Observations and insights on the history and future of health innovation at USAID

From August 17–24, GHTC—in partnership with our member the International AIDS Vaccine Initiative (IAVI)—hosted six US Congressional staff on a learning trip to Uganda. The staff represent Senate offices serving on key committees of jurisdiction over global health research and development (R&D) policy and funding. Uganda is a hub for cutting-edge scientific research and is a critical partner of the United States on shared global health research objectives. Long-standing partnerships between universities in the United States and Uganda have produced lifesaving global health tools and trained a new generation of researchers and clinicians, building the capacity of Uganda and neighboring countries in the region to discover solutions to mitigate their most pressing health challenges. Clinical research sites in Uganda have hosted trials that have resulted in new drugs, vaccines, and diagnostics for disease threats that affect populations in both countries, such as HIV and AIDS, and informed global treatment and prevention guidelines. Continued scientific partnership, nourished by US investments through the National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC), US Agency for International Development (USAID), Department of Defense, and other agencies, is critical to advance progress against long-standing health threats and prepare for the unknown pathogens of the future.Check out a tweet-by-tweet recap of the week:Day 1: The US-Uganda Research Partnership Our first stop on the @GHTCoalition/@IAVI congressional staff learning tour was the US Embassy, where we learned how US investments through USAID, CDC, NIH, DoD, and more have helped Uganda become a leader in global health R&D—saving lives and building scientific capacity. 🔬🌍— Emily Conron (@thatNTDgirl) August 19, 2019 Next, we visited the Ugandan Public Health Emergency Operations Center, which—with critical support from partners like @CDCgov—has responded to more than 70 outbreaks and public health events since it was founded, modeled on the EOC at CDC HQ in Atlanta. pic.twitter.com/oEMiVfG9CB— Emily Conron (@thatNTDgirl) August 19, 2019 We were grateful to meet with officials from the Ugandan Ministry of Health to hear their perspective on the US-Uganda partnership and how R&D can strengthen health systems, advance sustainability, and accelerate the journey to self-reliance. 🇺🇸🇺🇬— Emily Conron (@thatNTDgirl) August 19, 2019 Day 1 of the @ghtcoalition/@IAVI congressional staff learning trip ended with a reception hosted by @USAmbUganda to celebrate all that has been achieved by the US-Uganda partnership on global health R&D and all the future holds! 🇺🇸🇺🇬 pic.twitter.com/Kvn7QQJbps— Emily Conron (@thatNTDgirl) August 19, 2019 Day 2: Global Health R&D in Action We learned about the continuous cycle of global health research—from defining the problem to implementing and scaling up a new solution, informed at every step by robust community and stakeholder engagement. A site like MUJHU is often running several studies simultaneously. pic.twitter.com/T9fZgEQb8k— Emily Conron (@thatNTDgirl) August 20, 2019 Over 10,000 women have been enrolled in HIV prevention trials at MUJHU. Results from these studies, supported by NIH and CDC, have directly informed WHO policies and made an incredible global impact. Our congressional staff guests learned so much about the impact of R&D at MUJHU!— Emily Conron (@thatNTDgirl) August 20, 2019 Over 25,000 people have participated in clinical trials and field studies at the clinic, including phase I, II, and III clinical trials of new treatments and vaccines for TB and HIV-TB. The clinic has been a major site for the CDC-sponsored TB Trials Consortium for 15 years. pic.twitter.com/ujbNVEam27— Emily Conron (@thatNTDgirl) August 21, 2019 We heard directly from a former research participant about the impact of TB R&D and how her experience at UCRC made her an advocate and educator in her community. She encourages everyone experiencing symptoms of TB to seek care at the clinic. pic.twitter.com/E4FNYf529o— Emily Conron (@thatNTDgirl) August 21, 2019 Our last site visit of the day was @IDIMakerere, a powerhouse for infectious disease research, training, and treatment in Uganda. The Institute has over 100 current research projects ongoing and 1,000 full-time staff whose work is supported by a variety of USG partners.— Emily Conron (@thatNTDgirl) August 21, 2019 We heard short presentations from several young investigators—rising research stars whose work is shaping the understanding and response to leading infectious disease threats. pic.twitter.com/zAilpSSvo7— Emily Conron (@thatNTDgirl) August 21, 2019 Our congressional staff guests had a blast testing out this cutting-edge technology and imagining the possibilities of how VR can contribute to global health R&D. pic.twitter.com/s0iMWZh8cs— Emily Conron (@thatNTDgirl) August 21, 2019 Day 3: African-led Science Driving Innovation @UVRIug is one of the oldest research institutions in the region and had made many important discoveries in global health, including isolating the Zika virus as well as viruses including Chikungunya, West Nile, and many more—recently, close to one virus a year!— Emily Conron (@thatNTDgirl) August 21, 2019 We ended our @UVRIug tour at the brand-new Anthropod Containment Level 2 insectary where research will be conducted to develop new tools to tackle malaria. We suited up according to the highest biosafety standards! 🦟 pic.twitter.com/bxtwReRYue— Emily Conron (@thatNTDgirl) August 21, 2019 The ongoing HPTN-084 trial @UVRI_IAVI is conducting in fishing communities around Entebbe—the first large-scale clinical trial of a long-acting injectable medication for HIV pre-exposure prophylaxis in women—would be a game-changer for HIV prevention.— Emily Conron (@thatNTDgirl) August 24, 2019 After the presentation, our delegation was honored to receive a plaque recognizing the support of the American people for global health research & development in Uganda. pic.twitter.com/QIYpMYgd99— Emily Conron (@thatNTDgirl) August 24, 2019 Day 4: Community Partnerships Driving Research Progress We spent Day 4 of the @GHTCoalition/@IAVI congressional learning trip visiting fishing communities on Lake Victoria where @UVRI_IAVI leads clinical programs and conducts incredible research on HIV prevention.— Emily Conron (@thatNTDgirl) August 29, 2019 Onboard, @UVRI_IAVI’s community engagement officer oriented us to the lake and the islands we would be visiting—Kimi and Nsadzi. pic.twitter.com/hpfMlqqJkm— Emily Conron (@thatNTDgirl) August 29, 2019 We then met with members of the local Community Advisory Board in a small church (to escape a ferocious rainstorm!) to learn more about how community members are engaged in research efforts. pic.twitter.com/LB1bNTSGgc— Emily Conron (@thatNTDgirl) August 29, 2019 In our tour of Nsadzi, we learned more about ongoing research projects as well as the integrated HIV treatment and care at the health clinic. The visit helped us understand the linkages between R&D for new tools and implementation of existing tools through partners like @PEPFAR. pic.twitter.com/OjMfqNb0Qo— Emily Conron (@thatNTDgirl) August 29, 2019 Such collaborations increase access to HIV services for a population that otherwise would have limited access to care. This is one critical reason global health R&D is so important!— Emily Conron (@thatNTDgirl) August 29, 2019 Day 5: A Birds’ Eye View of the Impact of Global Health R&D We started with a visit to the Zika Forest—a protected field research station of @UVRIug. Home to more than 40 types of mosquitoes 🦟, the RNA of Zika Virus was isolated by researchers at the site in 1947, hence its name. pic.twitter.com/u1998vHebt— Emily Conron (@thatNTDgirl) August 29, 2019 Inside the forest, we peered up at the 120-foot observation and mosquito-baiting tower and learned about all of ground-breaking arbovirus research enabled by the structure over the decades. pic.twitter.com/L2H11LabSD— Emily Conron (@thatNTDgirl) August 29, 2019 We toured an HPTN 084 satellite clinic to learn how trial participants are enrolled in the study and better understand all of the partnerships that enable @UVRI_IAVI to positively impact the health of the communities where they work. pic.twitter.com/K5c1w8b52g— Emily Conron (@thatNTDgirl) August 29, 2019 Inside the clinic, I got to take a very “That NTD Girl” photo in front of a praziquantel dosing pole—a key tool in the fight against the NTD schistosomiasis (locally known as bilharzia), a major health challenge in communities around Lake Victoria. 💊💊💊 pic.twitter.com/4v1X6V8En3— Emily Conron (@thatNTDgirl) August 29, 2019 The other incredibly powerful part of our week—meeting researchers! Often, we talk about research and development like a noun—a thing that just happens. It’s very much a verb: a process, a series of steps that build to the discovery, refinement, and delivery of life-saving tools.— Emily Conron (@thatNTDgirl) August 29, 2019 Thanks to:@USAmbUganda Makerere University-Johns Hopkins University Research CollaborationUganda-Case Western Reserve University Research Collaboration@IDIMakerere & @AceUganda @UVRIug @UVRI_IAVI and of course, the congressional staff who spent a week learning with us!!— Emily Conron (@thatNTDgirl) August 29, 2019 The learning trip was an incredible experience that we hope will be a resource for our Congressional staff guests as they consider the US government’s role in improving global health, in particular through investments in R&D for new tools like drugs, vaccines, and diagnostics for use in low-resource settings. 

Interested in more global health innovation news? Every week GHTC scours media reports worldwide to deliver essential global health R&D news and content to your inbox. Sign-up now to receive our weekly R&D News Roundup email. Last Friday, the World Health Organization (WHO) launched the findings of its malaria eradication report, a three-year long analysis of the global fight against the mosquito-borne disease, calling for “transformative tools and knowledge” to achieve eradication. A summary of the report noted that current tools are not sufficient to wipe out the disease and urged scientists and global health funders to invest in research and development (R&D) of new vector control technologies, vaccines, and medicines to prevent and treat the disease. Currently, less than one percent of investment in health R&D goes to developing tools to tackle malaria. The report calls attention to the funds, tools, and political will needed to control the disease considering WHO data which shows that progress against malaria is stalling after a decade of significant decline in malaria cases and deaths. A phase 3 study from GSK’s ViiV Healthcare showed an injection of its drug cabotegravir and Johnson & Johnson’s Edurant (rilpivirine) could work just as well when given every two months as it does as a monthly therapy. An application of this two-drug injectable regimen as a once-monthly injection has already been put under US Food and Drug Administration priority review with a decision expected by December 29. In two earlier phase 3 trials, the long-acting injectable therapy was found to be as effective as both an oral three-drug regimen of two nucleoside reverse transcriptase inhibitors plus a third agent and ViiV’s own triple drug therapy, Triumeq, in reducing viral load. These results demonstrate progress in efforts to reduce the number of medicines a person living with HIV must take as well as the frequency of treatments. British technology and energy company, Sure Chill, has developed a refrigerator to protect medical supplies, such as vaccines, from power outages. Vaccines are often temperature sensitive to both high and low temperatures, which presents a major challenge for health workers in low-resource settings with limited or unreliable electricity supplies. The refrigerator works by harnessing a natural phenomenon. The refrigerator has a cold compartment that is surrounded by water that cools when connected to power, forming a layer of ice above the chamber. When the electricity is shut off, the warm water rises as the ice melts, keeping the water at a consistent temperature for up to four weeks without power. The refrigerator has kept more than 20 million vaccinations cold and has been approved for use by the WHO.