Faces of Innovation: Dr. Vinayak Joshi, researcher at VisionQuest Biomedical

Faces of Innovation—a new GHTC project that features scientists on the front lines of research and development on new global health tools and technologies—profiles Dr. Rohit Ramchandani, who we met at the American Society of Tropical Medicine and Hygiene Annual Conferenc. Dr. Ramchandani does research to innovate global treatment options for childhood diarrhea at the Johns Hopkins School of Public Health in Baltimore, Maryland and the University of Waterloo. My name: Rohit Ramchandani, DrPHWhere I work: Johns Hopkins School of Public Health in Baltimore, Maryland and the University of WaterlooI’m funded by: US Agency for International DevelopmentMy research: My research focuses on diarrhea in children…the second-leading cause of death in children under five globally…These are close to 500,000 deaths that are happening every year, most of which are preventable, and treatable. They’re treatable with medicines, oral rehydration salts [ORS] and zinc. That’s the globally recommended treatment for diarrhea. But the problem is, in many low- and middle-income countries, access to these medicines is not where it should be, particularly in rural communities. So we looked at that issue of access. We did it by leveraging human-centered design approach. And we really focused on the details and the challenges that mothers face treating their children with diarrhea…Our research showed that 40% of the time, mothers are preparing ORS in the wrong concentration: either too diluted, or too concentrated. That can lead to hypernatremia, that can make the diarrhea even worse, or the efficacy gets reduced if it’s too diluted. So we actually worked with a local pharmaceutical company in Zambia to shrink down then size of the ORS sachets—the standard all over the world is a one-liter sachet—we shrunk those down to make 200-mililiter sachets, and then we made the packaging double as a measurement vessel for the right amount of water…One of our key funders during our scale-up phase was USAID—their Discover Health Program. They played a fundamental role in some of the social marketing we were doing as we were scaling up the development of our diarrhea treatment kit.Motivation: There’s just a fundamental issue of justice in the world…We often think of innovation being new product development, high technology, but things like ORS and zinc—innovation can happen really in the delivery side of things. And that’s really where our innovation focused.Why federal support is critical: I think this is low-hanging fruit. Diarrhea, as one of the leading causes of death in the world for children—we have the solutions, we know what to do, and these kinds of innovations can really make a huge difference in saving lives.…[And] there’s a health security argument [to do this work]. The world is getting smaller and smaller every day. We are inextricably linked to one another. When I’m not in the lab: I’m a dad! I’m a dad of two amazing young girls. They inspire me every day. It makes my work in child health that much more meaningful—the inspiration I get from them. I want all parents to have that.

Faces of Innovation—a new GHTC project that features scientists on the front lines of research and development on new global health tools and technologies—profiles Dr. Aileen Marty, who we met at the American Society of Tropical Medicine and Hygiene Annual Conference. Dr. Marty works at Florida International University and serves on the President’s Advisory Council for Combating Antibiotic-Resistant Bacteria.My name: Aileen Marty, MDWhere I work: Herbert Wertheim College of Medicine, Florida International University I’m funded by: The US government has supported my research since I began doing research back in the early 1970s. Right now, I’m involved with PACCARB, the President’s Advisory Council for Combating Antibiotic-Resistant Bacteria.My research: We’re interested in not only resistance by bacteria to antibiotics, but also by other pathogens such as fungal agents, and eventually hope to also focus on antihelminthic agents, and so forth. We are taking a look at it from a one health perspective, which means we try and understand how the agriculture industry may impact the use and availability of antimicrobial agents for humans, what is going on in the environment that’s also altering these things, as well as stewardship and appropriate use of antibiotics and antimicrobials in hospitals and in clinics throughout the United States and throughout the world, and see how those interface with one another. The CDC [US Centers for Disease Control and Prevention] recently put out a document about antimicrobial resistance that’s highly important. It says we’re already in an era where, for a number of very serious bugs or germs, we are out of antibiotics that actually work. If we do not solve this problem, we’re going to find ourselves in the situation we were in prior to the 20th century. And that impacts much more than infections directly, because modern medicine relies on us not having infections in order to do the surgeries that we’re doing. And to help people with autoimmune diseases like psoriasis or cancer treatments that decrease a person’s immune systems, we depend on the availability of good functioning antibiotics and antimicrobial agents at the right time in the right place for the right patient.Motivation: I love humanity—and I seriously believe that we all have a role to play in making sure that we leave behind a better world than the world we came into. And I become very inspired when I work with young minds, and I make sure that they see the connections between the different systems of the world and how we need to be stewards of the earth.Why US federal support is critical: We mustn’t think of it only in terms of it being global. You must realize that we in the United States are part of the globe. Moreover, individuals who live in the United States, who are citizens of the United States, travel worldwide. And what happens in Bangladesh has an impact on what happens in New York. Look at the recent measles outbreak in New York state, for example. That outbreak originated with an outbreak in Ukraine that passed via Israel and was brought to the United States—and think about what that has done. When we manage outbreaks where they arise, wherever that is, we minimize the footprint there and decrease the risk everywhere. When I’m not in the lab: In my personal life, I have a huge family, which I love dearly, and many, many good friends, and we spend a lot of time coming up with good community plans for helping people. And I belong to the Florida Clinicians for Climate Action, and through that organization we are going to synagogues and churches and other houses of worship where we are explaining the public health impacts of climate change to our people.