Research Roundup: CEPI invests in vaccine printer tech, new bednet strategy to fight malaria, and Themis' chikungunya vaccine nabs FDA Fast Track

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 March 6, the World Health Organization (WHO) announced wide-ranging reforms in the organization’s structure intended to help it achieve its “triple billion” targets as part of its new five-year strategic plan—including one billion more people benefiting from universal health coverage, one billion more people better protected from health emergencies, and one billion more people enjoying better health and well-being. Among the reforms is the creation of a new chief scientist division formed “to strengthen WHO’s core scientific work and ensure the quality and consistency of WHO’s norms and standards.” Headed by Soumya Swaminathan who will serve as chief scientist, this division is also expected to offer and improve career opportunities for scientists at WHO. Other reforms include the creation of a new department of digital health, a division of emergency preparedness to complement WHO’s existing emergency response work, and a “WHO Academy” to train public health professionals. WHO officials have summed up the organizational transformation initiative as an effort to break down silos across WHO programs and ensure alignment among its offices worldwide. A new report released by the G20 Health & Development Partnership on March 5 urges finance ministers to help tackle some of the world’s most pressing global health challenges by developing new financing models and increasing concerted activity for research and development. The report calls for innovative solutions to funding health, citing that ill health could cost the world billions in treatment and lost economic productivity. Alan Donnelly, convener of the G20 Health & Development Partnership, stated that tackling these health challenges are “no longer just an issue for health ministers, it is now an issue for heads of government and for finance ministers because of the threat to the global economy as well as to humanity.” The partnership released the report in advance of the joint G20 health and finance ministers meeting in Japan in June as an appeal to the finance ministers to “remove the silo walls around health care.”For only the second time in history, a patient appears to have been cured of HIV. Like the first recorded case nearly 12 years ago, this outcome resulted from a bone marrow transplant initially intended to treat cancer. In both cases, transplants were from a donor with a mutation in a protein called CCR5, which rests on the surface of certain immune cells. The HIV virus uses this protein to enter those cells but cannot latch onto the mutated version. Although these transplants confirm for researchers that a cure for HIV is possible, bone marrow transplantation is unlikely to be a realistic treatment option in the near future due to the risk and harsh side effects involved—though rearming the body with immune cells modified to resist HIV may succeed as a practical treatment.

On February 15, President Trump signed into law a bipartisan spending bill—averting another partial government shutdown and ensuring full-year funding for the government for the remainder of fiscal year (FY) 2019. The move followed several days of speculation about whether discord between Congress and the President on funding for a border wall would imperil the spending measure passed by Congress to fund the remaining one-quarter of the federal government.The months-long saga ended with some great news for global health and research and development (R&D)—a roughly US$150 million funding increase for global health programs in the State and Foreign Operations (SFOPs) bill, as well as a significant boost to the Food and Drug Administration (FDA) under the Agriculture bill included in the package.The bill included some welcome increases to global health accounts which have been flat-funded for five years running, including a $50 million (1.16 percent) increase to the President’s Emergency Plan for AIDS Relief (PEPFAR) and a $2.5 million (2.5 percent) increase to the US Agency for International Development’s (USAID) Neglected Tropical Disease Program compared to FY 2018. Nutrition saw a $20 million (16 percent) increase and Maternal and Child Health got a $5.5 million (0.66 percent) boost. But perhaps the most notable win in the bill was a long-sought increase to USAID’s tuberculosis (TB) program. After TB was in the spotlight at the United Nations High-Level Meeting on TB in September, the United States backed up its pledge of additional support for the global fight against TB by including a $41 million (15.71 percent) increase to the program in the final spending package for FY 2019—the largest increase to the program in more than five years. All other global health accounts were level-funded compared to FY 2018, resulting in an overall increase of 3.23 percent for USAID Global Health—a stark difference from the 36 percent cut proposed in the President’s budget.While most accounts of relevance to global health R&D within the Department of Health and Human Services were funded for the entire fiscal year in a spending package passed in September, the FDA was one agency whose funding was still in limbo. The FDA’s unique funding structure—divided between budget authority, or discretionary funding (appropriated by Congress), and fees (paid by FDA users) —shielded the agency from some of the worst impacts of the partial government shutdown in December and January as it drew down on user fees to continue most operations. But the final FY 2019 funding package included a welcome $460 million (9 percent) increase for the agency, including a $269 million (9 percent) increase in budget authority.As the FY 2019 appropriations process lurched across the finish line, advocates were already gearing up for another budget battle for FY 2020. Check back for regular updates as appropriations hearings begin and GHTC continues monitoring the prospects for global health R&D accounts in the coming year.  For reference, the text of the Conference Report to accompany H.J. Res. 31, the Consolidated Appropriations Act, 2019, is available here, the text of the Joint Explanatory Statement is here (with the Global Health Program breakdown on page 454 of the PDF), and a division-by-division summary is available here.