Kim Lufkin

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. Researchers say that a new discovery could pave the way for the development of flu treatments or even a universal vaccine. GHTC member the International AIDS Vaccine Initiative, in partnership with India’s Translational Health Sciences and Technology Institute, recently launched a new HIV Vaccine Design Program. An increasing number of new medical devices are aiming to help people deal with health conditions in ways that previously required the aid of a medical professional. GHTC member the PATH Malaria Vaccine Initiative recently named some of the world's most eminent malaria scientists to its Vaccine Science Portfolio Advisory Council. In related news, the biotechnology company Antigen Discovery has received a three-year grant worth $2.5 million from the National Institute of Allergy and Infectious Diseases for its efforts to develop a malaria vaccine.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. A new bill introduced in the House of Representatives aims to tighten reporting requirements for ClinicalTrials.gov, the public online registry run by the National Institutes of Health. The HIV and AIDS drug Truvada safely and effectively reduces the risk of HIV for certain at-risk populations, according to the first US Centers for Disease Control and Prevention guidelines on using the drugs for prevention. Nature Medicine recently examined how several pharmaceutical companies are testing new drug candidates to treat drug-resistant tuberculosis. The Government Accountability Office has released a new report that details regulatory policies and requirements put into place under various US global health programs. The Bill & Melinda Gates Foundation announced that Dr. Orin Levine has been named director of Vaccine Delivery. Levine, a member of the GHTC, is currently a professor of International Health and executive director of the International Vaccine Access Center at the Johns Hopkins University’s Bloomberg School of Public Health.

As the XIX International AIDS Conference continues in Washington this week, research for new tools to prevent and treat HIV and AIDS is standing out as a major theme. Below, we provide a summary of various sessions that have touched on research and product development topics. The US Congress and the Global AIDS Epidemic: Amid a group of protestors on Wednesday, former Sen. Bill Frist (R-TN) moderated a session with Sen. Chris Coons (D-DE), Sen. Mike Enzi (R-WY), Rep. Barbara Lee (D-CA), and Senator Marco Rubio (R-FL). When discussing her newly released bill—the Ending the HIV and AIDS Epidemic Act of 2012—Lee said that even in these “difficult” financial times, “we must move forward toward an AIDS-free generation.” Several other panelists stressed that a large part of achieving an AIDS-free generation will involve research for new products to prevent, test, and treat the disease. Speaking about recent scientific advances to create an HIV and AIDS cure, Rubio said that increased investment in innovation is critical to advancing these efforts. Coons echoed these comments, saying, “We need to double-down, we need to invest in basic science, invest in translational science, a vaccine, and new drugs. We need to innovate.” Rep. Barbara Lee (D-CA) at the International AIDS Conference. Photo credit: PATH. Effective Solutions to Combat HIV: Increasing Evidence of the Impact of Neglected Tropical Diseases on HIV Transmission and Disease Progression: In a session that examined the link between HIV and AIDS and neglected tropical diseases (NTDs), Giuseppe Pantaleo, chief of the Division of Immunology and Allergy at the University of Lausanne, said that 25 percent of people living with HIV worldwide are also co-infected with an NTD. He added that because of the high co-infection rate, there is a great need to focus on research, such as the clinical links between HIV and NTDs. Maria Aparecida Shikanai Yasuda from the University of Sao Paulo reiterated this point, saying that research is needed to develop new NTD drugs that are less toxic and more efficient. Astrid-Christina Koch, with the Delegation of the European Union to the United States, said that the second phase of the European and Developing Countries Clinical Trials Partnership will fund more stages of research. Currently the partnership covers research Phases II and III but will expand to cover Phases I through IV. This expansion could go a long way in addressing product development for NTDs and other global health diseases. Microbicides, pre-exposure prophylaxis (PrEP), and vaccines continue to take center stage at AIDS 2012. At a session to discuss The Role of Vaccines in Ending the Pandemic, panelists stressed that vaccines have proven to be one of the best, cost-effective global health solutions, and that research needs to continue to develop a vaccine for HIV and AIDS. Margaret McCluskey from the US Agency for International Development quoted Sen. John Kerry (D-MA), who has called an HIV and AIDS vaccine the “holy grail.” During a session on Wednesday on Microbicides and PrEP: Back to Basics, Ian McGowan from the University of Pittsburgh emphasized that a range of microbicide and PrEP formulations—from intra-muscular injections to vaginal and rectal products, rings, and oral pills—are needed to provide men and women worldwide with a range of HIV prevention choices that best fit their specific needs. Kim Lufkin is the GHTC’s communications officer.

The world of HIV and AIDS research and development (R&D) is changing dramatically, and sessions this week at the XIX International AIDS Conference have examine how R&D advocates need to adapt and adjust their strategies in this new environment. The global financial crisis is at the forefront of many people’s minds, along with issues like increasing demands on already strapped country-level budgets and the possible shift from the Millennium Development Goals to the Sustainable Development Goals. At a session on Tuesday to discuss persuading policymakers to invest in tuberculosis (TB) R&D, Richard Horton from the Lancet said that TB advocates have recently recognized the need for a different approach that involves going directly to policymakers, as well as bringing TB scientists and researchers together with national decision-makers in order to create a collective will to address the leading killer of HIV-positive people worldwide. Two members of parliament from the United Kingdom—Cathy Jamieson and Pamela Nash—stressed that in addition to making their evidence and arguments simple and understandable, advocates need to connect their issues to a politician’s constituents, as constituents are always a policymaker’s top priority. “My job as a politician is to listen to the evidence and expertise that you bring, and then make sure funding is available to address those priorities,” Jamieson said. (from left to right): GHTC Director Kaitlin Christenson, IAVI's Prince Bahati, Henriette Laursen of AIDS-Fondet, Christine Lubinski from the Infectious Diseases Society of America, and Chamunorwa Jefrey Mashoko from AVAC. Photo credit: PATH Later that afternoon, the GHTC and several coalition members—Aeras, AVAC, the International AIDS Vaccine Initiative (IAVI), and the International Partnership for Microbicides—hosted a session to discuss how advocates can adapt their advocacy to meet today’s challenges. Four main themes emerged—the first focused on taking a community approach to R&D advocacy that includes a range of diseases and products. “Policymakers are tired of vertical advocacy,” Prince Bahati of IAVI said, adding, “We as advocates have the opportunity to create a platform of integrated advocacy, comprised of advocates, and scientists. We need to adapt to the transition that is happening and create one voice.” Chamunorwa Jefrey Mashoko, an AVAC advocacy fellow, added that a key part of this effort will involve scientific collaboration between African and American researchers. Panelists also discussed the need to engage new voices in their advocacy, including researchers working on new HIV and TB tools, as well as the people and communities who will ultimately benefit from these new products. Christine Lubinski from the Infectious Diseases Society of America said that some of the most successful project she’s worked on involved taking members of Congress to African countries in order to see first-hand TB and HIV research projects and clinical trials, and to meet African scientists. She added that it’s vital to show policymakers that there is a domestic constituency who believes in global health R&D, comprised of academic institutions, scientists, and researchers. “We have game-changing tools in the pipeline,” Lubinski said, adding, “We have a real opportunity with some of these new products, and I believe that’s our biggest weapon as advocates.” Additionally, the panelists talked about how there is a great need to recognize investments that have been made in global health R&D from donors, as well as how to engage new donors from countries such as Brazil, Russia, India, and China. Finally, the panelists stressed the importance of advocating for new tools as well as increased access to existing and proven tools. “There really isn’t a division between advocating for R&D and advocating for existing tools,” Henriette Laursen of AIDS-Fondet said. She added, “We can look at the historical successes of R&D and recognize that they are both part of the package.” Kim Lufkin is the GHTC’s communications officer.

On the second day of the XIX International AIDS Conference, the need for a host of new tools to prevent and treat HIV and AIDS has already made it to the forefront of the agenda. Of particular note has been the resounding call for a vaccine to prevent HIV, with leading policymakers, scientists, and advocates saying that the world will never reach the end of AIDS without this powerful tool. In a session that focused on improving the effectiveness and efficacy in the HIV and AIDS response, Senator Lindsey Graham (R-SC) said that a vaccine is desperately needed to help make a sizable dent in the pandemic. Graham’s call for a vaccine was echoed by Bill Gates from the Bill & Melinda Gates Foundation. The “ultimate tool” in the fight against HIV and AIDS “will be a vaccine,” Gates said, adding that the US government has been the largest supporter of efforts to develop and vaccine “by far.” He also said that microbicide gels and rings will be powerful prevention products. Without a number of these new tools, the world cannot “talk seriously about moving toward the end” of the pandemic. “We will get these tools, but only if we stay the course.” Later in the afternoon, National Institutes of Health (NIH) Director Francis Collins and Jon Cohen from Science magazine chaired a panel that looked at what lies ahead in HIV and AIDS science. Gary Nabel, director of the NIH’s Vaccine Research Center, said “we’ve never been in a more exciting position” in the search for an HIV and AIDS vaccine. He added that recent discoveries related to broadly neutralizing antibodies over the past two years have made HIV vaccine research “like a phoenix rising from the ashes.” When sharing their hopes for the status of HIV and AIDS research, several panelists also stressed the urgent need to develop new HIV prevention and treatment options. Nabel said that by 2020, he expects researchers will be “in the midst of efficacy trials for an HIV vaccine candidate.” Robert Siliciano of the Johns Hopkins University School of Medicine stressed that by 2020, scientists will be leading clinical trials for new drugs that attack HIV reservoirs. And Dawn Averitt-Bridge of the Well Project said that by 2020, she hopes the world has effective microbicides to prevent HIV, a functional cure for the disease, and that “research makes it into the lives of the people and families we all care so much about.” Cohen ended the session with a call for young people to become the “next generation of scientists” leading HIV and AIDS research. “I’m looking to the young people, because that’s where the revolution is going to happen.” Kim Lufkin is the GHTC’s communications officer.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. The US Food and Drug Administration has approved the first over-the-counter, self-administered HIV test. Developed by OraSure Technologies, the test is 92 percent accurate and will cost less than $20. A recent article in IRIN News highlights the serious need for new antibiotic drugs worldwide, and discusses the potential of public-private partnerships to boost antibiotic discoveries. The United Nations (UN) is urging countries to impose various innovative financing mechanisms in an effort to raise money to offset cutbacks in development aid. The UN hopes that coordinated taxes on carbon emissions, air traffic, currency transactions, and other taxes could raise more than $400 billion a year. Global Health Initiative (GHI) leaders announced last week that the GHI office will be phased out at the State Department. According to GHI Executive Director Lois Quam, the GHI office will be replaced by the State Department’s new Office of Global Health Diplomacy.