Mandy Goldberg, MPH

In this guest post, Mandy Goldberg from Research!America writes about an event today in Washington, DC, that focuses on research and development (R&D) for new malaria tools. The event is sponsored by Research!America, the Global Health Technologies Coalition (GHTC), and several other partners. In the United States, the bite of a mosquito is uncomfortable and irritating. For 3.3 billion people abroad, a mosquito bite can be deadly. Almost half of the global population is at risk of contracting malaria from the bite of an infected mosquito. Although malaria is preventable and curable, an estimated 655,000 people, mostly children in Africa, died from the disease in 2010. On April 25, the global health community commemorates the fifth annual World Malaria Day by recognizing the progress that has been made in the fight against malaria and calling for increased investment to sustain this momentum and achieve malaria control worldwide. The current basis of malaria control efforts are mosquito control strategies and treatment. Studies have shown that bednets can reduce malaria transmission by 90 percent in areas with high coverage rates. In addition, indoor residual spraying with insecticides can also reduce malaria transmission in areas with at least 80 percent coverage. In the past decade, malaria deaths have decreased by one-third in Africa. In countries with improved access to malaria control interventions, child mortality rates have fallen by 20 percent. More research is needed, however, to develop new, longer-lasting tools to bring eradication within reach. Photo credit: PATH/Evelyn Hockstein The tide is turning against malaria, thanks in part to remarkable achievements in R&D. In the past decade, malaria deaths have decreased by one-third in Africa. In countries with improved access to malaria control interventions, child mortality rates have fallen by 20 percent. More research is needed, however, to develop new, longer-lasting tools to bring eradication within reach. Hope on the way: the malaria product pipeline Anti-malarial medicines are used for curative and preventive purposes, but the increasing threat of drug resistance is making R&D for new, more effective drugs even more essential. Widespread resistance to the drug chloroquine in the 1970s and 1980s necessitated the use of artemisinin-based combination therapies (ACT), currently the best available treatment. The plant from which artemisinin is derived is in short supply in nature, threatening future availability of ACT. OneWorld Health, a drug development affiliate of PATH, in collaboration with private-sector partners, is working to solve this problem through the development and production of semi-synthetic artemisinin at an affordable price that can sustain the supply of ACT for years to come. In addition, the product development partnership Medicines for Malaria Venture (MMV) has several promising drug candidates in its R&D pipeline. MMV is developing a one-dose cure to replace current three-day regimens, eliminating the need for treatment follow-up and reducing the likelihood of drug resistance. MMV is also working on the development of non-artemisinin-based treatments. Considering recent reports of increasing resistance to ACTs in Southeast Asia, increased investment is needed to support the development of new therapies that may be necessary to control malaria in the future. The greatest hope for malaria eradication is the development of a safe, effective vaccine to prevent infection. RTS,S, the most advanced malaria vaccine candidate, has been shown to reduce the risk of infection by 50 percent among children age 5-17 months in a recent late-stage clinical trial. Developed through collaboration between the Walter Reed Army Institute of Research, GlaxoSmithKline, and the PATH Malaria Vaccine Initiative, this vaccine could be recommended for widespread use by the World Health Organization as early as 2015. Research has played an essential role in the progress already made against malaria, and additional scientific breakthroughs may be around the corner due to the robust R&D pipeline. Malaria R&D has the potential to save hundreds of thousands of lives, including American troops stationed abroad, and also has important economic benefits here at home by creating jobs and stimulating economic growth. In order to fully realize these health and economic benefits, increased investment in malaria R&D is required.

Research!America, a GHTC member, recently hosted an event on global health research and development (R&D) in New York. In this guest post, Mandy Goldberg, MPH, shares highlights from the event. Research!America, in partnership with the AIDS Vaccine Advocacy Coalition (AVAC), Drugs for Neglected Diseases initiative North America (DNDi), Global Alliance for TB Drug Development (TB Alliance), International AIDS Vaccine Initiative (IAVI), SUNY Downstate Medical Center, and Treatment Action Group (TAG), hosted a forum, Global Health Research and Development in New York: Fueling Innovation and Saving Lives, on Monday, April 9, at the New York Academy of Sciences. Mary Woolley, president and CEO of Research!America, opened the forum by acknowledging the remarkable progress made in the growing field of global health research in New York in the past decade. She also released the results of a new state poll commissioned by Research!America that shows that 64 percent of New Yorkers are concerned about global health, and 63 percent believe that global health research is important to New York’s economy. Congresswoman Nita Lowey (D-NY-18) then took the stage and explained the significance of global health R&D as an economic driver that creates jobs for New Yorkers. She stated that “despite the critical importance and significant economic impact of these programs, funding for global health is threatened again this year” in regard to the proposed fiscal year (FY) 2013 budget, and pledged to continue fighting for “robust funding for all our global health programs, including critical research and development.” Renowned global health commentator Laurie Garrett, senior fellow for global health at the Council on Foreign Relations, moderated a discussion between panelists Rachel Cohen, regional executive director, DNDi North America; Jack DeHovitz, MD, MPH, distinguished service professor and director, SUNY Downstate AIDS International Training and Research Program; Margaret McGlynn, president and CEO, IAVI; Mel Spigelman, MD, president and CEO, TB Alliance; and Pol Vandenbroucke, MD, vice president of development, emerging markets, Pfizer. In her opening remarks, Garrett emphasized the importance of the US commitment to global health funding, especially after the 2008 financial crisis, when “the United States stepped up to the plate” after the community saw “a huge number of players disappear” from the field. She stated that “if we cannot protect the US commitment to global heath spending, every single program in global health is going to have to chop, chop, chop its budget.” Laurie Garrett moderated a panel including Mel Spigelman, Pol Vanderbroucke, Rachel Cohen, Margaret McGlynn, and Jack DeHovitz. Panelists then discussed how innovative partnerships among public, private, and academic sectors are transforming the way that research is conducted and yielding promising developments for the future of global health. Spigelman highlighted that the TB Alliance is “on the verge” of technological breakthroughs, which require an increased commitment to research due to the costly final stages of testing and clinical trials. Partnerships in global health R&D are cost-effective, he argued, citing the TB Alliance’s NC-002 clinical trial conducted in partnership with the US Agency for International Development, Bayer, and Novartis. This trial has the potential to produce a drug regimen that could reduce the TB treatment to 4 months, potentially saving as much as 90 percent of current costs. Vandenbroucke emphasized that the private sector has unique resources and capabilities to contribute to partnerships that are essential for the development of health technologies. He stated that cuts to the federal budget would affect the work of the pharmaceutical industry “in the long term, as less funds are available to do the basic groundwork to study diseases” that Pfizer then applies during its advanced drug development process. Cohen expressed concern over the fact that neglected tropical diseases (NTDs) received the single largest percentage funding cut of the global health programs in the President’s FY 2013 budget request and the impact this would have on DNDi’s work. She noted that there is currently no federal funding available for late-stage product development for NTDs, and the current FY 2013 budget request “totally eviscerates the possibility of future investments, at least for the coming 2 years,” if passed, which threatens the continued progress of DNDi’s efforts. McGlynn spoke about the evolution of IAVI from an advocacy organization to a product development partnership, with the support of Mayor Bloomberg and New York City. IAVI’s Vaccine Design and Development Laboratory, established in Brooklyn in 2006, plays a pivotal role in the Mayor’s New York City Bioscience Initiative and is a key component of IAVI’s global AIDS vaccine R&D network. McGlynn stressed that the scientific expertise of New York City’s “globally educated and raised” workforce has been essential to IAVI’s work, and to the growth of global health R&D in the area. DeHovitz reinforced that multisectoral collaborations have yielded major advancements in the field of HIV and AIDS. He cited the federal contribution to international HIV and AIDS through the work of the Fogarty International Center at the National Institutes of Health, which funds advanced research training in public health at five New York City universities. He also spoke of “the huge upsurge of interest among our health care students in global health,” stating that 45 percent of medical school entrants are interested in global health and 30 percent of medical school graduates have had a global health experience in school. “They’re committed, they’re interested and they want to help,” he said, noting the potential impact of this group to the future of global health. New York—home to seven of the top 50 US research universities, the largest bioscience workforce and second-largest life sciences workforce of any US city, and three global health product development partnerships (PDPs)—is clearly a world leader in global health R&D, and this growing industry is a promising economic engine for the state. There was a general consensus in the room that the community needs to work together to ensure that global health R&D remains a priority. Great progress has been made in the development of new technologies to fight TB, HIV and AIDS, and NTDs, and increased funding is needed to sustain this momentum and build upon previous successes. Spigelman noted that the current “slash and burn” Congress could have a devastating effect on global health efforts, and argued that the US will get “the most bang for that buck” by investing in global health technologies that will reduce the foreign aid budget in the long term. Woolley concluded the forum with a call to action, asking the global health community to share with others, including their members of Congress, the importance of the work that they do. A video of the event is available here. For more information on global health R&D in New York, check out the New York edition of Research!America’s economic impact state fact sheet and public opinion poll series.

Research!America, a member of the GHTC, recently conducted analyses in target states to measure the health and economic impact of global health research and development (R&D), highlighting its benefits for states across the nation and strengthening the evidence base for Congress’ support of federal investments in global health R&D. Mandy Goldberg, MPH, global health R&D advocacy intern, shares the organization’s findings in New Jersey. This is the fifth post in a series. When people think of hotspots for global health R&D, the state of New Jersey may not immediately come to mind. But it should. Despite ranking eleventh in population size, New Jersey ranks third in R&D investment among states, thanks mainly to robust private-sector investment. Health R&D is a pillar of New Jersey’s economy and is critical to economic growth in the state. Despite the current economic climate, R&D spending in New Jersey increased by 11.4 percent in 2010, and global R&D spending was up by $1.4 billion, according to a 2011 report by the Healthcare Institute of New Jersey, implying even more future economic benefits for the state. New Jersey is home to 17 of the 20 largest pharmaceutical, medical technology, and diagnostic companies in the world, including the national headquarters of Johnson & Johnson, Merck, Novartis, and Sanofi-Aventis. The private-sector plays an important role in the development of new and improved vaccines, drugs, and diagnostics for diseases that affect the world’s most vulnerable populations, both through its own R&D work and through its involvement in product development partnerships. New Jersey is a surprising hotbed for global health R&D activity in the United States. It ranks third in R&D investment nationwide and is home to 17 of the 20 largest pharmaceutical, medical technology, and diagnostic companies in the world. Photo: Evelyn Hockstein/PATH One noteworthy example of a New Jersey company engaged in global health R&D is Temptime. The company, at the prompting of global health partners, created a small sticker that changes color to show whether a vaccine has been exposed to temperatures that make it unsafe for use. The sticker, originally intended for another use, was repurposed for use with medical products such as vaccines, which need to be kept within a stable temperature range from manufacture until use to remain safe and effective. Temptime’s partnership with PATH and the US Agency for International Development allowed the company to become a world leader in monitoring temperature-sensitive vaccines, enabling the delivery of an additional 140 million doses of vaccines and helping save 140,000 lives worldwide. Past Global Health Council CEO Jeffrey Sturchio referred to New Jersey last year as the “silicon valley of global health research and development,” and 94% of New Jersey residents believe it is important for their state to be a leader in health R&D. Given increasing investment in global health R&D in other countries, continued investment from both the public and private sectors is needed for New Jersey and the United States to preserve their status as leaders in global health R&D and maintain rich economic benefits for the state and nation as a whole.

Research!America, a member of the GHTC, recently conducted analyses in target states to measure the health and economic impact of global health research and development (R&D), highlighting its benefits for states across the nation and strengthening the evidence base for Congress’ support of federal investments in global health R&D. Mandy Goldberg, Global Health R&D Advocacy intern, shares the organization’s findings in Illinois. This is the fourth post in a series. “The world is interconnected, and that demands an integrated approach to global health,” President Obama stated when he announced the US Global Health Initiative on May 5, 2009. His former neighbors in Illinois agree. More than 50 percent of Illinoisans think more about global health today than they did five years ago, and for good reason. In addition to innumerable health benefits worldwide, global health research and development (R&D) has an important economic impact on the state of Illinois. Illinois boasts more than 200 academic, government, and nonprofit research institutions, as well as seven research and technology parks, all of which contribute significantly to employment within the state. Illinois is one of the top 10 bioscience employers in the United States, with more than 57,000 people working in the industry. For each bioscience job, almost six additional jobs are created on average, according to a 2010 analysis by Battelle and BIO. Dollar for dollar, global health is one of Illinois’s best investments. Photo: Evelyn Hockstein/PATH Spending on global health R&D not only adds jobs to the market, it also directly contributes to state economic growth. In 2010, Illinois received more than $700 million from the National Institutes of Health (NIH), the world’s largest funder of global health research. Every $1 million that the NIH invests generates more than $2 million in new state business activity. Public-sector investment provides important economic incentives to stimulate private-sector investment. One private-sector partner doing notable work in global health is Abbott, an Illinois-based healthcare company. Abbott invested $4.1 billion in R&D in 2011 and generated $38.9 billion in revenue, a great boost to the state economy. Just last week, Abbott announced a new joint research agreement with the Drugs for Neglected Diseases initiative (DNDi), a product development partnership dedicated to developing new drugs for patients suffering from the most neglected tropical diseases. Abbott and DNDi will work together to discover and advance new antimicrobials that fight disease, leading to the end-goal of finding new treatments for several of the world’s most neglected diseases, including Chagas disease, helminth infections, leishmaniasis, and sleeping sickness. Dollar for dollar, global health is one of Illinois’s best investments. Illinoisans recognize its value: 92 percent of state residents believe it is important for Illinois to be a leader in health R&D. However, Illinois ranks only 8th in R&D investment and 13th in federal funding despite ranking 5th in the nation in population. Increased investment is needed to secure this economic pillar and produce further growth in one of Illinois’s most rewarding economic sectors.