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Research Roundup: Funding gaps in health innovation, new regimen for TB treatment, and a malaria drug resistance model

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PATH/Mike Wang

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week.

September 5, 2018 by Ansley Kahn

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.

A new analysis has found that many of the products needed to combat the world’s most prevalent infectious diseases are not likely to be developed based on the current candidates in the research and development (R&D) pipeline and exposed significant funding gaps for R&D. According to the analysis—which was conducted by Duke Global Health Institute using a modelling tool developed by the World Health Organization’s Special Programme for Research and Training in Tropical Diseases (TDR)—there are 500 products for neglected diseases already in development which would cost an estimated US$16.3 billion to complete, yielding approximately 128 expected product launches. Additionally, the study identified 18 high-priority products it deemed “missing” from the current pipeline, such as vaccines for HIV and AIDS, tuberculosis, and hepatitis C. The research also exposed an annual funding gap of $1.5–2.8 billion, comparing current annual spending on product development to the costs required to move current products through the pipeline as well as develop the 18 “missing” products.

TB Alliance announced the launch of a new clinical trial, known as SimpliciTB, which will evaluate whether a new four-drug regimen against tuberculosis (TB) can treat most types of the disease more quickly and effectively than currently available treatments. The trial, which will launch in Tbilisi, Georgia, will enroll 450 patients across at least 10 countries. It will test the efficacy of a four-month treatment with the BPaMZ regimen—comprised of the newly FDA-approved drug bedaquiline, an investigational drug known as pretomanid, a re-purposed antibacterial medication called moxifloxacin, and a standard drug regularly used in treatment, pyrazinamide—in individuals with drug-sensitive TB. It will also test a six-month regimen of BPaMZ among patients with multidrug-resistant TB. A previous eight-week trial of the BPaMZ regimen among 250 patients revealed that patients on the regimen cleared bacteria at the fastest rate ever seen, up to three times faster than the standard first-line regimen. If proven successful in SimpliciTB, the BPaMZ regimen could significantly impact the way TB is treated globally.

Competition between parasite strains in a human host reduces the odds of drug resistance developing in a high-transmission area, according to a new mathematical model for malaria developed by researchers at Emory University and the Centers for Disease Control and Prevention's Division of Parasitic Diseases and Malaria. Where multiple strains of malaria already exist, a drug-resistant strain will usually go extinct simply because it has the disadvantage of being a “late-comer.” However, if a drug-resistant strain does become established, that same competition facilitates the spread of the drug-resistant strain more quickly. The researchers are developing a software tool based on the model they’ve developed, which can be applied to studying a range of pathogens and infectious diseases.

Categories: Malaria, Tuberculosis

About the author

Ansley KahnGHTC

Ansley Kahn is a senior program assistant at GHTC who supports GHTC's communications and member engagement activities.

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September 9, 2018

Research Roundup: Predatory bacteria, genetically engineered mosquitoes, and tracking disease outbreaks from space

Written by Ansley Kahn / GHTC
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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. Germ-eating microbes may offer a new line of defense in fighting back against antibiotic-resistant bacteria, according to lab studies funded by the Defense Advanced Research Projects Agency. The most impressive predatory bacteria from the studies was an organism called Bdellovibrio, which preyed upon 145 of the 168 human pathogens tested, invading larger bacteria and eating them from the inside out. Researchers collected remaining ‘survivor’ bacteria, allowing them to reproduce to see if they were able to mutate and resist attacks from Bdellovibrio; however, no direct mutants ever became resistant. This microbe-eating method has been shown effective in fighting bacterial lung disease in rats. No germ-eating microbe experiments have been performed in humans to date. The government of Burkina Faso has granted scientists permission to release genetically engineered mosquitoes, marking a key step in using bioengineering to eventually eliminate malaria in the region. The impending release will also mark the first time a genetically engineered animal will be released into the wild in Africa. The mosquitoes being released will be mostly male with a ‘sterile male’ mutation, meaning none will be able to produce offspring. Although these mosquitoes won’t have any specific mutations related to malaria transmission, researchers hope this release will foster improved trust in science and research among government regulators and local residents and inform future releases. This inaugural release will lay the groundwork for teams in Burkina Faso, Mali, and Uganda to eventually release “gene drive” mosquitoes that will dramatically and rapidly reduce the mosquito population. NASA is using weather satellites to track and predict disease outbreaks before they occur, deploying this technology to track cholera outbreaks in Yemen. Given cholera infections typically result from drinking contaminated water, the team at NASA used environmental data such as rainfall levels and water and air temperatures to build their prediction map and pinpoint where the worst cholera outbreaks will likely occur. NASA’s model proved 92 percent accurate in predicting cholera outbreaks in Yemen, though the information came too late to be useful to the medical teams on the ground. Researchers have continued to improve their prediction algorithm and hope to deploy their data this year to direct health workers to critical areas and save lives.
PATH/Wendy Stone
August 26, 2018

Research Roundup: Long-acting HIV drugs, a universal flu vaccine candidate, and a low-cost device in...

Written by Ansley Kahn / GHTC
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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. A large-scale study has shown that monthly injections of two long-acting HIV drugs are just as effective as taking daily pills. The phase III study, led by ViiV Healthcare—a London-based collaboration between GlaxoSmithKline and Pfizer—tested an experimental drug, cabotegravir, and rilpivirine in 618 HIV-infected people from 13 different countries over a 48 week period. It found HIV viral suppression levels were the same in both individuals taking daily pills and individuals receiving a monthly injection of each drug. Long-acting HIV medications have the potential to transform the way HIV is both treated and prevented, offering an alternative option for people who find it challenging to adhere to taking daily pills. It is possible ViiV could apply for regulatory approval for these drugs as early as next year. The world could be one step closer to a universal flu vaccine, according to a study out of the University of Pennsylvania Perelman School of Medicine. Researchers there have developed a flu vaccine candidate that was found to elicit a strong antibody response to a structure on the surface of flu viruses, called the hemagglutinin (HA) stalk and protect mice from infection of various flu strains. The HA stalk has been a target for universal flu vaccines as it does not vary from one flu subtype to another, unlike seasonal flu vaccines that target the “head” region of the HA protein which tends to mutate rapidly and varies by flu type. The experiment was repeated successfully in ferrets and rabbits. The scientists’ next step is to test the vaccine in non-human primates and then humans. A group of students at Makerere University in Kampala, Uganda have invented a low-cost, reusable device to detect malaria quickly without drawing blood. Deemed a “game changer” by the Royal Academy of Engineering, which recently honored the product’s research team with its Africa Prize for Engineering Innovation, the simple device, called Matibabu, uses magnets and a matiscope to detect the deadly disease. A matiscope is a custom-made device that shines a red beam of light on to a user’s finger to detect whether a substance known as haemozoin crystals, a by-product of the malaria parasite, is present. The latest prototype of the device only requires two minutes to detect malaria, as opposed to 30 minutes or more when using a microscope. Since no blood is drawn, the device has the potential to be administered by non-specialists at the community level. The inventors of the device still have a few hurdles to overcome. For example, the current model only detects 80 percent of malaria cases, which misses the mark of the international norm of 99 percent. With supplemental funding, the developers hope to further refine the device and bring it to market within two years.