Breakthroughs Blog: NIH

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. The National Institutes of Health (NIH) began enrolling patients in a study to test hydroxychloroquine—a malaria drug also used to treat rheumatoid arthritis and lupus—as a potential therapy for patients hospitalized with symptomatic COVID-19. Although President Trump has repeatedly touted hydroxychloroquine as a “game-changer” treatment in combating the novel coronavirus, the drug has yet to be proven safe and effective as a COVID-19 therapy in a clinical trial. This NIH-funded trial is one of 18 trials in the United States seeking to determine if hydroxychloroquine can treat COVID-19. The US Food and Drug Administration issued an emergency authorization allowing doctors to prescribe hydroxychloroquine and chloroquine to treat COVID-19—leading to a spike in demand and causing shortages.US researchers began clinical trials of a second experimental COVID-19 vaccine that uses a skin-deep shot instead of the usual deeper injection. This study is evaluating if two doses of Inovio Pharmaceuticals’ vaccine candidate is safe enough for efficacy larger tests. The Inovio vaccine works by packaging a section of the virus’ code inside synthetic DNA which is then injected into the skin. The cells act a mini factory, producing harmless protein copies which prompt the immune system to make protective antibodies against them should the real virus ever come along. After the injection, researchers use a device to give the injection site an electrical zap to help the vaccine more easily penetrate and get to work. This vaccine—like the NIH and Moderna’s vaccine candidate—is not made using the actual virus, meaning there’s no chance of getting infected from the vaccine and that it is able to be produced more quickly than traditional vaccines.Australian researchers have published a study showing ivermectin, a drug commonly used to treat parasitic infections, can also kill coronavirus in a laboratory setting in under 48 hours. Research was carried out on cell cultures in the lab, which does not always translate to effectiveness in people who have contracted the infection. The exact manner in which the drug kills the virus is unknown, but researchers say it was likely done by "dampening down" the ability of host cells to clear the drug. Ivermectin has already been studied and approved to treat other conditions, offering an advantage over new drug development—a long process that typically involves many years of studying safety and efficacy before being able to reach human patients. Further research is needed to determine whether the drug could be used to treat COVID-19.

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 clinical trial to test an experimental vaccine against the novel coronavirus is expected to kick off today. This initial trial will inject 45 healthy participants with different doses of the vaccine candidate co-developed by the National Institutes of Health and Moderna Inc. The goal for the initial trial is to check that the vaccine shows no worrisome safety side effects in order to set the stage for larger efficacy tests. Public health officials say it may take up to 18 months to fully validate the potential vaccine. Dozens of research groups and companies are racing to develop a vaccine against the novel coronavirus. A second vaccine candidates from Inovio Pharmaceuticals is expected to begin safety tests next month. A man initially known as the “London Patient” has become only the second person in the world to be cured of HIV. The man, Adam Castillejo, has decided to go public with his identity one year after being declared free of the virus and now 30 months after ceasing antiretroviral therapy. Mr. Castillejo was cured of HIV after receiving a stem cell treatment for cancer. The donors of these stem cells have an uncommon gene that gives them, and now Mr. Castillejo, protection against HIV by preventing the virus from replicating inside the body. In 2011, Timothy Brown, the "Berlin Patient" became the first person reported as cured of HIV, three and one-half years after having similar treatment. Although this high-risk therapy was primarily used to treat the patients’ cancer—and is not a feasible treatment for millions living with HIV worldwide—it offers hope to finding a cure for HIV using gene therapy. A new collaboration between Medicines for Malaria Venture and the Liverpool School of Tropical Medicine will establish pregnancy registries in malaria-endemic countries in Africa to fill the data gap on the use of antimalarials in one of the most vulnerable populations to malaria. The study will be conducted across three African countries and will capture data on the real-life use of artemisinin-based combination therapies (ACTs)—the standard care for malaria— during all stages of pregnancy, including the first trimester. The goal of the study is to collect enough safety and exposure data that, if positive, would allow for policy change on the use of ACTs in the first trimester of pregnancy. ACTs are currently not recommended in the first trimester of pregnancy owing to a historic lack of safety data.

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.  Last Thursday, the World Health Organization (WHO) launched the first digital version of its latest Model list of Essential Medicines (EML), which provides countries with guidance on the most crucial medicines to have in supply. The EML list has been revised every two years by a group of WHO experts since 1977 but has previously only been published in print or PDF format. The new electronic format makes the EML list more accessible and easily searchable, as users can filter results and export customized lists to Microsoft Excel or Word. More than 150 countries currently use the EML list to determine which medicines best meet their national health needs to compile their own national essential medicines list. US biotech firm Moderna has shipped its first batch of an experimental coronavirus vaccine to US government researchers at the National Institute of Allergy and Infectious Diseases for initial trials that could begin as soon as April. The experimental vaccine candidate will be used in a phase 1 study in the United States, which will test two doses of the vaccine on 45 healthy people. Even if this initial clinical trial is successful, further testing and regulatory approvals would be required before the vaccine could be deployed for widespread use—a process that could take at least one year or 18 months. Moderna is among a slew of companies around the world rapidly trying to identify treatments or develop vaccines against the novel coronavirus that emerged in Wuhan, China late last year, which has infected more than 80,000 people worldwide. The first clinical trial in the United States of a potential treatment for the novel coronavirus is now underway at the University of Nebraska Medical Center. In a draft research plan published last month, WHO said this antiviral medicine remdesivir was considered “the most promising candidate” to treat the novel coronavirus, citing laboratory studies suggesting it might be able to target Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS)—cousins of the novel coronavirus. Remdesivir, which is made by Gilead Sciences, is part of a study already underway in China to test its efficacy against the novel coronavirus and was previously tested in some Ebola patients in the Democratic Republic of Congo before the study was stopped. Currently, there are no proven treatments or vaccines for the novel coronavirus.

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.  The second-largest Ebola outbreak in history—which has infected 3,500 people and killed 2,250 in the Democratic Republic of Congo (DRC) since August 2018—is down to its last chain of transmission despite ongoing violence that has hampered response efforts. The waning of the Ebola outbreak comes as the outbreak of the novel coronavirus, COVID-19, has captured global attention and potentially funding as well. According to a World Health Organization (WHO) spokeswoman, “Funding needs [for the Ebola response] have not as yet been fully met, and currently there is a risk there will not be funding for WHO activities beyond February.” Despite the waning of Ebola cases in DRC, last Wednesday, an independent committee that advises WHO unanimously agreed the Ebola outbreak continues to be a public health emergency—a designation recently extended to the COVID-19 outbreak. Though WHO and others have worked tirelessly to contain Ebola, the region’s health system remains weak and the likelihood of future outbreaks is high. The experimental antiviral drug remdesivir successfully prevented disease in rhesus macaques infected with Middle East respiratory syndrome coronavirus (MERS-CoV), according to a study performed by the US National Institutes of Health and supported by the Biomedical Advanced Research and Development Authority. Remdesivir both prevented disease when administered before infection and improved the condition of the macaques when given after the animals already were infected. MERS-CoV is closely related to COVID-19, which emerged in Wuhan, China in December of last year and has grown to be a public health emergency. The promising results of this study support the case for additional clinical trials of remdesivir for MERS-CoV and COVID-19. Gilead Sciences developed remdesivir and collaborated in the research. On Monday, February 10, President Trump released his proposed budget for fiscal year 2021, which seeks deep cuts of US$3 billion to global health funding. The proposed cuts include a 34 percent reduction to global health programs at the State Department and US Agency for International Development (USAID) and a seven percent cut in funding to the Centers for Disease Control and Prevention (CDC)’s Center for Global Health. President Trump’s budget also proposed a 58 percent reduction in funding to the Global Fund to Fight AIDS, Tuberculosis and Malaria and a 50 percent cut in funding to WHO. Despite these widespread proposed cuts, the budget did include some boosts in funding—a $50 million increase for CDC’s global health security activities and $15 million for USAID’s Global Health Security programs. President Trump’s budget has been condemned by public health experts and many lawmakers, who have spoken out against the cuts which are unlikely to go into effect.