Tag Archives: global health research

Neglected Tropical Diseases: Topic of Capitol Hill Briefing/Meetings

On June 17, Research!America hosted a Capitol Hill briefing on neglected tropical diseases in partnership with Drugs for Neglected Diseases initiative (DNDi), Global Health Technologies Coalition (GHTC), The American Society for Tropical Medicine and Hygiene, and Doctors Without Borders/Médecins Sans Frontières (MSF).

Research!America also led a series of Hill meetings last week with influential congressional offices to discuss some of the successes of USAID’s NTD program and to highlight the need for continued investments. USAID’s NTD program – which was authorized by Congress in 2006 – has helped to deliver more than 580 million treatments to approximately 260 million people through mass drug administration campaigns. We were joined by Georgetown University, Baylor College of Medicine, the Global Network for NTDs, IMA World Health and the Latin America Society for Chagas (LASOCHA). The group – which represented a broad range of partners from organizations that implement USAID NTD programs to patient advocates to leading NTD expert, Dr. Peter Hotez – discussed the importance of the USAID NTD program to their work and updated staffers on emerging issues in NTD prevention and treatment. Continue reading →

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Lancet Publishes Series on Drug-Resistant Tuberculosis

On March 24, World Tuberculosis Day, the Lancet published a series of papers on the need to combat drug-resistant tuberculosis. Cases of drug-resistant TB are on the rise, posing a growing threat to the health of populations in all parts of the world.

The series consists of six papers written by international experts in the tuberculosis field, including Professor Alimuddin Zumla, Director of the Centre for Infectious Diseases at the University College London Medical School and Dr. Marco Schito at the National Institute of Allergy and Infectious Diseases. Some papers focus on TB diagnostics, highlighting advances such as the Xpert MTB/RIF test as well as the dire need for new affordable and effective diagnostics that can detect drug-resistant strains of the disease. One paper focuses on the more technical aspects of the disease and identifies the need for additional funding to research biomarkers for drug-resistant TB. Yet another paper discusses the importance of integrated health service and control efforts, as countries are facing a high burden of TB as well as non-communicable diseases such as diabetes and cancer. Finally, the last two papers discuss the importance of community engagement in research and the need for visionary political leadership to advance global efforts to control TB.

Taken together, this series not only warns of the danger of the TB, but of the danger of inaction. If we are to make progress in the global fight against TB, we must take some of the recommendations for research and control efforts laid out in these papers. It will take concerted action from political leaders, health policy makers, funders and researchers to stem the growing threat of drug resistant TB.

-Morgan McCloskey, global health intern

Toddler “functionally cured” of HIV

On March 4, NIH-supported investigators reported the first ever “functional cure” of HIV in a toddler in Mississippi. The child received antiretroviral drugs within hours of birth and continued on the drugs for 18 months, when treatment was stopped. Despite discontinued treatment, the toddler no longer had detectable levels of HIV when seen by medical professionals 6 months later. Subsequent tests confirmed that the child had indeed been “functionally cured” of HIV. Although more research is necessary to see if these results can be duplicated, scientists believe this provides hope for the hundreds of thousands of children born with HIV each year. NIH funding not only supported investigators involved in monitoring the child, but also played an instrumental historical role in developing the antiretroviral drugs that were used to cure the child.  We are one step closer to a world free from HIV.

In light of this breakthrough, it is disturbing and sadly ironic that Congress and the White House on Friday permitted federal funding for biomedical research to be cut — after years of sustained or increased funding – as part of sequestration.  How much progress will be squandered if these cuts, and the indifference to American priorities they exemplify,  aren’t reversed?

GHTC Briefing Highlights Importance of Federally Funded Global Health Research

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Research!America’s booth at GHTC briefing

On February 26, the Global Health Technologies Coalition held a Capitol Hill briefing, “Renewing US leadership: Policies to advance global health research.” The briefing included displays from global health nonprofits, the launch of GHTC’s fourth annual policy report as well as a panel discussion. Panelists included Dr. Lee Hall, Chief of Parasitology and International Programs at NIAID, Dr. Alan Magill, Director of Malaria at the Gates Foundation and Dr. Caroline Ryan, Deputy Coordinator for Technical Leadership at PEPFAR. Each highlighted key U.S. contributions to global health including the development of a rapid TB diagnostic, advances in HIV/AIDS treatment and delivery through PEPFAR and a new treatment for leishmaniasis developed in part by researchers at the Department of Defense.  Speakers pointed out that many of these medical breakthroughs were accomplished through leveraging U.S. government funding and working in public-private partnerships. All speakers expressed concern that cutting federal funding for global health research could jeopardize progress for these lifesaving tools.

In particular, Alan Magill warned of “breaking something that will be very difficult to put back together.” Speaker and moderator Lisa Cohen, Executive Director of the Washington Global Health Alliance, wrapped up the session citing Research!America poll data and reminding us that there is incredible support for this work – we just need to connect the dots for decision makers and funders. “78% of Americans think it is important to support global health research – we don’t think about this but when Americans are asked, it is clear that people care about these issues.”

Morgan McCloskey, global health intern

TB Vaccine Trial Paves the Way for Future Research

On February 4, Aeras released the results of a clinical trial of one of their TB vaccine candidates. The trial was conducted in South Africa with nearly 3,000 infants and while the vaccine was safe and well-tolerated, ultimately it was not found to provide protection against TB. Although the results were not what researchers had hoped, the trial was the first of its kind and proved that a large-scale clinical trial to test a TB vaccine in infants can be successfully run in a country with a high TB burden like South Africa. Researchers also pointed out that there are twelve other TB vaccines in clinical development and the infrastructure built through this trial can be used to test these candidates in the future.

Instead of being disappointed with the results, the global health community must move forward in the fight against TB with renewed urgency.  TB kills 1.4 million each year and over 12 million suffer from TB infection. Cases of drug-resistant TB are on the rise and the existing treatments are extremely complex and expensive, meaning that only 3% of drug-resistant patients receive proper treatment. The economic cost of TB is also enormous – in South Africa alone, TB control costs nearly $300 million each year. New drugs, diagnostics and vaccines are urgently needed to saves lives and money.

-Morgan McCloskey, global health intern

Promising Results for NIH Dengue Vaccine

On January 23, the NIH announced that a Phase I clinical trial for a dengue vaccine candidate has yielded promising results. Dengue is a potentially lethal virus which causes severe fever, headaches, and rashes. WHO estimates that 50 to 100 million cases of dengue occur worldwide each year, including here in the U.S., and has recently warned of the possibility of a global dengue epidemic.

The results of the trial, in which 90% of participants developed some immunity to the virus, represent a significant breakthrough in the development of a safe and effective dengue vaccine. The vaccine costs just $1 to produce, making it cost effective and ideal for future distribution to developing countries. The vaccine will enter Phase II clinical trials shortly and is yet another example of the importance of federal funding to advance global health research.

Briefing on the Social and Economic Impact of NTDs

On January 17, the Hudson Institute and the Global Network for Neglected Tropical Diseases held a briefing event to discuss their recently released report, Social and Economic Impact Review on Neglected Tropical Diseases. In addition to negative health outcomes, the report highlights the social and economic costs of these deadly diseases and argues that NTD control and elimination programs are a cost effective public health measure. For example, Michael Kremer, Gates professor of Developing Societies at Harvard University, discussed de-worming as an extremely cost effective development intervention. Several studies around the world, including in the southern United States, have shown that de-worming is worth our money and attention as it can lead to increased labor outputs, higher wages and better test scores among students.

Panelists at the event also paid tribute to many organizations that have altered the landscape of NTDs: the Rockefeller Foundation, whose campaign against hookworm has had a long standing effect in the American South and pharmaceutical company Merck & Co., who made an unprecedented commitment in 1987 to donate the drug Mectizan for as long as necessary for the control of onchocerciasis (river blindness). Other pharmaceutical companies have followed suit and drug donation programs are now being administered around the world. Of course, these programs would not be possible without collaborative partnerships between a host of public and private sector entities, from multilateral and government agencies to local on-the-ground operations. In addition to transforming the NTD landscape, lessons learned from these public private partnerships and other NTD control efforts have helped to inform other global health programs around the world.

Finally, Ellen Nagler, CEO of the END Fund, discussed the Fund’s private philanthropy model that allows the private sector to invest in NTD interventions for maximum impact. The END Fund provides capital resources and capacity to collaborate with governments and existing organizations to scale up treatments for individuals most at risk. Fifty cents per person to treat the seven diseases affecting 90% of the world’s poorest is a powerful return on investment. Nagler concluded that in order to raise the money necessary to reach our goals and eliminate these diseases, a lot more people will need to be educated about NTDs and their impact throughout the world. Please read Research!America’s summary of the report  in tomorrow’s post.

-Jennifer Chow, Director of Global Health R&D Advocacy

Importance of Affordable Diagnostics

An article in the most recent issue of The Scientist highlighted the importance of affordable diagnostics for global health. Although scientific advances have improved treatment options for many global diseases, a lack of effective, low-cost diagnostics hinders the health of many in the developing world. For example, medicines to treat HIV and tuberculosis have been life-saving for many individuals, but they can cause liver damage and patients on these medications must be monitored. However, the primary test for liver damage requires expensive equipment that is simply not available in low-income countries. To solve this problem, a Massachusetts biotech company, Diagnostics For All, developed a 10 cent paper-based test that can diagnose liver damage with a single drop of blood.

Other U.S.-based companies are working on similar low-cost diagnostics. In Texas, Global BioDiagnostics Corp is developing a more effective test for tuberculosis that will cost just $5. Both of these projects are excellent models for incorporating the idea of access into the research process and designing products that can actually be utilized in low-resource settings. However, there is often not enough money for companies to develop these kinds of products. In fact, a principal investigator at PATH says that “the problem [with low-cost diagnostics] is almost always funding.” Therefore, it is crucial to increase funding for affordable diagnostics. Not only would increased investment support these U.S.-based companies, but the end products could truly transform health care in the developing world.

Update: Another article, published in The Scientist on January 10, also addresses the urgent need for better diagnostics in resource-limited countries. In addition to making diagnostics more affordable, truly successful new diagnostics must also be “sensitive, specific, user-friendly, rapid, equipment-free and deliverable” and these considerations must be built into the R&D process. Overcoming these research challenges hinges not only on additional funding, but collaboration between research companies, the healthcare industry and local governments. Several Product Development Partnerships (PDPs) are leading the charge in these kinds of innovative collaborations. For example, the Foundation for Innovative New Diagnostics (FIND), a PDP based in Geneva, Switzerland, is working with manufacturers, health organizations and ministries of health and developing diagnostics from the initial design to the operational research phase to determine the diagnostic’s efficacy in a low resource setting. The importance of these kinds of new tests, which will result in more appropriate treatment plans that can save lives and money, cannot be overlooked.

-Morgan McCloskey, global health intern

World AIDS Day

Each year on World AIDS Day, December 1, the world unites in the fight against HIV. It is estimated that 34 million people around the world are living with HIV and over 25 million people have died from the disease since 1981. The good news is that strong investments in HIV/AIDS research have resulted in remarkable scientific advances such as new prevention tools and drugs that allow individuals to manage their disease. However, there is still much more work to be done and World AIDS Day highlights the need for continued investments in research, education and improved access to treatment. It is also important to raise awareness of another category of diseases that can undermine efforts to eliminate HIV: neglected tropical diseases (NTDs).

NTDs affect over 1.4 billion people and there is significant overlap between NTD and HIV infection in many areas of the developing world. For example, females with schistosomiasis in Africa have a nearly 3-fold risk of HIV infection. Co-infection with HIV and NTDs like leishmaniasis or hookworm can dramatically worsen symptoms and speed up the progression of HIV to AIDS.

Advances in HIV/AIDS prevention and treatment have proven the incredible power of research to save lives and we must not retreat on our progress in the face of scientific advances. Funding for global health research and development that includes the advancement of new and improved tools against NTDs and HIV/AIDS will yield multiple benefits for our health. Smart and steady investments in global health R&D will help us realize our shared visions of a generation free from these debilitating diseases.

-Morgan McCloskey, global health intern

Climate Change May Increase Threat of NTDs in the U.S.

The devastation caused by Hurricane Sandy has prompted a renewed discussion about climate change. Political leaders and climate scientists alike have raised concerns about the relationship between global warming and an increase in the number of extreme weather events. In addition to these concerns, climate change may also increase the threat of neglected tropical diseases (NTDs) here in the U.S. NTD transmission depends heavily on environmental conditions and warming temperatures may increase the severity or change the patterns of these diseases.

For example, funded by a grant from the Department of Defense, researchers at Texas Tech determined that climate change will allow dengue to thrive in the U.S. Historically found only in tropical regions, rising temperatures will allow the range of dengue-infected mosquitoes to shift north, increasing the risk of dengue within the continental U.S. We may already be seeing the first evidence of this shift – three cases of dengue fever have been reported in Florida in the past few weeks. Similarly, climate change is one suspected culprit in this year’s West Nile outbreak, as CDC officials note that unusually warm weather in 2012 may have played a role.

However, additional research is necessary to fully understand the impact of climate change on the range and transmission of NTDs. Even experts in the field have called for more research into the issue, arguing that “not enough attention is being paid to climate change in relation to NTD control.” They recommend improving NTD surveillance systems and increasing investment in field research, which will not only allow for the establishment of more effective NTD control programs worldwide, but will help the U.S.  better understand and protect against these diseases here at home.

-Morgan McCloskey, global health intern

Research!America Releases Top 10 Reasons to Invest in Global Health R&D

Why do you think we should be investing in global health research and development? Research!America has just released “Top 10 Reasons Why the U.S. Should Invest in Global Health R&D.” This evidence-based list provides compelling reasons why these investments are critical for the U.S., ranging from the humanitarian benefits to research as a powerful driver of U.S. economic activity. The list can be found on Research!America’s new Global Health R&D Advocacy website.

The site introduces Research!America’s new initiative for neglected tropical diseases (NTDs), including a recently released fact sheet on NTDs in the U.S. Additional NTD resources include a global health budget section, a section on the value of the U.S. investment in global health, and a globally focused NTD sheet, which will be available soon — so check back!

Please let us know what you think should be included on the Top 10 list in our comments section below — we may incorporate your suggestions into our future publications!

World Sight Day

On October 11th, World Sight Day, the World Health Organization will raise awareness about visual impairment around the world, as well as their Vision 2020 initiative aimed at eliminating avoidable blindness by 2020. WHO estimates that 285 million people worldwide are visually impaired and about 39 million of those individuals are permanently blind. However, up to 80% of these cases are due to preventable causes like cataracts, glaucoma, diabetes, trachoma and onchocerciasis. The last two causes on that list may not sound familiar – trachoma and onchocerciasis are two types of neglected tropical diseases (NTDs), diseases that have historically received little attention despite affecting 1.4 billion people throughout the world and right here in the U.S. On World Sight Day, we must not only raise awareness about these diseases, but of the need for additional funding and research to eliminate NTDs once and for all.

As the world’s leading cause of infectious blindness, trachoma results in an estimated $2.9 billion in lost productivity each year. Trachoma is a parasitic infection that mainly affects poor, rural communities in Africa and Asia. WHO has established key strategies for eliminating the disease, including surgery and antibiotic treatments for affected individuals and educational campaigns about the importance of facial cleanliness. International partnerships between the U.S. Agency for International Development, the International Trachoma Initiative and pharmaceutical companies have implemented these programs and helped to reduce trachoma cases from 149 million in 1997 to 60 million in 2008. Onchocerciasis, or river blindness, is the second leading cause of infectious blindness and can result in over $30 million in economic losses each year. Onchocerciasis is a parasitic infection transmitted through black sand flies and primarily affects river communities in sub-Saharan Africa. Through collaboration with global partners like WHO and USAID, the African Program for Onchocerciasis Control has focused on insecticide spraying and administering drugs in high risk communities since 1995. Overall, this strategy has reduced cases of river blindness by 73%, down to an estimated 37 million cases today.

This year on World Sight Day, we must celebrate the progress that has been made, while recognizing that there is clearly more work to be done. Current programs can be difficult to implement in rural areas and vaccines do not exist for either of these diseases. Additional investment in NTD research to develop new prevention and treatment methods will be an important component for Vision 2020’s efforts to eliminate preventable blindness around the world.

Morgan McCloskey, global health intern

Recognizing Public Health Heroes

On September 30, The Washington Post highlighted efforts in Haiti to eliminate lymphatic filariasis, commonly known as elephantiasis. A neglected tropical disease (NTD), elephantiasis is a parasitic infection spread by mosquitoes that can lead to swelling of the arms or legs — sometimes severely enough that individuals with the disease are stigmatized or unable to work. The good news is that elephantiasis can be prevented with anti-parasitic medicines. The Centers for Disease Control and Prevention and the U.S. Agency for International Development’s NTD program have taken a leadership role in administering these drugs in countries that are affected by elephantiasis. U.S. public health professionals have joined forces with local public health professionals and helped to organize programs, provide technical assistance and monitor progress. Through the collaborative efforts of these invaluable individuals, nine countries have already been declared free of elephantiasis. With support from the CDC and international charities, the Haitian health ministry is working hard to distribute this life-saving medication and join the list of countries free of elephantiasis.

This kind of outstanding work by public health professionals happens every day all around the world. Although there is no risk of elephantiasis in America, there are other NTDs emerging in the U.S. such as Chagas disease, West Nile virus and dengue fever. The CDC and other public health professionals play a crucial role in treating these diseases and organizing prevention and education campaigns here at home. These tireless individuals keep our drinking water safe, our air clean and our children healthy. Please join Research!America and other public health organizations in recognizing these public health heroes on November 19 for Public Health Thank You Day. For more information or to learn how you can get involved, please visit www.researchamerica.org/ph_thank_you or like our PHTD Facebook page at www.facebook.com/PHTD1.

-Morgan McCloskey, global health intern

World Heart Day

On September 29th, World Heart Day, the global health community will raise awareness about cardiovascular disease (CVD). Cardiovascular diseases range from heart failure, meaning the heart is not pumping enough blood, to a heart attack, which happens when blood vessels are damaged and blood flow to the heart is blocked. An estimated 17.3 million people died from CVD in 2008 and over 80% of all CVD deaths occur in low and middle income countries. This year, we are also raising awareness of one of CVD’s “hidden causes”: neglected tropical diseases (NTDs), and of the research necessary to combat these killers.

A group of parasitic and bacterial infections that disproportionately affect people in poverty, NTDs may be an important factor in the burden of CVD in the developing world. These diseases cause fever, disfiguring sores, visual impairment and organ failure. This includes heart damage that leads to CVD later in life. Chagas disease, a parasitic infection afflicting over 10 million individuals worldwide (including an estimated 300,000 people right here in the United States), can eventually cause heart failure if the parasite damages heart tissue.  Up to 70% of individuals with African sleeping sickness will experience some degree of heart damage. Over 200 million individuals have schistosomiasis, another parasitic infection that can lead to lasting heart damage if the parasite invades the heart muscle. And dengue fever – another NTD emerging in the U.S. – has also been shown to reduce heart function in severe cases.

These risks highlight the importance of early detection and prevention of NTDs. U.S. researchers and federal agencies have made progress against many of these diseases and we must make sure to equip them with the diagnostic tools and drugs necessary to treat patients before they sustain heart damage. Similarly, improved surveillance and screening programs are needed to truly understand how many of the world’s CVD cases can be attributed to NTDs. In addition to prevention strategies like healthy eating and exercise, investment for NTD research is an important component in reducing the global burden of cardiovascular disease. To learn more about NTDs, please visit Research!America’s global health website.

-Morgan McCloskey, global health intern

NTDs on Congressional Agenda

On September 21st, Senator Chris Coons (D-DE) and Roger Wicker (R-MS) announced that the Senate Malaria Working Group was turning into an official Senate congressional caucus focused on combating 17 neglected tropical diseases (NTDs) in addition to malaria. With NTDs affecting over 1.4 billion people worldwide and documented cases of NTDs here in the U.S., this commitment to finding new solutions is good news. Past U.S. government involvement in the fight against NTDs has yielded promising results. The National Institutes of Health and the Department of Defense have funded crucial basic research for NTDs. Similarly, the Centers for Disease Control and Prevention have implemented strong surveillance programs and the U.S. Agency for International Development’s NTD Program has made remarkable progress toward controlling the spread of several NTDs with existing treatments. However, these programs are constrained by the limits of existing tools and continued funding is needed to advance NTD prevention and control. Some of the most commonly used drugs are not effective or have toxic side effects, resulting in unnecessary complications or the need for repeat doses. Vaccines and adequate diagnostic tools are also lacking for many of these diseases. While continuing to treat these diseases on the ground, research to develop new tools is vital. More effective drugs and diagnostics will improve current treatment and control programs, while new vaccines could eliminate the threat of NTDs altogether. Investment into NTD research to develop these new prevention and treatment methods is essential for a successful global fight against NTDs. Members of Congress are recognizing the importance of combating NTDs. As advocates, researchers and implementers, we need to continue to make our voices heard for the health and prosperity of Americans and people worldwide.

-Morgan McCloskey, global health intern