R&D breakthroughs for tuberculosis, cholera and the power of a gene-edited mosquito

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. In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. Researchers discovered that the meal times of malaria-infected organisms may impact the rate at which the malaria parasite multiplies in the host’s blood. A team at the University of Edinburgh studied the parasitic rhythms of reproduction and invasion of red blood cells in malaria-infected mice and found that the parasites timed their daily multiplication rhythms to match when the animals were fed. When the mice’s feeding time changed, the parasites altered the timing in which they invaded red blood cells. Researchers believe that interfering with the biological processes that link eating to these parasite rhythms—through diet, drugs, or other approaches—could reduce the spread of malaria infection A team of scientists recently created a prototype oral flu vaccine that does not need to be temperature controlled—paving the way for potential new oral vaccines that do not require refrigeration or freezing. Unlike traditional biological vaccines, which are made from part of a virus or bacteria and must be temperature controlled to remain stable, this oral vaccine prototype contains manmade peptides that mimic peptides in real viruses. Scientists found the prototype triggered a strong immune response when tested in human cell cultures and in mice. While more research is needed, these early results are promising. A heat-stable oral vaccine would be easier to transport and store, which could improve care in low-resource, hard-to-reach communities were immunization supply chains may be insufficient. Scientists at the Jena and Friedrich Schiller University Hospital are working to develop a rapid antibiotic resistance test. Current diagnostics for drug-resistant infections can take up to 72 hours to deliver results—a long amount of time for these infections, which can be acutely life-threatening. Using light-based analytical methods combined with microfluidic sample processes—which the researchers colloquially referred to as a miniature Lab-on-a-Chip system—the scientists were able to clearly identify bacterial strains and their resistances in fewer than three hours. New rapid tests for antibiotic-resistant infections could help get patients on treatment more quickly and reduce the overprescription of antibiotics.

From the development of new drugs for malaria and tuberculosis to the mapping of debilitating but preventable diseases, research and development (R&D) can be a catalytic force for scaling up impact. Many of USAID’s [US Agency for International Development] global health successes in preventing child and maternal deaths, controlling the HIV and AIDS epidemic, and combating infectious diseases can be partially attributed to breakthrough research and development that altered the course of an illness or accelerated diagnostics and treatment through breakthrough innovation and ingenuity. This year’s report to Congress coincides with our new five-year strategy, which focuses on three interrelated goals. Our first goal is to accelerate the development, introduction, scale-up, and sustained use of new technologies, health tools, and approaches; secondly, we want to influence the adoption of priority life-saving health and development interventions; and finally, we want to strengthen the capacity of people, systems, and partnerships to conduct research and utilize results to improve health outcomes.Photo caption and credits: A lab technician in Rwanda. Riccardo Gangale for USAID/ Courtesy of Photoshare  Although R&D can take years to come to fruition, when it does, it can save lives and be a total game changer. Take malaria for instance. One of the most notable areas of R&D investments for USAID is the development of new vaccines, medicines, and insecticides for malaria prevention and control, as well as research to improve malaria programs. Many lives have been saved since the launch of the U.S. President’s Malaria Initiative (PMI) in 2005, but continued success depends on strategic R&D investments.Last year, the sustained efforts of many partners paid off and led to the development of three new classes of malaria drugs, including the drug Tafenoquine which, if approved, could be the first new medicine to treat relapsing malaria in more than 60 years. In Cambodia, research on the safety and tolerability of single, low-dose Primaquine, a drug used for reducing malaria transmission, has been recommended for adoption in areas moving toward malaria elimination.Another health challenge with the potential for high returns on investment in terms of R&D is multidrug-resistant tuberculosis (MDR-TB). USAID knows from experience that this is a very complex and expensive disease to treat because of its severity and long-term treatment plan, which is why the agency has been supporting several clinical studies evaluating the efficacy of shorter drug regimens.For treatment that can last for as long as two years, medicine adherence has been a huge challenge in combating MDR-TB. Shorter and simpler to administer regimens may help increase adherence and acceptability, while decreasing side-effects and transmission. Interim results from STREAM Stage-1, one of the USAID-supported studies of shorter MDR-TB regimens, have potential to inform global guidelines and improve the lives of millions of people.Along with high-quality research, USAID has continued to invest in ground-breaking tools and innovations that have been deployed in countries around the world. These cost-effective tools have not only saved lives, but millions of taxpayers’ dollars. They have also contributed to strengthening our national security by enabling countries to mitigate impact and contain the spread of infectious diseases.During the 2015-2016 Zika outbreak in Central and Latin America, for instance, USAID supported 26 innovations to combat Zika and future threats through the Combating Zika and Future Threats Grand Challenge. Innovations range from mosquitoes infected with Wolbachia, a naturally-occurring bacteria that prevents the transmission of diseases to humans, to a disease surveillance digital platform that could protect vulnerable communities from becoming hot spots not only for Zika but also for malaria, dengue, chikungunya, and other infectious diseases, including currently known and unknown threats.School students in Paris, Colombia participate in growing and releasing their own Wolbachia mosquitoes as part of a science project. Photo Credit: World Mosquito Program Colombia.The Grand Challenges enable us to adopt an open-source model that empowers more people from all walks of life to offer solutions to global health problems. Research and partnerships spur innovation, which in turn harnesses the ingenuity and expertise of an increasingly diverse global development community. USAID facilitates this process and opens the door for new ideas. Supporting innovative research approaches in disease mapping is another way for USAID to maximize global health impact. Knowing where diseases are most prevalent can shed light on their root causes, strengthen programs and more effectively target interventions.Lymphatic filariasis or LF, for instance, is a parasitic disease spread by mosquitoes and one of seven neglected tropical diseases that USAID prioritizes. Last year, USAID supported the expanded roll-out of a new survey protocol to assess the LF in low prevalence settings. In Ethiopia, the study mapped the disease in 45 districts, and results showed that only three of them warranted treatment. This finding saved millions of dollars that may have otherwise been spent to provide treatment in areas where the disease was not endemic. The World Health Organization has endorsed the new survey protocol to be used in other areas of uncertain disease prevalence, including Vietnam and Cameroon.These handful of tools and research projects are only a small fraction of the global health R&D portfolio that USAID has supported around the world. Despite the fact that USAID investments in health R&D are often working behind the scenes, their contribution to saving and improving lives is significant. These types of strategic investments continue to change the way communities think about what is possible in disease prevention and health promotion. You can download a copy of USAID’s latest global health-related R&D report here.This blog originally appeared on USAID’s website and has been cross-posted to Breakthoughs with USAID’s permission.