Ansley Kahn

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. Atomwise, Inc., a biotech company using artificial intelligence (AI) for drug discovery, and Drugs for Neglected Diseases initiative (DNDi) announced the discovery of drug-like compounds that could be used to develop first-in-class treatments for Chagas disease. DNDi scientists selected three therapeutic protein targets that would inhibit the action of the parasite that causes Chagas disease and for each protein, Atomwise screened millions of compounds using its AI-powered screening technology to predict those that bind and potentially inhibit the protein function. The compounds identified will now go on to further optimization and then potential drug development. While Chagas disease affects approximately six million people worldwide, current treatments are suboptimal, with long treatment durations and uncertain efficacy for those in the advanced stage of the disease. A malaria vaccine found to confer up to 100 percent protection in early human trials with healthy volunteers will soon be tested in a large clinical trial for the first time. In early 2020, the vaccine—known as PfSPZ and developed by Sanaria— will undergo testing in a clinical trial of 2,100 people between the ages of 2-50 in Bioko, an island off the coast of Equatorial Guinea. PfSPZ works by eliciting an immune response against the malaria parasite and is unique in that it employs the use of a whole malaria parasite instead of only a small number of genetically engineered parasite proteins like most malaria vaccine candidates and must be injected intravenously. If this initial trial is successful, Sanaria plans to carry out another trial on the island involving approximately 10,000 people to compare disease levels between communities that receive the vaccine and use standard malaria prevention measures with those that use only standard prevention measures. The National Institutes of Health (NIH) has begun its first-in-human clinical trial of a universal flu vaccine that researchers hope will provide broad, durable, and long-lasting protection against multiple influenza subtypes—including those that might cause a pandemic—for all age groups. Developed by scientists at NIH’s National Institute of Allergy and Infectious Diseases, the experimental vaccine “is designed to teach the body to make protective immune responses against diverse influenza subtypes by focusing the immune system on a portion of the virus that varies relatively little from strain to strain,” according to the NIH. The trial will gradually enroll 53 healthy adults between the ages of 18-70 years old and will assess how the participants’ immune responses to the vaccine candidate vary based on age and the likelihood of previous exposure to different influenza subtypes.

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 World Health Organization committee of experts who met on Friday to discuss the recent escalation of the Ebola outbreak in the Democratic Republic of Congo (DRC) decided against declaring it a public health emergency of international concern. The response to this outbreak, which has persisted for more than eight months and has killed more than 751 people, has been complicated by conflict, political instability, and distrust of Ebola services in the DRC. An experimental vaccine is being administered to known contacts of Ebola patients, as well as contacts of contacts and frontline workers, through a ring vaccination approach; yet, this remains a resource-intensive task that relies on the ability to quickly trace all contacts at risk and community trust in order to be effective. Commenting on why the committee decided against declaring this outbreak a global health crisis, Professor Robert Steffen, chairman of the committee, stated, “Although there was great concern about rising number [of cases] in some regions, the outbreak has not spread internationally,” but also added that efforts to contain the crisis should be redoubled. Other experimental therapies—a second vaccine and a post-exposure prophylaxis treatment—are also under consideration to help combat the epidemic. While the HIV virus is detectable in blood, once it enters human cells, the virus can remain hidden and out of reach of the immune system. However, a new study’s findings suggest that scientists may have discovered a way to reveal the presence of HIV in human cells. Scientists have identified a new shape of an essential HIV protein, dubbed State 2A, that allows the virus to gain entry into cells by interacting with a receptor on the cells, known as CD4, and two types of antibodies. Previously, scientists knew about three shapes, or conformations, that the protein uses to force its way into human cells. However, this fourth shape is one that the virus doesn’t usually adopt but allows it to elude the immune system. Forcing the protein, known as the envelope, in this new shape may reveal vulnerabilities within the virus to make it visible to the immune system, opening up a new potential strategy to enhance the effectiveness of treatment. Forbes interviewed Dr. Curt LaBelle, Managing Partner of the Global Health Investment Fund (GHIF)—a social impact investment fund initially structured and backed by the Bill and Melinda Gates Foundation (Gates Foundation) and JP Morgan in 2012. Focused on achieving a “double bottom line” of improving health outcomes and securing financial returns, the fund targets US$5-15 million investments in innovative global health companies that develop products that can be used in resource-limited settings. Now backed by other organizations such as GSK, Merck, and Grand Challenges Canada, among others, GHIF has advanced numerous technologies including a low-cost cataract surgery tool, a new oral cholera vaccine, and a river blindness treatment. This interview highlights the fund’s investment methodology and process, recent and successful investments, and how the fund manages the social impact of its investments, among other topics.

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 pursuit of a malaria vaccine, the biotech firm, Sanaria, has partnered with roboticists at Johns Hopkins University to develop a guillotine to decapitate and dissect out the salivary glands of mosquitoes, which hold the malaria-causing parasite. This guillotine, which can decapitate 30 mosquitoes at a time with the guidance of a “mosquito surgeon,” will help Sanaria effectively mass-produce its malaria vaccine candidate, PfSPZ, which requires one whole malaria parasite per vaccine dose. Eventually automating this process, even partially, would likely boost the mosquito dissection rate above the current average of 300 mosquitoes per hour achieved by highly trained technicians. The PfSPZ vaccine, which is currently in phase 2 clinical trials, is thought to work by inducing killer T cells to attack the parasites in the human body as they’re developing in the liver. Scientists at Oxford University have harvested antibodies from volunteers vaccinated in research trials of an Ebola vaccine to develop a treatment for the viral infection. Traditionally, antibodies intended for treatment are collected from the blood of people who have survived infection. This technique instead uses antibodies collected from those who have been exposed to the Ebola vaccine but not the Ebola virus itself—suggesting that protective therapies can be developed from people who are disease-free. To create the experimental treatment, scientists made a cocktail of four antibodies from trial volunteers who had been given an experimental Ebola vaccine and whose immune system responded to the shot by making antibodies. This cocktail successfully cured six guinea pigs of the virus when administered three days after infection. The research team believes this approach could be used for other emerging diseases caused by viruses. Brazilian researchers say they have developed a simpler, cheaper, and faster method to diagnose the Zika virus that doesn’t require laboratory equipment or trained staff. The method uses a technology called loop-mediated isothermal amplification (RT-Lamp), which amplifies the viral genome of the biological sample to detect the virus. While the current method of detecting Zika virus, polymerase chain reaction (PCR), is considered the gold standard for virus detection, it requires expensive equipment, specialist staff, and laboratories with good infrastructure. On the other hand, RT-Lamp has the ability to detect a very low quantity of the virus and has an individual cost of around US$0.25 compared to $10 for the PCR test. The RT-Lamp technology has long been used for other diseases, such as Ebola, but not for Zika. The authors of the study have requested a patent of this technique and hope to transform the technology into a commercial kit to be used for diagnosing patients.

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.Contraceptive jewelry may one day offer women a new approach to meet their family planning needs. Researchers from FHI 360 are exploring using transdermal patch technology to administer contraceptive hormones through patches applied to areas of jewelry—such as earrings, watches, rings, or necklaces—that are in contact with skin, allowing the drug to be absorbed into the body. Initial testing on animals suggests that contraceptive jewelry may deliver sufficient amounts of hormones to provide contraception, however no human testing has been performed to date. Researchers believe the tool could help improve adherence among certain women and allow for more discreet use of contraception, as well as serve the needs of women in developing countries who may have limited access to health care services and long-acting contraceptives such as injectables, implants, and intrauterine devices. Innovators at Cardiff Medicentre and Picofluidics have developed a specific type of microneedle that can be produced for approximately one-tenth of the cost of those currently on the market. Trials have confirmed the viability of their plasma treatment technology that enables the cost-effective production of collections of many thousands of microneedles, which are used to deliver medicines or vaccines, often in the form of a patch applied to a person’s skin. The developers hope to collaborate with partners to commercialize the technology, which they see as having many potential uses including pain-free injection of medications such insulin, vaccines, or intradermal fluid removal for diagnostic purposes and early disease detection. Scientists at Centenary Institute have uncovered a new avenue to improve treatment of drug-resistant tuberculosis (TB) by increasing the effectiveness of the immune system using widely-available anti-platelet drugs, including aspirin. Researchers used fluorescent microscopy in animal models to observe the build-up of blood clots and the activation of platelets around sites of infection, confirming that TB bacterium hijack platelets from the body's blood clotting system to weaken the immune system. Using anti-platelet drugs to treat the infection, researchers were able to prevent the hijacking, enabling the body to better control the infection. This study provides evidence that platelets have been found to worsen TB and “opens up the possibility that anti-platelet drugs could be used to help the immune system fight off drug resistant TB.”

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 phase II clinical trial, led by the Drugs for Neglected Diseases initiative (DNDi), found that a two-week treatment of benznidazole was just as effective in treating Chagas— a parasitic disease which causes permanent damage to the heart as well as the nervous and digestive systems—as the conventional eight-week treatment course. The shorter treatment means reduced side effects, which range from skin rashes to peripheral neuropathy, and thus also improved treatment adherence—both of which are critical for the control and elimination of Chagas disease. DNDi hopes to make the disease less debilitating for future patients “and turn this breakthrough discovery into a reality for people affected by the disease.” On Monday, March 11, the Trump administration released its budget proposal for fiscal year 2020. While the budget proposal requested US$291 million for the President’s domestically-focused “Ending the HIV epidemic” plan, —which includes funding for biomedical interventions—the global health community has called out the proposed reduction in funding to fight HIV globally also included in the President’s 2020 budget proposal. Overall, the President’s Budget Request proposes deep cuts to biomedical research across a wide range of federal agencies and to global health programs at the Department of State and the US Agency for International Development. TB Alliance announced that the US Food and Drug Administration (FDA) has accepted a new drug application for pretomanid, a novel tuberculosis (TB) drug candidate, as part of a treatment regimen for extensively drug-resistant TB; treatment-intolerant, multidrug-resistant TB; and treatment-nonresponsive, multidrug-resistant TB. Pretomanid would be used in combination with bedaquiline and linezolid. In a clinical trial in South Africa using this treatment regimen, 89 percent of study participants resolved their clinical infection after six months of treatment and six months of post-treatment follow up. The FDA granted priority review of this new drug application leveraging the Prescription Drug User Fee Act with an action date expected in the third quarter of this year.

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.On March 6, the World Health Organization (WHO) announced wide-ranging reforms in the organization’s structure intended to help it achieve its “triple billion” targets as part of its new five-year strategic plan—including one billion more people benefiting from universal health coverage, one billion more people better protected from health emergencies, and one billion more people enjoying better health and well-being. Among the reforms is the creation of a new chief scientist division formed “to strengthen WHO’s core scientific work and ensure the quality and consistency of WHO’s norms and standards.” Headed by Soumya Swaminathan who will serve as chief scientist, this division is also expected to offer and improve career opportunities for scientists at WHO. Other reforms include the creation of a new department of digital health, a division of emergency preparedness to complement WHO’s existing emergency response work, and a “WHO Academy” to train public health professionals. WHO officials have summed up the organizational transformation initiative as an effort to break down silos across WHO programs and ensure alignment among its offices worldwide. A new report released by the G20 Health & Development Partnership on March 5 urges finance ministers to help tackle some of the world’s most pressing global health challenges by developing new financing models and increasing concerted activity for research and development. The report calls for innovative solutions to funding health, citing that ill health could cost the world billions in treatment and lost economic productivity. Alan Donnelly, convener of the G20 Health & Development Partnership, stated that tackling these health challenges are “no longer just an issue for health ministers, it is now an issue for heads of government and for finance ministers because of the threat to the global economy as well as to humanity.” The partnership released the report in advance of the joint G20 health and finance ministers meeting in Japan in June as an appeal to the finance ministers to “remove the silo walls around health care.”For only the second time in history, a patient appears to have been cured of HIV. Like the first recorded case nearly 12 years ago, this outcome resulted from a bone marrow transplant initially intended to treat cancer. In both cases, transplants were from a donor with a mutation in a protein called CCR5, which rests on the surface of certain immune cells. The HIV virus uses this protein to enter those cells but cannot latch onto the mutated version. Although these transplants confirm for researchers that a cure for HIV is possible, bone marrow transplantation is unlikely to be a realistic treatment option in the near future due to the risk and harsh side effects involved—though rearming the body with immune cells modified to resist HIV may succeed as a practical treatment.