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GHTC joined civil society in urging G20 policymakers at today’s C20 meeting with the G20 Health Working Group to strengthen R&D to meet urgent health challenges, including achieving universal health coverage (UHC) and combating antimicrobial resistance (AMR) and other health threats.GHTC director Jamie Bay Nishi delivered remarks on advancing R&D for AMR at this face-to-face meeting with G20 officials, and the coalition provided input on broader civil society recommendations.During the meeting, the C20 called for leaders of the world’s largest economies to recognize the central role R&D plays in achieving the G20 health priorities and to take the following actions:Universal health coverageRecognize health and its enablers, including R&D, as a fundamental human right: The right to health guarantees the enjoyment of the highest attainable standard of physical and mental health, which includes the prevention, treatment, and control of disease. Strong and resilient health systems, robust R&D capacity, and equity and gender equality are vital to leaving no one behind.Health preparednessProvide sustainable financing to address urgent R&D gaps: G20 nations should commit new funding to address urgent gaps in the global response to COVID-19 and other emerging threats, including funding R&D for new diagnostics, treatments, vaccines, and other innovations. This should include support for multilateral institutions including the Coalition for Epidemic Preparedness Innovations [CEPI].Embrace access principles as central to these efforts: Any funding for R&D for new tools must attach public interest access principles to ensure that the end product is affordable, accessible, and available for everyone who needs it.Enhance coordination mechanisms for R&D: The creation of an R&D action package with the Global Health Security Agenda could ensure that country health system strengthening efforts include a focus on capacities to develop new drugs, vaccines, diagnostics, and other medical countermeasures.Antimicrobial resistanceDrive collective action on AMR: Successfully diagnosing and treating more people with tuberculosis (TB) will help prevent the development and spread of drug-resistant TB, a key driver of the global threat of AMR. While G20 commitments on paper represent significant progress in the fight against TB, action on these has been fairly limited as of yet. Increase funding for TB R&D: This should align with member state commitments made in the political declaration of the United Nations High Level Meeting on Tuberculosis (UNHLM) to “contribute appropriately” to TB R&D, which is in line with the new World Health Organization TB Research and Innovation Strategy. One way to do this is to benchmark funding against a target, such as 0.1 percent of gross domestic expenditure on R&D to be spent on TB R&D. Tackle market failure for AMR using drug-resistant TB as a pathfinder: The renewed global drive to tackle TB, following the UNHLM, will be incomplete without solving market failure for TB R&D. The G20 can drive this agenda by promoting a collaborative approach to TB R&D that includes push, pull, and pooling incentives, as well as principles of equity, access, affordability, and transparency. G20 countries should also engage with and provide ongoing support to the Global AMR R&D Collaboration Hub.

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. Due to overwhelming demand, Gilead Sciences has paused granting patients access to remdesivir, an experimental drug which up until now has been used under a “compassionate use” policy against COVID-19—the disease caused by the novel coronavirus. In a statement, the company said it is focused on processing previously approved requests and establishing a new system that allows patients to get the drug in a similar time frame to what it would have taken to work through the requests it has already received. The company will make exceptions for pregnant women and children under the age of 18, as well as those with confirmed cases of COVID-19 who are experiencing “severe manifestations” of the disease. Gilead noted that, in recent weeks, there has been an “exponential increase” in requests for compassionate use of remdesivir due to the spread of COVID-19 in the United States and Europe, which has flooded the treatment access system which was never intended for use in response to a pandemic. Remdesivir is currently being studied in five large clinical trials, two of which could yield results in early April. The World Health Organization (WHO) has announced it will launch a multi-arm, multi-country clinical trial, known as the SOLIDARITY trial, for potential coronavirus therapies. The trial will test four drugs or drug combinations already licensed and used for other illnesses as part of a global effort to identify treatments for COVID-19. The four therapies include the antiviral drug remdesivir; a combination of two HIV drugs, lopinavir and ritonavir; lopinavir and ritonavir plus interferon beta; and the antimalarial drug chloroquine—all of which have shown some effectiveness against the novel coronavirus either in vitro and/or animal studies. These therapies will be compared to the standard of care—the regular support hospitals treating patients currently use, such as supplementary oxygen. Ten countries have already indicated they will take part in the trial. WHO launched a similar trial in the Democratic Republic of Congo in November 2018 to test four therapies against Ebola. Phase 2 and 3 clinical trials of Takeda’s tetravalent dengue vaccine candidate showed that it is safe, produces immunity in children, and protects against the disease—regardless of previous exposure to different strains of the virus—according to studies published in The Lancet. In the phase 3 trial, researchers found an overall vaccine effectiveness of 80.2 percent in the first 11 months and 73.3 percent in the first 17 months. Takeda’s dengue vaccine candidate is only the second dengue vaccine to enter clinical trials, following Sanofi Pasteur's Dengvaxia. Sanofi’s vaccine was 56–61 percent effective in preventing dengue in children, but it was tied to severe illness in some individuals vaccinated without having prior exposure to infection. Dengvaxia was approved by the US Food and Drug Administration last May, but with caveats due to potential adverse effects. Takeda is conducting clinical trials in dengue endemic countries before seeking regulatory approval.

GHTC submitted written testimony to the House appropriations subcommittees with jurisdiction over the US Agency for International Development and Department of State and the Department of Health and Human Services and its sub-agencies urging these subcommittees to sustain and protect global health R&D funding in the fiscal year 2021 (FY21) budget.