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.  Researchers have reported that a once-a-month birth control pill that gradually releases a contraceptive drug worked as designed in a key test in animals. The experimental device is small and star-shaped with six arms that each hold a certain dose of medication. The device is folded inside an ordinary-sized pill capsule. Once swallowed, its coating is dissolved by stomach acid, allowing the star to unfold. As the medication slowly dissolves out of each of the arms, the device breaks down until it can safely pass through the digestive system. Experts caution that more safety testing is required before the device can be tested in women and question whether the device dissolves in the same way in different people. The Bill and Melinda Gates Foundation is investing US$13 million for further development of the device, which could improve family planning options for women in developing countries.The first field trial of a new typhoid vaccine that can be used in young children has shown it protected 81.6 percent of recipients. The trial, which took place in Nepal and included children as young as nine months old, provides evidence of the vaccine’s potential level of impact for preventing typhoid, a bacterial infection often spread through contaminated water which leaves people sick for weeks or months. As some strains, particularly in South Asia, become resistant to antibiotics, prevention of the disease has become particularly important. There are two other typhoid vaccines, but one comes in a capsule too large for young children to swallow, and the second is an injection that doesn’t work in children under the age of two. This new vaccine, known as TCV, has already been endorsed by the World Health Organization (WHO)’s Global Advisory Committee on Vaccine Safety, and further two-year field tests are also underway in Bangladesh and Africa to gauge its effectiveness in other regions. Typhoid affects 11 million people every year and kills approximately 117,000. Last week, WHO released its 2019 World Malaria Report, which notes that the fight against the mosquito-borne disease has stalled. According to the report, malaria still infects millions of people every year, killing more than 400,000 which are mostly children in Africa. The report also found that an estimated 11 million women in sub-Saharan Africa—29 percent of all pregnancies—were infected with malaria in 2018, leading to nearly 900,000 children being born with a low birthweight. Additionally, the report cites that funding for the fight against malaria is broadly flat and calls on donor nations and governments in countries affected by the disease to step up the fight, noting that global political commitment and investment is critical to sustaining progress.

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.  Indian generic drug manufacturer Cipla and the Drugs for Neglected Diseases initiative have developed a new, palatable pediatric formulation of HIV medicines priced at US$1 day, which experts say could save the lives of thousands of children each year. The drug, called Quadrimune, contains four HIV drugs—ritonavir, lopinavir, abacavir and lamivudine—and comes in strawberry-flavored granules the size of grains of sugar that can be mixed with milk or sprinkled on baby cereal. The granules are also coated with a polymer that doesn’t melt until it hits the stomach, eliminating the need for cold transport or storage of the drug, which can be inconsistently available in rural areas, especially in sub-Saharan Africa. Quadrimune is still under review by the US Food and Drug Administration and, if approved, will likely lead to rapid certification by the World Health Organization. Each year, approximately 80,000 babies and toddlers die of AIDS in part because their medicines come in hard pills or bitter syrups that are very difficult for small children to swallow or keep down.Final data from a landmark clinical trial of four Ebola therapies in the current outbreak in the Democratic Republic of the Congo show two of the drugs dramatically reduce the risk of dying from the disease, especially in those who started treatment quickly after the onset of their illness. Findings of the PALM trial show that a monoclonal antibody cocktail called REGN-EB3, made by Regeneron Pharmaceuticals, and a single monoclonal antibody developed by the US National Institute of Allergy and Infectious Diseases called mAb114 led to a survival rate of about 65 percent in treated patients compared to 33 percent in the overall outbreak. The other two products tested in the trial, an antibody product called ZMapp and the antiviral drug remdesivir made by Gilead Sciences, did not perform as well, saving only half the patients who were treated with one of those two therapies. The PALM trial began November of last year but ended early in August of this year because an interim analysis showed REGN-EB3 and mAb114 were statistically better than ZMapp and remdesivir.When babies are born with HIV, starting treatment within hours to days is better than waiting a few weeks or months, which is the norm in many countries. The findings from a small study in Botswana, funded by the US National Institutes of Health, show that very early treatment limits how HIV takes root in a newborn’s body, shrinking the “reservoir” of the virus that hides out waiting to rebound in case the children stop taking their medication. The study also demonstrated that the earliest-treated children had more normal functioning of some key parts of their immune system. These findings could influence care in regions hard hit by the epidemic and offer clues as scientists pursue a cure. Though it has become routine practice to give pregnant women a cocktail of anti-HIV drugs to prevent mother-to-child transmission of the virus, it is estimated that 300 to 500 infants are infected every day in sub-Saharan Africa.

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.  US-based company Integrum Scientific has developed a “lab on wheels” that developers say could greatly improve the response to disease outbreaks and epidemics. The vehicle is equipped with everything onboard needed to rapidly diagnose patients or carry out research studies and can be transported to outbreak areas by plane and driven to even the most remote locations. The mobile lab can be outfitted as a biosafety level 2 or 3 lab, comes with almost ten meters of lab bench space, has an -80 degree Celsius freezer, satellite communication, and two generators that can run on “dirty” diesel fuel commonly found in African countries. It is also built for traversing unpaved, muddy roads and is equipped with a reinforced door and security system. The first vehicle may soon be tested in Uganda. A prototype was parked outside the annual conference of the American Society of Tropical Medicine and Hygiene this past week. A major trial in Uganda that used a new chemical entity in bednets has shown promising results, offering hope for an alternative solution as mosquitoes have grown increasingly resistant to pyrethroid, a chemical commonly used in long-lasting insecticide treated bednets. Researchers found that though pyrethroid-treated bednets continued to be effective, households given bednets with a combination of pyrethroid and the chemical piperonyl butoxide experienced 27 percent fewer cases of malaria among children ages two to ten. These households also had 80 percent fewer malaria-carrying mosquitoes. This combination bednet formula received a conditional recommendation from the World Health Organization (WHO) in 2017, and its Vector Control Advisory Group is expected to make another assessment in 2020 to determine whether to provide a full recommendation for the intervention. WHO reports have shown stagnation in global progress against malaria in recent years, which coincides with increasing concerns about the impact of pyrethroid resistance on anti-malaria efforts. An experimental HIV vaccine developed by Scripps Research and the International AIDS Vaccine Initiative elicited antibodies that can neutralize a wide variety of HIV strains in early animal studies. The test, in rabbits, showed that these “broadly neutralizing” antibodies targeted at least two critical sites on the virus. These results offer a proof of principle, as researchers widely assume a vaccine must elicit these antibodies to multiple sites on HIV to provide protection against a constantly evolving virus. The research team continue to test and improve their vaccine strategy in small animal models and hope to eventually test the vaccine in monkeys and then humans. According to UNAIDS, approximately 35 million people worldwide have died from AIDS and about 38 million others are now living with HIV infection.

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. Christine Petersen, who we met at the American Society of Tropical Medicine and Hygiene Annual Conference, who researches how infectious diseases transmit between animals and people at the University of Iowa.My Name: Christine Petersen, DVM, PhD.Where I work: Center for Emerging Infectious Diseases at the University of Iowa in Iowa City, Iowa. I’m funded by: National Institutes of Health. My research: My work is funded by the National Institutes of Health to help figure out how infectious diseases transmit between animals and people. As someone who lives in Iowa, where there’s six pigs for every person, it’s critical to understand those interactions between animals and people. Infectious diseases can be everything from the flu that we all get our shots for to parasitic diseases, like malaria, that affect anybody who travels and goes to places for work or for play.Motivation: I was one of those kids who watched nature shows growing up and loved them. I always wanted to go and work with these amazing animals around the planet. It turns out those amazing animals gives diseases to the people that live with them or use them as a food source. In 1996, when 30 percent of the population in Kenya were dying of AIDS, most of them were dying of diseases they likely acquired from the very livestock that helps keep them alive. I wanted to be able to help those animals to stay healthier so the people could stay healthier.  Why federal support is critical: It’s critical for policymakers to support global health research because we can’t separate where animals come from. We do not have borders that keep animals of all species out of this country. Like it or not, we share diseases with those animals. We need those animals to eat, to be our friends, and to make our lives happy. But all of us have diseases that we share, and we need to prevent them from making the animals sick and us sick. When I’m not in the lab: Not surprisingly, given the other things I’ve said, I do have two dogs, two cats, some fish, and some snails thanks to my ten-year-old daughter’s class. I love running with the dogs, going on hikes, and going kayaking. 

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. Mary Kamb, who we met at the American Society of Tropical Medicine and Hygiene Annual Conference, who leads the Elimination and Control Epidemiology team at the Centers for Disease Control and Prevention, Division of Parasitic Diseases and Malaria.My Name: Mary Kamb, MD.Where I work: Centers for Disease Control and Prevention (CDC), Division of Parasitic Diseases and Malaria in Atlanta, Georgia.I’m funded by: the US federal government. My research: I lead the Elimination and Control Epidemiology team in the Parasitic Diseases Branch. We focus on neglected tropical diseases that are able to be eliminated through one method or another, usually preventative chemotherapy, like Lymphatic filariasis and Onchocerciasis…but also diseases like Guinea worm, which don’t have a treatment but have strong public health programming that, in that case, can lead to eradication.We [CDC] work primarily with ministries of health on programs to improve programmatic implementation and surveillance. It’s very practical, on what we call program operations research or program science, to ensure and improve high-quality programs. My team is made of scientists who come from a number of backgrounds. Some are medical doctors, like me, some are epidemiologists, or social scientists, or have training in other areas. We work closely with people from our laboratory…very closely, hand in hand, and also with people who work on the drivers behind people’s behavior around programs. For example, why people would not want to participate in a mass drug administration, or why might people be fearful of using drugs or not seek care…really working across disciplines. I think it makes for a stronger program and for better understanding of all the issues around ensuring high-quality programs. Most of our work involves collaborating with partners, often other health ministries, the World Health Organization, and other international partners working on neglected tropical diseases. We also try and work with other branches and teams across CDC, for example with people working in Global Water, Sanitation, & Hygiene (WASH), immunizations, malaria, or other areas because we can learn from and support each other. Many of these areas can really inform elimination and control of neglected tropical diseases.Motivation: I worked for many years on the elimination effort of mother to child transmission of HIV and syphilis. I worked most of my career focused on HIV and other sexually transmitted diseases. Working in neglected tropical diseases is very interesting both because there are diseases that can be eliminated, but also because…it’s an area of great need that affects people and countries who are often living in poverty. The longer I work in public health, the more interested I am in health equity and understanding the real drivers of why certain countries are affected by diseases that we feel should be gone but aren’t necessarily gone. We have to dig deeper to find out what are those other drivers…those social issues that are affecting good health. Why federal support is critical: I think living in the United States, we might think we are immune from some of these diseases that affect other countries, but we’re not. Having people who are living healthily in other countries across our borders doesn’t just help people across the border, it helps Americans. In today’s world, diseases can cross borders so easily. Having healthier neighbors also makes for a stronger and safer world. When people don’t have to worry about diseases, they can focus on other issues that are important and making a stable community. I think that global health is such a win-win for everyone in the world. When I’m not in the lab: One of the things I really like to do is keep in touch with friends around the world…I like to keep in touch with people and travel. I also like to bird watch.

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. Joseph Tucker, who we met at the American Society of Tropical Medicine and Hygiene Annual Conference, who uses grassroots methods, like open challenge contests, to influence health messages and interventions in local communities, at the University of North Carolina. My Name: Joseph Tucker, MD, PhD. Where I work: University of North Carolina in Chapel Hill, North Carolina.  I’m funded by: National Institutes of Health  My research: My research is in sexually transmitted diseases (STD), including HIV, in low- and middle-income countries and is primarily focused on diagnostics. We are interested in having open challenge contests where we solicit ideas from the community and then select great ideas and implement them. We’ve used this open challenge approach to come up with new ideas for promoting HIV and STD testing in a wide range of contests. In many parts of China, for example, gay men hesitate to get tested for HIV and many campaigns are top-down—they’re focused on expert-driven ideas and solutions. The idea with the open challenge approach is to have grassroots ideas from local communities influence the messaging and services and, in this case, for HIV testing. We had an open challenge contest where local gay men contributed images, memes, and short messages, and those all fed into the intervention to promote HIV testing for gay men.  Motivation: There’s a huge unmet need in terms of low- and middle-income countries and diagnostics. For me, personally, I do a lot of research in China. I studied Mandarin in college…there’s a number of different links between me and the city of Guangzhou. It’s been fun to develop this line of research over the years.  Why federal support is critical: These open challenges are a very low-cost way to engage communities and add value. Many times, we hire companies and it’s a clunky, top-down, expert-based approach, but there’s so much innovation within local communities—and the US government has recognized this for many years. There are many federal agencies that use open challenge contests and, I think, this is a simple, effective way of improving global health. When I’m not in the lab: I have two sons who are seven and four months old, and they keep me very busy.