Breakthroughs Blog: Zika

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week.A new low-cost and heat-stable vaccine—ROTASIL—has been found effective against severe rotavirus in phase III clinical trials. The vaccine, which was developed by the Serum Institute of India and tested in partnership with PATH, had an efficacy of nearly 39 percent in children with severe rotavirus and 55 percent against a very severe form of rotavirus. The vaccine is a hybrid of bovine and human rotavirus and is capable of targeting all five rotavirus serotypes. Indian children face a high burden of rotavirus, as the country accounts for 22 percent of all rotavirus deaths worldwide. {% component type: A GeneXpert machine. (Photo: PATH/Georgina Goodwin)India is rolling out a new program to expedite the diagnosis of pediatric tuberculosis (TB) and multi-drug resistant TB cases to speed treatment. While children generally respond well to TB treatments, a pediatric TB case is usually severe and requires a quick, accurate diagnosis to ensure effective treatment. FIND and the Revised National Tuberculosis Control Program have worked in India to establish an infrastructure to aid in accurately and quickly diagnosing children, developing a courier system to quickly relay samples from clinic to lab for diagnosis and relay results back to the health provider via text message within 24 hours. The organizations have also led an initiative that has added over 600 GeneXpert diagnostic machines throughout India. India’s goal is to make the GeneXpert machines a front-line tool for TB diagnosis.Research conducted by the National Institutes of Health (NIH) and Sanofi has created an antibody capable of killing 99 percent of HIV strains. Fighting HIV is difficult because of the virus’ ability to mutate quickly, which often results in the presence of numerous different HIV strains in a single patient. NIH and Sanofi harnessed the natural defense system of a small number of people who produce broadly neutralizing antibodies,” which can kill up to 90 percent of HIV strains in the body. The researchers combined three antibodies to produce a tri-specific antibody that has proved to be more effective than any naturally occurring antibody yet discovered. The first human clinical trial is planned for 2018.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. Sanofi Pasteur’s announcement that it will cease work on its Zika vaccine candidate has raised concerns about the future of Zika vaccine development. While the World Health Organization has reported 40 Zika vaccine candidates in development, with six candidates in phase 1 clinical trials, Sanofi was the only major pharmaceutical company working on a vaccine against the virus. Its exit from this space raises questions about who will fund clinical development if these candidates show further promise. Additionally, many unanswered questions remain about the virus’s epidemiology and the target population for a vaccine. While the number of Zika cases is now falling, Zika epidemics will likely reoccur in the future. Because of this risk, developing an effective and low-cost Zika vaccine must remain a priority. Johnson & Johnson and the Biomedical Advanced Research and Development Authority (BARDA) have formed a partnership to develop vaccines and drugs to protect against pandemic influenza. Among its projects, the partnership is seeking to develop a “universal” flu vaccine that protects against all or most influenza strains. This collaborative effort highlights a larger trend in partnerships between the private sector, the US government, and nonprofits to develop vaccines and technologies against emerging health threats for which there is currently limited commercial market. Pakistan has launched its first nationwide vaccination drive for polio, aiming to immunize over 37 million children. Pakistan is one of just three countries where polio cases remain, so this nationwide drive is an important step toward eradication. While polio still remains endemic in Pakistan, the number of cases has reduced dramatically in recent years from 306 cases in 2014 to just 4 today. Pakistan has experienced obstacles in its attempts to eradicate the virus, which include efforts by extremists to target immunization campaigns.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week.Sanofi, a major vaccine developer, ceased their Zika vaccine program, highlighting how difficult it is to develop an effective vaccine for Zika. The US Biomedical Advanced Research and Development Authority reduced funding to Sanofi for the vaccine program last month, and Sanofi announced in early September it will no longer seek funding to continue its vaccine research. Smaller companies are in clinical stages of testing different Zika vaccine candidates, but Sanofi was the first major US pharmaceutical company to begin research on a potential vaccine for the virus. A female Culex quinquefasciatus mosquito (CDC/ James Gathany)The Infectious Diseases Data Observatory, a research observatory based out of the University of Oxford in the United Kingdom, is developing a data-sharing platform to compile and share Ebola data to aid in the response to future outbreaks. Researchers are seeking to engage local African leaders in the platform's creation to provide cultural context and ensure the resulting system improves the capacity of African researchers to conduct research in outbreak scenarios. Organizers agree that developing the platform now—during a period of no active outbreaks—is critically important, as having the platform available for aid workers and medical professionals before the next Ebola outbreak may aid in saving lives. A new, low-cost tool has been introduced in disadvantaged areas to treat newborn asphyxia. Newborn asphyxia is highly prevalent in low-resource settings, with about 20 percent of all newborn deaths in India caused by the condition. Therapeutic hypothermia—which reduces an infants body temperature—is a common treatment, but hypothermia-inducing machines are typically too costly for low-resource settings. Dr. Niranjan Thomas of Vellore, India created the MiraCradle, a fast-acting, low-cost device made of several phase changing materials—substances that absorb and release thermal energy—that is used as a regulation agent to keep a newborn hypothermic. The MiraCradle is currently being used in about 125 hospitals throughout India and South Africa.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. Scientists at the UK’s John Innes Centre believe that a plant closely related to tobacco may hold promise in accelerating polio eradication by transforming vaccine manufacturing. Scientists have hijacked the plant’s growing mechanisms with genetic code for making the outer surface of poliovirus and taught them to grow virus-like particles, which are then extracted into a vaccine. This resulting vaccine mimics the poliovirus, and thus elicits an immune response, but contains none of the properties that cause a poliovirus infection. Scientists are hopeful this may be an effective way to create safe vaccines in the future that aren't made with live viruses, and hope to mimic the process with other viruses as well. Following the 2014 Ebola outbreak in several African countries, an African Centers for Disease Control and Prevention (Africa CDC) was formalized and launched to focus on capacity building in Africa to protect against infectious disease threats. Ending malaria is an important target of the Africa CDC, but there is much to be done to achieve this goal. First, efforts to collect real-time data must be strengthened to ensure the Africa CDC makes informed decisions. Second, international aid institutions and African nations must provide adequate resources to support the Africa CDC. Third, the international community must continue to work toward malaria eradication. Scientists believe individuals in the Americas have developed herd immunity that has resulted in a significant drop-off in Zika incidence. Once a person is infected with Zika, it is not possible for them to be infected again, so they can no longer pass on the virus to mosquitoes who pass it on to other individuals. Scientists think because Zika is usually asymptomatic in non-pregnant individuals, many have been infected and are now immune. This suggests that as the number of people resistant to the virus increases, incidence of others contracting the virus will decrease. With that said, however, scientists still urge pregnant women to take caution when traveling to Zika endemic areas of the world.