Ansley Kahn

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. Since 2015, scientists from the Fiocruz Institute in Brazil have been infecting mosquitoes with Wolbachia bacteria in a lab and then releasing them into the wild in trial tests in the hopes of slowing the spread of mosquito-borne diseases like dengue. Wolbachia bacteria—common among insects except the Aedes aegypti mosquito, which transmits dengue, Zika, and chikungunya—works by boosting a mosquito's immune system, making it less likely to contract disease. However, if a mosquito does contract dengue, Wolbachia makes it harder for the virus to grow inside the insect and be transmitted to humans. The hope is that the lab-infected mosquitoes will reproduce with wild mosquitoes, spreading the bacteria through the population. Scientists report “significant reductions” in cases of dengue and chikungunya in neighborhoods near where mosquitoes were released. Tests also show more than 90 percent of mosquitoes in areas where the first infected insects were released more than three years ago have the bacteria. Scientists see this technique as one in a suite of tools to control mosquito populations and halt the spread of disease. The Biomedical Advanced Research and Development Authority (BARDA) awarded the Sabin Vaccine Institute (Sabin) an initial US$20.5 million, with options for an additional $107.5 million, to support development of vaccines against Marburg virus and Sudan Ebola virus. With the initial award, Sabin will conduct development and non-clinical activities with the intent of continuing clinical research through phase 2 trials, which may be supported by the additional funding. The Sudan Ebola vaccine candidate is the first of this virus strain to receive BARDA support and the Marburg vaccine candidate is the second to receive BARDA support. BARDA is also supporting the development of vaccines, therapeutics, and diagnostics against the Ebola virus strain causing the current outbreak in the Democratic Republic of the Congo. For the first time, researchers have developed a rapid diagnostic test that uses a biomarker in saliva to detect the mosquito-borne parasite that causes malaria. The test, which will be marketed as SALVA!, is less invasive than traditional malaria diagnostics, which require a blood sample, and can even detect the disease before people carrying the parasite show symptoms or fall ill. Easy-to-administer at the community level, the test also delivers results in five to twenty minutes without samples being sent to a lab. Global Health Innovative Technology Fund has awarded the test’s developers more than £1 million for field trials and continued development. The World Health Organization has called for more new tools to detect malaria, a disease for which there are more than 200 million cases worldwide each year.

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. A study has revealed that an antibody, known as IgM, is far more influential in combating malaria than previously thought—which may have important implications on the development of a malaria vaccine. It was previously thought that IgM played a supporting role in the body’s immune response to malaria, that it would initiate this response and then disappear when the primary antibody, IgG, took over. However, this new research shows IgM acting as a co-lead with IgG to block and clear malaria infection in the blood. As a next step, scientists are seeking to understand why the immune system generates both antibodies in response to malaria infection and determine whether vaccines that stimulate an immune system to produce IgM antibodies give better protection against malaria. Researchers hope this new insight brings them one step closer to developing a highly effective vaccine against malaria. The Biomedical Advanced Research and Development Authority (BARDA) announced that it will provide US$14 million and organizational expertise to support the continued development of the investigational Ebola treatment known as mAb114. BARDA will assist Ridgeback Biotherapeutics of Miami, the company manufacturing mAb114, with its application for licensure with the US Food and Drug Administration (FDA). mAb114, a monoclonal antibody that works by binding to virus proteins, thus reducing their ability to infect human cells, is currently being used in the Democratic Republic of the Congo to help combat the ongoing Ebola outbreak as part of a clinical trial. mAb114 has already obtained an FDA Breakthrough Therapy Designation, which allows participating companies to work more closely with FDA officials in pushing for approval. Last week, at the United Nations (UN) General Assembly High-Level Meeting on Universal Health Coverage (UHC), member states reached a comprehensive agreement which commits countries to advance UHC for their citizenry. UN Secretary-General António Guterres called the political declaration “the most comprehensive agreement ever reached on global health” and a “significant achievement” that will drive progress over the next decade on tackling diseases like HIV and AIDS, tuberculosis, and malaria, along with the growing burden of non-communicable diseases and antimicrobial resistance through primary health care systems. In adopting the declaration, member states have committed to investing in policies that expand access to health care while preventing financial hardship and developing and implementing high-impact health interventions to combat diseases and protect women’s and children’s 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.Scientists from Target Malaria, a research consortium backed by the Bill and Melinda Gates Foundation, have for the first time outside of the lab released genetically sterilized mosquitoes in Burkina Faso to combat malaria. Using a technique known as a gene drive, scientists injected male mosquito embryos with an enzyme that sterilizes them, with the goal of reducing the mosquito population over time. Target Malaria is also developing an enzyme to prevent male mosquitoes from passing on X chromosomes, which results in all male offspring, thereby reducing malaria transmission since female mosquitoes are the ones that primarily bite and transmit disease. Researchers continue to push for new approaches to combat malaria, which killed more than 400,000 people in Africa in 2017. Progress against the disease is stalling, according to the World Health Organization (WHO). Biotech company Themis has raised US$44 million to develop its chikungunya vaccine through a phase 3 trial and move the lead candidate from its immuno-oncology research and development (R&D) program into humans. Themis filed an IPO to raise the funds last year but held off due to “adverse market conditions,” leaving the company to consider other options to fund further development. Last month, Merck invested $200 million in Themis for vaccine R&D, indicating Themis had lined up private financing to fund further development. The phase 3 trial is due to start in the coming months, enroll thousands of participants, and deliver data around the middle of next year. Themis is considering taking the vaccine to market itself. The US Food and Drug Administration (FDA) has accepted an application for approval of Merck’s Ebola vaccine, V920, also known as rVSV∆G-ZEBOV-GP. The vaccine is eligible for priority review and Merck will learn of the FDA’s decision by March 14. If the vaccine receives FDA approval, Merck would become the first company to receive clearance to sell a vaccine against the virus in the United States. In addition to its FDA filing, Merck has had an application for approval in Europe accepted for review earlier this year and has also applied for WHO prequalification status. V920 has been used on an investigational basis during the current Ebola outbreak in the Democratic Republic of the Congo, with only 71 cases among the 93,965 at-risk people who received the vaccine, according to WHO.

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. On Friday, Kenya became the third African country—following Malawi and Ghana— to introduce the world’s only licensed malaria vaccine. Health authorities are administering the vaccine to young children in rural areas where transmission rates are high. The aim is to reach approximately 360,000 children per year across the three countries in which the vaccine is being rolled out. Although the vaccine only protects about one-third of children who are immunized, those who are vaccinated are likely to have less severe cases of malaria. The vaccine—developed by GlaxoSmithKline, PATH, and partners—is the first and only vaccine to significantly reduce malaria in children, according to the World Health Organization. Malaria kills approximately 435,000 people every year, the majority of whom are children under five years of age in Africa. For the first time, researchers have used CRISPR gene-editing technology to try to treat a person infected with HIV. Scientists in China used CRISPR to engineer human stem cells to mimic a rare form of natural immunity against the HIV virus and transplanted them into a man with HIV and blood cancer. Though many of the cells survived in the man’s body for more than a year without causing detectable side effects, the number of cells was not high enough to significantly reduce the amount of HIV in his blood. While this research was a mixed success, scientists say it serves as proof of concept that CRISPR can be used to edit human stem cells that can be implanted safely in a patient. Researchers at the University of Alberta have developed a user-friendly, affordable, one-step test to diagnose dengue—a mosquito-borne disease that infects nearly 400 million people per year and causes flu-like symptoms. Unlike many traditional diagnostic tests for dengue which, in order to produce a precise diagnosis, require expensive equipment, multiple steps, and advanced training to operate, this test only requires a small blood or plasma sample and a portable tester that produces results in about two hours. As this new dengue test requires cold chemicals, the researchers are now exploring the use of vacuum-drying to create a powder that could withstand the heat in tropical climates where dengue is endemic. Additional research is required for field trials.

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. Human clinical trials are being planned to evaluate whether Ivermectin, a drug used to treat parasitic diseases like river blindness and elephantiasis, could become a new drug to combat malaria. Earlier this year, clinical trials conducted in Burkina Faso using Ivermectin for conditions unrelated to malaria found that it reduced malaria transmission by making the blood of people who were repeatedly vaccinated lethal to mosquitoes. Studies have also found that Ivermectin can kill plasmodium falciparum, the malaria parasite carried by mosquitoes, when administered to humans. The US Centers for Disease Control and Prevention, in collaboration with the Kenya Medical Research Institute (Kemri) and other global health partners, will perform the upcoming trials. Kemri and its partners say they hope this breakthrough could lead to the development of a new class of antimalarials in less than two years. Researchers have devised and tested a new mobile program which encourages tuberculosis (TB) patients to adhere to their treatment regimen. Compliance is a challenge with TB because treatment typically lasts for at least six months and involves multiple daily pills that can cause side effects such as nausea, fever, rashes, and stomach pain. The program, Keheala, texts patients to remind them to take their pills daily and asks them to actively verify that they have done so. Patients are ranked and told where they stand in an “adherence contest” against other patients. If patients do not verify that they have taken their pills, they receive more texts, calls, and finally a clinic is alerted. In the trial conducted, only four percent of patients in the Keheala program had bad outcomes, while 13 percent of those in the control group did. Based on these results, the US Agency for International Development will fund an expansion of this trial. Adherence to medications is crucial in treating TB, as those who miss too many pills often develop drug-resistant strains. As a result of the dengue outbreak sweeping across Bangladesh, the World Health Organization and the International Atomic Energy Agency have agreed to trial an innovative technique, known as the sterile insect technique (SIT), which uses radiation to sterilize male mosquitoes. Once sterilized, the male mosquitoes are released into the wild to mate with female mosquitoes, who then do no reproduce—reducing the mosquito population over time. SIT has been used successfully in parts of Africa to eradicate the tsetse fly which transmits sleeping sickness. Experts believe irradiating insects is better than other ways of controlling the mosquito population as it does not involve introducing non-native species or risk mosquitoes developing resistance to insecticides. The first group of sterilized mosquitoes will be released into the wild in Bangladesh in 2021-22.

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.Researchers have developed a low-cost, biodegradable larvicide that can kill the larvae of the Aedes aegypti mosquito, which transmits Zika, dengue, yellow fever, and chikungunya. Using a technique known as microencapsulation, researchers developed capsules, or shells, made of corn starch that slowly release thyme essential oil when in water—where Aedes aegypti mosquitoes lay their eggs—but remain intact in a dry environment. Thyme oil contains a natural compound that kills the larvae. In the study, the shells only released 20 percent of the thyme oil on first contact with water, meaning the microcapsules could remain functional for approximately five rain cycles. Researchers suggested that the public sector could produce and distribute these low-cost microcapsules so that people can pour them where rainwater accumulates. Stemming mosquito development at the larvae stage, when insects are most vulnerable and not yet a potential vector for diseases, is key to stemming mosquito and disease proliferation. The Bill and Melinda Gates Foundation and the philanthropy Flu Lab announced Thursday that US$12 million will be awarded to as many as eight scientific teams to conduct foundational research in pursuit of a universal flu vaccine. The maximum grant will be two million dollars and will stretch over two years. The announcement of six of the grants was made last week in Singapore at Options for the Control of Influenza, the flu world’s largest scientific conference. This research will investigate how to design a flu vaccine that could protect against the multitude of influenza strains, which would not need to be updated frequently as flu viruses mutate. Gavi, the Vaccine Alliance (Gavi), called on donors for $7.4 billion to help immunize 300 million children against life-threatening diseases between 2021 and 2025—saving up to eight million lives worldwide. This announcement was made in Yokohama, Japan alongside a three-day international conference on African development. Gavi is backed by the Bill and Melinda Gates Foundation, World Health Organization, donor governments, and others to fund immunization programs in low-income nations. Gavi CEO Seth Berkley reinforced the urgency around this announcement, noting that 1.5 million people die of vaccine-preventable diseases every year.