Breakthroughs Blog: Vaccines

Tomorrow US policymakers and global health advocates will come together to talk progress made on preventing maternal and child deaths. During the day, the US Agency for International Development (USAID) will host a high-level forum called Acting on the Call: Ending Preventable Child and Maternal Deaths to both celebrate progress and assess the challenges that remain. That evening, the 5th Birthday and Beyond coalition will celebrate America’s leadership and investments worldwide to help children reach their fifth birthday. US investment in R&D has led to new innovations that are saving the lives of mothers and children. Photo: PATH/Teresa Guillien While you’ll probably hear a lot of different facts and figures, one message will be clear—the world has made remarkable progress in preventing the deaths of millions of women and children. In fact, maternal and child deaths have been cut in half in just over two decades. That means that every day this year, 17,000 more children will live and 700 more mothers will survive childbirth than did two decades ago. Central to this progress has been US investment in research and development (R&D) that has led to new medicines and innovative health products that are saving the lives of mothers and children. Globally new vaccines, drugs, diagnostics, and other health innovations have led to 4.2 million fewer child deaths in 2013 compared to 1990, according to a report by the Institute for Health Metrics and Evaluation. Innovations like the polio vaccine, oral rehydration solution to treat diarrhea, and antiretroviral therapies that prevent maternal to child HIV transfer, and others treatments have resulted in incredible gains for maternal and child health.   No country has done more than the United States to help save the lives of the world’s poorest mothers and children. A critical part of the US approach has been our world-leading investment in global health R&D. In fact, the US government is the largest funder of global heath R&D in the world—contributing over 45 percent of total investment. US government investment in global health R&D has led to breakthroughs that have transformed or are poised to transform efforts to reduce maternal and child mortality. Some examples include: The Oxytocin-Uniject™ This is a device filled with oxytocin that helps contract the uterus to reduce post-partum hemorrhage—or excessive bleeding—the leading cause of maternal death worldwide. It is easy to inject and requires little training to administer, so it’s made a dramatic difference in the ability of health workers to administer oxytocin in emergencies or in remote locations outside of traditional hospital facilities. USAID played a crucial role in funding research towards the development of this product. RTS,S malaria vaccine candidate RTS,S is the most clinically-advanced vaccine candidate for malaria—a disease which kills a child every 40 seconds. A recent study showed that infants who receive the RTS, S vaccine had one third fewer cases of both clinical and severe malaria. A vaccine could be an important tool in reducing child sickness and death from malaria. The Department of Defense provided critical funding for the early development and clinical testing of RTS,S. Rotavirus vaccines Rotavirus-induced diarrheal disease kills roughly 435,000 children younger than five each year. Two currently available rotavirus vaccines were introduced in the past two decades, with other vaccines under development showing tremendous progress. The National Institutes of Health developed the first available rotavirus vaccine and has been a financial partner in the development of subsequent vaccines. In addition, the Centers for Disease Control and Prevention also monitors efficacy and safety, and supports clinical trials of rotavirus vaccines. New contraceptive technologies Family planning technologies allow women to space their pregnancies—making it more likely for both the mother and child to survive childbirth. An analysis of 172 countries found that family planning prevented 272,000 maternal deaths in just one year. However, the contraceptive options that exist today don’t always meet the needs of women in developing countries. New vaginal rings are being developed that will be long-lasting and easy for the user to insert and remove without a doctor’s assistance, while new multipurpose prevention technologies combine the delivery of contraceptives with microbicides which reduce the transmission of HIV and other sexually transmitted infections. USAID provides funding towards the development of many of these new contraceptive technologies. While tremendous progress has been made in decreasing maternal and child deaths worldwide thanks in part to new health innovations, each year 6.6 million children still die before their first birthday and 289,000 women still die from pregnancy-related causes. That translates to 18,000 children under the age of five and 800 pregnant women or women in childbirth dying every single day. The United States can and must do more. While the United States should increase access to proven and existing drugs, vaccines, and other health tools for maternal and child health, it is just as critical to develop the next generation of tools to prevent and treat existing and emerging diseases. Sustained and continued investment by the US government in global health R&D is critical to ending maternal and child deaths.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. As the DC summer kicks into full swing, Congress has had a busy month moving forward fiscal year (FY) 2015 funding legislation for a variety of government programs including global health research and development (R&D). Last week, both the House and Senate State and Foreign Operations (SFOPs) appropriations subcommittees held mark-ups of their draft bills. Unfortunately, the results were lukewarm for many global health R&D programs. Sens. Cardin (D-MD), Boozman (R-AR), and Coons (D-DE), along with Reps. Castro (D-TX) and McCaul (R-TX) have introduced legislation to authorize the US Agency for International Development’s (USAID) Global Development Lab. The Lab would expand innovative public-private partnerships focused on ending extreme poverty. A group of 35 leading scientists have come together to explore new strategies to accelerate vaccine development for deadly diseases such as malaria, HIV, tuberculosis. The scientists are part of a new initiative—called the Human Vaccines Project—aimed at paving a road map of the human immune system to help researchers speed up the development of vaccines for existing and emerging diseases. SciDev.Net reports that despite the fact that the United Nations World Intellectual Property Organization (WIPO) Re:Search project has brokered at least 60 partnerships to facilitate patent sharing between owners and researchers since 2011, no new drugs or therapies are in development as of today. However, Thomas Bombelles—head of global health at WIPO—says the creation of partnerships is an important first step and that WIPO now has funding to build research capacity in low- and middle-income countries, as well as aid information flow. USAID has released its report to Congress on its global health programs during FY 2013. The report describes the agency’s work to “end extreme poverty through its contributions in global health by ending preventable child and maternal deaths, creating an AIDS-free generation, and protecting communities from infectious diseases.” Pharmaceutical companies GlaxoSmithKline and Johnson & Johnson will collaborate to develop a new HIV treatment that will require only a single pill. If the trials are successful, the new treatment could offer a less toxic alternative to the current therapies available to treat HIV.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. Kaitlin Christenson, director of the GHTC, summarizes news out of the World Health Assembly (WHA) impacting the global health research and development (R&D) community including debates on the post-Consultative Expert Working Group on Research and Development: Financing and Coordination and post-2015 development agenda, and themes related to regulatory system strengthening, access to essential medicines, and the value of R&D. Renate Baehr—executive director of Deutsche Stiftung Weltbevoelkerung—writes about the next rendition of the European & Developing Countries Clinical Trials Partnership and how its expansion will impact more lives in low- and middle-income countries. She discusses how the program has been broadened to include neglected tropical diseases and how African countries will now fully participate in the group’s governance and decision making. The Canadian government announced it would provide $12 million to Grand Challenges Canada to finance innovations to improve maternal and child health in the developing world. The funding will support 65 projects to be implemented across 25 low-and middle-income countries. The announcement came in advance of the Canadian Prime Minister’s global summit on maternal, newborn, and child health taking place in Toronto from May 28-30. Wired reports on the passage of a resolution at WHA to create a global action plan to tackle the emerging problem of antibiotic resistance that will include exploring technology innovations in diagnostic testing and new drug development. The article notes that some experts believe this will not do enough to stem the problem and are calling for the creation of an intergovernmental body on antibiotic resistance that would be similar to the Intergovernmental Panel on Climate Change.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. Yesterday, Senator Patty Murray (D-WA) introduced in the US Senate a significant piece of global health legislation that would strengthen global health research programming within the US Agency for International Development and improve coordination of global health research and development across the US government. The legislation—known as the 21st Century Global Health Technology Act—is companion legislation to the House version of the bill, HR 1515, which was introduced by Representatives Albio Sires (D-NJ) and Mario Diaz-Balart (R-FL) in April 2013. Knight Therapeutics—the developer of a new treatment for the parasitic disease leishmaniasis—is looking to be the first company to auction off the priority review voucher it received from the Food and Drug Administration (FDA). The company received this voucher—which it can redeem to have any drug moved to the front of FDA’s line for product review—following the approval of its leishmaniasis drug Impavido in late March. A Guardian article on the vaccine cold chain discusses the logistical challenges for the global health community in delivering and administering vaccines—which require constant refrigeration for efficacy—in environments with unreliable electricity and infrastructure. It calls for the next generation of vaccines to be developed with the goal of eliminating a burdensome cold chain and notes the success of the MenAfriVac™ vaccine for meningitis which can be used for up to four days outside the cold chain. During the World Health Assembly, UNITAID, the Drugs for Neglected Diseases initiative, and the Medicines Patent Pool launched a new initiative to develop and deliver improved treatments for children suffering from HIV and AIDS. The initiative–known as the Paediatric HIV Treatment Initiative (PHTI)–will focus on three areas: (1) research and development; (2) intellectual property; and (3) market-shaping to ensure availability of treatment regiments for children living with HIV and AIDS. The World Health Organization released a new document on its efforts to find innovative financing for neglected diseases. The documents states there is a $50 million budget line for demonstration projects and the Global Health R&D Observatory over four years, but did not make clear where the observatory would be situated.