Breakthroughs Blog: Diarrhea

To celebrate Valentine’s Day, GHTC staff embraced our health policy wonkiness by participating in the time-honored beltway tradition: #HealthPolicyValentines.For those who are unfamiliar, this tradition started in 2012 when a former staffer and Twitter aficionado at the US Department of Health and Human Services, Emma Sandoe, became inspired to “tweet one ‘health policy valentine’ every day until Valentine’s Day.” Other health policy experts soon joined in with their own poems and puns related to health care, and an annual tradition was born.Now every February, health policy wonks tweet out their most creative #HealthPolicyValentines. This year, GHTC staff joined in on the fun to share our passion for global health research and development (R&D). Here are our favorites: Please be my valentine 💕Be “mon amour” 💑To defeat diseases like #AIDS, #TB & #malaria 🦠We need R&D for #vaccines, #diagnostics & cures. 💉 🔬 💊#HealthPolicyValentines #innovate4health @GHTCoalition— Jamie Bay Nishi (@JBayNishi) February 13, 2020 I love your guts ❤️Yet diarrheal diseases impact many worldwide 🌍Thankfully, with ORS, Zinc & #vaccines 💉 💊We’re helping more children survive. 🧒🏽 🧒🏼 🧒🏿#HealthPolicyValentines— Marissa Chmiola (@MarissaChmiola) February 13, 2020 Roses are red 🌹Violets are blue 💙With a universal vaccine 💉 We can take on the #flu 🦠#HealthPolicyValentine— Julien Rashid (@Julien_Rashid) February 13, 2020 Hey girl. My love for you is like biomedical research 🔬: complex, lengthy, & life-altering. #HealthPolicyValentines— Ansley Kahn (@ansleykahn) February 13, 2020 Roses are red 🌹Please be my honey 💑If we proactively develop vaccines to #outsmartepidemics 💉We’ll save lives & money 👩‍👩‍👧‍👧💰#HealthPolicyValentines— Philip Kenol (@Phil_kenol88) February 13, 2020 Getting in the #Valentines spirit a day early...Hey girl. Someone should alert @CDCgov because what you're doing to my heart is a health emergency. #HealthPolicyValentines pic.twitter.com/R8udCacb4d— Emily Conron (@thatNTDgirl) February 13, 2020 Hey girl, my love for you is like antimicrobial resistance.🦠🧫 Constantly evolving and growing every day (because we lack the right tools to stem its rise.)#HealthPolicyValentines #globalhealth #AMR pic.twitter.com/jstQXWIzFk— Marissa Chmiola (@MarissaChmiola) February 14, 2020 I’ve been bitten by your love 🥰You make my temperature rise 🌡️Is it #malaria or #dengue fever? 🦟We need diagnostic tests to surmise. ⁉️#HealthPolicyValentines— Ansley Kahn (@ansleykahn) February 14, 2020 Find yourself someone as committed to you as @NIAIDNews Director Tony Fauci is to infectious disease & #globalhealth R&D 😍🔬 His 36 years of leadership have earned him a spot in the Hall of Fame of my heart 💕 #HealthPolicyValentines pic.twitter.com/4ONP15XhNS— Emily Conron (@thatNTDgirl) February 14, 2020 I love you. You love me.Thanks to new technologies, we are reducing child mortality. #HealthPolicyValentines #Innovate4health pic.twitter.com/BRcv7G3Wh0— Jamie Bay Nishi (@JBayNishi) February 14, 2020 Roses are red 🌹Violets are blue 💙We can’t achieve #HealthForAll 🌍⚕️👩‍👩‍👧‍👦Without investing in R&D too! 🔬#HealthPolicyValentines pic.twitter.com/araErSTv2N— Philip Kenol (@Phil_kenol88) February 14, 2020 Feeling passionate about sexual & reproductive health (#SHRH) with my #HealthPolicyValentines:A woman deserves love 💕 She deserves gratification 🥰But she also deserves a healthy & bright future 👩‍🔬👩‍🎓‍Which is why we need more contraceptive innovation. 🤰🏽— Marissa Chmiola (@MarissaChmiola) February 14, 2020 Find someone that loves you the way @DrTedros loves #UHC.#HealthPolicyValentines pic.twitter.com/AFNBvOc42r— Julien Rashid (@Julien_Rashid) February 14, 2020

Faces of Innovation—a new GHTC project that features scientists on the front lines of research and development on new global health tools and technologies—profiles Dr. Rohit Ramchandani, who we met at the American Society of Tropical Medicine and Hygiene Annual Conferenc. Dr. Ramchandani does research to innovate global treatment options for childhood diarrhea at the Johns Hopkins School of Public Health in Baltimore, Maryland and the University of Waterloo. My name: Rohit Ramchandani, DrPHWhere I work: Johns Hopkins School of Public Health in Baltimore, Maryland and the University of WaterlooI’m funded by: US Agency for International DevelopmentMy research: My research focuses on diarrhea in children…the second-leading cause of death in children under five globally…These are close to 500,000 deaths that are happening every year, most of which are preventable, and treatable. They’re treatable with medicines, oral rehydration salts [ORS] and zinc. That’s the globally recommended treatment for diarrhea. But the problem is, in many low- and middle-income countries, access to these medicines is not where it should be, particularly in rural communities. So we looked at that issue of access. We did it by leveraging human-centered design approach. And we really focused on the details and the challenges that mothers face treating their children with diarrhea…Our research showed that 40% of the time, mothers are preparing ORS in the wrong concentration: either too diluted, or too concentrated. That can lead to hypernatremia, that can make the diarrhea even worse, or the efficacy gets reduced if it’s too diluted. So we actually worked with a local pharmaceutical company in Zambia to shrink down then size of the ORS sachets—the standard all over the world is a one-liter sachet—we shrunk those down to make 200-mililiter sachets, and then we made the packaging double as a measurement vessel for the right amount of water…One of our key funders during our scale-up phase was USAID—their Discover Health Program. They played a fundamental role in some of the social marketing we were doing as we were scaling up the development of our diarrhea treatment kit.Motivation: There’s just a fundamental issue of justice in the world…We often think of innovation being new product development, high technology, but things like ORS and zinc—innovation can happen really in the delivery side of things. And that’s really where our innovation focused.Why federal support is critical: I think this is low-hanging fruit. Diarrhea, as one of the leading causes of death in the world for children—we have the solutions, we know what to do, and these kinds of innovations can really make a huge difference in saving lives.…[And] there’s a health security argument [to do this work]. The world is getting smaller and smaller every day. We are inextricably linked to one another. When I’m not in the lab: I’m a dad! I’m a dad of two amazing young girls. They inspire me every day. It makes my work in child health that much more meaningful—the inspiration I get from them. I want all parents to have that.

Faces of Innovation—a new GHTC project that features scientists on the front lines of research and development on new global health tools and technologies—profiles Dr. Mohammad Nuhu Amin, who we met at the American Society of Tropical Medicine and Hygiene Annual Conference. Dr. Amin researches sanitation and diarrheal diseases with support from the United States Agency for International Development.My name: Nuhu Amin BDS, MPH, HSCWhere I work: International Centre for Diarrhoeal Disease Research in Bangladesh (icddr,b) I’m funded by: US Agency for International Development My research: My primary goal is to do interventions to reduce diarrhea and cholera in low- and middle-income countries, particularly in the urban communities of Dhaka. I’ve worked at icddr,b for the last ten years, and I’ve had the opportunity to work with lots of US universities. Currently I’m working with Stanford University with Professor of Medicine Dr. Stephen Luby on a Rohingya distribution impact assessment. I’m also working on another project with Emory University on a fecal pathogen exposure assessment. And our team is doing a different project with Emory University in collaboration with the University of Sydney to track the sanitation chain to detect pathogens, like norovirus, salmonella, shigella, and cholera, that cause diarrhea. We have previously also collaborated with Johns Hopkins University and we have lots of colleagues who work with Oregon University and other state universities in the United States.Motivation: I am a medical graduate, and I’ve had lots of patients with different problems including diarrhea and other infectious diseases. Bangladesh is a tropical country, so infectious disease rates are really high. This motivates me to not only focus on treatment, but to do the research to remove and prevent these diseases.Why US federal support is critical: USAID is one of our four core donors. They have been funding us for more than 50 years to support the research of our institute. I think the contribution of the US government is important for this research and development. When I’m not in the lab: I’m also a dental surgeon, so I have a clinic. Every day, for two or three hours, I treat patients and particularly patients who are poor. Dental health treatment is expensive, so I aim to serve my patients at a low-price. I have two kids as well, so I spend my time with them—they’re very inspiring for me. In addition, I love to travel to different countries. This year I traveled to almost four countries including Swaziland, South Africa, and India. I love to meet with other people around the world—that’s my hobby. 

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. Rotasiil, a first-of-its-kind thermostable vaccine to prevent rotavirus—the most common cause of severe diarrheal disease in children worldwide—has achieved prequalification from the World Health Organization. This status will allow United Nations agencies and other organizations to procure the vaccine at low-cost for use in low- and middle- income countries. Developed by the Serum Institute of India with clinical trial and licensure support from PATH, Rotasiil is an oral vaccine administered to infants in a three-dose course, which does not require refrigeration—making it easily distributable in places where power shortages and failures can disrupt the cold chain necessary to keep traditional vaccines viable. Rotasiil is the fourth rotavirus vaccine on the market, and the second developed by an Indian organization. Japanese company Kansai Plascon has launched the world’s first mosquito repellent paint in Zambia. The paint technology, which has shown to be safe in humans, disrupts the nervous system of a mosquito upon contact, reducing its ability to remain on walls where the paint has been applied. “The knock-down effect lasts for up to two years, offering lasting protection from malaria infection and other mosquito-borne diseases,” Kansai said. Mosquito repellent paint offers a new tool in the arsenal to fight malaria—one of the world’s deadliest diseases—alongside other anti-malarial measures such as bednets, prophylactics, and insecticide spraying. The Office of the Assistant Secretary for Preparedness and Response (ASPR) and the Defense Advanced Research Projects Agency (DARPA) has launched a new partnership to strengthen the health security of the United States by focusing on the research, development, and deployment of medical countermeasures and advanced technologies to combat these threats. ASPR and DARPA will focus on two initial areas of collaboration—bacterial pathogens to combat microbial threats and the discovery of molecular biomarkers. ASPR’s Biomedical Advanced Research and Development Authority (BARDA) and DARPA will conduct preclinical and clinical trials of a new type of therapeutic for antibiotic resistant bacteria with an aim to develop a product that mitigates the effects of multidrug-resistant infections. BARDA and DARPA will also focus on discovering and validating biomarkers—which define a person’s exposure to a virus before the person shows symptoms of infection—and developing tests that can identify infected patients quickly to help contain disease outbreaks. Through the partnership, ASPR and DARPA will increase collaboration and share data—maximizing the impact and investment of both agencies.