Breakthroughs Blog: Guest post

Research!America, a GHTC member, recently hosted an event on global health research and development (R&D) in New York. In this guest post, Mandy Goldberg, MPH, shares highlights from the event. Research!America, in partnership with the AIDS Vaccine Advocacy Coalition (AVAC), Drugs for Neglected Diseases initiative North America (DNDi), Global Alliance for TB Drug Development (TB Alliance), International AIDS Vaccine Initiative (IAVI), SUNY Downstate Medical Center, and Treatment Action Group (TAG), hosted a forum, Global Health Research and Development in New York: Fueling Innovation and Saving Lives, on Monday, April 9, at the New York Academy of Sciences. Mary Woolley, president and CEO of Research!America, opened the forum by acknowledging the remarkable progress made in the growing field of global health research in New York in the past decade. She also released the results of a new state poll commissioned by Research!America that shows that 64 percent of New Yorkers are concerned about global health, and 63 percent believe that global health research is important to New York’s economy. Congresswoman Nita Lowey (D-NY-18) then took the stage and explained the significance of global health R&D as an economic driver that creates jobs for New Yorkers. She stated that “despite the critical importance and significant economic impact of these programs, funding for global health is threatened again this year” in regard to the proposed fiscal year (FY) 2013 budget, and pledged to continue fighting for “robust funding for all our global health programs, including critical research and development.” Renowned global health commentator Laurie Garrett, senior fellow for global health at the Council on Foreign Relations, moderated a discussion between panelists Rachel Cohen, regional executive director, DNDi North America; Jack DeHovitz, MD, MPH, distinguished service professor and director, SUNY Downstate AIDS International Training and Research Program; Margaret McGlynn, president and CEO, IAVI; Mel Spigelman, MD, president and CEO, TB Alliance; and Pol Vandenbroucke, MD, vice president of development, emerging markets, Pfizer. In her opening remarks, Garrett emphasized the importance of the US commitment to global health funding, especially after the 2008 financial crisis, when “the United States stepped up to the plate” after the community saw “a huge number of players disappear” from the field. She stated that “if we cannot protect the US commitment to global heath spending, every single program in global health is going to have to chop, chop, chop its budget.” Laurie Garrett moderated a panel including Mel Spigelman, Pol Vanderbroucke, Rachel Cohen, Margaret McGlynn, and Jack DeHovitz. Panelists then discussed how innovative partnerships among public, private, and academic sectors are transforming the way that research is conducted and yielding promising developments for the future of global health. Spigelman highlighted that the TB Alliance is “on the verge” of technological breakthroughs, which require an increased commitment to research due to the costly final stages of testing and clinical trials. Partnerships in global health R&D are cost-effective, he argued, citing the TB Alliance’s NC-002 clinical trial conducted in partnership with the US Agency for International Development, Bayer, and Novartis. This trial has the potential to produce a drug regimen that could reduce the TB treatment to 4 months, potentially saving as much as 90 percent of current costs. Vandenbroucke emphasized that the private sector has unique resources and capabilities to contribute to partnerships that are essential for the development of health technologies. He stated that cuts to the federal budget would affect the work of the pharmaceutical industry “in the long term, as less funds are available to do the basic groundwork to study diseases” that Pfizer then applies during its advanced drug development process. Cohen expressed concern over the fact that neglected tropical diseases (NTDs) received the single largest percentage funding cut of the global health programs in the President’s FY 2013 budget request and the impact this would have on DNDi’s work. She noted that there is currently no federal funding available for late-stage product development for NTDs, and the current FY 2013 budget request “totally eviscerates the possibility of future investments, at least for the coming 2 years,” if passed, which threatens the continued progress of DNDi’s efforts. McGlynn spoke about the evolution of IAVI from an advocacy organization to a product development partnership, with the support of Mayor Bloomberg and New York City. IAVI’s Vaccine Design and Development Laboratory, established in Brooklyn in 2006, plays a pivotal role in the Mayor’s New York City Bioscience Initiative and is a key component of IAVI’s global AIDS vaccine R&D network. McGlynn stressed that the scientific expertise of New York City’s “globally educated and raised” workforce has been essential to IAVI’s work, and to the growth of global health R&D in the area. DeHovitz reinforced that multisectoral collaborations have yielded major advancements in the field of HIV and AIDS. He cited the federal contribution to international HIV and AIDS through the work of the Fogarty International Center at the National Institutes of Health, which funds advanced research training in public health at five New York City universities. He also spoke of “the huge upsurge of interest among our health care students in global health,” stating that 45 percent of medical school entrants are interested in global health and 30 percent of medical school graduates have had a global health experience in school. “They’re committed, they’re interested and they want to help,” he said, noting the potential impact of this group to the future of global health. New York—home to seven of the top 50 US research universities, the largest bioscience workforce and second-largest life sciences workforce of any US city, and three global health product development partnerships (PDPs)—is clearly a world leader in global health R&D, and this growing industry is a promising economic engine for the state. There was a general consensus in the room that the community needs to work together to ensure that global health R&D remains a priority. Great progress has been made in the development of new technologies to fight TB, HIV and AIDS, and NTDs, and increased funding is needed to sustain this momentum and build upon previous successes. Spigelman noted that the current “slash and burn” Congress could have a devastating effect on global health efforts, and argued that the US will get “the most bang for that buck” by investing in global health technologies that will reduce the foreign aid budget in the long term. Woolley concluded the forum with a call to action, asking the global health community to share with others, including their members of Congress, the importance of the work that they do. A video of the event is available here. For more information on global health R&D in New York, check out the New York edition of Research!America’s economic impact state fact sheet and public opinion poll series.

Phil Carroll, senior policy communications associate at PATH, writes about Marc LaForce, recently retired director of the Meningitis Vaccine Project. This post is part of an ongoing effort on Breakthroughs to highlight leaders and heroes in global health research and development (R&D). Marc LaForce’s career at PATH has been nothing but illustrious. He came to our organization in 2001 to lead a project that had more than a few skeptics. Funded by the Bill & Melinda Gates Foundation, the Meningitis Vaccine Project , a partnership between PATH and the World Health Organization (WHO), was tasked with leading R&D for a new vaccine against group A meningococcal meningitis—a particularly deadly strain of meningitis that forms a belt across sub-Saharan Africa. The most significant ask was to deliver the vaccine at a price the countries could afford: less than 50 cents a dose. It was a daunting challenge, but one that Marc and his team did not shy away from. By working with a host of multi-sector partners, including multilateral institutions like the WHO and a well-established manufacturer in India, the Meningitis Vaccine Project succeeded in creating MenAfriVac™, the first vaccine designed specifically for Africa. In addition, the US Government played a critical role in the creation of this new vaccine. The Centers for Disease Control and Prevention, US Food and Drug Administration, National Institutes of Health, and US Agency for International Development all made scientific and research contributions to the development and delivery of MenAfriVac™. It should also be noted that the success of this project would not have happened without the cooperation and involvement of African governments, which identified the need for a vaccine, stressed the importance of a low price per dose, and finally helped orchestrate the immunization campaigns in country. Marc LaForce, retired director of the Meningitis Vaccine Project. Photo credit: PATH To date, MenAfriVac™ has reached almost 55 million people since its launch in Burkina Faso at the end of 2010. Even more impressive is that in all of those vaccinees, not a single case of meningitis A has been reported. The creation and roll-out of MenAfriVac™ represents one of the most exciting success stories in global health R&D, and demonstrates how a strong commitment to R&D from a range of partners can result in an amazing new tool that can make an impact of millions of lives. However, as Marc pointed out at the Global Health Technologies Coalition’s annual briefing on Capitol Hill last week, the battle against this disease is far from over. We need greater investment in R&D for an additional vaccine that would protect against other types of meningitis. Through Marc’s leadership and vision, we know that an effective, affordable, and accessible vaccine is not just possible, but achievable. February 28 was Marc’s last day at PATH before his official retirement, and he left us with quite the legacy. Leaders at PATH are fond of referring to the success of Meningitis Vaccine Project as the “beginning of the end” of meningitis A in Africa. In many ways, this phrase can be applied to Marc’s new chapter in life. Instead of hitting the links or working on his tan in Florida as other retirees might, Marc will return to his former life in academia, molding the minds of the next generation of public health professionals and scientific leaders. Who knows, there might just be a future Marc LaForce among them.

Janna Oberdorf, Director of Communications and Outreach for Women Deliver, writes about the recent “Women Deliver 50” initiative to mark International Women’s Day. Earlier this week, Women Deliver released its “Women Deliver 50,” a list of 50 inspiring ideas and solutions delivering for girls and women around the globe. Launched in celebration of International Women’s Day, this list showcases game-changing innovations and technologies that are making advances for girls and women worldwide. Several of the innovations include health technologies that harness research and development (R&D) to develop and deliver woman-centered prevention and treatment options. Selected from hundreds of nominations from 103 countries, some of the “Women Deliver 50” winners impact the lives of girls and women on a global scale by improving access to health technologies. For example, the GAVI Alliance is working to reduce the cost of HPV vaccines and to support their broad introduction in many of the world’s poorest countries. More than 85 percent of the 275,000 women who die every year from cervical cancer live in developing countries. Through its efforts, GAVI is aiming for millions of girls worldwide to receive the HPV vaccine, providing them with a better chance at a healthy and productive life. The “Women Deliver 50" list showcases game-changing innovations and technologies that are making advances for girls and women worldwide. Photo credit: PATH There are also medical technologies that, through R&D, are evolving to better meet the needs of girls and women. Female condoms have been around for 20 years, but even when available, women often decide not to use them because of cost and design concerns. With this in mind, PATH solicited input from couples around the world, and designed a more affordable, easy-to-use and comfortable female condom. With this new product, PATH is helping women to better protect themselves from HIV infection and unintended pregnancies. An innovative organization working to accelerate R&D for female-initiated solutions for HIV prevention is the International Partnership for Microbicides, a “Women Deliver 50” finalist. Vaginal rings, a popular method for delivering contraceptives, are long-acting, discreet, and easy to use. IPM has adapted this technology to the fight against HIV, and is preparing to launch a licensure program in partnership with the Microbicide Trials Network to determine whether a vaginal ring containing antiretroviral drugs can safely and effectively provide women with monthly protection against HIV. Should it be successful, the ring would empower women with the tools they need to protect their health. The “Women Deliver 50” winners demonstrate that we can develop revolutionary tools that impact the health and livelihoods of girls and women worldwide. We need to continue to create, test, and scale-up new and existing technologies. We still don’t have all the vaccines, drugs, devices and other health technologies that girls and women need, and it is critical for us to bridge this gap. As we’ve seen time and time again, when we invest in health innovations for girls and women, we see a positive ripple effect across society. If you weren’t one of the 6,000 people who voted for these 50 solutions, you can still weigh in with your thoughts. Visit the Women Deliver website to learn more about these exciting interventions, as well as other ideas and solutions making a difference around the world. And then visit Women Deliver on Facebook and Twitter to tell us what you think.

Research!America, a member of the GHTC, recently conducted analyses in target states to measure the health and economic impact of global health research and development (R&D), highlighting its benefits for states across the nation and strengthening the evidence base for Congress’ support of federal investments in global health R&D. This is the sixth and last post in a series. "If you want to live longer and healthier than the average American, then come to New York City,” Mayor Mike Bloomberg announced in December 2011. The city’s life expectancy for a 40-year old in 2009 was 82, compared with 80.1 for the rest of the United States. Babies born in New York City in 2009 will see an increase of nearly three years on their life spans, versus 1.5 years nationwide. With the leadership of the mayor, who has an outstanding track record on public health leadership, and the dedication of its health commissioners, New York City has significantly brought down its rates of tuberculosis (TB) and stabilized the growth of new HIV infections over the last two decades. This leadership in public health also translates into a strong commitment to R&D. New York City has the world’s largest concentration of major academic research centers and the largest bioscience workforce of any city in the United States. The state is home to seven of the top 50 American research universities and attracts increased investment in the sciences with a 9 percent corporate tax break for R&D facilities. Combined with the commitment of its elected officials—and economic drivers like the new applied sciences campus, NYCTech, on Roosevelt Island—New York institutions are creating partnerships that transform how we do the business of health research. It is projected that NYCTech could in turn provide up to $150 million in seed money for up to 600 new local start-ups, which could generate an estimated 30,000 new jobs. Partnerships for health R&D contribute to the health and economy of New York, and the effects of these partnerships are felt around the world. After the National Institutes of Health, New York’s International AIDS Vaccine Initiative (IAVI) has the largest AIDS vaccine development program and partners with more than 50 other institutions to conduct research and clinical trials. The Global Alliance for TB Drug Development (TB Alliance), also headquartered in the Big Apple, manages the largest, most comprehensive portfolio of TB drug candidates ever. With the first cases of totally drug resistant TB identified in India earlier this year, identifying improved strategies to control TB has never been more critical. New York City has the world’s largest concentration of major academic research centers and the largest bioscience workforce of any city in the United States. Photo credit: PATH Public-private partnerships like IAVI and the TB Alliance rely in part on support from the federal government. Unfortunately, President Obama’s proposed fiscal year 2013 budget raises concerns for health R&D. “Public funding is evaporating at a time of tremendous opportunity. We’re on the brink of delivering potentially revolutionary new treatments for tuberculosis, with similar great promise in other areas of global health,” said Mel Spiegelman, president of TB Alliance. Former New York City Health Commissioner and current Centers for Disease Control and Prevention Director Tom Frieden agrees with the need for sustained federal investment to protect the health and safety of Americans at home and abroad. “There are still far too many people who die from conditions that are easily preventable. Continued investments will help millions more live healthy and productive lives while helping to protect our own country from health threats,” he said.