Research Roundup: Long-acting HIV drugs, a universal flu vaccine candidate, and a low-cost device in the fight against malaria

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.

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. Clinical trials have begun for the latest vaccine candidate against the Zika virus. The trial, which will include 28 adult participants, will test the safety and immune response from the vaccine, which contains a weakened form of the virus created from the combined genetic material of different viral strains. If the vaccine candidate is found to be safe, it could be added to another vaccine candidate currently undergoing testing for effectiveness against four types of dengue—creating a single vaccine against both diseases. Both vaccine candidates were developed at the National Institute of Health’s National Institute of Allergy and Infectious Diseases. On August 10, the US Food and Drug Administration approved Annovera, the first-of-its-kind self-insertable contraceptive vaginal ring that can be used for an entire year. Annovera, developed by the Population Council, is being heralded as a revolutionary new option for low-income women as it can be used for a year without a return trip to the physician or pharmacy and does not require refrigeration. Along with the benefits it offers regarding convenience, Annovera also offers women versatility. “Annovera offers the convenience of a long-acting method like the IUD because there is no daily action needed, but the control of a short-acting method like the pill because a woman can start or stop it at any time,” said Julia Bunting, president of the Population Council. Although pricing for Annovera has not yet been made public, the Population Council is continuing its efforts to make the product available to the approximately 214 million women in low- and middle-income countries that have an unmet need for contraception. Annovera is expected to hit the market at the end of 2019 or early 2020. A new type of bednet—that combines a chemical that kills mosquitoes with another that impedes their reproduction—was found to reduce clinical malaria cases by 12 percent, compared to conventional nets, during a two-year clinical trial in Burkina Faso. The study also showed a 51 percent reduction in risk of a malaria-infective mosquito bite in areas with the combination bednets. The bednets used in the study combine a pyrethroid insecticide, which repels and kills mosquitoes, with pyriproxyfen, an insect growth regulator that shortens the lives of mosquitoes and reduces their ability to reproduce. With mosquitoes increasingly becoming resistant to the pyrethroids used in conventional nets, these bednets offer an alternative to fighting malaria in areas where mosquitoes have become resistant.