Research Roundup: India to expand list of essential medicines, China’s emerging leadership in the pharmaceutical industry, WHO paves the way for hepatitis C generics, and more

A new initiative seeks to develop research capacity within Africa and create a regional hub with the ability to determine research needs and award grants. The Alliance for Accelerating Excellence in Science in Africa (AESA) will be launched this June out of the African Academy of Sciences in Nairobi, Kenya, with an initial grant of US$4.5 million from the Wellcome Trust, the United Kingdom’s Department for International Development, and the Bill & Melinda Gates Foundation. The Wellcome Trust may also transfer management of its Developing Excellence in Leadership, Training and Science program to AESA, a five-year, $60 million initiative. While AESA will solicit funding from both African and international donors, it will independently manage and allocate grants. The recent Ebola epidemic in West Africa caught the international community off guard; funding for and interest in Ebola was limited, and several promising vaccines for Ebola were suspended in the pipeline. However, an article in the New York Times suggests that we should have been prepared, citing research papers from as early as the 1970s discussing the threat of an Ebola outbreak. The research found the presence of Ebola antibodies in 10 to 26 percent of Liberian citizens, indicating that "medical personnel in Liberian health centers should be aware of the possibility that they may come across active cases [of Ebola.]" According to the authors, “the investigators collected their samples, returned home, and published the startling results in European medical journals.” They argued that inaction is primarily attributable to the lack of engagement of local scientists and officials. The article ultimately calls for investments in local capacity for research, delivery, and care to ensure equity in global health. Francis Collins, director of the National Institutes of Health (NIH), and Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases at NIH, wrote an editorial for Science Magazine on the value of research and development for global health. They expressed concern that certain members of Congress believe that the NIH should shift its focus to match the disease burden in the United States, calling it “unwise” as US investments in global health not only reflect an “enduring tradition of humanitarian concern,” but boost the economy and advance American diplomatic interests.

On Thursday, March 26, 2015, the Global Health Technologies Coalition (GHTC) launched its sixth annual policy report titled Meeting the challenge, seizing the opportunity: US leadership can advance global health R&D with a luncheon and panel discussion on Capitol Hill. The recent Ebola crisis was a common theme as panelists discussed what lessons could be learned about the need for further global health research and development (R&D) to enhance America’s preparedness to address future health threats. Dr. Joanne Carter—executive director of GHTC member RESULTS and moderator of the event—opened the discussion by reflecting on recent successes in global health R&D, while also emphasizing the need for increased investments in tools to tackle existing and emerging public health challenges. Carter noted how years of budget stagnation and sequester cuts have stymied the development of promising technologies and eroded US preparedness to tackle global health threats like Ebola. She expressed that “as we have achieved hard fought gains, challenging fiscal circumstances have put funding for global health product development at risk. Global health crises like Ebola and emerging obstacles like antibiotic drug resistance have demonstrated that existing tools are not enough. If we are going to successfully combat these challenges and reach our goal of a healthier world, we must continue to innovate.” Panelist Daniel Bausch, MD, MP&TM—senior consultant for the Clinical Team in the Department of Pandemic and Epidemic Diseases at the World Health Organization—echoed the need for forward-looking investments in R&D and preparedness, noting that the world has spent much more money fighting Ebola than it would cost to prevent the epidemic. Bausch maintained that while the US and global response to the Ebola crisis was unprecedented, we must learn from our failures to combat future epidemics. He underscored that R&D should be treated as a preventative measure, rather than a response to a crisis, reminding the audience that the clinical trial process can take years, even decades. Bausch called for increased long-term US government investments in global health R&D and strengthening health systems and R&D infrastructure in developing nations, noting that in an increasingly interconnected world “US health is global health.” Panelist Ann Mei Chang—executive director of the US Global Development Lab at the US Agency for International Development (USAID)—echoed Bausch’s remarks admitting that the US government is “much better at responding to crises than investing long term.” Bausch further cited the challenges that budget cuts pose for global health researchers, explaining that “if you’re a researcher in a university setting, you probably spend at least 50 percent of your time looking for funding.” He further remarked that research is often stalled because researchers lack the funding to continue their work in an already long and difficult process. Panelist Captain Michael Schmoyer—director of the Office of Pandemics and Emerging Threats at the US Department of Health and Human Services (HHS)—remarked that there were bright spots in the US response to Ebola, including the ability of US agencies to collaborate and work together. He asserted that during the outbreak, coordination between HHS, the Centers for Disease Control and Prevention (CDC), USAID, the Department of Defense (DoD), and the Food and Drug Administration was unprecedented. Captain Schmoyer confessed that agency leaders surprised themselves with their ability to work effectively together and that the response to the Ebola crisis could serve as a model for US agency coordination moving forward. He cited the example of how HHS worked with other agencies including the DOD, CDC, and USAID to set up the first medical unit to care for those healthcare workings responding to Ebola. The other panelists agreed that partnership and collaboration, both across the US government and with other sectors, is essential to advancing global health R&D during times of crises and under normal circumstances. Chang discussed how the US Global Development Lab at USAID advances R&D by leveraging existing funding through diverse partnership from different sectors including the private sectors, nongovernmental organizations, universities, and local government. She emphasized the value of open innovation, through calls for proposals and ideas, to elevate previously untapped voices. Chang cited an example of the value of this collaborative model during the Ebola outbreak. USAID partnered with the White House Office of Science and Technology, CDC, and DoD to launch the Fighting Ebola Grand Challenge for Development, focused on improving the personal protective equipment used by healthcare workers on the front line. Chang said the competition received ideas from engineers, architects, and even wedding dress designers, and now USAID is working with a manufacturer to develop the winning design and introduce it into the field. Captain Schmoyer further endorsed the value of partnership noting that some of the simplest, but most invaluable, ideas generated in the Ebola response resulted from consulting new partners. All three panelists agreed that there were lessons the US could learn from the Ebola crisis to enhance our nation’s preparedness to respond to future health threats. Carter closed the event by noting that “As the world creates a new agenda for global development and seeks to confront existing and emerging health challenges, the time is right for US policymakers to strengthen the nation’s investments in research and product development and reaffirm our resolve to harness American ingenuity to save lives, improve health, and enhance economic prosperity and security around the world.” She called on US policymakers to “meet the challenge and seize the opportunity.” For more information, find the full report here and an accompanying piece on the site Medium.