Marissa Chmiola

A “who’s who” of politicians, philanthropists, CEOs, and civil society leaders descended upon New York City this week for the annual United Nations General Assembly (UNGA)—a gathering renowned for its policymaking, pledging, and perennial traffic problems. GHTC was on the scene all week—attending side events, tuning into the official debates, and navigating police barriers—to be your eyes and ears on the ground. Here is what we heard and our top four takeaways on global health research and development (R&D): 1. We can’t end TB without new tools, so it’s vital for world leaders to marshal the political will and resources to close the TB R&D funding gap. Tuberculosis (TB) was a top topic at this year’s assembly with the convening of the first high-level meeting (HLM) on TB. Repeatedly, we heard—from advocates and policymakers, at side events and in in the official proceedings—how poor treatment options are a cornerstone of our failure to eradicate TB and of growing drug resistance, and that new vaccines and improved treatments and diagnostics will be key to turning the tide. While much attention focused on this lack of necessary tools, equal attention focused on the lack of political will and resources to end the epidemic. Many speakers lamented how shamefully slow progress has been since the World Health Organization (WHO) declared TB a global emergency 25 years ago and highlighted the urgent need to close the funding gap for TB, including the US $1.3 billion gap for TB R&D.   As the curtain closed on the HLM, world leaders, as expected, endorsed a carefully negotiated political declaration. GHTC was pleased to see it include a commitment to increasing investment in TB R&D by $2 billion and strong recognition of the importance of cross-border, cross-sector collaboration in driving product development. However, we also share concerns raised by other advocates on accountability. For this meeting to catalyze true change, rhetoric must now translate to action, and commitments must be matched with mechanisms that track investments and hold nations accountable. 2. There are many roads on the path to universal health coverage, but innovation can be an accelerator. Universal health coverage (UHC) was another topic that took the spotlight at UNGA 73, championed by the issue’s top “cheerleader in chief” WHO Director-General Dr. Tedros Adhanon Ghebreyus, who has made achieving UHC a centerpiece of his directorship. Given the focus of the world’s doctor on UHC, many advocates at UNGA framed their specific issues through the lens of UHC, highlighting the myriad of steps needed to achieve this ambitious goal‒from building a stronger health workforce, to expanding access to medicines, to tackling leading killers like malaria, HIV and AIDS, and TB. Yet, a common theme heard across these conversations is that along each of these roads, innovation can be an accelerator.   Throughout the week, speakers highlighted how innovations and new technologies can help deliver care more efficiently and effectively, improve access and drive down costs, and accelerate countries along the path to achieving UHC. TB advocates highlighted how shorter treatment regimens can improve care, decrease costs, and free up resources, while digital health advocates argued that better use of data can empower health workers to track and treat patients and allocate precious health resources most effectively. Others highlighted how innovative new tools like point-of-care diagnostics can bring improved care to the community level and to people in the most remote corners of the globe. 3. We need additional resources for R&D, and that requires countries to step up in an equitable way. Domestic resource mobilization and equitable financing were words repeated throughout the week, particularly in conversations around the TB HLM and closing the TB R&D funding gap. Advocates, think tanks, and even government officials, argued that high-burden TB countries need to increase domestic investment in TB R&D and treatment. Some advocates have called for a “fair share” or equitable financing approach to TB R&D financing, with each country committing to spend .1 percent of their GDP on R&D. Others spoke to the potential of the BRICS nations—Brazil, Russia, India, China, and South Africa—to play a greater role in financing R&D.   While much of the TB financing dialogue focused on increasing public sector contributions, conversations also highlighted the impact and further potential of financing models like the airline-tax-funded work of UNITAID or public-private partnership approaches—like product development partnerships and the work of the Global Health Innovative Technology Fund—which have married multisector contributions to bring novel, affordable, accessible tools to market. Other speakers highlighted the opportunity for industry to increase its TB R&D investment, though many lamented that although industry has brought new TB drugs and diagnostics to market in recent years, uptake has been slow due to high product costs. 4. There is reason for optimism and reason for concern. The mood seemed mercurial in midtown Manhattan, as UNGA orators vacillated between optimism and concern about the future of global health and development. In the drumbeat to UNGA, the always-impatient optimists Bill and Melinda Gates unveiled their foundation’s Goalkeepers report. The report’s stylish line graphs, which show a downward trajectory on health issues like child mortality, are uplifting and inspiring—a great reminder of the staggering progress we’ve achieved in global health and what’s possible for the future.   The basis of our optimism about the world has always been our belief in the power of innovation to redefine what’s possible – Bill and Melinda Gates   Yet, three years in, it has also become clear the world is not on track to meet the Global Goals. And even the optimistic Gates are reminding us that though we hold the blueprint for a healthier world, continued progress is not inevitable. The choices our policymakers implement today will determine whether progress continues or stalls. Throughout the week, many speakers gave voice to fears, highlighting concerns that foreign aid spending is under increased attack in leading donors countries like the United States—a notion echoed in President Trump’s speech to the Assembly—and that political changes like Brexit and an “America First” doctrine signal a movement toward isolationism over collective action. Given significant global health R&D funding comes through foreign aid budgets and the necessity of collaborative global action to deliver the cures of tomorrow, these developments are worrisome. Will these trends threaten progress, or will momentum continue? That’s a question we’ll surely continue to reflect on for many UNGAs to come.

Mosquitoes: This pervasive posse of pests and the deadly diseases they carry have terrorized towns and sickened citizens for far too long. For decades, a fearless force of heroic health workers has fought to keep these bloodthirsty bugs at bay, but to finally put an end to these murderous mozzies and the dastardly diseases they distribute, they need new tools, including vaccines, drugs, diagnostics and vector-control products. For World Mosquito Day, GHTC is taking a moment to shine a spotlight on the ghastly gang of mosquito-borne diseases and the innovations we need to finish these frightening foes for good. Malaria Mal A. Ria is old, cruel, and has killed more people than all of humanity’s wars combined. Since the 1950s, countries have fought a sustained war against this nefarious nemesis. Increased global action led to the development and introduction of cheaper drugs, rapid diagnostics, and child-friendly medicines, as well as mass distribution of insecticide-treated bednets, which help drive Mal A. Ria from several countries where she formally had a foothold and weakened her forces. Yet, today progress has stalled and Mal A. Ria is fighting back hard, having developed resistance against commonly used insecticides and treatments Fortunately, scientists are fighting back too. A new generation of insecticides and vector control products is advancing through the pipeline, the first vaccine is undergoing pilot roll out in sub-Saharan Africa while other candidates progress through development; and researchers are employing cutting-edge gene editing techniques to alter Mal. A Ria’s ability to pass on her parasite. Continuing support for these efforts is critical to wipe out this formidable foe. Dengue   Also known by the aliases “Breakbone Fever” and “Dandy Fever,” Den Gue has largely operated under the radar as a member of the Neglected Tropical Disease crime syndicate, attacking as many as 400 million people annually. Den Gue often induces a painful fever, and his attacks can leave victims with long-term neurological and liver problems, or in some cases kill them. He typically attacks during the day, rendering bednets a less effective tool to fight him. Unfortunately, health workers have no specific treatment or cure to deploy against Den Gue. While there is a vaccine, it is only appropriate for use in certain circumstances and better point-of-care diagnostic tests are needed to ensure its safe administration. Ultimately, a variety of tools will be needed to vanquish this adversary, so researchers are hard at work testing other vaccine candidates and exploring whether infecting mosquitoes with a bacterium known as Wolbachia could prove to be an effective tactic. Chikungunya While he may be a lesser-known member of the Neglected Tropical Disease crime syndicate, Chiku N. Gunya is still a dangerous adversary reaching over 60 countries in Asia, Africa, Europe, and the Americas. An attack by Chiku N. Gunya can leave victims with debilitating joint pain that can sometime persist long after the attack. Unfortunately, health workers have few tools at their disposable to reign in his criminal activity: There is no vaccine, specific treatment, or cure, and current diagnostic tools are challenging to employ in remote regions. Researchers are working feverishly to deliver new tools to fight this foe. Several promising vaccine candidates are now undergoing testing in human clinical trials and researchers are exploring whether currently available antivirals could be repurposed to combat Chiku N. Gunya, as well as developing new antivirals treatments. Zika While Zi Ka has been operating since at least the 1940s in certain places in Africa and Asia, her crimes did not capture widespread public attention until she carried out a large-scale attack on the Americas from 2015-2016, leading the World Health Organization to declare a public health emergency. Her crimes are particularly cruel, as the victims she targets are pregnant women, resulting in severe birth defects in some children. When Zi Ka captured her spot on the most wanted list in 2015, health workers had few tools to stop her reign of terror and that remains the case. There is no vaccine, specific treatment, or cure, and diagnostic tests have trouble distinguishing her attacks from that of Den Gue or other mosquito-borne disease miscreants. Scientists are working to ensure the world is better prepared if she decides to undertake another major attack. While it could be many years until they are available, several vaccine candidates are currently under development, and experimental diagnostic tests have been made available on an emergency basis as researchers continue to test and refine these tools.  R&D: The key to ending these enemies While our heroic health workers have made strides in stifling these diabolical diseases and protecting the populace, these cronies still cause considerable calamity in communities worldwide. Our call to action should be clear: We need research and development (R&D) and new technologies to exact an end to these enemies for good.

For many mothers and babies around the world, the first 48 hours after birth are the most dangerous of their lives. For eight years, Saving Lives at Birth—spearheaded by USAID—has challenged problem solvers worldwide to create innovative solutions to make birth safer and save lives. Here are ten incredible innovations from this initiative: Many newborns struggle to breathe. While in developed countries, doctors use CPAP machines, these devices are too costly for most health facilities in low-resource nations. Fortunately, innovators at Rice University have developed a low-cost solution—the Pumani bCPAP. Delivering comparable treatment at 1/15th the cost, the Pumani has tripled the survival rate of babies with respiratory distress.   Blood pressure (BP) disorders like pre-eclampsia are a leading cause of maternal death. BP cuffs have been used to monitor BP since the early 1900s, but they can be hard to maintain and read by less-skilled health workers. A startup named Biospectal is reinventing this approach. It has developed the OptiBP, a cuff-less smartphone app that allows instant, accurate BP monitoring through a fingertip.   Affecting 60% of newborns, jaundice can cause brain damage or death if left untreated. In low-resource nations, doctors often don’t have access to costly lab equipment needed to diagnose the disorder. That’s where the BiliSpec comes in. Developed by Rice University, this handheld, battery-powered device can diagnose jaundice within two minutes using just a $0.05 paper strip and a drop of blood.   Even a small dip in a newborn’s temperature can put her life at risk. Continuous temperature monitoring is key to detecting issues early, but in overcrowded health facilitates, it can be hours between readings. To address this gap, Rice University developed the Neonatal Temperature Monitor—a simple, affordable tool to continuously monitor and display infant temperature, alerting staff of problems.   Malaria during pregnancy is dangerous for both mothers and their unborn babies. Researchers are studying whether a promising new malaria vaccine candidate—Sanaria’s PfSPZ vaccine—could offer a solution. The research team will test the vaccine in pregnant women and monitor the mothers and newborns post-birth. If successful, the project could radically change malaria management in pregnant women.   Poor water and sanitation in low-resource health facilities can expose moms and babies to infection at birth. Chlorine is a commonly used disinfectant, but supply chain issues make it hard for facilities to ensure a steady supply. PATH and MSR Global Health created an innovative, low-cost tool—the SafiStation Chlorine Generator—to produce chlorine on site using just water, salt, and electricity.     While stillbirths are common in poor regions, increasing evidence suggests that non-breathing newborns are often misidentified as stillborn when they have heart rates (HR) and could survive with resuscitation. To address this gap in care, researchers developed the NeoBeat, a low-cost, belt-like device that takes seconds to put on a baby and provides a continuous digital display of newborn HR.   Jaundice is common among newborns. Fortunately, if found and treated early it is also curable. To facilitate diagnosis and treatment in low-resource areas, innovators developed the Bilikit, a comprehensive package of low-cost tools to manage jaundice. The kit includes the Bilistick, a rapid, hand-held, portable diagnostic device, and the Bili-Hut, a portable, high-intensity phototherapy device.   Blood donation shortages in Africa can leave health workers with few options if a woman is hemorrhaging blood during childbirth. Attendants often resort to using a soup ladle and gauze to try to salvage and recycle a patient’s own blood. The Hemafuse pump by Sisu Global Health is a cost-effective, hygienic alternative. This tool sucks up blood, filters it, and transfers it to a bag for reuse.   Over 100,000 women die annually from postpartum hemorrhage (PPH) or excessive bleeding. PPH is treatable, but the tools widely used to control dosage are too costly or infrastructure intensive for low-income nations. That’s a problem Shift Labs hopes to solve with DripAssist—a low-cost, battery-powered tool that constantly monitors medicine flow via an IV drip, sounding an alarm if it fluctuates.   View as a video below: Photo credits: PATH/Doune Porter; Pumani bCPAP: 3rd Stone Design, GHTC; OptiBP: GHTC: Bilispec: Rice University, 3rd Stone Design; Neonatal Temperature Monitor: GHTC; PfSPZ vaccine: Leiden University Medical Center, GHTC; Safistation: PATH/Adam Drolet; Neobeat: Laerdal; Bilikit: GHTC, Bilimetrix srl Trieste, USAID, Little Sparrow Technologies; Hemafuse: Sisu Global Health; DripAssit: Medgadget, GHTC

Last Friday, President Donald Trump signed into law a US$1.3 trillion spending bill to fund the US government through the rest of fiscal year (FY) 2018. Reluctantly signed by the President among a flurry of “will he, won’t he” tweets, the legislation represents a forceful rebuke by Congress of the Administration’s proposal to drastically slash funding for global health and medical research programs. Key US agencies and programs that advance global health research and development (R&D) not only saw their funding protected in the spending bill, but many also saw increases. This outcome demonstrates that our community’s appeals and messages have not fallen on deaf ears and that Congressional policymakers on both sides of the aisle want to see the United States continue its leadership in advancing innovation to improve the health of those in need around the world. Here are some of the key takeaways from the 2,000+-page bill: US Agency for International Development & State Department While the Trump Administration proposed slashing funding for global health programs at the US Agency for International Development (USAID) and the State Department by 25 percent, Congress stood firm in protecting these programs. The bill ultimately sustained overall funding for these programs at FY17 enacted levels. A few programs received increases including a boost of $15 million for GAVI, the Vaccine Alliance; $20 million for tuberculosis (TB); and $15 million for maternal and child health. Funding for USAID HIV and AIDS programming and family planning at State and USAID, which the President proposed eliminating fully, was protected at FY17 levels. Congress also directed $135 million from repurposed Ebola emergency supplemental funding to support USAID’s global health security programs.   USAID plays a leading role in developing health technologies for low-resource settings through its various global health programs, so it is critical that these programs receive adequate funding, so they can continue to prioritize R&D among their other activities. In light of the President’s proposal for deep cuts to these programs, a combination of level funding for some programs and increases for others is a positive sign in the midst of a challenging budget environment. National Institutes of Health   Strong bipartisan support for the National Institutes of Health (NIH) continued for FY18. While the President proposed a 21 percent cut to NIH funding, the final spending bill instead provided the agency with an increase of $3 billion—8.8 percent—over FY17 levels. This represents a historic funding high for NIH in actual dollars with increases spread across various NIH institutes and programs. Notably, the National Institute of Allergy and Infectious Diseases received a 7.2 percent increase—39 percent above the President’s FY17 request—while the Fogarty International Center, which was targeted by the Administration for elimination, received a boost of 5.2 percent compared to FY17.   NIH is the world’s leading funder of R&D for neglected diseases, providing approximately 40 percent of total global funding, so any changes to its funding produce a ripple effect felt by global health research institutes and people around the world. It is encouraging to see Congress continue its record of bipartisan support for NIH and take action to strengthen our nation’s leadership in medical research. Centers for Disease Control and Prevention   The US Centers for Disease Control and Prevention (CDC) also received a plus up in the FY18 omnibus. The agency saw its funding increased by $1.1 billion—nearly 15 percent—over FY17 levels. This was in sharp contrast to the 16 percent cuts proposed by the Administration. The CDC Center for Global Health (CGH) received a 12 percent increase, compared to a 21 percent proposed cut. This included a $1.5 million boost for parasitic disease and malaria and a substantial increase of $50 million for global health security programming, which supports implementation of the Global Health Security Agenda (GHSA). Funding for global immunization and AIDS programming within CGH remained level. The National Center for Emerging and Zoonotic Infectious Diseases also received a more modest 5 percent increase over FY17 funding.   CDC plays a critical role in advancing technologies and improving health systems to better detect, prevent, and respond to infectious disease threats worldwide. There was much concern surrounding the FY18 budget for CDC as the agency is facing a funding cliff. CDC and USAID received $1 billion from the Ebola emergency supplement to fund GHSA, but this money is set to run out in 2019. As a result, the agency has already announced plans to scale back its GHSA work in 39 of 49 countries. While more funding is still needed to sustain these programs, and the agency has yet to clarify how it will adjust programming in light of its FY18 appropriations; it is promising to see Congressional appropriators recognize the value of CDC’s engagement in improving global health security. Biomedical Advanced Research and Development Authority   The Biomedical Advanced Research and Development Authority (BARDA), which develops medical countermeasures against health threats including emerging infectious diseases and antimicrobial resistance (AMR), also received a boost in the FY18 spending bill. The agency saw its funding increased by $25 million—about 5 percent—over FY17 levels.   BARDA has played an increasing role in R&D for naturally occurring threats and emerging infectious diseases in response to the Ebola and Zika epidemics. With its focus on bridging the “valley of death” in product development and its ability to use unique contracting mechanisms to forge innovative and long-term private-sector partnerships, BARDA is well positioned to make an impact in this space. However, the agency has been constrained by a lack of dedicated funding for its emerging infectious disease portfolio. While it is promising to see appropriators increase the agency’s overall funding for FY18, GHTC will be pushing for more dedicated funding for emerging infectious diseases in FY19. Department of Defense   The Department of Defense’s (DoD) activities in infectious disease research also saw increases in the omnibus. DoD’s Peer Reviewed Medical Research Program—a program that conducts research on AMR, diarrheal diseases, emerging infectious diseases, malaria, TB, and vaccine development for infectious diseases—received $330 million in funding, which is an increase of $30 million over FY17 levels.   The FY18 spending bill is a big win for global health R&D stakeholders and advocates, but this victory may only be temporary. The legislation funds the government through the end of September, and the Trump Administration has once against proposed drastic cuts to global health and medical-research programs for FY19. So while the ink dries on this year’s spending bill and we take a moment to celebrate, GHTC is already gearing up for another difficult battle ahead on next year’s budget.

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 this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. Using a new research platform that extracts DNA directly from soil, researchers at Rockefeller University have discovered a new class of antibiotics. Scientists have long seen soil as a potential untapped source for new antibiotics; however, tapping this resource has proved challenging because only about 1 percent of bacterial species in soil can be cultured in labs. This new discovery platform is culture-independent. It allows scientists to extract, clone, and sequence DNA from the soil without growing bacteria in the lab. Researchers are hopeful this new platform can be scaled to systematically search for new antibiotics in the environment. With recent advances in gene therapy techniques, researchers are looking at the potential of these techniques to improve treatment for those living with AIDS and cure the disease. Scientists have used gene-editing tools to cut DNA at the exact spot to disable the HIV entryway gene both in immune T cells and blood stem cells. While the results of these initial experiments were less promising than researchers had hoped, there was a silver lining: Patients saw a decrease in the number of cells where the HIV virus lurked in a dormant state. Thus, researchers are looking at the potential to pair altered cells with existing antiretroviral medicines to improve the body’s ability to eliminate the virus. Scientists are also looking at the potential to use gene editing to introduce new genes that would help T cells recognize and kill HIV, similar to therapy introduced last year to treat cancer. Aeras announced resultsfrom an innovative clinical trial that provides new encouraging evidence that tuberculosis (TB) vaccines could prevent sustained infections in high-risk adolescents. A prevention-of-infection phase 2 trial in South Africa demonstrated that revaccination with the Bacille Calmette-Guerin vaccine significantly reduced sustain TB infections in adolescents. Another experimental vaccine candidate, H4:IC31, also reduced sustained infections, although not at statistically significant levels. However, these results mark the first time a subunit vaccine has shown any indication of ability to protect against TB infection or disease in humans.

2017 was a year that brought changes, upheavals, and uncertainties for the global health and development community: From the inauguration of a US president that expressed skepticism about foreign assistance and beget uncertainty about the United States’ continued leadership in global health, to the election of a new leader at the World Health Organization (WHO) that faces a tough task of reforming the agency and proving it’s up to the job in the wake of missteps during the Ebola crisis. While the landscape seemed to shift continuously under our feet this year, the community was also buoyed by evidence of our shared progress and success. In developing countries, more women than ever have access to contraceptives. The end of polio is truly within sight. And we have the largest pipeline of promising global health technologies ever in history. As the year comes to an end, GHTC is reflecting on the global health innovation stories and news that shaped 2017. Here are some of those moments: 1. Coalition formed to develop vaccines to prevent pandemics The 2014 Ebola epidemic prompted some real reckoning by the global community and raised important questions on how we can be better equipped with the tools and systems to stop outbreaks before they become epidemics. While the world still remains woefully unprepared, 2017 saw an important step forward with the formation of the Coalition for Epidemic Preparedness Innovations (CEPI). Launched with nearly $600 million in funding from the governments of Norway, Japan, and Germany, and in partnership with the Wellcome Trust and the Bill & Melinda Gates Foundation, CEPI aims to develop vaccines against the diseases most likely to cause the next epidemic. 2. US global health and research funding saved from the chopping blockCDC researcher handles pathogen in biosafety lab. Photo: CDC/ Dr. Scott Smith  The year started on an ominous note with the release of the Trump Administration’s fiscal year (FY) 2018 budget proposal, which called for deep cuts to US global health and medical research programs for FY18 as well as proposed rescissions to the US Agency for International Development’s (USAID) global health funding for FY17. While advocates feared Congress would take a cue from the Administration as it finalized FY17 budget negotiations, champions in Congress stepped up and defended these investments. When the dust finally settled, the FY17 omnibus budget passed with sustained funding across these areas, including slight boosts to global health funding at USAID and the US Centers for Disease Control and Prevention, and a US$2 billion increase for the National Institutes of Health (NIH). While budget negotiations remain ongoing for FY18, advocates are optimistic Congress will continue to sustain strong funding for global health and medical research. 3. G20 makes first-ever pledge to support R&D to combat global health challenges The world’s wealthiest nations paid some serious lip service to advancing global health research and development (R&D) this year. In their 2017 summit declaration, G20 leaders committed to working together to advance R&D for antimicrobial resistance (AMR) and potentially pandemic diseases— marking the first time R&D for global health has featured on the G20 declaration. Leaders pledged support for coordinated R&D initiatives, like the WHO R&D Blueprint and CEPI as well as called for a new AMR R&D collaboration hub. Although the G20 focused on R&D through the lens of AMR and health security—which addresses only a portion of global health challenges—this was a good sign that the world’s leaders are embracing the importance of health R&D to global development. It is now imperative that words turn into concrete action and that leaders sustain this momentum as Argentina takes helm of the G20 in 2018. 4. Demise of an R&D pooled fund at WHONot all news can be good news. This year brought a disappointing resolution to an over decade-long effort to stand up a voluntary pooled fund at WHO to finance R&D for neglected diseases. At this year’s World Health Assembly, WHO announced that it would cease work on the pooled fund and its initial round of demonstration projects—citing a lack of contributions pledged to support the sustainability of the fund. While this is a disappointing end for global health advocates, on a positive note, WHO pledged to continue a companion effort—the WHO Global Observatory on Health R&D—which was created to facilitate coordination and guide prioritization for global health research. 5. WHO begins process to establish essential diagnostics listA PATH research examines onchocerciasis (river blindness) diagnostic tests. Photo: PATH/Patrick McKern One of the biggest innovations of 2017 could be something decidedly low-tech: a list. While WHO has operated the Model List of Essential Medicines for decades to guide countries in procuring drugs and treatments, this year a group of scientists asked an interesting question: If we have a list for medicines, why don’t we have one for diagnostics? After a sustained advocacy campaign, supported by GHTC, calling for WHO to establish an essential diagnostics list (EDL), the agency formally announced in June it would create an EDL and took the first step in doing so, creating an expert advisory group tasked with developed the list. While the list is not expected to be operational until early 2019, this welcomed move by WHO will improve diagnostic access and innovation and ultimately save lives. 6. Nonprofit-backed Chagas drug beats ex-“Pharma Bro” company’s bid for rival launch Readers always like a David vs. Goliath story, and this one captured a lot of media attention this year. This August, in a surprising move, a creative multisector partnership involving GHTC member Drugs for Neglected Diseases initiative (DNDi) successfully secured approval from the US Food and Drug Administration (FDA) for the Chagas drug benznidazole, achieving this milestone before a rival attempt by a company formally run by Martin Shkreli (aka “Pharma Bro”) to register their version of the drug. Under Shkrell’s leadership, this company announced plans to take benznidazole—a drug that has been around since the 1970s, but lacked FDA approval—and register it with the FDA to secure a tropical disease priority review voucher (PRV) to sell. It also expressed plans to its investors to then hike the price of the drug to nearly $1,000 a course (vs. the $60-$100 it’s now being sold at in Latin America). This alarmed advocates who worried the drug would become prohibitively expensive to the nearly 300,000 Americans impacted by Chagas’ disease. This partnership appears to be a win-win for both Americans and people around the world. The company involved in the partnership has committed to making the drug accessible to Americans at an affordable price, and under a provision in the partnership agreement, 50 percent of revenue from a PRV sale will be used to fund programs to expand access to the drug in the United States and other nations. 7. Innovators get creative in combatting the world’s deadliest animal Bill Gates famously reminded us that the world’s deadliest animal is not a shark or a lion, but the pesky, yet lethal mosquito. This year innovators got particularly creative in exploring ways to wipe out these deadly pests and the diseases they carry. Work continued on gene-drives, genetic modification of mosquitoes, and the introduction of the transmission-blocking Wolbachia bacteria. But scientists also tried to see if they could use mosquitoes rather than syringes to deliver malaria vaccines; created a crowd-sourced, mobile-based monitoring platform to track disease-carrying mosquitoes by the sound of their buzz; and innovated a way to introduce sterile mosquitoes into a population via temperature-controlled drone. 8. New global health technologies advance through pipelineOver the past year, several other promising new health innovations have moved through the development pipeline and one step closer to reaching people in need. Here are just a few highlights: A new low-cost, heat-stable rotavirus vaccine, ROTASIL—developed by GHTC member PATH—was found effective against severe rotavirus in Phase II clinical trials. A promising new HIV vaccine candidate that targets multiple strains of HIV—developed by Janssen Pharmaceutical Companies of Johnson & Johnson as well as the NIH National Institute of Allergy and Infectious Diseases (NIAID)—entered human clinical trials. This marks only the fifth time in history an HIV vaccine candidate has reached this milestone. The first vaccine specifically developed for leprosy entered a Phase I clinical trial, with results expected in 2018. A US Army-developed Zika vaccine candidate ZPIV performed well in three Phase I clinical trials, producing an immune response in more than 90 percent of participants. Building on the success of its monthly dapivirine microbicide ring, which is now under regulatory review, GHTC member the International Partnership for Microbicides announced the launch of clinical trials for a three-month vaginal ring that releases both dapivirine and a contraceptive. NIAID also sponsored Phase I and II trials of a promising Chikungunya vaccine candidate. Currently there is no available vaccine for the disease. A new, anti-malaria compound—developed by Novartis and GHTC member Medicines for Malaria Ventures—entered clinical trials in nine countries in Africa and Asia. Partners hope this new drug will help stave off the development of further malaria drug resistance and expects to complete Phase 2b studies by late 2019. A promising new oral therapy for sleeping sickness—fexinidazole—was found effective in curing the illness in Phase III clinical trials. The treatment—developed by DNDi and Sanofi—could receive regulatory approval as early as the end of next year. As we look forward to 2018, it is time for the global health community to redouble our efforts to make sure this vital progress in global health innovation continues to ensure that people around the world will have access to lifesaving and life-improving health technologies.