Research Roundup: Rotavirus vaccine prequalified and breakthroughs in understanding leprosy and a long-acting malaria medicine

Last week’s World Health Organization (WHO) Executive Board (EB) meeting featured a packed agenda covering diverse topics ranging from WHO’s overall plan of work for 2019-2023 to the global burden of snakebite envenoming—as well as some unexpected chicken dancing by delegates. Given that the EB sets the agenda for May’s World Health Assembly (WHA), the inclusion of an agenda item on access to medicines and WHO’s plan on intellectual property (IP) indicates that we can expect a contentious few months leading to the WHA. Here is how debates on these agenda items shook out:Access to medicines For the third consecutive year, the EB addressed the issue of access to medicines and health technologies—a topic that has received much attention in recent years and sparked strong, diverse opinions from member states on how best to address. Last year at the WHA, member states reached a compromise to allow consideration of the findings of the United Nations Secretary-General’s High-Level Panel on Access to Medicines (HLP) at this year’s EB. For the meeting, the Secretariat produced a comprehensive report mapping out WHO’s current activities against the specific HLP recommendations. Though a number of countries objected to this approach on the grounds that it implicitly endorsed the findings of the HLP report, there was broad consensus in the room that access to medicines is a global problem that requires WHO action and that the agency could not afford to delay any longer.As a result, the EB agreed on a decision point calling for WHO to develop a “roadmap report” outlining WHO’s work plans on access as part of the process of finalizing the overall 2019-2023 plan of work. This report will be submitted to the 2019 WHA.Intellectual property Speakers at the EB, 2018 (Photo: GHTC/Matt Robinson) While the access to medicines agenda item reached a consensus decision more quickly than expected, the debate on IP raged over multiple days during both formal and informal sessions at the EB. The debate ultimately boils down to a divergence between high-income countries—countries with significant pharmaceutical industries—and low- and middle-income countries on whether WHO is an appropriate forum to address IP. Those against WHO taking an active role on IP (including the United States and Japan) argue that the World Trade Organization and the World Intellectual Property Organization are the appropriate forums. On the other side, a coalition of countries led by Brazil and India argue that IP in medicines is a unique category and that international policy must be set with a health perspective first. As the global normative organization for health, WHO is thus the appropriate venue to address IP.After many days of closed-door negotiations, the board ultimately decided to move forward with a consensus resolution text. It called for member states to implement recommendations from the new WHO report on IP and public health as appropriate for their national contexts and to continue further discussions and for the Director-General to begin implementing the recommendations and submit a progress report to WHA in 2020. Notably, the following provisions were stripped out of the resolution, including calls for member states to:1. Promote transparency and understanding of research and development costs2. Identify essential products at risk of shortages and take measures to prevent stock outs3. Commit to dedicating at least .01 percent of gross domestic product to basic and applied research relevant to developing countriesGHTC will continue tracking these issues over the coming months heading into WHA, and we look forward to what will be a spirited meeting in May!

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. Research carried out in part by an artificially intelligent (AI) robot discovered that a common ingredient in toothpaste—triclosan—showed potential to interrupt malaria-causing parasites at two critical stages of malaria progression. Triclosan, an ingredient used to prevent plaque build-up, is believed to halt the parasites growth in the blood and liver by inhibiting two different enzymes within the parasite, enoyl reductase and DHFR. Triclosan was able to target and inhibit DHFR, even in parasites resistant to the common antimalarial pyrimethamine. This discovery could potentially pave the way for new drug development, and the successful use of AI could result in more robots used for drug discovery purposes. A National Institutes of Health (NIH)-funded schistosomiasis vaccine candidate will soon enter a Phase 1b clinical trial in an endemic region of Brazil. Researchers at Baylor College of Medicine, the George Washington University, and the René Rachou Institute will lead a double-blind, randomized, and controlled study in a group of 60 males and non-pregnant females with potential previous exposure to the parasite to test two different formulations of the vaccine. Schistosomiasis is the second most deadly parasitic infection in the world, affecting more than 200 million people worldwide. The vaccine being tested targets one of two parasite species, which accounts for one-third of all cases and one-half of schistosomiasis deaths worldwide. Many individuals previously treated for schistosomiasis are susceptible to reinfection, highlighting the importance of developing a safe and effective vaccine. A new tuberculosis (TB) vaccine candidate yielded positive results in monkeys, according to a new study published in Nature Medicine. The monkey species, rhesus macaques, are genetically similar to humans, but are significantly more susceptible to TB. The vaccine reduced overall TB disease by 68 percent—a major increase compared to the non-measurable protection rate of the current TB vaccine in rhesus macaques. Additionally, 41 percent of vaccinated monkeys had complete protection from TB, while 30 percent developed a less severe case of TB than unvaccinated monkeys. Thirty percent of vaccinated rhesus monkeys showed no protection. TB kills more than 1.7 million people every year, and the rise of drug-resistant TB highlights the growing need for an effective vaccine.