Breakthroughs Blog: Ebola

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. In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week.  Spanish researchers at Madrid's October 12 Hospital are working to develop what would be the world’s first vaccine against all five strains of the Ebola virus. The research team, along with scientists at two other hospitals in Madrid, have examined blood samples taken from three people cured of Ebola in Spain. These three people produced what lead researcher, Rafael Delgado, called ‘very effective’ antibodies against the Zaire strain with which they were infected. Delgado noted researchers aim to reproduce these antibodies on a larger scale that would make them effective against all five strains of the Ebola virus. An experimental vaccine developed by Merck was administered during the outbreak in the Democratic Republic of Congo in May; however, it is only effective against the Zaire strain. PREDICT, a global surveillance program that aims to avert future pandemics in the human population, has discovered a new virus that infects wrinkle-lipped bats. The virus, discovered in Myanmar, is the first of its kind to be detected on a global scale and is in the same virus family as the ones that cause SARS and MERS. The research team also identified among the Myanmar bats a second new virus previously found in Thailand, conveying how diseases can easily spread globally. Although these new viruses are related to viruses that have previously caused deadly epidemics in humans, more research is required to determine if either new virus poses a threat to humans. An experiment by Australian researchers has killed 80 percent of disease-carrying mosquitoes in trial locations across north Queensland. The experiment—carried out by scientists from the Commonwealth Scientific and Industrial Research Organization and James Cook University, in partnership with Verily—targeted a specific type of mosquito, the Aedes aegypti mosquito, which spreads diseases such as Zika and dengue fever. Using a process called the Sterile Insect Technique, researchers bred almost 20 million mosquitoes, infecting males with bacteria that made them sterile. The sterile male mosquitos did not bite or spread disease and when they mated, the resulting eggs did not hatch causing a crash in the population. Further field trials may be held in other parts of Australia.

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. In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. A new, rapid diagnostic tool designed to detect Ebola in low-resource settings—EbolaCheck—is heading into its first field trial. Like other Ebola diagnostics, it works by detecting viral genetic material in blood, but it also has several characteristics that make it innovative and easy to deploy in the field: It is mobile; inexpensive, costing ten times less; rapid, taking as little as 70 minutes; needs minimal power to operate, and can be administered by staff with little training.The first field trial is scheduled to launch in rural areas of Brazil in January 2018, with an intent to study potential deployment challenges like temperature, humidity, and operating procedure. A group of Ugandan millennials designed a low-cost, reusable malaria diagnostic tool—Matibabu—capable of quickly detecting malaria without drawing blood. Matibabu beams a red laser on an individual’s finger, detecting changes in shape, color, and concentration of red blood cells, all of which are affected by the presence of the malaria-causing parasite. Matibabu can diagnose malaria in only two minutes (compared to 30 minutes or more for a blood test) with an 80 percent success rate, though the developers noted some patient skepticism due to the simplicity and uniqueness of the test. Matibabu has already generated strong interest among the global community: The designers won the 2013 United Nations Women’s Empowerment award and are shortlisted for the Royal Academy of Engineering’s Africa prize for engineering innovation, with an award of £25,000. If the developers win, they plan to use the funds to begin clinical trials and work to increase the accuracy of the tool. Through gene therapy, researchers at UCLA engineered blood-forming stem cells in animals to produce chimeric antigen receptor (CAR) molecules that create T-cells capable of recognizing and destroying HIV-infected cells. These engineered cells persisted in destroying infected cells for more than two years after the initial edit, offering hope as a method to create long-term HIV immunity. While these findings are preliminary and the sample size is small, they are the first to show that this method of gene editing works in creating targeted immune cells that can mature and become functional throughout the body. This method of gene editing, coupled with other effective treatments like antiretroviral therapy, may pave the way for safe and lifelong HIV immunity.

There is no doubt that the past decade has brought transformative breakthroughs in global health innovation, from new medicines, to combatting leading child killers like malaria and tuberculosis (TB), to interventions that are making an AIDS-free generation possible. These game changers have saved millions of lives and helped unlock better health and opportunity for people around the world. The Global Health Technologies Coalition (GHTC) spent this past decade standing side-by-side in partnership with scientists and innovators, working to ensure they have the resources and supportive policies needed to advance innovation that truly drives impact. As we close out our tenth anniversary year and mark our first decade of advocacy, we wanted to take a moment to reflect on our shared progress and celebrate the headlines and moments that shaped global health research and development (R&D) over the past decade. Here are ten highlights: Could pills taken daily prevent HIV infection? That was a key question on researchers and activists minds in the early 2000s.By the end of the decade, the evidence pointed to yes. In 2012, the US Food and Drug Administration (FDA) approved the use of the antiretroviral drug Truvada as pre-exposure prophylaxis (PrEP) to prevent HIV infection. While it took several more years for PrEP to begin to be approved and introduced in low- and middle-income countries (LMICs), it has proved a powerful new tool in the global fight against HIV and AIDS. Revolutionary. Simple. Empowering. These are words that have been used to describe Sayana Press, an all-in-one injectable contraceptive developed by GHTC member PATH. Sayana Press combines a long-acting contraceptive with the easy-to-use Uniject injection system that involves minimal training, making it an especially suitable tool for low-resource settings and for women to self-administer. Since its introduction in 2014, more than 1 million doses of Sayana Press have been delivered to women worldwide, giving them greater power and autonomy over their reproductive health. Despite the fact that over 70 percent of all malaria deaths are children, before 2009 there was not a single high-quality malaria drug designed for kids. Instead, parents would crush adult tablets in what amounted to a daily struggle to provide an accurate dose as well as convince their kids to swallow these bitter tasting pills. This changed with the introduction of Coartem Dispersible, the first malaria medicine designed for children. Developed by GHTC member Medicines for Malaria Ventures, the medicine is affordable, easy-to-administer, sweet-tasting, and dosed for children. As of 2016, over 300 million treatments have been distributed worldwide, saving an estimated 750,000 lives. For more than a century, meningitis has ravaged a swath of the African continent known as the “meningitis belt,” killing one in ten people it sickened. But thanks to the efforts of a coalition of partners, including GHTC member PATH, we’ve stopped deadly meningitis A epidemics in their tracks. In 2010, MenAfriVac—a low-cost vaccine against mengingitis A—was introduced in Africa. Since then, more than 270 million people in 26 countries have been vaccinated, and thankfully, meningitis A is becoming a disease of the past. HIV and AIDS remains one of the greatest threats to women’s health globally, yet women and girls still lack the range of tools they need to protect themselves. Thanks to over a decade of effort by a unique partnership led by GHTC member the International Partnership for Microbicides, the future looks different. The partnership has advanced a new woman-center HIV prevention tool: a monthly, vaginal microbicide ring that deliver antiretroviral drugs. The groundbreaking new tool was found to reduce HIV risk in women in late-stage clinical trials in 2016, and it is now under regulatory review and poised for potential introduction worldwide. For parents with kids suffering from TB, getting their child to take multiple pills a day for months was a serious struggle, from trying to split up pills, to achieving the right dosage, to convincing children to swallow bitter tasting medicine. In 2016, this process became easier with the introduction of the first kid-friendly TB drugs. Developed by GHTC member TB Alliance, the drugs are appropriately dosed for children, dissolvable in water, and fruit-flavored to appeal to children. Already close to 80 countries, have adopted this improved treatment, with 700,000 courses ordered. Malaria has plagued humanity for tens of thousands of years. Fortunately, this past decade has brought a number of new and improved tools and approaches to tackle this age-old scourge, including the world’s first approved malaria vaccine, Mosquirix. In 2017, the World Health Organization announced plans to pilot the vaccine—developed by GHTC member PATH—in sub-Saharan Africa. While developing a high-efficacy vaccine against malaria has proved challenging due to the parasite’s complexity, Mosquirix, which reduced the rate of infection in children by 39 percent in clinical trials, is an important scientific breakthrough, and health officials hope it will prove a valuable addition in fighting malaria used alongside existing interventions. In 2014, the world’s deadliest Ebola outbreak caught the global community unaware and unprepared, devastating nations in Western Africa. While health workers went to work in the field to contain the immediate crisis, scientists went to work in their labs to develop a vaccine to prevent future epidemics. Thanks to research on Ebola vaccines that had been undertaken in the early 2000s, researchers were able to accelerate the leading Ebola vaccine candidate—RVSV-ZEBOV—from preclinical testing to phase III trials in less than two years. In 2016, it was announced that the vaccine was found nearly 100 percent effective in these trials. The vaccine could be approved by the FDA as early as 2019. More than two billion people worldwide suffer from hidden hunger—a condition characterized by deficiencies in micronutrients such as zinc, iron, and Vitamin A, which can cause stunted growth, blindness, and learning disabilities. In the 1990s, a young economist Howarth Bouis had a kernel of an idea: What if we could create better crops to provide better nutrition? His answer was biofortification, a process of naturally breeding sustenance crops so they are rich in micronutrients. After years of proof of concept research, in 2009, the nonprofit he founded—GHTC member HarvestPlus—introduced its first wave of crops in LMICs, providing nutrient-rich food for people in need. For decades, diagnosing multi-drug resistant TB (MDR-B) meant using older testing methods that took weeks to deliver results and required expensive laboratory equipment. In 2010, this began to change with the introduction of the Xpert MTB/RIF test, an automated diagnostic test developed by GHTC member FIND, which does not require microscopes or a laboratory, involves very little training to operate, and can deliver results in less than two hours, start to finish. FIND and partners will soon introduce a next-generation version—the Genexpert Omni—that is smaller, more portable, and battery-operated, which should further expand access to improved TB diagnosis. View a slideshow of more moments and milestones in global health R&D over the past decade. Here’s to ten more years of progress! At GHTC, we are proud to work with so many believers, innovators, and changemakers who are driving progress in global health. As we embark on 2018 and beyond, we recommit to continuing this momentum and look forward to another decade of advancing innovation to save lives.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. A new study found a significant link between forest loss and the timing of Ebola outbreaks. Previous research had already established an association between deforestation patterns and outbreaks hotspots, but this study is the first to connect it to a timeline. Researchers tracked both deforestation events and nearby Ebola outbreaks and found a two-year gap between the event and the outbreak, suggesting there is a delayed, but causal link between deforestation and the emergence of the virus. This discovery may allow scientists to set up early warning systems and aid in the overall prediction of future outbreaks. New evidence has strengthened theories surrounding the role of antibody-dependent enhancement (ADE)—or an antibody-facilitated attack that makes infection more deadly—in severe dengue complications. This evidence suggests individuals infected on more than one occasion with different serotypes—or variants—of dengue may develop a life-threatening infection called dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS), due to antibodies produced from the first infection binding with the virus during the second infection to allow it to more easily enter cells and reproduce. A study of more than 600 children found those with multiple dengue infections of different serotypes had a 7.64 times higher risk of developing DHF/DSS. This evidence sparked a debate about ADE, since genetics, T-cells, and innate immunity all play critical roles in disease complication. Scientists at Stanford University have created a crowd-sourced, cell-phone-based mosquito-monitoring platform to build a network of mosquito surveillance and a global map of mosquito distribution. The platform—Abuzz—will allow citizen scientists—or participants—to use their cell phones to record and submit the buzzing sound of a mosquito. The system then identifies the species using the particular sound of the buzz and plots on a map where and when the mosquito was sighted. The system is compatible with most cell phones—not just smartphones—which opens up the platform to many more people who may not have access to costly technology. If enough contributions are submitted from around the world, Abuzz could create a map of the locations of dangerous species, which the scientists hope could be used to improve mosquito control efforts.