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Discovering new interventions to prevent preterm birth

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Paul Joseph Brown / GAPPS

With more than 15 million babies born preterm every year, of which one million will die in infancy, preterm birth is a global health crisis that must be elevated and prioritized on an international scale.

October 24, 2012 by Eve Lackritz

In this guest post, Eve Lackritz, MD—senior program officer with the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS), an initiative of Seattle Children’s—writes about new research projects to develop innovative prevention products and strategies for preterm births worldwide.

With more than 15 million babies born preterm every year, of which one million will die in infancy, preterm birth is a global health crisis that must be elevated and prioritized on an international scale.

Although preterm birth is the second-leading cause of death for all children under age five worldwide, preterm research ranks 99th in National Institutes of Health funding. Causes of preterm birth are multiple and poorly understood; the majority have no known cause, and 80 percent cannot be prevented with current interventions. It is a critical time to advance a global prevention research agenda to understand the biology of pregnancy, how multiple social, biological, and clinical factors cause adverse birth outcomes, and test new and innovative strategies for prevention.

In India, there are 3.5 million preterm births every year, more than anywhere else in the world. Photo credit: Paul Joseph Brown / GAPPS.

Last week, GAPPS announced five projects funded through the Preventing Preterm Birth initiative (PPB), part of the Bill & Melinda Gates Foundation’s Grand Challenges in Global Health. The initiative seeks to discover biological mechanisms that lead to preterm birth and develop novel interventions for prevention.

A core objective of the PPB is to advance research that will have the potential to translate results into novel solutions for low- and middle-income countries, including requiring that new products be practical and affordable for global impact. While preterm births occur worldwide, developing countries often lack the healthcare infrastructure needed to keep preemies alive, and therefore bear the greatest burden of infant mortality. In high-income countries where premature babies are more likely to survive, they can face lifelong health problems, including cerebral palsy, developmental delays, and asthma.

One of the projects funded through the PPB will work to develop a diagnostic test to detect inflammation in the uterus early in pregnancy. Conducted by Dr. David Olson of the University of Alberta and an interdisciplinary team, the investigators will work to develop new diagnostics and therapeutics that can identify women at risk, alter the inflammatory response, and prolong pregnancy. Tests and treatments such as these could have an important impact and lessen the burden of prematurity worldwide.

Infection and inflammation are important contributors to preterm birth. Dr. Sam Mesiano from Case Western Reserve University School of Medicine is investigating ways to enhance the body’s anti-inflammatory processes through the study of the body’s receptors for progestin-based therapies. The long-term goal of this project is to develop an inexpensive oral therapy that will reduce the prevalence of preterm birth worldwide.

Finding ways to prevent preterm birth will be a long and difficult challenge. Projects like these are an important start, but there is a long way to go. Increased awareness of this leading cause of child death is critical to attracting the public and private funding needed to discover new solutions. Time and again, we have seen that investment in research results in solutions, and in this case, will help make every birth a healthy birth.

Categories: Guest post

About the author

Eve LackritzGlobal Alliance to Prevent Prematurity and Stillbirth

Dr. Eve Lackritz is a senior program officer at the Global Alliance to Prevent Prematurity and Stillbirth, a global nonprofit that seeks to improve birth outcomes worldwide by reducing the burden of premature birth and stillbirths.

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In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. President Barack Obama recently pledged to restore the United States to a position of global leadership in research and technology, but Nature examines how sequestration threatens research funding. GHTC members the Drugs for Neglected Diseases initiative (DNDi) and the Medicines for Malaria Venture (MMV) announced the identification of three chemical series that could lead to new treatments for neglected tropical diseases. The series were made possible by MMV's open access Malaria Box. The US Agency for International Development recently announced the launch of its Higher Education Solutions Network—a new partnership with seven top American and foreign universities designed to develop innovative solutions to global development challenges, including global health. Pharmaceutical companies Johnson & Johnson, Merck, and Eli Lilly plan to launch a one-stop database of global clinical trial sites aimed at streamlining paperwork and speeding the process for testing new drugs. A US Food and Drug Administration panel voted unanimously to recommend the effectiveness of a new hepatitis B vaccine but also raised concerns about its safety, asking for more data from studies on a wider population.
October 23, 2012

The final presidential debate: Global health was missing from the foreign policy discussion

Written by Kim Lufkin / GHTC
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It’s not much of a surprise that Monday night’s presidential debate, which focused on foreign policy, was consumed by a discussion of defense spending, and security and trade policies regarding the Middle East, North Africa, and China. While not unexpected, it’s still disappointing that both Barack Obama (D) and Mitt Romney (R) were relatively silent on issues like global health, research, and international aid. We’ve written previously about how critical it is for the candidates to address these issues, given the impact of presidential policies on funding for global health research and other development programs. While there have been some brief mentions during the debate season of the role of science and technology—both candidates have discussed how science and technology can help create domestic jobs and tackle issues like energy and climate change—it’s critical to also address the role of science in international health and development. Indeed, there’s been some reaction from the international development community regarding the lack of foreign aid and assistance in Monday night’s debate. Devex provides a summary of some clues offered up by both Romney and Obama regarding foreign aid and development in Pakistan, the Middle East, North Africa, and South Asia. But as this word cloud from the US Global Leadership Coalition indicates, health, research, and science—among a host of other topics—were missing from the debate. Perhaps Josh Barro from Bloomberg puts it most succinctly: “The biggest problem with this debate, as with the previous ones, is what wasn’t discussed. There was no discussion of Europe or sub-Saharan Africa and only a brief mention of Latin America by Romney (who, as Matt Yglesias notes, got his key factoid wrong). The candidates did not discuss immigration, the drug war, global health, climate change or the international financial system.” He adds that “apparently ‘foreign policy’ has come to mean ‘places in the Middle East and North Africa where we are or might be bombing people, plus some really stupid and demagogic discussion of trade with China.’” With the election now less than two weeks away—and domestic issues such as jobs and the economy taking center stage—it seems increasingly unrealistic that either candidate will offer up much on global health, research, or other development topics soon. But no matter what the outcome is in two weeks, the next president must demonstrate more support for global health and foreign aid than the candidates displayed during Monday night’s debate.