcal, Hib and HPV.
I am also involved in research into: pneumonia, typhoid, HPV and malnutrition.