Breakthroughs Blog: Child health

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 US Food and Drug Administration (FDA) on Thursday approved updated COVID-19 vaccines from Pfizer and Moderna that target the KP.2 virus strain, which emerged from the highly contagious JN.1 variant that began circulating widely in the United States last winter. The new shots are expected to be available within days amid spiking case rates and hospitalizations for COVID-19. Experts also hope the vaccines will provide cross-protection against closely related subtypes of the virus, including KP.3.1.1 and KP.3, which are now spreading rapidly and account for 36 and 17 percent of all new cases, respectively. The FDA has not yet approved a third vaccine from drugmaker Novavax.The World Health Organization (WHO) this week recommended three new oral regimens for multidrug-resistant or rifampicin-resistant tuberculosis (TB) that can cure patients more quickly and successfully than the current painful injectable regimens. These regimens—which include the use of new and repurposed medicines like bedaquiline, pretomanid, linezolid, and delamanid—can be offered to nearly all patients and can improve treatment success by shortening treatment time to six to nine months, rather than the usual 18 months, while reducing treatment toxicity and the spread of drug-resistant forms of TB. WHO’s recommendations are based on results from the BEAT-TB clinical trial conducted in South Africa and the endTB trial conducted in seven countries between 2017 and 2023 by Médecins Sans Frontières, Partners In Health, and Interactive Research and Development and funded by Unitaid.  A new study found that giving azithromycin to all children up to five years old can greatly reduce childhood mortality in sub-Saharan Africa, more so than by limiting the distribution of the antibiotic to younger children, as recommended by WHO. The study, published Wednesday in the New England Journal of Medicine, found that twice-yearly distribution of azithromycin to children ages 1 to 59 months in rural communities in Niger reduced childhood mortality by 14 percent when compared with children who received a placebo. Further, the study found that targeting only children ages 1 to 11 months (recommended by WHO in 2020) did not lead to a significant reduction in childhood mortality. However, concerns remain about the effect of routinely distributing the antibiotic to all children under five on antimicrobial resistance. 

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. Last week, Valneva and LimmaTech Biologics AG announced a new strategic partnership and exclusive licensing agreement for the development, manufacturing, and commercialization of Shigella4V, a tetravalent bioconjugate vaccine candidate against shigellosis. Shigellosis is caused by Shigella bacteria and is the second leading cause of fatal diarrheal disease globally, particularly in low- and middle-income countries. There are currently no approved vaccines for Shigella. Under the agreement, LimmaTech will receive support for conducting Phase 2 clinical trials of the vaccine candidate in low- and middle-income countries, which are expected to begin later this year. Then, Valneva will be responsible for the further development of the vaccine candidate through potential regulatory approval and commercialization if approved.The Biological Pest Control Centre in Valencia, Spain is releasing thousands of sterilized tiger mosquitoes, one of the species whose females transmit dengue to humans, to reduce the spread of dengue and other vector-borne diseases in Europe, as climate change has led to an expanding population of tiger mosquitoes across the continent and rising dengue rates globally. The lab employs an electron accelerator that uses radiation to sterilize the males, releasing an estimated 45,000 male mosquitos every week, who then unsuccessfully mate with the disease-spreading females, leading to an eventual reduction in the overall mosquito population. Similar sterilization techniques have been previously used to address disease vectors, but the Spanish lab is pioneering its use on the tiger mosquito.Last week, Indian company Biological E announced that the World Health Organization (WHO) has prequalified its novel oral poliovirus type 2 vaccine, a next-generation live attenuated oral vaccine, which can hopefully help reduce the incidence of vaccine-derived poliovirus, along with Indonesia PT Bio Farma's vaccine that was prequalified earlier this year. Cases of vaccine-derived poliovirus have increased in recent years in areas with low immunization rates. The new vaccine has improved genetic stability and carries a lower chance of starting new outbreaks of vaccine-derived virus compared to currently available poliovirus type 2 vaccines. Biological E said its manufacturing facilities can produce more than 500 million doses each year, with Indian regulators already having cleared the vaccine for export purposes.

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 results of a new study presented at the 2024 International AIDS Conference showed that long-acting injectable cabotegravir was safe and well tolerated as an HIV pre-exposure prophylaxis method in cisgender women before and during pregnancy. These exciting results come from an extension study of the efficacy trials among cisgender women that analyzed the outcomes of more than 300 pregnancies and infants. There has been limited data on the safety of long-acting injectable cabotegravir during pregnancy, so hopefully, these findings can fill that knowledge gap and lead to greater access to this highly effective HIV prevention option for this population, who may experience biological changes and social dynamics that can increase their likelihood of acquiring HIV during and after pregnancy.Last week, the Administration for Strategic Preparedness and Response at the US Department of Health and Human Services announced $25 million in funding to Walgreens to support a decentralized clinical trial testing COVID-19 vaccines. The study specifically aims to identify vaccine correlates of protection, or measurable immunity markers that correlate with protection against disease, using licensed or authorized COVID-19 vaccines to help assess immunity duration and streamline future clinical trials. This decentralized approach, which will include about 20 Walgreens pharmacies in urban, suburban, and rural communities, allows for a more diverse pool of study participants by bringing the study closer to where participants live. The funding comes through Project NextGen, a US government-led program to accelerate the development of next-generation COVID-19 technologies, including vaccines.  New data shows that Merck & Co.’s monoclonal antibody is safe and effective at reducing the incidence of respiratory syncytial virus (RSV)-related infections in infants. The Phase 2b/3 trial tested clesrovimab, also known as MK-1654, in healthy pre-term and full-term infants, finding that the antibody reduced the incidence of RSV-related infections over 150 days when compared to a placebo and hit key safety measures. The company announced that detailed findings will soon be presented to the scientific community and filed with global regulators. Hopefully, the antibody will eventually serve as an additional tool in the growing toolkit of new vaccines and monoclonal antibodies to address the burden of RSV in infants and older adults.

Last week, rain clouds gathered over Geneva as delegates from all over the world completed their annual pilgrimage to the World Health Assembly (WHA), the World Health Organization’s (WHO’s) annual forum for the 194 member states. The somber background reflected the mood heading into the meeting, as many were expecting this year’s gathering to be a washout. A visibly weary WHO Director-General Dr. Tedros Adhanom Ghebreyesus expressed his disappointment on the opening day that negotiations on a pandemic accord had not been completed in time for a WHA vote. Representatives also expected contentious fights over sexual and reproductive health and geopolitical conflicts, such as the ones in Ukraine and Gaza, to spill over into the proceedings, freezing debate and derailing possible progress on agenda items ranging from climate and health to universal health coverage. Yet, despite some serious bumps in the road, WHA also showcased that any multilateral system obituary is premature and that multilateralism can still deliver the necessary change we need to advance the global health agenda.   WHA approves new IHR amendments, resets timeline for pandemic agreement negotiationsAll eyes were on whether member states could come together to finalize the negotiations around the pandemic accord, a proposed convention to address some of the shortcomings exposed during the COVID-19 pandemic, as well as amendments to the International Health Regulations (IHR), an existing framework that codifies member state and WHO responsibilities in preparing for and responding to a public health emergency.  Heading into WHA, many stakeholders waited with bated breath to see if member states could bring both these processes across the finish line. Unfortunately, despite two long years of grueling negotiations, countries were unable to forge sufficient consensus to approve the pandemic accord. Instead, countries agreed to extend the mandate of the intergovernmental negotiating body, which coordinates the deliberation process for another year, providing additional time to reach compromises around the most contentious issues (financing, technology transfer—the process by which knowledge is transferred from the originator of a technology to other manufacturers to support the diffusion of health technologies into additional markets—, and a proposed access- and benefit-sharing system, which would pair commitments by countries around the sharing of pathogen samples and sequencing data with commitments from manufacturers to set aside a dedicated portion of their products for equitable distribution during health emergencies).  Nonetheless, member states notched a desperately needed win in reaching consensus on amendments to the IHR, achieving an agreement in the final hours of WHA. The consensus takes on added significance given that country representatives were not only in a race against time but also against fast-eroding trust in multilateralism, which was deeply fractured by the pandemic and subsequent geopolitical conflicts. The amendments to these technical rules, last revised in 2005 following the SARS outbreak, represent the first significant change in international law in the aftermath of the COVID-19 pandemic. While there were many changes to the IHR, one that stands out the most is that the added provisions include a commitment to solidarity and equity on strengthening access to medical products and to financing, including specific text that directs countries to promote research and development (R&D) and strengthen local production of quality, safe, and effective relevant health products. The previous IHR did not include any mention of R&D or the need to ensure equitable access to new tools.   WHA reinvigorates maternal and child health agenda  Progress was also made on a couple of other fronts in Geneva. Alarmed by the stagnation of progress in reducing maternal and child mortality, member states passed a critical resolution committing to specific actions to prevent the deaths of women, babies, and children.The resolution, led by Somalia and other cosponsors, commits countries to tackle the leading causes of maternal and child deaths, particularly in the hardest-hit nations. In it, countries agreed to improve access to maternal health services, including sexual and reproductive services, and comprehensive child health services through stronger primary health care and expanded access to emergency services. It also urges countries to develop and invest in tools that enable access to essential quality medicines for pregnant women, lactating women, mothers, and newborns and calls on WHO to strengthen and expand collaborative efforts, such as those promoted by WHO technical departments and the Global Accelerator for Pediatric formulations, or GAP-f, network, for facilitating better access to medicines for children. The WHA resolution marks WHO’s first significant action on maternal mortality in nearly a decade, following the adoption of the Global Strategy for Women’s, Children’s and Adolescents’ Health in 2015. Antimicrobial resistance in the spotlight  Antimicrobial resistance (AMR) also was in the spotlight in Geneva. With the United Nations High-Level Meeting (UN HLM) on AMR taking place in New York in September and a high-level ministerial meeting in Saudi Arabia in November, this year has been supercharged with attention on the issue, with WHA featuring numerous AMR events, roundtables, and initiatives.  Delegates approved a resolution to accelerate national and global responses on AMR, with many of them highlighting it as a crucial building block for the meetings in the fall. The resolution welcomes WHO’s strategic and operational priorities to address drug-resistant bacterial infections in the human health sector, which include prevention of infections; universal access to affordable, quality diagnosis and appropriate treatment of infections; strategic information, science and innovation; and effective governance and financing of the human health sector response to AMR.  The resolution also calls on member states to support investments in R&D for new tools to combat AMR and replenish the shockingly waning pipeline, to strengthen the capacities and standards of laboratories, and to participate in the WHO’s Global Antimicrobial Resistance and Use Surveillance System, or GLASS.While WHA did ultimately feature some contentious moments, especially around the geopolitics of Ukraine and Gaza, and major pushback on sexual and reproductive health, the latter almost derailing the adoption of several key decisions, the wins on IHR, maternal and child health, and AMR will have reverberations beyond WHA. Delegates hope that these wins will provide the necessary momentum to continue to make progress on the pandemic accord and at the UN HLM on AMR in the fall.