Two thousand eighteen was a turbulent year in global health. Between reemerging crises, breakthrough scientific discoveries, and the continued looming threat of health research funding cuts, 2018 took us on a roller coaster ride of peril and promise. Now as the year comes to an end, GHTC is taking a moment to reflect on the global health innovation stories and news that shaped 2018.
Here are the highlights from our year in review:
A patient suffering from sleeping sickness visits a hospital in DRC. PATH/Georgina Goodwin
In 2018, a revolutionary treatment emerged for a neglected tropical disease, sleeping sickness. The first all-oral drug for sleeping sickness, developed by the Drugs for Neglected Diseases initiative (DNDi) and Sanofi,
received a positive scientific opinion from the European Medicines Agency—paving the way for the treatment to be rolled out in endemic countries
in 2019. This groundbreaking treatment, known as fexinidazole, is a tablet taken once daily for ten days that treats the most common form of sleeping sickness, a disease spread by tsetse flies, which causes neuropsychiatric symptoms and can be deadly if left untreated.
Current treatments for sleeping sickness require a complicated series of infusions and pills, are costly, and involve long hospital stays. Fexinidazole
is a simple once-a-day pill that could reduce the logistical burdens to treating a disease for which approximately 65 million people in sub-Saharan
Africa are at risk.
A patient in Zambia receives a malaria diagnostic test. PATH/Gena Morgan
This year, the global health community witnessed regulatory approval of the first new treatment for Plasmodium vivax malaria in 60 years by the US Food and Drug Administration (FDA). The new drug, tafenoquine, is a single-dose treatment developed by GlaxoSmithKline and Medicines for Malaria Venture. P. vivax malaria causes around 8.5 million infections every year in Asia, Latin America, and parts of Africa. It’s tricky to combat because the P. vivax parasite can lie dormant in the liver, where it reactivates, and can cause new episodes of malaria weeks, months, or even years after the initial infection. In a study of the treatment, 60 percent saw no relapse six months after taking the drug. Tafenoquine has been submitted for approval to the Australian regulatory authority and is slated to be submitted for approval in malaria-endemic countries. Experts hope this new treatment will accelerate the path to elimination of this mosquito-borne disease.
One of the most disheartening stories of 2018 was the reemergence of Ebola in the Democratic Republic of Congo (DRC). Ongoing conflict in the region has hampered response efforts, with the outbreak now reaching 500 confirmed cases. Yet, amidst this crisis, there is one reason for optimism: An experimental vaccine appears to be helping those it reaches. Close to 45,000 people have received the experimental rVSV-ZEBOV Ebola vaccine—the largest use of the product since a clinical trial in 2015 showed it worked. While the vaccine’s effectiveness during this outbreak has not been formally assessed, World Health Organization (WHO) officials believe it is having a major impact. The vaccine’s developer, Merck, announced last month that it has begun the process of submitting evidence to seek FDA approval, a crucial step to bring the vaccine to market. Meanwhile, new preliminary research also suggests experimental treatments deployed during the outbreak are improving survival rates, and researchers have begun clinical trials in eastern DRC to test the effectiveness of four of these experimental drugs. This research raises new hope that science may soon offer us both a vaccine and treatments to combat Ebola.
While the Trump Administration proposed in its fiscal year (FY) 2018 and 2019 budgets to slash funding for global health and medical research programs, in the end Congress pushed back. In March, Congress passed the FY18 omnibus, which protected, and in many cases increased, funding to key US agencies and programs that advance global health research and development (R&D). In September, Congress passed an FY19 spending bill covering the Defense, Labor, Health and Human Services (LHHS), and Education departments. The bill boosted funding for medical research across the Department of Health and Human Services, with the National Institutes of Health receiving a $2 billion increase and the US Centers for Disease Control and Prevention and the Biomedical Advanced Research and Development Authority also receiving modest increases.
These funding bills represent a forceful rebuke by Congress of the Administration’s proposals to draw back support for global health and medical research programs and demonstrate that Congressional policymakers on both sides of the aisle want to see the US continue its leadership in advancing innovation to improve the health of those in need around the world. Given that funding for the US Agency for International Development (USAID) was maintained through a continuing resolution that expires on December 21, we now await further action by Congress to determine how FY19 funding for global health accounts at USAID will shake out.
A healthworker in Laos prepares a vaccine. PATH/Aaron Joel Santos
A dog in India. PATH/Gabe BienczyckiWinston Churchill once said, “No idea is so outlandish that it should not be considered.” That’s clearly a motto researchers have taken to heart, as evidenced
by the number of stories we read this year about unusual and creative ways scientists are trying to fight infectious diseases. Here’s a sample of some
of our favorites. One could say it’s a bacteria-eat-bacteria world out there, with researchers studying whether germ-eating microbes could be used to combat drug-resistant infections. Man’s best friend may also be man’s diagnostic tool, according
to new research showing that dogs can be trained to detect malaria in people.
In the future, administering a vaccine could be as easy and pain-free as putting on a Band-Aid if microneedle patches in development come to fruition. The contents of your takeout dinner might be the next frontier in HIV prevention,
as scientists have developed a technique to modify a strain of rice to produce HIV-neutralizing proteins.
While these ideas may seem fantastical, history has taught us that groundbreaking discoveries can come from unusual places.