March 8, International Women’s Day, “has grown to become a global day of recognition and celebration across developed and developing countries alike,” reads InternationalWomansDay.com, a global hub for sharing news and resources about the day. While great strides have been made in the past hundred years to improve the health and equality of women in America, there are still areas of medical care and research where women are at risk; these areas represent a great opportunity for America to lead the way in promoting health and equality for women around the world. Some Research!America alliance member organizations work every day to bring increased awareness to health issues affecting women or to advocate for females in research and science careers.
The Society for Women’s Health Research (SWHR) is a national non-profit organization that seeks to “bring attention to the myriad of diseases and conditions that affect women uniquely.” SWHR has helped make women’s health issues a national priority by advocating for greater funding for sex-based biological differences research and legislative and regulatory issues related to women’s health, as well as administering public educational campaigns on women’s health. WomenHeart: The National Coalition for Women with Heart Disease is the only national patient-centered organization that focuses exclusively on women’s heart disease. The overall mission of WomenHeart is “to improve the health and quality of life of women living with or at risk of heart disease, and to advocate for their benefit.”
Though the number of women in science, technology, engineering and math (STEM) research disciplines is gradually rising, there is still a significant disparity in the ratio of men to women in STEM careers. The Association for Women in Science, or AWIS, advocates for the interests of women in science and technology. AWIS seeks to educate the public about bias against women in STEM careers, the disparities in career advancement and underrepresentation of women in the STEM workforce through publication of fact sheets and advocacy activities.
The U.S. government is committed to improving women’s health around the globe. Through policies and programs such as the Global Health Initiative, women’s health activities under PEPFAR and an executive order to develop a U.S. strategy to prevent and respond to gender-based violence, the U.S. has made significant investments in women’s health. At a recent event about U.S. priorities for women’s global health in the president’s second term, Kathleen Sebelius, Secretary of Health and Human Services, said “nothing has a greater return than investment in women’s health” and promised that the U.S. will continue to operate under the “guiding principle that no woman should be denied access to the care she needs for a healthy life for her and her children.”
Find local International Women’s Day events through the InternationalWomansDay.com event calendar. In the Washington, DC area, look for a launch event for an international network designed to help women grow their careers through mentoring. The United Nations Entity for Gender Equality and the Empowerment of Women, UN Women, will be offering a free webcast of its International Women’s Day event at the UN headquarters in New York.
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?
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
You may be familiar with chocolate kisses and candy hearts on Valentine’s Day, but have you ever heard of “kissing bugs?” These insects, found throughout Latin America and parts of the United States, transmit Chagas disease, a parasitic infection that can lead to heart disease in both humans and animals. Chagas infects up to 10 million people worldwide and is a growing problem here in the U.S. It is estimated that 300,000 individuals here at home have Chagas and the disease costs the U.S. nearly $1 billion annually in lost productivity and health care costs. Some experts are also concerned about the growing number of animals with Chagas infections. A recent study showed that in Louisiana, up to 60% of dogs in some kennels have tested positive for Chagas. The Lackland Air Force Base in San Antonio has reported Chagas in military working dogs, and several dogs overseas have actually had to return home because of symptoms from the disease, leaving the units they supported without explosive detection dogs. Clearly this is just one small part of the global story of Chagas as the disease costs thousands of lives and imposes a significant economic burden on all affected countries, most notably in Latin America. More research is necessary to better understand the true impact of Chagas in both animals and people and to develop more effective tools to combat this potentially deadly disease worldwide.
–Morgan McCloskey, global health intern
On February 5, the Task Force for Global Health, a non-profit based in Decatur, Georgia announced that it received a $28.8 million, five-year grant from the Gates Foundation for neglected tropical disease research. This funding will support the new Neglected Tropical Diseases Support Center and will allow the center to work with the NTD community to address challenges in implementing NTD control programs. The Center will focus primarily on operational research and will work to develop new solutions to increase the efficiency and cost-effectiveness of NTD interventions. The grant will also support the development of a “Coalition for Operational Research for NTDs,” which will allow for more collaboration between international NTD researchers. Awarded just over a year after the London Declaration on NTDs, this grant is an important step forward in the fight against NTDs as it “will support the research needed to eliminate and control these dreaded diseases.”
-Morgan McCloskey, global health intern
On February 7, The Lancet Infectious Diseases published an enlightening report on the global economic impact of Chagas disease. Chagas, a parasitic disease transmitted through insects called “kissing bugs,” infects nearly 10 million people worldwide, including 300,000 here in the U.S. Some people can carry the disease without knowing they have it, while others can experience debilitating respiratory infections and potentially lethal heart complications. The study examines in detail both the global and domestic economic cost of Chagas disease, which rival better publicized infections such as Lyme disease, and illustrates the urgent need for research for new tools to fight this disease.
-Ian Bradley, Research!America intern
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
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.
In November 2012, the Hudson Institute and the Global Network for Neglected Tropical Diseases released a Social and Economic Impact Review on Neglected Tropical Diseases. The report, which was the culmination of a comprehensive research and policy analysis study, outlined the economic and social impact of seven of the most common NTDs including lymphatic filariasis, onchocerciasis, trachoma, schistosomiasis, hookworm, ascariasis and trichuriasis. These diseases impose a huge economic burden by causing roughly 46-57 million years of healthy life lost due to premature death or years lived with a disability. The report also quantified the economic burden in terms of lost productivity caused by NTDs and highlighted the success of current treatment efforts. For example, trachoma, the world’s leading cause of preventable blindness, causes up to $5.3 billion in lost economic productivity each year while treatment efforts for lymphatic filariasis have saved over $24 billion in lost economic productivity.
The report argues that one of the most promising ways to treat many of these NTDs is mass drug administration (MDA), which involves treating entire populations with drugs for the seven most common NTDs. These MDA programs are also successful examples of critical public private partnerships. The combination of federal government investments in basic R&D and private sector investment in later stage R&D has produced crucial drugs that private sector companies are now donating in order to support mass drug administration programs. These public private sector collaborations, combined with investments in research and development for new tools to control NTDs, remain one of the core recommendations from the report. Research!America will continue to advocate for federal government support for R&D for NTDs and will be working with the private sector to limit the economic devastation and healthy life years lost to these diseases.
-Chris Bennet, Senior Manager of Global Health R&D Advocacy
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
On January 16, Uniting to Combat NTDs released “From Promises to Progress,” the first annual report on the London Declaration on NTDs. The report details the progress made by global partners that signed onto the London Declaration one year ago. Notable successes include leading pharmaceutical companies donating treatments for 100% of drug requests in endemic countries and the development of new NTD control plans in over forty countries. The past year has also seen regulatory approval for two new NTD diagnostics: a new test for lymphatic filariasis and the first rapid test for sleeping sickness developed by the Foundation for Innovative New Diagnostics.
Alongside this report, WHO also launched its second NTD report, “Sustaining the Drive to Overcome the Global Impact of Neglected Tropical Diseases.” The report targets two diseases for global eradication: guinea worm disease by 2015 and yaws by 2020. WHO also reports successes in preventive treatment, noting that 711 million people received treatment for at least one NTD in 2010 and projecting that these treatments will continue to reach more individuals in the future. However, there is still significant work to be done. Diseases like African sleeping sickness and leishmaniasis remain extremely difficult and costly to treat. There has been a 30-fold increase in dengue in the past 50 years and there is the potential for a global dengue epidemic, but we lack the appropriate tools to control and treat the virus. Whether it is scientific research to develop new drugs or operational research to develop the most effective control plans, additional investment in NTD research is crucial. Despite these challenges, Dr. Chan, Director-General of WHO, says that “the prospects for success have never been so strong.” The more we can raise awareness about these diseases that primarily affect the 1.4 billion people under poverty, the more we can do to mobilize resources for the global fight to combat NTDs. We want to make sure we continue turning prospects into actual success.
-Morgan McCloskey, global health intern
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
As we ring in the New Year, 2013 promises to be an exciting time to be involved in the fight to raise support and awareness for neglected tropical diseases. As the world becomes more interconnected and global warming changes disease patterns, NTDs are increasingly spreading across borders – including right here at home. For example, Slate recently published an article addressing the return of dengue in the United States. In the past few years, dengue has sickened hundreds in Florida and other southern states. Experts warn that the combination of the virus, a lack of immunity to dengue and widespread mosquitoes provide the perfect storm of conditions for larger dengue outbreaks in the U.S.
As the spread of NTDs adds urgency to the fight, scientists continue to work every day to develop innovative ideas to combat NTDs. In a trial experiment in Africa, researchers are testing the ability of prawns to combat schistosomiasis. A parasitic disease that can be fatal, schistosomiasis is spread through water snails. Prawns are the primary consumers of snails, so researchers hope that re-introducing prawns to rivers at the African test site will help decrease transmission of the disease. In addition to innovative experiments, every week there are reports of new scientific breakthroughs that will help save lives. Just last week, the FDA approved a drug to fight drug resistant tuberculosis, the first new drug for the disease in over four decades. Developed by Johnson & Johnson, the drug cures patients in less time than older treatment options. It is these kinds of innovations and breakthroughs that demonstrate the power of research investments and the importance of research for global efforts to eliminate neglected diseases. Be sure to check back soon for new NTD highlights!
–Morgan McCloskey, global health intern
The U.N. has suspended vaccine work in Pakistan following the tragic killings of eight health workers during a three-day polio immunization campaign. Other health workers have been injured or threatened during efforts to deliver vaccines to children around the country.
Polio is a highly infectious disease and can cause irreversible paralysis, but there is a vaccine that can prevent the disease. Coordinated efforts from organizations like the World Health Organization, Rotary International and the Gates Foundation have helped reduce the threat of polio through vaccine distribution and stronger surveillance systems. Thanks to these highly successful immunization campaigns, the total number of polio cases per year has fallen by 99% since 1988. Although polio is nearly eradicated, it remains endemic in three countries, including Pakistan. Immunization in these areas is essential not only to protect the health of local individuals, but to prevent re-infection in nearby countries that are currently polio-free.
To read the full story, visit U.N. Halts Vaccine Work in Pakistan After 2 More Killings.
–Morgan McCloskey, global health intern