Breakthroughs Blog: WHO

WHO is moving forward on creating of new pooled fund to finance R&D. PATH/Patrick McKern In this guest post, Alexandra Heumber—head of policy affairs at the Drugs for Neglected Diseases initiative—discusses actions taken during the World Health Organization (WHO)’s Executive Board meeting which could impact financing for the research and development (R&D) of new health technologies for developing countries. Earlier this week, the WHO’s Executive Board concluded its 136th annual executive board meeting. Given the Ebola epidemic and ongoing debates about chronic underinvestment in health R&D for developing countries, it was no surprise that global health R&D featured prominently on the board’s agenda. The board discussed the follow-up of the report of the Consultative Expert Working Group on Research and Development (CEWG): Financing and Coordination, which proposed establishing a voluntary pooled fund to finance global health R&D. The board agreed to move forward with establishing this fund at the WHO Special Programme for Research and Training in Tropical Diseases (TDR). The fund will finance R&D for type II and III diseases, as well as specific needs of developing countries in relations to type I diseases. During discussions, member states stressed the importance of this fund, recalling the CEWG recommendations and citing the Ebola crisis and growing antimicrobial drug resistance in justifying its urgent need. At the same time, member states recognized that the success of the fund will depend on securing adequate funding, particularly new funding from new donors. There was broad agreement among member states representing different regions to move forward in creating the fund and more broadly in setting up the four elements to serve as a framework to monitor, coordinate, and finance global health R&D based on the CEWG report. These include: The global R&D observatory to monitor funding for R&D and expenditures A coordinating body with a scientific review committee The pooled fund at TDR Ongoing demonstration projects to illustrate how the fund would work and how CEWG principles such as delinkage—separating drug prices from the cost of R&D—and incentive mechanisms could be implemented During the board meeting, several member states pledged funding to advance these ongoing efforts: Switzerland pledged US$6 million to the demonstration projects and observatory budget line, of which $4 million has already been allocated to the TDR pooled fund. The remaining $2 million will be awarded through matching grants from low- and middle-income countries (LMICs) at the rate of $1 for every $2 contributed. Forty-thousand will be used to start the global health R&D observatory. Norway pledged $1.3 million including$650,000 to the TDR pooled fund and $650,000 to be awarded through matching grants from LMICs, again at the rate of $1 for every $2 contributed. Brazil pledged $1 million. It is encouraging to see the overall CEWG process being reinvigorated and concrete outcomes moving forward. Nevertheless, more mobilization by stakeholders and member states, including political and financial commitments, must occur. Public leadership by all countries is now crucial to make the proposed framework a reality.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. Kathy Neuzil, director of Vaccine Access and Delivery at PATH, reflects on the lessons learned from Meningitis Vaccine Project (MVP) in light of the achievement of its final milestone: World Health Organization prequalification of an infant version of the meningitis A MenAfriVac® vaccine. MenAfriVac® was approved for people aged 1 to 29 years in 2010, and has since been used to effectively protect 215 million people in sub-Saharan Africa. Neuzil attributes MVP’s success to the tenacity of its team and the inclusion of country partners at every stage from product development to distribution. A new type of antibiotic may be the key to treating drug-resistant infections, according to a study published in Nature last week. The antibiotic, teixobactin, was extracted from dirt, and fights infections by targeting the fatty molecules that bacteria use to build their cell walls. While most antibiotics target the bacteria’s DNA, which can be easily mutated, the study’s lead researcher, Kim Lewis, believes it would take at least 30 years for the fatty molecules to mutate and thus develop resistance to teixobactin. The antibiotic has been successfully tested on mice with no side effects, and could be available for use in humans in five to six years. Johnson & Johnson has started human trials of an experimental Ebola vaccine in the United Kingdom, and hopes to expand testing to approximately 2,000 people by mid-February. Johnson & Johnson has produced over 400,000 courses of the vaccine and has invested significantly in the Danish pharmaceutical company Bavarian Nordic to develop a booster shot to enhance the efficacy of the vaccine and to promote long-term protection against Ebola. Dr. Margaret Hamburg, commissioner of the Food and Drug Administration (FDA), sat down with Ryan Hohman of Friends of Cancer Research last week to discuss hot topics in FDA drug policy. Hamburg affirmed the FDA’s commitment to expediting research and development of new treatments, stating that in this “critical time for biomedical research and innovation” the FDA has a role to play in “translating all of the exciting new discoveries and opportunities and science into real world products that matter for people.”

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. This month at the Saving Lives at Birth: A Grand Challenge for Development’s DevelopmentXChange event in Washington, DC, bright minds from all over the world came together to display groundbreaking prevention and treatment approaches for pregnant women and newborns in low- and middle-income countries. The event also offered an opportunity for policymakers and decision makers to talk about the importance of science, research, and innovation for global health. During last week’s US-Africa Leaders Summit, the White House released a fact sheet on American and African cooperation for global health. As the world’s largest donor to global health, the United States is committed to working with African governments to improve the health of its citizens—including achieving an AIDS-free generation, ending preventable maternal and child deaths, enhancing global health security, and supporting African countries invest in the health of its own citizens. The World Health Organization said it thinks an Ebola vaccine should be ready for public use by 2015. There is currently no vaccine or cure for Ebola, which is currently widespread in parts of West Africa and has killed over 900 people since March of this year. This year’s outbreak is the biggest ever reported since Ebola was discovered over 40 years ago. In the Huffington Post’s blog, Dr. Jonathan Mermin—director of the Center for Disease Control and Prevention’s National Center for HIV and AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis (TB) Prevention—writes about the desperate need for new tools to prevent, detect, and treat TB and that “until we have better ways of detecting and treating TB, thousands of Americans and millions of people worldwide will continue to suffer from an illness that should have been consigned to history long ago.” An experimental vaccine to prevent dengue could be commercially available by July 2015, according to the vaccine’s makers—pharmaceutical company Sanofi Pasteur. There is currently no vaccine to prevent this mosquito-borne disease that affects thousands of people—mainly in low- and middle-income countries—every year.

During the past year, leaders from the US Global Leadership Coalition (USGLC)—an advocacy organization promoting diplomacy and development—have traveled across America seeking out innovators and innovations that best demonstrate how strategic US investments in global development can enhance America’s foreign policy and security interests—an approach USGLC calls “smart power” diplomacy. The VVM is a health innovation that is saving lives and money. Photo: Umit Kartoglu Not surprisingly, USGLC leaders discovered that investments in global health innovation are an essential part of America’s “smart power” toolbox. As USGLC leaders traveled from city to city, they discovered numerous examples of how American businesses and nongovernmental organizations (NGOs) are working with the US government to deliver global health innovations that are not only improving lives worldwide, but also creating jobs here in the United States and enhancing America’s global leadership. In fact, nearly half of the 30 programs USGLC identified as “leading American innovators” in its Innovations in Smart Power report—released today—focused on improving global health and nutrition. The report featured two innovations developed by GHTC members, including the PATH-developed Vaccine Vial Monitor (VVM), which indicates whether vaccines have been damaged from exposure to heat. The VVM not only saves lives, but also produces an estimated $14 million annual savings by preventing undamaged vaccines from being discarded. USGLC also featured the Global Health Fellows Program II—led by the Public Health Institute—which brings private sector experts from America to low- and middle-income countries in Africa and Asia—for up to three months—to share their expertise in research and medical technologies with healthcare workers in local communities. Two interns sponsored by the Global Health Fellow Program help build a house for an HIV expectant mother in Uganda. Photo: Global Health Fellows Program II/PHI Other creative global health innovations featured in the report include low-cost toilets to reduce diarrheal disease, fortified peanut paste to combat malnutrition, and an easy squeeze pouch to help HIV-positive mothers deliver antiretroviral drugs to their newborn babies. All of these projects were supported by the US government, and demonstrate how American ingenuity and investments can tackle some of the world’s greatest global health problems. It’s clear that sustained American investment in global health innovation not only supports domestic and international health improvements and economic growth, but also serves as an important diplomatic tool and a demonstration of America’s character. In other worlds, investing in global health innovation=smart power.