Breakthroughs Blog: Child health

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. Australian scientists solved a mystery about how malaria-causing parasites infect the human body, making a key discovery that could pave the way toward an effective vaccine for the disease. Researchers found that one of the malaria-causing parasites, P.vivax, infects humans by latching onto a protein that carries iron to young red blood cells. In response, researchers created antibodies designed to block this from taking place, thus halting the infection process. Future research on the antibodies’ effectiveness is needed, but researchers remain optimistic the discovery will lead to a potential vaccine candidate for P.vivax, though it could be another decade before clinical trials begin. In December, the World Health Organization (WHO) prequalified the first infant-safe typhoid vaccine—Typbar TCV—for global use. The move comes after years of research, including a high-profile “challenge trial” involving volunteers swallowing the live virus, which found the vaccine was 87 percent effective in preventing infection. This approval by WHO allows donors, including United Nations agencies, to purchase Typbar TCV—which is now priced atUS$1.50 a dose and could drop to $1.00 if donors order more than 100 million doses—for use in low-resource countries. Global use of the vaccine should help curb the use of antibiotics for treatment, mitigating the increasing threat of antibiotic-resistant typhoid. Vitamin C may shorten tuberculosis (TB) treatment time by killing more bacteria, according to a new study in Antimicrobial Agents and Chemotherapy. Researchers at Albert Einstein College of Medicine accidentally discovered that antioxidants, like vitamin C, stopped TB bacteria in test tubes from becoming “persisters”—or TB bacteria that become dormant during treatment and eventually cause reinfection. To test this discovery further, researchers conducted a mice study and found promising results: The mice given vitamin C in concurrence with TB drugs had ten times fewer bacteria in their lungs than the mice not given vitamin C. While human studies are necessary to confirm effectiveness, researchers agree that coupling TB drugs with vitamin C is a safe, accessible, and inexpensive choice.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. The release of antibiotics into the environment is a significant environmental threat, according to a new United Nations Environment Programme report. The presence of antibiotics have been found in soil deposits, lake and river sediment, and wastewater facilities around the world, suggesting industrial, human, and pharmaceutical disposal leads to traceable amounts of antibiotic compounds in the environment. This issue alarms experts because even minimal traces of antibiotics may lead to the continued evolution of antimicrobial resistant bacteria. While more research is needed on the consequences of antibiotics in the environment, experts suggest various strategies to help mitigate the problem including deploying improved methods to treat wastewater, treating animal waste before using it as fertilizer, and improving antimicrobial stewardship. An Army-developed Zika vaccine candidate (ZPIV) performed well across three Phase 1 clinical trials, according to new findings published in The Lancet. The three studies were designed to elicit information on background immunity, vaccine dosage, and vaccine schedule in adult populations. A total of 67 participants received two injections four weeks apart, and researchers found more than 90 percent of participants who received the ZPIV vaccine had an immune response to the virus. The Army developed the vaccine candidate in response to the 2015 outbreak, noting the need for a Zika vaccine not only to advance global health, but also to protect US service members and their families. Countries are restricting use of the world’s only dengue vaccine—Dengvaxia— following an announcement by developer Sanofi Pasteur raising safety concerns. The company discovered, from data analysis, that the vaccine could raise the risk of a deadly form of dengue for people who had not been exposed to the virus prior to vaccination. In response, the Philippines ceased an ongoing, mass immunization campaign, and Brazil tightened restrictions on the vaccine. While Sanofi stressed there were no reported deaths related to the dengue vaccine, they believe more severe cases of dengue may occur if an immunized individual, who was not previously infected before receiving the vaccine, is then subsequently infected with dengue. This rare complication leaves children at a higher risk of contracting the severe form of dengue, as they are less likely to have been exposed to infection before receiving the vaccine. Dengue sickens hundreds of millions of people and kills more than 20,000 every year, underscoring the need for a safe, effective, vaccine.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week A tech nonprofit, WeRobotics, is seeking to deploy drones to deliver hundreds of thousands of sterile mosquitoes into Zika hotspots across Latin America to assist with mosquito population control. Existing research suggests releasing sterile mosquitoes into the wild may eventually reduce populations by as much as 90 percent, though actual mosquito introduction has proven challenging. To solve this, WeRobotics developed small, temperature-controlled drones designed to deploy mosquitoes in rural and hard-to-reach locations, ensuring all affected areas receive the sterile mosquitoes. The drone’s cool temperature leaves the mosquitoes in a deep sleep state, protecting them during the journey, and the drone then releases the mosquitoes from a controlled height to ensure they do not die from impact. WeRobotics plans to deploy these drones soon and will educate local communities about the project. The World Health Organization (WHO) recently announced that about 11 percent of all medicines circulating in low- and middle- income countries are substandard or counterfeit. WHO estimates between 72,000—169,000 children may die from pneumonia and 116,000 may die from malaria every year after receiving falsified or substandard products, suggesting this is a widespread and alarming problem in the world’s poorest countries. Experts believe majority of these cases remain unreported, compounding existing issues with counterfeit or substandard medicine monitoring across affected countries. This is the first time WHO has assessed in-depth the global scope of the problem. In 2013, the agency set up a voluntary global monitoring system for substandard and fake drugs, which has helped bring to light the extent of the issue. An estimated 50 million doses of antibiotics are prescribed for typhoid every year, with overuse or misuse of these drugs contributing to the global rise of antibiotic-resistant bacteria. In the city of Karachi, Pakistan—a typhoid-endemic country—antibiotic resistance is rising by 30 percent per year, and 100 percent of typhoid cases are expected to be multi-drug resistant by 2020. A new typhoid vaccine may be the solution to this growing problem. The typhoid conjugate vaccine (TCV) is more effective in preventing typhoid than its predecessor and may protect individuals for up to five years—longer than the previous vaccine. Most importantly, TCV may be given to children under the age of two, expanding the level of coverage to infants who are in critical need of a vaccine. With rising levels of antibiotic-resistant bacteria, having an effective and inclusive typhoid vaccine may save thousands of lives.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. A resurrected malaria prevention strategy—seasonal malaria chemoprevention—saved an estimated 40,000 lives in 2015 and 2016, according to new research. The strategy involves giving children a dose of antimalarial drugs monthly during the rainy season—the season with the highest incidence of malaria—to prevent the disease. Researchers and public health professionals were initially skeptical of this technique when applied in real-world settings since it requires thousands of local aid workers to deliver malaria drugs to rural and hard-to-reach areas, but recent results have shown reductions in malaria prevalence similar to those seen in clinical trials in areas deploying the strategy. While historical and recent studies suggest this technique is effective, there are signs this method will only work for a limited time before existing drugs fail because of resistance, meaning alternative solutions must continue to be explored. As the world gets closer to eradicating polio, a funding crisis looms for many countries. Funding for the Global Polio Eradication Initiative is scheduled to be halved in 2019 and expire the following year, except in the most high-risk countries. A reduction in polio funding will leave countries with depleted resources, straining their capacity to vaccinate against other life-threatening diseases and conduct surveillance activities. Today, polio funding supports health workers that also deliver routine immunizations as well as 70 percent of all global funding for surveillance. Also, as polio transmission rates move toward zero, global strategies must be implemented to maintain eradication, including using the safer injectable polio vaccine for up to ten years following eradication, which will be more difficult to achieve if polio resources are strained. At the close of the first Global Ministerial Conference on Ending Tuberculosis, 75 health ministers agreed to take committed action to end tuberculosis (TB)by 2030. Ministers met in Moscow, Russia over two days to discuss and strategize solutions for TB. They concluded with a pledge to take action on four fronts: (1) move to achieve universal health coverage, (2)mobilize domestic and international investments to close gaps in implementation and research, (3) advance research and development for new tools to tackle TB, and (4) build accountability by tracking and reviewing progress in ending TB. Ministers also vowed to take increased action to minimize the risk and spread of antimicrobial resistance.