Breakthroughs Blog: Diarrhea

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 study published last week tested a promising new malaria vaccination strategy that aims to boost immunity through bites from mosquitoes carrying a genetically engineered version of the malaria parasite, which could pave the way for improved malaria vaccines. There are two approved vaccines for malaria, but they are only about 75 percent effective and require booster shots. In a trial, researchers exposed participants to bites from mosquitoes that had a version of the malaria parasite that was genetically modified to stop developing after delivery into a human, finding that nearly 90 percent of participants exposed to the modified parasites avoided contracting the disease after being bitten. The next step will be a larger trial to confirm this strategy as a viable candidate to advance malaria control efforts.A new study found that vaccines for diarrhea could reduce bacteria-associated diarrhea and antibiotic use among young children in low- and middle-income countries, which could also help reduce the emergence of antimicrobial resistance due to antibiotic overuse in low-resource settings where cases of diarrheal disease are most common. The research team used data from a previously published study exploring enteric infections and diarrheal illness in children in low- and middle-income countries and generated simulations to estimate the hypothetical impact of nine vaccine scenarios, including six single-pathogen vaccines and three combination vaccines. They found that, compared to the other single-pathogen vaccines, a vaccine against Shigella could cause the greatest reduction in antibiotic courses, and an adenovirus-norovirus-rotavirus vaccine could cause the greatest reductions in antibiotic use compared to the other combination vaccines.Last week, the Coalition for Epidemic Preparedness Innovations (CEPI) announced $1.46 million in funding for PATH to develop antibody reagents for developing vaccines against Severe Acute Respiratory Syndrome, or SARS. Antibody reagents are critical for measuring and analyzing a vaccine’s potency and ability to induce an immune response. PATH will lead efforts to develop and test reagents, as well as collaborate with the Texas Children’s Center for Vaccine Development to select and scale up a SARS-CoV-1-specific antibody to ensure these reagents are available globally, particularly in low and middle-income countries. The project aims to strengthen global health security by allowing researchers and manufacturers the tools to develop and scale up vaccines quickly in the face of an outbreak or new variant.

To celebrate Valentine’s Day, GHTC staff embraced our health policy wonkiness by participating in the time-honored beltway tradition: #HealthPolicyValentines.For those who are unfamiliar, this tradition started in 2012 when a former staffer and Twitter aficionado at the US Department of Health and Human Services, Emma Sandoe, became inspired to “tweet one ‘health policy valentine’ every day until Valentine’s Day.” Other health policy experts soon joined in with their own poems and puns related to health care, and an annual tradition was born.Now every February, health policy wonks tweet out their most creative #HealthPolicyValentines. This year, GHTC staff joined in on the fun to share our passion for global health research and development (R&D). Here are our favorites: Please be my valentine 💕Be “mon amour” 💑To defeat diseases like #AIDS, #TB & #malaria 🦠We need R&D for #vaccines, #diagnostics & cures. 💉 🔬 💊#HealthPolicyValentines #innovate4health @GHTCoalition— Jamie Bay Nishi (@JBayNishi) February 13, 2020 I love your guts ❤️Yet diarrheal diseases impact many worldwide 🌍Thankfully, with ORS, Zinc & #vaccines 💉 💊We’re helping more children survive. 🧒🏽 🧒🏼 🧒🏿#HealthPolicyValentines— Marissa Chmiola (@MarissaChmiola) February 13, 2020 Roses are red 🌹Violets are blue 💙With a universal vaccine 💉 We can take on the #flu 🦠#HealthPolicyValentine— Julien Rashid (@Julien_Rashid) February 13, 2020 Hey girl. My love for you is like biomedical research 🔬: complex, lengthy, & life-altering. #HealthPolicyValentines— Ansley Kahn (@ansleykahn) February 13, 2020 Roses are red 🌹Please be my honey 💑If we proactively develop vaccines to #outsmartepidemics 💉We’ll save lives & money 👩‍👩‍👧‍👧💰#HealthPolicyValentines— Philip Kenol (@Phil_kenol88) February 13, 2020 Getting in the #Valentines spirit a day early...Hey girl. Someone should alert @CDCgov because what you're doing to my heart is a health emergency. #HealthPolicyValentines pic.twitter.com/R8udCacb4d— Emily Conron (@thatNTDgirl) February 13, 2020 Hey girl, my love for you is like antimicrobial resistance.🦠🧫 Constantly evolving and growing every day (because we lack the right tools to stem its rise.)#HealthPolicyValentines #globalhealth #AMR pic.twitter.com/jstQXWIzFk— Marissa Chmiola (@MarissaChmiola) February 14, 2020 I’ve been bitten by your love 🥰You make my temperature rise 🌡️Is it #malaria or #dengue fever? 🦟We need diagnostic tests to surmise. ⁉️#HealthPolicyValentines— Ansley Kahn (@ansleykahn) February 14, 2020 Find yourself someone as committed to you as @NIAIDNews Director Tony Fauci is to infectious disease & #globalhealth R&D 😍🔬 His 36 years of leadership have earned him a spot in the Hall of Fame of my heart 💕 #HealthPolicyValentines pic.twitter.com/4ONP15XhNS— Emily Conron (@thatNTDgirl) February 14, 2020 I love you. You love me.Thanks to new technologies, we are reducing child mortality. #HealthPolicyValentines #Innovate4health pic.twitter.com/BRcv7G3Wh0— Jamie Bay Nishi (@JBayNishi) February 14, 2020 Roses are red 🌹Violets are blue 💙We can’t achieve #HealthForAll 🌍⚕️👩‍👩‍👧‍👦Without investing in R&D too! 🔬#HealthPolicyValentines pic.twitter.com/araErSTv2N— Philip Kenol (@Phil_kenol88) February 14, 2020 Feeling passionate about sexual & reproductive health (#SHRH) with my #HealthPolicyValentines:A woman deserves love 💕 She deserves gratification 🥰But she also deserves a healthy & bright future 👩‍🔬👩‍🎓‍Which is why we need more contraceptive innovation. 🤰🏽— Marissa Chmiola (@MarissaChmiola) February 14, 2020 Find someone that loves you the way @DrTedros loves #UHC.#HealthPolicyValentines pic.twitter.com/AFNBvOc42r— Julien Rashid (@Julien_Rashid) February 14, 2020

Faces of Innovation—a new GHTC project that features scientists on the front lines of research and development on new global health tools and technologies—profiles Dr. Rohit Ramchandani, who we met at the American Society of Tropical Medicine and Hygiene Annual Conferenc. Dr. Ramchandani does research to innovate global treatment options for childhood diarrhea at the Johns Hopkins School of Public Health in Baltimore, Maryland and the University of Waterloo. My name: Rohit Ramchandani, DrPHWhere I work: Johns Hopkins School of Public Health in Baltimore, Maryland and the University of WaterlooI’m funded by: US Agency for International DevelopmentMy research: My research focuses on diarrhea in children…the second-leading cause of death in children under five globally…These are close to 500,000 deaths that are happening every year, most of which are preventable, and treatable. They’re treatable with medicines, oral rehydration salts [ORS] and zinc. That’s the globally recommended treatment for diarrhea. But the problem is, in many low- and middle-income countries, access to these medicines is not where it should be, particularly in rural communities. So we looked at that issue of access. We did it by leveraging human-centered design approach. And we really focused on the details and the challenges that mothers face treating their children with diarrhea…Our research showed that 40% of the time, mothers are preparing ORS in the wrong concentration: either too diluted, or too concentrated. That can lead to hypernatremia, that can make the diarrhea even worse, or the efficacy gets reduced if it’s too diluted. So we actually worked with a local pharmaceutical company in Zambia to shrink down then size of the ORS sachets—the standard all over the world is a one-liter sachet—we shrunk those down to make 200-mililiter sachets, and then we made the packaging double as a measurement vessel for the right amount of water…One of our key funders during our scale-up phase was USAID—their Discover Health Program. They played a fundamental role in some of the social marketing we were doing as we were scaling up the development of our diarrhea treatment kit.Motivation: There’s just a fundamental issue of justice in the world…We often think of innovation being new product development, high technology, but things like ORS and zinc—innovation can happen really in the delivery side of things. And that’s really where our innovation focused.Why federal support is critical: I think this is low-hanging fruit. Diarrhea, as one of the leading causes of death in the world for children—we have the solutions, we know what to do, and these kinds of innovations can really make a huge difference in saving lives.…[And] there’s a health security argument [to do this work]. The world is getting smaller and smaller every day. We are inextricably linked to one another. When I’m not in the lab: I’m a dad! I’m a dad of two amazing young girls. They inspire me every day. It makes my work in child health that much more meaningful—the inspiration I get from them. I want all parents to have that.

Faces of Innovation—a new GHTC project that features scientists on the front lines of research and development on new global health tools and technologies—profiles Dr. Mohammad Nuhu Amin, who we met at the American Society of Tropical Medicine and Hygiene Annual Conference. Dr. Amin researches sanitation and diarrheal diseases with support from the United States Agency for International Development.My name: Nuhu Amin BDS, MPH, HSCWhere I work: International Centre for Diarrhoeal Disease Research in Bangladesh (icddr,b) I’m funded by: US Agency for International Development My research: My primary goal is to do interventions to reduce diarrhea and cholera in low- and middle-income countries, particularly in the urban communities of Dhaka. I’ve worked at icddr,b for the last ten years, and I’ve had the opportunity to work with lots of US universities. Currently I’m working with Stanford University with Professor of Medicine Dr. Stephen Luby on a Rohingya distribution impact assessment. I’m also working on another project with Emory University on a fecal pathogen exposure assessment. And our team is doing a different project with Emory University in collaboration with the University of Sydney to track the sanitation chain to detect pathogens, like norovirus, salmonella, shigella, and cholera, that cause diarrhea. We have previously also collaborated with Johns Hopkins University and we have lots of colleagues who work with Oregon University and other state universities in the United States.Motivation: I am a medical graduate, and I’ve had lots of patients with different problems including diarrhea and other infectious diseases. Bangladesh is a tropical country, so infectious disease rates are really high. This motivates me to not only focus on treatment, but to do the research to remove and prevent these diseases.Why US federal support is critical: USAID is one of our four core donors. They have been funding us for more than 50 years to support the research of our institute. I think the contribution of the US government is important for this research and development. When I’m not in the lab: I’m also a dental surgeon, so I have a clinic. Every day, for two or three hours, I treat patients and particularly patients who are poor. Dental health treatment is expensive, so I aim to serve my patients at a low-price. I have two kids as well, so I spend my time with them—they’re very inspiring for me. In addition, I love to travel to different countries. This year I traveled to almost four countries including Swaziland, South Africa, and India. I love to meet with other people around the world—that’s my hobby.