Breakthroughs Blog: Zika

Mosquitoes: This pervasive posse of pests and the deadly diseases they carry have terrorized towns and sickened citizens for far too long. For decades, a fearless force of heroic health workers has fought to keep these bloodthirsty bugs at bay, but to finally put an end to these murderous mozzies and the dastardly diseases they distribute, they need new tools, including vaccines, drugs, diagnostics and vector-control products. For World Mosquito Day, GHTC is taking a moment to shine a spotlight on the ghastly gang of mosquito-borne diseases and the innovations we need to finish these frightening foes for good. Malaria Mal A. Ria is old, cruel, and has killed more people than all of humanity’s wars combined. Since the 1950s, countries have fought a sustained war against this nefarious nemesis. Increased global action led to the development and introduction of cheaper drugs, rapid diagnostics, and child-friendly medicines, as well as mass distribution of insecticide-treated bednets, which help drive Mal A. Ria from several countries where she formally had a foothold and weakened her forces. Yet, today progress has stalled and Mal A. Ria is fighting back hard, having developed resistance against commonly used insecticides and treatments Fortunately, scientists are fighting back too. A new generation of insecticides and vector control products is advancing through the pipeline, the first vaccine is undergoing pilot roll out in sub-Saharan Africa while other candidates progress through development; and researchers are employing cutting-edge gene editing techniques to alter Mal. A Ria’s ability to pass on her parasite. Continuing support for these efforts is critical to wipe out this formidable foe. Dengue   Also known by the aliases “Breakbone Fever” and “Dandy Fever,” Den Gue has largely operated under the radar as a member of the Neglected Tropical Disease crime syndicate, attacking as many as 400 million people annually. Den Gue often induces a painful fever, and his attacks can leave victims with long-term neurological and liver problems, or in some cases kill them. He typically attacks during the day, rendering bednets a less effective tool to fight him. Unfortunately, health workers have no specific treatment or cure to deploy against Den Gue. While there is a vaccine, it is only appropriate for use in certain circumstances and better point-of-care diagnostic tests are needed to ensure its safe administration. Ultimately, a variety of tools will be needed to vanquish this adversary, so researchers are hard at work testing other vaccine candidates and exploring whether infecting mosquitoes with a bacterium known as Wolbachia could prove to be an effective tactic. Chikungunya While he may be a lesser-known member of the Neglected Tropical Disease crime syndicate, Chiku N. Gunya is still a dangerous adversary reaching over 60 countries in Asia, Africa, Europe, and the Americas. An attack by Chiku N. Gunya can leave victims with debilitating joint pain that can sometime persist long after the attack. Unfortunately, health workers have few tools at their disposable to reign in his criminal activity: There is no vaccine, specific treatment, or cure, and current diagnostic tools are challenging to employ in remote regions. Researchers are working feverishly to deliver new tools to fight this foe. Several promising vaccine candidates are now undergoing testing in human clinical trials and researchers are exploring whether currently available antivirals could be repurposed to combat Chiku N. Gunya, as well as developing new antivirals treatments. Zika While Zi Ka has been operating since at least the 1940s in certain places in Africa and Asia, her crimes did not capture widespread public attention until she carried out a large-scale attack on the Americas from 2015-2016, leading the World Health Organization to declare a public health emergency. Her crimes are particularly cruel, as the victims she targets are pregnant women, resulting in severe birth defects in some children. When Zi Ka captured her spot on the most wanted list in 2015, health workers had few tools to stop her reign of terror and that remains the case. There is no vaccine, specific treatment, or cure, and diagnostic tests have trouble distinguishing her attacks from that of Den Gue or other mosquito-borne disease miscreants. Scientists are working to ensure the world is better prepared if she decides to undertake another major attack. While it could be many years until they are available, several vaccine candidates are currently under development, and experimental diagnostic tests have been made available on an emergency basis as researchers continue to test and refine these tools.  R&D: The key to ending these enemies While our heroic health workers have made strides in stifling these diabolical diseases and protecting the populace, these cronies still cause considerable calamity in communities worldwide. Our call to action should be clear: We need research and development (R&D) and new technologies to exact an end to these enemies for good.

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 Ministry of Public Health of the Democratic Republic of Congo has launched Ebola vaccinations for high-risk populations only one week after announcing the latest outbreak of the disease in the North Kivu province. Of the 44 cases reported so far, 17 have been confirmed. A total of 3,220 doses of the rVSV-ZEBOV vaccine candidate, developed by Merck, are currently available in country while additional doses have been requested. An agreement between Gavi, the Vaccine Alliance and Merck will ensure additional doses of the vaccine are available on an emergency basis as it goes through the licensing process. The World Health Organization has provided key logistical support in establishing a cold chain and sending necessary supplies for the vaccinations, aiding in the deployment of vaccine experts, and facilitating the negotiation of protocols with the manufacturer and the national authorities. Biobanks provide vital specimens and infrastructure to support scientific research and innovation. While in the developing world, biobanks are well established, issues such as unreliable internet connectivity, a lack of access to resources such as water and electricity, a lack of highly skilled and trained personnel, and the cost of setup have stifled their establishment in low- and middle-income countries (LMICs) on the African continent. Despite these barriers, LMICs in Africa should prioritize setting up biobanks, argues a group of researchers from the University of Western Cape and Stellenbosch University. They write, “Having access to rich genetic diversity across Africa would allow researchers to understand disease, develop better diagnostics and treatments, medicines and vaccines, geared toward the continent’s population.” A single-dose Zika vaccine candidate developed by researchers at The Ohio State University has proven effective in triggering an immune response in mice, according to a recent study. The vaccine uses a weakened, harmless form of the Vesicular stomatis virus—also known as foot-and-mouth diseases in cattle—to deliver proteins from the Zika virus. This method has been used with other vaccines, such as the Ebola vaccine being used in the recent outbreaks. While further testing is required to see if it is effective in humans, the vaccine candidate’s suggested ability to elicit an immune response with one dose means it has the potential to be especially valuable in hard-to-reach areas and low-resource settings.

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. In the past year, outbreaks of high-fatality diseases and pathogens such as Ebola, MERS, Zika, Nipah virus, Lassa fever, and Rift Valley fever have caused at least 190 deaths and cost millions. While these outbreaks have remained relatively contained, health officials warn these diseases all have the potential to strike again and cause a global epidemic that could kill thousands, wreak economic havoc, and threaten global security the world over. According to experts, the lack of investment in research and development is contributing to this risk. The technology company Univercells has raised over US $18.8 million in series B funding to support continued development of its platform to manufacture cost-efficient biologics. This comes on the heels of positive results from a pilot program of the company’s affordable vaccine manufacturing platform. The pilot, which tested production of the Sabin inactivated polio vaccine, showed the platform could delivers 43 million doses of the vaccine per year at a cost of US $0.15 per dose—considerably lower than current versions on the market. Univercells’ backers believe these two manufacturing platforms have incredible potential to make biologics and vaccines more affordable and accessible worldwide. The World Health Organization declared in May that Nepal has eliminated trachoma as a public health problem. Trachoma, a bacterial infection that causes swollen and inverted eyelids, is the world’s leading cause of blindness with approximately 190 million people in 41 countries at risk worldwide. Nepal follows in the footsteps of Cambodia, Laos, Mexico, Morocco, Oman, and Ghana in a list of countries that have eliminated trachoma since a global campaign to eliminate the disease was launched twenty years ago. Annual administration of antibiotics in at-risk areas and improved hygiene practices have helped drive this progress. 

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. The release of antibiotics into the environment is a significant environmental threat, according to a new United Nations Environment Programme report. The presence of antibiotics have been found in soil deposits, lake and river sediment, and wastewater facilities around the world, suggesting industrial, human, and pharmaceutical disposal leads to traceable amounts of antibiotic compounds in the environment. This issue alarms experts because even minimal traces of antibiotics may lead to the continued evolution of antimicrobial resistant bacteria. While more research is needed on the consequences of antibiotics in the environment, experts suggest various strategies to help mitigate the problem including deploying improved methods to treat wastewater, treating animal waste before using it as fertilizer, and improving antimicrobial stewardship. An Army-developed Zika vaccine candidate (ZPIV) performed well across three Phase 1 clinical trials, according to new findings published in The Lancet. The three studies were designed to elicit information on background immunity, vaccine dosage, and vaccine schedule in adult populations. A total of 67 participants received two injections four weeks apart, and researchers found more than 90 percent of participants who received the ZPIV vaccine had an immune response to the virus. The Army developed the vaccine candidate in response to the 2015 outbreak, noting the need for a Zika vaccine not only to advance global health, but also to protect US service members and their families. Countries are restricting use of the world’s only dengue vaccine—Dengvaxia— following an announcement by developer Sanofi Pasteur raising safety concerns. The company discovered, from data analysis, that the vaccine could raise the risk of a deadly form of dengue for people who had not been exposed to the virus prior to vaccination. In response, the Philippines ceased an ongoing, mass immunization campaign, and Brazil tightened restrictions on the vaccine. While Sanofi stressed there were no reported deaths related to the dengue vaccine, they believe more severe cases of dengue may occur if an immunized individual, who was not previously infected before receiving the vaccine, is then subsequently infected with dengue. This rare complication leaves children at a higher risk of contracting the severe form of dengue, as they are less likely to have been exposed to infection before receiving the vaccine. Dengue sickens hundreds of millions of people and kills more than 20,000 every year, underscoring the need for a safe, effective, vaccine.