Research Roundup: What we’re reading this week

Jeff Meer is special advisor for global health policy and development at the Public Health Institute (PHI), a GHTC member. Based in Washington, DC, he provides strategic guidance to the organization on global health advocacy and develops new business proposals for global health projects. On Nov. 3-4, the Coalition Advancing Multipurpose Innovations (CAMI), a project of PHI, convened a symposium in Washington, DC, on “Multipurpose Prevention Technologies (MPTs) for Reproductive Health.” The gathering was attended by more than 100 product developers, researchers, academics, funding organizations, nongovernmental organization leaders, policymakers, and reproductive health practitioners. Participants discussed how best to advance emerging MPT science, with the goal of providing women around the world with safe, effective, low cost, and user-friendly means of protecting themselves simultaneously from HIV, other sexually transmitted and reproductive tract infections, and/or unintended pregnancy. The conference, funded primarily by the US Agency for International Development (USAID)’s Global Health Bureau and held at the Henry J. Kaiser Family Foundation’s Barbara Jordan Conference Center, follows a think tank convened earlier this year under the auspices of the Initiative for Multipurpose Prevention Technologies (IMPT), which is led by Bethany Young Holt of PHI. Other funders for the symposium include the National Institute of Health’s Office of AIDS Research, Gilead, and the Mary Wohlford Foundation. Dr. Young Holt directs CAMI, which serves as secretariat to the IMPT at PHI. Conference held to discuss Multipurpose Prevention Technologies (MPTs) and how they can help improve reproductive health to help women around the world . Photo Credit: Nguyen Ba Quang/PATH There are technologies already available to prevent unintended pregnancy and also block sexually transmitted infections. These include the male and female condom. However, newer MPTs are based on other technologies that may be more useable in some geographic and cultural contexts. These include impregnated vaginal rings, barrier devices, gels, and vaccines. The MPT field is developing a range of options for women, some of which may be more appropriate for different points in the life cycle. There are more than one dozen important MPTs now in development and testing, and some are much closer to commercial introduction than others. Among the topics covered at the symposium were: the state of the scientific field in developing MPTs; pressing issues like the effect of hormonal contraception on acquisition of HIV; the perspective of product developers; and regulatory pathways for MPTs in the United States and abroad. Other topics covered include: lessons learned from introduction of other reproductive health technologies; integrating end-user needs in product development; donor perspectives; public-private partnerships for MPT development; and political leadership on MPTs. Many experts consider MPTs to be a key global health technology area. Technologies such as MPTs that address multiple global health challenges—similar to vaccines that address more than one illness—can be both efficient and cost-effective interventions. And the twin challenges of preventing unintended pregnancy in order to reduce maternal mortality and reducing the transmission of HIV and AIDS are certainly high on the global agenda: they are the subject of United Nations Millennium Development Goals 5 and 6. Also, making inroads in these areas could offer substantial cost savings to governments and consumers alike. For example, in the United States alone, the estimated direct medical cost of unintended pregnancies in 2002 was $5 billion. Direct medical costs associated with treatment and care of sexually-transmitted infections in the United States in 2006 were even higher—approximately $14.6 billion. Despite this encouraging landscape, the MPT field is also fraught with challenges. Collaboration across scientific disciplines is never simple, and the worlds of research on contraception and sexually-transmitted infections do not necessarily regularly intersect. There are also significant regulatory hurdles to the introduction of technologies that deal with multiple health issues, and these can be daunting in trying to introduce even helpful and potentially life-saving technologies on a global scale. And any global health technology must pass the ultimate test of user acceptability. This symposium is meant to ask and answer some of these vexing questions, so that MPTs can be introduced successfully the first and every time. More information about the rationale for MPTs can be reviewed here.

Today, the US Agency for International Development (USAID) celebrates 50 years of leadership and expertise in addressing development challenges to improve lives across the globe. Since it launched, USAID has had a rich history of supporting global health, including research and development (R&D). Some of the major breakthroughs in global health that USAID has supported include: Oral rehydration therapy (ORT). ORT, a treatment for diarrhea, is credited with saving tens of millions of children’s lives. USAID began supporting this effort in the 1960s. In 1979, USAID made the largest donor investment in the establishment of the International Centre for Diarrhoeal Disease Research, where scientists continue to conduct important R&D to improve ORT. Eradicating smallpox. In 1966, USAID joined the global effort to eradicate smallpox, a contagious disease that killed more than 300 million people in the 20th century. In the same decade that USAID began to fight the disease, 10 million to 15 million people contracted the disease a year, and more than 2 million people died from it. Through investing in research that adapted the mechanics of US military jet injectors for application of the smallpox vaccine, USAID played a critical role in achieving global eradication of the disease. Funding research for tools to help women. USAID funded research to develop the Uniject™ injection system, a tool that delivers the drug oxytocin to help reduce excessive bleeding during the third stage of childbirth. More recently, USAID has ramped up efforts to combat HIV by funding research for microbicide gels, a tool that has the potential to help women protect themselves from the virus. Through investing in a groundbreaking trial held at the Centre for the AIDS Programme Research in South Africa (CAPRISA), USAID played a critical role in supporting the first proof-of-concept trial that showed a microbicide can protect women against HIV and herpes. USAID has helped save lives across the world through its strong support for global health R&D Photo: Wendy Stone/PATH USAID’s commitment to global health R&D remains strong today. In fact, USAID is a vital partner to many GHTC members. USAID and the International AIDS Vaccine Initiative (IAVI) have been in a cooperative agreement since 2006 to accelerate the discovery of an AIDS vaccine. USAID also supports the Global Alliance for TB Drug Development (TB Alliance) in its effort to develop better drugs to treat tuberculosis (TB). The agency also contributed significant funding to the Meningitis Vaccine Project (MVP)—a partnership between PATH and the World Health Organization—for its efforts to discover and deliver a new meningitis vaccine. USAID supported a comprehensive analysis of the economic costs of meningitis epidemics, aided efforts to improve meningitis surveillance, and helped to address regulatory issues. With this strong commitment from USAID, the future of global health R&D will undoubtedly hold many breakthroughs that have the potential to save millions of lives worldwide.