Research Roundup: A Zika vaccine priority, partnerships for better cures, and a nationwide polio vaccine drive

The 72nd session of the United Nations General Assembly (UNGA) featured a number of firsts: It was the first UNGA for new United Nations (UN) Secretary-General António Guterres, as well as the first for recently elected World Health Organization (WHO) Director-General (DG) Dr. Tedros Adhanom Ghebreyesus. Both used this annual gathering of world leaders to solidify their signature issues in a public forum. DG Ghebreyesus’ signature issue was achieving universal health coverage (UHC), in which all people can access a basic standard of necessary health care without being driven into poverty. DG Ghebreyesus publicly stated at multiple events and in numerous tweets that he views achieving UHC as a political decision to support human rights. Research and development (R&D) and innovations in health care are a vital part of any agenda to achieve UHC. At a US Pharmacopeia event, President Ameenah Gurib of Mauritius discussed drug development as not only a key economic driver in her country, but also as a core part of achieving UHC. South African Minister of Health, Minister Aaron Motsoaledi, speaking at a Stop TB Partnership reception, stated that the fight against tuberculosis (TB) would never be won without accelerated investments in R&D to advance the next generation of tools needed to make treatment more effective. “Research and development (R&D) and innovations in health care are a vital part of any agenda to achieve UHC.” Using the example of TB, it is easy to see that the prospect of achieving overall UHC is dependent on innovations that will increase efficiency and drive down costs. Current analyses indicate that countries would need to spend an average of about 5 percent of their gross domestic product to achieve UHC—a goal that, for many nations, is “aspirational in the short term.” Multi-drug resistant TB (MDR-TB), which typically takes two years or longer to treat, can exact an enormous burden on a country’s financial resources. For example, data from the United States shows that MDR-TB is at least US$100,000 more expensive to treat than standard TB, with an estimated $134,000 spent treating every MDR-TB patient compared to $17,000 for regular TB treatment. Imagine if a new drug regimen could reduce treatment time to under a year. The savings in both human suffering and resources within the health system would be enormous. Fortunately, MDR-TB treatments in development today hold promise to offer faster, simpler, and more affordable solutions. “…It is easy to see that the prospect of achieving UHC overall is dependent on innovations that will increase efficiency and drive down costs.” Beyond the hugely positive impact of new technologies within health systems, global health R&D has other wide-reaching, positive externalities. To explore these, GHTC convened a panel discussion with Dr. Peter Singer of Grand Challenges Canada, Bumpei Tamamura of the GHIT Fund, and Jan-Willem Scheijgrond of Philips. Each of the panelists noted a variety of reasons their organizations view investments in global health R&D as not only the right thing to do, but also as good business. From the perspective of a government-supported innovation agency, Dr. Singer noted that through its investment in global health R&D, Grand Challenges Canada has achieved phenomenal bang for its buck. The agency has supported over 800 innovations with an investment of roughly $200 million. Further, two-thirds of this investment goes directly into low- and middle-income countries (LMICs), where it not only supports technological development, but also builds the human capital and innovation economy that will allow these countries to achieve long-term prosperity. Bumpei Tamamura highlighted how fostering multi-sector, multi-country partnerships can advance a nation’s health technology sector. Supported by both the Japanese government and Japanese pharmaceutical and technology companies, the GHIT Fund views its role as creating the incentives to support partnerships between Japanese companies and their global counterparts to leverage respective strengths. Noting the Fund’s success in supporting product development, Mr. Tamamura explained that the Fund is now looking to expand its portfolio of partnerships into manufacturing and distribution, potentially with developing country counterparts. From Philips’ perspective, Jan-Willem Scheijgrond explained investing in global health R&D is not about charity—it is about good business. He noted that Philips operates under a corporate mandate to improve the lives of 3 billion people worldwide, but can only reach half of those people through operations in developed markets like Europe and the United States. “We need to stop seeing health care as a cost, and instead see it as an investment,” he stressed. For Philips, investing in technologies to serve LMICs is part of meeting its core mandate. By investing in health for low-income groups, Philips helps improve health, create jobs, and lift families out of poverty while simultaneously building a new customer base for other products, especially as income levels rise. This can help build a virtuous cycle for both the public and the company, Scheijgrond explained. “Investing in global health R&D is not about charity—it is about good business.” Ultimately, global health R&D is vital not only to health, but also to achieving overall development in economic and social contexts. It improves the efficiency of health systems, allowing countries to move more quickly toward UHC. It creates jobs and generates economic impact across the world, raising incomes and lifting families out of poverty. It also creates bridges between industry in LMICs and global leaders, setting up the conditions for LMIC entrepreneurs to take their place on the global business stage. When asked to sum up the value of investing in global health R&D, Dr. Singer encapsulated it best: “You can reach your own goals that you’ve set for your own people, working with your own people, better, faster, and cheaper.” “[By investing in global health R&D] you can reach your own goals that you’ve set for your own people, working with your own people, better, faster, and cheaper.” For an UNGA session not explicitly focused on global health, the GHTC secretariat was pleased to see UHC—and the role global health R&D plays in contributing to UHC—recognized so prominently in the multi-stakeholder dialogues. We are looking forward to maintaining this momentum heading into the upcoming WHO Executive Board meeting, where a number of critical issues are on the agenda.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week.  Researchers at MIT are working to create an all-inclusive vaccine for infants that can protect against diphtheria, whooping cough, polio, measles, meningitis A, B, and C, and more. The researchers have designed a promising micro-particle that could combine all of these vaccines into one single shot. The shot has not yet been tested on humans, though results were promising in a trial on mice. If this micro-particle proves effective and safe in human trials, this all-inclusive vaccine will be useful for infants in developing countries—as reducing the  number of vaccines necessary for infants in low-resource settings means fewer clinic visits. Mobile technology has the potential to help save the lives of newborns and their mothers in Tanzania. Researchers and phone developers are hoping to reduce rates of maternal mortality by launching a new service called “Text to Treatment” that uses toll-free texting to provide women with information that facilitates access to treatment centers. For instance, this service allows users to send money for travel to free clinics. Similarly, the “Mobilising Maternal Health” program also aims to provide better access to health care services by connecting women to transportation services, such as ambulance taxis and other travel to free clinics. Both of these programs have saved lives, with a 40 percent increase in female patients visiting treatment centers due to the “Text to Treatment” service and 30 percent reduction in maternal deaths due to the “Mobilising Maternal Health” program. These services have the potential to help bridge the rural-urban divide that impacts access to timely, high-quality health care for new mothers. Researchers at the University of Alberta, Canada have discovered the malaria parasite uses tagged carbohydrates to avoid detection and continue the spread of the disease in humans—especially in the liver. The researchers believe if treatments can be improved to account for the tagged carbohydrates, then these solutions may weaken the parasite to the point where it cannot survive within the host. They also believe these findings may help improve malaria vaccine design. Malaria remains one of the leading killers in the developing world, with about 650,000 annual deaths due to the disease.