Breakthroughs Blog: MDGs

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. In a new paper—developed by the Council on Health Research for Development, GHTC, the International AIDS Vaccine Initiative, and PATH—the authors make the case for the inclusion of research and innovation for health as a central component of the post-2015 development agenda. The paper describes the impact that increased investments in R&D and innovation for health—particularly for the world’s poorest—have had in contributing to progress toward achieving the Millennium Development Goals (MDGs)—particularly for MDGs 4 (reduce child mortality), 5 (improve maternal health), and 6 (combat HIV and AIDS, malaria, and other diseases). In a recent special report from the Global Post, the prominence of public-private partnerships in global health is analyzed as governments laud private sector partners for their expertise and vast resources. However, while most believe public-private partnerships to be highly effective, the Global Post looks into how to quantify their impact given the lack of comprehensive and transparent metrics for evaluation. Last week we at the United Nations General Assembly, the US Agency for International Development, the UK Department for International Development, the Swedish International Development Cooperation Agency, the Australian Department for Foreign Affairs and Trade, and the Omidyar Network have launched a US$200 million Global Innovation Fund. Grants ranging from $50,000 to $15 million will be available for social enterprises, for-profit businesses, researchers, government agencies, and nonprofits. The Atlantic highlights a recent incident in El Paso, Texas, where a former hospital nursery employee tested positive for tuberculosis (TB), which caused panic and precautionary screenings of more than 700 infants who passed through the nursery over the last year. In addition to demonstrating that Americans are not immune to this diseases, the article also asks why an effective vaccine to prevent TB in the first place has yet to be discovered. The National Institutes of Health (NIH) and the US Food and Drug Administration (FDA) have received national recognition for the “most outstanding intellectual property deal” for MenAfriVac™—a low-cost meningitis vaccine developed specifically for populations in sub-Saharan Africa. The vaccine—developed by GHTC member PATH and the Serum Institute of India—incorporated technology from the FDA, as well as a patent license for a manufacturing process granted by the NIH.

In this guest post, Claire Wingfield—product development policy officer at PATH—writes about a new paper exploring why research and development (R&D) of high-priority health tools for diseases and conditions affecting low- and middle-income countries (LMICs) should be a critical component of the post-2015 development agenda. The new paper make the case for the inclusion of research and innovation for health as a central component of the post-2015 agenda. Photo: PATH/Gabe Bienczycki A dearth of adequate health technologies and interventions targeting poverty-related diseases—like HIV and AIDS, malaria, tuberculosis, and neglected tropical diseases—means that millions of people in LMICs continue to die each year from preventable and treatable diseases and conditions. Progress on developing new interventions targeting the health priorities of LMICs has faltered because these diseases occur almost exclusively among the world’s poorest and most marginalized populations. Thus, there is little or no perceived commercial market encouraging companies to develop products targeting LMICs. Because the health burden imposed by poverty and social vulnerability remains far too high, achieving health for all is one major goal of the post-2015 development agenda. In a new paper—developed by the Council on Health Research for Development, the Global Health Technologies Coalition, the International AIDS Vaccine Initiative, and PATH—the authors make the case for the inclusion of research and innovation for health as a central component of the post-2015 development agenda. The paper describes the impact that increased investments in R&D and innovation for health—particularly for the world’s poorest—have had in contributing to progress toward achieving the Millennium Development Goals (MDGs)—particularly for MDGs 4 (reduce child mortality), 5 (improve maternal health), and 6 (combat HIV and AIDS, malaria, and other diseases). These investments have helped to create an enabling environment for research in and for the benefit of LMICs by increasing demand for new health technologies, expanding coverage of proven interventions, and strengthening the innovation infrastructure in these countries. Building on the work of The Lancet Commission on Investing in Health—a group of renowned economists and global health experts—the paper discusses the need for increased R&D investments by all countries to achieve the dramatic health gains envisioned in the post-2015 agenda. Adequate investment in R&D is important, but it alone does not guarantee more products or drive innovation toward the right type of products. PATH/Patrick McKern Adequate levels of investment, as suggested by The Lancet Commission, are critical for spurring the development of new health tools, provided they align with financing needs in R&D—notably predictability and flexibility. But even that sort of investment alone does not guarantee more products, and it does not drive innovation toward the right type of products—those that are suitable, acceptable, affordable, and accessible to populations most in need. It is essential, therefore, that indicators for R&D for health tools that primarily affect LMICs address a comprehensive set of outcomes including financing needs, infrastructure and human resources needs, enabling policies, necessary partnerships, capacity strengthening, and access requirements. Because poor health and disability contribute substantially to poverty, research and innovation for health is linked to improving economic prosperity and is critical to eradicating poverty. Therefore, it must be continuously prioritized within the post-2015 development agenda. Ultimately, the success or failure of the post-2015 agenda relies just as much on how the goals and targets are implemented as it does on how progress will be measured. Thus any research and innovation indicators measuring progress against the goals and targets outlined in the post-2015 agenda must also increase accountability of researchers, governments, and funders, and inform research processes. Inclusion of research and innovation for health must facilitate an enabling environment for research and innovation in LMICs and encourage endemic countries to set and pursue a domestically-driven health research agenda. The post-2015 development agenda is an opportunity for LMICs to set their own health agendas and research priorities and to assert their leadership in strengthening the R&D landscape focused on the needs of the poorest and most marginalized populations. Therefore, it is essential that there is broad agreement among all of the relevant stakeholders that research and innovation for health—which includes the scaling up of proven health interventions as well as the development of new and improved high-priority health technologies—is critical to meeting the ambitious goals of eradicating poverty and ensuring sustainable development for all within a generation. In support of the inclusion of research and innovation for health in the post-2015 agenda, over 150 organizations and individuals recently signed a petition to United Nations (UN) Secretary General Ban Ki-moon and Member States urging the UN to keep the research, development, and delivery of new and improved health tools for diseases and conditions impacting LMICs at the heart of the post-2015 development agenda. It is our hope that the Members States and other UN officials shaping the agenda will head this call.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. With the 69th session of the United Nations (UN) General Assembly going on this week in New York and the global community debating how best to refine the post-2015 development agenda, over 150 organizations and individuals signed a petition to UN Secretary General Ban Ki-moon and Member States urging the UN to keep the research, development, and delivery of new and improved health tools at the heart of the post-2015 development agenda. A new public-private partnership to fight against HIV and AIDS has been launched—part of a Clinton Global Initiative five-year Commitment to Action that will strengthen laboratory systems in sub-Saharan Africa. The $15 million, five-country collaboration—called Stronger Together—will leverage the expertise of each partner country to build up laboratory infrastructure, which remains critical to disease control and product development. This week, the Obama administration announced a new set of federal executive actions to combat antibiotic-resistant bacteria in an effort to protect public health. The administration will put forth an executive order that would direct the federal government to work both domestically and internationally to reduce the emergence and spread of antibiotic-resistant bacteria. Specifically for health research and development, the National Institutes of Health, Biomedical Advanced Research and Development Authority, and the Food and Drug Administration will launch a $20 million prize to facilitate the development of a rapid diagnostic test that can be used by health providers to identify highly resistant bacterial infections. GHTC member the Global Health Innovative Technology Fund (GHIT Fund) has awarded seven new grants totaling US$15.3 million to tackle malaria, Chagas disease, and dengue fever. The investments aim to speed up the development of promising drugs and vaccines to battle these three insect-borne diseases.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. The Senate Appropriations Labor and Health and Human Services (LHHS) Subcommittee released its fiscal year 2015 appropriations legislation, after a lengthy internal debate on domestic health concerns. The legislation is—for the most part—good news for funding levels and policy issues for several key global health research programs at the National Institutes of Health, the Centers for Disease Control and Prevention (CDC), and the Office of Global Affairs at the Department of Health and Human Services. Since its discovery nearly 40 years ago, we have learned a lot about Ebola. Yet there are still no effective treatments or vaccines to protect people against this deadly disease. According to an article in Vox, this is not because of “a lack of human ingenuity or scientific capacity,” but rather due to a global innovation system that does not prioritize the health research needs of world’s poorest populations. Drs. S. Patrick Kachur, MD, MPH, FACPM—chief of the Malaria Branch in the Division of Parasitic Diseases and Malaria at CDC’s Center for Global Health—and Larry Slutsker, MD, MPH—director of the Division of Parasitic Diseases and Malaria at CDC’s Center for Global Health— write in Breakthroughs about the emerging global security threat of anti-malaria drug resistance and CDC’s efforts to prevent, detect, and respond to this growing threat. They write: “…to sustain momentum and move toward elimination of malaria, new tools and technologies will be required.” Despite progress made to prevent maternal and child deaths by the United Nations’ Millennium Development Goals (MDGs), still too many mothers and children are compromised or killed by preventable diseases. PATH President and CEO Steve Davis writes for Devex about the need to take advantage of the progress made thus far by the MDGs and accelerate innovation to meet the health needs of millions of people in low- and middle-income countries. It’s World Breastfeeding Week (August 1-7) and as breastfeeding has served as the primary method for a mother to feed her infant since the dawn of humanity, we wonder if this could be a way for a mother to administer life-saving medicines to her baby? According to a group of researchers in the United States and United Kingdom, the answer is yes. Two recent promising developments in the fight against malaria were announced last week. Malaria is one of the leading killers of women and children in the world, and in sub-Saharan Africa particularly—where 90 percent of the more than 620,000 annual malaria deaths occur—new tools to fight the disease are desperately needed.