Breakthroughs Blog: Maternal 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. COVID-19 vaccine trials in the United States, several of which are now in phase 3, have so far not included pregnant women or women who are breastfeeding, and only one potential US-market vaccine manufacturer—AstraZeneca—has begun testing in children. Vaccine candidates are customarily tested first in healthy adults, the population deemed most likely to provide clear results on vaccine efficacy and be at lowest risk for side effects, often leaving out younger populations and women who are pregnant. As manufacturers have been starting to broaden their volunteer pools to other typically underrepresented and at-risk populations—for example, adults over the age of 65 and people with HIV—some experts and advocates remain concerned about the lack of data regarding pregnant women and children.The US Food and Drug Administration (FDA) recently granted emergency use authorization (EUA) to SalivaDirect, a saliva-based COVID-19 diagnostic test developed by researchers at the Yale School of Public Health and funded by the National Basketball Association (NBA). The test joins several other saliva-based tests that have been greenlit by FDA in recent months. SalivaDirect’s Yale-based research team is now working with other labs to develop more saliva-based diagnostics, including one developed at the University of Illinois at Urbana-Champaign, which also received EUA last week. Researchers hope that increased availability of saliva-based tests—which often do not require administration by a trained health care worker and cost less than the standard nasopharyngeal swab tests—will improve speed and affordability of COVID-19 detection.Pharmaceutical companies and research centers, supported by the European Union (EU), have created a 37-member initiative working to advance research and development (R&D) to combat the COVID-19 pandemic. Called the Corona Accelerated R&D in Europe (CARE) initiative, the research-focused consortium has three main goals: screen libraries to identify existing compounds that have potential to be repurposed against COVID-19, perform in silico screening to find new small molecules that fight SARS-CoV-2, and apply approaches like fully human phage and yeast display to the discovery of virus-neutralizing antibodies. The initiative is one of several organizational collaborations working on strategies against COVID-19 and will work to ensure its efforts integrate with and complement other programs, with plans to operate for the next five years.

One of the great things about working at GHTC is that every day we get to read stories about incredible innovations in global health. Most of the technologies we read about are inventive, some are revolutionary, and a few are so unusual, one might think they were ripped from the pages of a science fiction novel. So, to enjoy a bit of fun and mischief this Halloween, we’ve created a new game, TRICK or TREATment, to test our readers’ knowledge of global health technologies. For each question, we will present a description of a global health technology. Choose TREATment if you believe this innovation exists and has market approval. Choose TRICK if you think we are trying to pull one over on you and, instead, the product is still in development or just a figment of our imagination.  Loading... (function(i, s, o, g, r, a, m) { var ql = document.querySelectorAll('A[quiz],DIV[quiz],A[data-quiz],DIV[data-quiz]'); if (ql) { if (ql.length) { for (var k = 0; k

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.

For many mothers and babies around the world, the first 48 hours after birth are the most dangerous of their lives. For eight years, Saving Lives at Birth—spearheaded by USAID—has challenged problem solvers worldwide to create innovative solutions to make birth safer and save lives. Here are ten incredible innovations from this initiative: Many newborns struggle to breathe. While in developed countries, doctors use CPAP machines, these devices are too costly for most health facilities in low-resource nations. Fortunately, innovators at Rice University have developed a low-cost solution—the Pumani bCPAP. Delivering comparable treatment at 1/15th the cost, the Pumani has tripled the survival rate of babies with respiratory distress.   Blood pressure (BP) disorders like pre-eclampsia are a leading cause of maternal death. BP cuffs have been used to monitor BP since the early 1900s, but they can be hard to maintain and read by less-skilled health workers. A startup named Biospectal is reinventing this approach. It has developed the OptiBP, a cuff-less smartphone app that allows instant, accurate BP monitoring through a fingertip.   Affecting 60% of newborns, jaundice can cause brain damage or death if left untreated. In low-resource nations, doctors often don’t have access to costly lab equipment needed to diagnose the disorder. That’s where the BiliSpec comes in. Developed by Rice University, this handheld, battery-powered device can diagnose jaundice within two minutes using just a $0.05 paper strip and a drop of blood.   Even a small dip in a newborn’s temperature can put her life at risk. Continuous temperature monitoring is key to detecting issues early, but in overcrowded health facilitates, it can be hours between readings. To address this gap, Rice University developed the Neonatal Temperature Monitor—a simple, affordable tool to continuously monitor and display infant temperature, alerting staff of problems.   Malaria during pregnancy is dangerous for both mothers and their unborn babies. Researchers are studying whether a promising new malaria vaccine candidate—Sanaria’s PfSPZ vaccine—could offer a solution. The research team will test the vaccine in pregnant women and monitor the mothers and newborns post-birth. If successful, the project could radically change malaria management in pregnant women.   Poor water and sanitation in low-resource health facilities can expose moms and babies to infection at birth. Chlorine is a commonly used disinfectant, but supply chain issues make it hard for facilities to ensure a steady supply. PATH and MSR Global Health created an innovative, low-cost tool—the SafiStation Chlorine Generator—to produce chlorine on site using just water, salt, and electricity.     While stillbirths are common in poor regions, increasing evidence suggests that non-breathing newborns are often misidentified as stillborn when they have heart rates (HR) and could survive with resuscitation. To address this gap in care, researchers developed the NeoBeat, a low-cost, belt-like device that takes seconds to put on a baby and provides a continuous digital display of newborn HR.   Jaundice is common among newborns. Fortunately, if found and treated early it is also curable. To facilitate diagnosis and treatment in low-resource areas, innovators developed the Bilikit, a comprehensive package of low-cost tools to manage jaundice. The kit includes the Bilistick, a rapid, hand-held, portable diagnostic device, and the Bili-Hut, a portable, high-intensity phototherapy device.   Blood donation shortages in Africa can leave health workers with few options if a woman is hemorrhaging blood during childbirth. Attendants often resort to using a soup ladle and gauze to try to salvage and recycle a patient’s own blood. The Hemafuse pump by Sisu Global Health is a cost-effective, hygienic alternative. This tool sucks up blood, filters it, and transfers it to a bag for reuse.   Over 100,000 women die annually from postpartum hemorrhage (PPH) or excessive bleeding. PPH is treatable, but the tools widely used to control dosage are too costly or infrastructure intensive for low-income nations. That’s a problem Shift Labs hopes to solve with DripAssist—a low-cost, battery-powered tool that constantly monitors medicine flow via an IV drip, sounding an alarm if it fluctuates.   View as a video below: Photo credits: PATH/Doune Porter; Pumani bCPAP: 3rd Stone Design, GHTC; OptiBP: GHTC: Bilispec: Rice University, 3rd Stone Design; Neonatal Temperature Monitor: GHTC; PfSPZ vaccine: Leiden University Medical Center, GHTC; Safistation: PATH/Adam Drolet; Neobeat: Laerdal; Bilikit: GHTC, Bilimetrix srl Trieste, USAID, Little Sparrow Technologies; Hemafuse: Sisu Global Health; DripAssit: Medgadget, GHTC