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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. Since 2015, scientists from the Fiocruz Institute in Brazil have been infecting mosquitoes with Wolbachia bacteria in a lab and then releasing them into the wild in trial tests in the hopes of slowing the spread of mosquito-borne diseases like dengue. Wolbachia bacteria—common among insects except the Aedes aegypti mosquito, which transmits dengue, Zika, and chikungunya—works by boosting a mosquito's immune system, making it less likely to contract disease. However, if a mosquito does contract dengue, Wolbachia makes it harder for the virus to grow inside the insect and be transmitted to humans. The hope is that the lab-infected mosquitoes will reproduce with wild mosquitoes, spreading the bacteria through the population. Scientists report “significant reductions” in cases of dengue and chikungunya in neighborhoods near where mosquitoes were released. Tests also show more than 90 percent of mosquitoes in areas where the first infected insects were released more than three years ago have the bacteria. Scientists see this technique as one in a suite of tools to control mosquito populations and halt the spread of disease. The Biomedical Advanced Research and Development Authority (BARDA) awarded the Sabin Vaccine Institute (Sabin) an initial US$20.5 million, with options for an additional $107.5 million, to support development of vaccines against Marburg virus and Sudan Ebola virus. With the initial award, Sabin will conduct development and non-clinical activities with the intent of continuing clinical research through phase 2 trials, which may be supported by the additional funding. The Sudan Ebola vaccine candidate is the first of this virus strain to receive BARDA support and the Marburg vaccine candidate is the second to receive BARDA support. BARDA is also supporting the development of vaccines, therapeutics, and diagnostics against the Ebola virus strain causing the current outbreak in the Democratic Republic of the Congo. For the first time, researchers have developed a rapid diagnostic test that uses a biomarker in saliva to detect the mosquito-borne parasite that causes malaria. The test, which will be marketed as SALVA!, is less invasive than traditional malaria diagnostics, which require a blood sample, and can even detect the disease before people carrying the parasite show symptoms or fall ill. Easy-to-administer at the community level, the test also delivers results in five to twenty minutes without samples being sent to a lab. Global Health Innovative Technology Fund has awarded the test’s developers more than £1 million for field trials and continued development. The World Health Organization has called for more new tools to detect malaria, a disease for which there are more than 200 million cases worldwide each year.

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. A study has revealed that an antibody, known as IgM, is far more influential in combating malaria than previously thought—which may have important implications on the development of a malaria vaccine. It was previously thought that IgM played a supporting role in the body’s immune response to malaria, that it would initiate this response and then disappear when the primary antibody, IgG, took over. However, this new research shows IgM acting as a co-lead with IgG to block and clear malaria infection in the blood. As a next step, scientists are seeking to understand why the immune system generates both antibodies in response to malaria infection and determine whether vaccines that stimulate an immune system to produce IgM antibodies give better protection against malaria. Researchers hope this new insight brings them one step closer to developing a highly effective vaccine against malaria. The Biomedical Advanced Research and Development Authority (BARDA) announced that it will provide US$14 million and organizational expertise to support the continued development of the investigational Ebola treatment known as mAb114. BARDA will assist Ridgeback Biotherapeutics of Miami, the company manufacturing mAb114, with its application for licensure with the US Food and Drug Administration (FDA). mAb114, a monoclonal antibody that works by binding to virus proteins, thus reducing their ability to infect human cells, is currently being used in the Democratic Republic of the Congo to help combat the ongoing Ebola outbreak as part of a clinical trial. mAb114 has already obtained an FDA Breakthrough Therapy Designation, which allows participating companies to work more closely with FDA officials in pushing for approval. Last week, at the United Nations (UN) General Assembly High-Level Meeting on Universal Health Coverage (UHC), member states reached a comprehensive agreement which commits countries to advance UHC for their citizenry. UN Secretary-General António Guterres called the political declaration “the most comprehensive agreement ever reached on global health” and a “significant achievement” that will drive progress over the next decade on tackling diseases like HIV and AIDS, tuberculosis, and malaria, along with the growing burden of non-communicable diseases and antimicrobial resistance through primary health care systems. In adopting the declaration, member states have committed to investing in policies that expand access to health care while preventing financial hardship and developing and implementing high-impact health interventions to combat diseases and protect women’s and children’s health.

On Monday, the United Nations (UN) members unanimously adopted a high-level political declaration on universal health coverage (UHC), which World Health Organization (WHO) Director-General Dr. Tedros Adhanom Ghebreyesus called a “landmark for global health and development.” While the adoption of the declaration is welcome news, in many ways it represents a starting point for the next phase of UHC, in which the thornier issues of financing, follow through, and accountability will rise to the forefront. UHC declaration adopted unanimously at United Nations High-Level Meeting It was a bit of a bumpy journey to Monday’s political declaration. After months of tense negotiations among member states, the UHC debate had stalled over two hot-button issues—sexual and reproductive health and the rights of migrants and refugees—which weren’t resolved until a few days before the High-Level Meeting. Thankfully, countries were able to push the UHC declaration across the finish line, with a several countries, including the United States, disassociating themselves from the provisions linked to those thornier issues. It was encouraging to see that the final declaration was inclusive of GHTC-supported language on research and development (R&D), focused in particular on innovative financing for new products and technologies, emphasizing the role of the private sector and new models for sustainable investment.  “This declaration represents a landmark for global health and development,” Dr Tedros Adhanom Ghebreyesus The UHC process now moves into a new phase: countries are tasked with developing their own strategies or national action plans to fulfill these commitments and advance UHC within their own borders. The agreement is intended to be country-led, and as member states adopt the commitments to their own geographic contexts, they must outline a clear path for how they will mobilize their governments and increase investment in UHC.  Assessing gaps in the tools to mitigate each countries’ priority health challenges also needs to be considered as part of this new phase.  It’s all about the money Now that countries have committed to UHC, how will they pay for it? That question seemed to be on everyone’s mind as numerous events throughout the week of the UN General Assembly focused on the financing side of UHC. The message was clear: not enough is being done, particularly on domestic resource mobilization. Most countries don’t have a UHC investment strategy to achieve the lofty goals set forth in the UHC declaration and the Sustainable Development Goals. As countries start to develop their health investment plans, it is crucial that investment in R&D remain an integral pillar. UHC cannot be achieved without stepping up the fight against the world’s endemic and emerging infectious diseases. This will require new tools and technologies, as was echoed by stakeholders throughout the week, including Global Fund Executive Director Peter Sands and Dr. Tedros. We also need to invest more in the uptake and scaling of innovations and technologies and ensure that we are thinking of end-to-end solutions.  "Existing tools won't be enough"@PeterASands highlights that innovation hasn't been fast enough. We need to push more aggressively to scale up innovation and integration of new tools. @GlobalFund #TBinnovation #HealthForAll pic.twitter.com/7tSluSlIL5— GHTC (@GHTCoalition) September 22, 2019 There were several side events this week on financing reforms, tax redistribution into UHC—from the tobacco industry, for example—and the need for innovative financing approaches. Outcomes-based finance such as social impact bonds and blended finance models, in particular, attracted some attention. All countries did commit to spending one percent or more of their GDP on public health as part of the declaration. That is likely insufficient to achieve UHC, but money isn’t the only factor for success. Some countries, such as the United States, already spend more on health care but still lack access to coverage for all citizens.  Accountability emerges as central focus after the political declaration Now the real work begins. Many speakers this week devoted time to discussing the challenge of accountability and follow through, drawing on past experiences from other high-level meetings.  Stakeholders recognized that the declaration is just a starting framework and that the lofty language needs to be translated into tangible actions and investment. While this declaration symbolizes a major shift for the global health agenda, fears persist that the momentum will dissipate and that countries won’t be able to follow through on their commitments by 2030—just over a decade from now.  Those fears are warranted. Just last week, WHO published a report stating that while advances have been made on UHC, as many as five billion people will be left without full access to healthcare in 2030 at the current rate of progress. Countries must set clear targets for moving their populations on the journey towards UHC and create specific metrics through which progress can be monitored. Mechanisms and incentive structures must be put in place to allow for follow-up and accountability, underscoring the political will expressed in New York this week. In adopting the declaration, member states have committed to investing in policies which would allow everyone, everywhere to have access to quality health care products and services without financial hardship. Leaders must now pivot to move from commitment to concrete action.

GHTC co-sponsored a congressional briefing on Tuesday organized by the American Society for Tropical Medicine and Hygiene (ASTMH) in conjunction with the Senate Malaria and Neglected Tropical Diseases Caucus to highlight the essential role of the US Department of Defense (DoD) in the fight against malaria. Most Americans think of malaria as a disease that only threatens people in far-off nations. But with American military personnel deployed in countries all around the globe, malaria remains an ongoing threat to the health of our servicemembers and, by extension, our military readiness.  In fact, the battle against this parasite has been a persistent feature of US military history. Malaria has affected almost every US military deployment since the American Civil War and has caused more lost person-days than bullets during all military campaigns fought in malaria-endemic regions in the twentieth century. During World War II, General Douglas MacArthur famously complained to Dr. Paul Russell, then the Army's top malaria expert, “Doctor, it's going to be a very long war if for every division I have facing the enemy, I have one sick in hospital and another recovering from this dreadful disease.”  Since World War II, DoD has been a world leader in the research and development (R&D) of new tools to prevent, diagnose, and treat malaria. While these efforts have always been focused foremost on protecting the health and readiness of US servicemembers, they have also benefitted communities around the world.”  For instance, earlier this year, pilot introductions of the world’s first malaria vaccine, RTS,S—which was developed with research support from DoD’s Walter Reed Army Institute of Research (WRAIR)—were launched in three sub-Saharan African countries. WRAIR remains a leader in malaria vaccine research, in partnership with the Naval Medical Research Center (NMRC), which is co-located on the same research campus and brings unique research capabilities. Amazingly, WRAIR and NMRC have also contributed to the development of every single malaria prevention drug approved by the US Food and Drug Administration, including all five available today. In 2018, a new single-dose treatment was approved for a strain of malaria that sickens around 8 million people annually—including US servicemembers. This treatment stems from research conducted at DoD and military research centers, research that has also led to the use of this compound as a drug for malaria prevention.  These are just a few of the most recent examples that demonstrate the invaluable impact that DoD research has had on the global fight against malaria. The briefing, held in the Russell Senate Office Building with congressional staff and members of the malaria research and advocacy community in attendance, was a special opportunity to hear from some of the top malaria experts in the US military, including Colonel Deydre Teyhen, commander of WRAIR; Lieutenant Colonel Mara Kreishman-Deitrick, director of Experimental Therapeutics at the WRAIR Center for Infectious Disease Research; Colonel Viseth Nguay, director of the WRAIR Malaria Vaccine Branch; Colonel Philip Smith, director of the WRAIR Center for Enabling Capabilities; and Captain Eileen Villasante, head of the Malaria Department at NMRC.  In her opening remarks, Colonel Teyhen highlighted that, whereas most Americans might think a shark is the most dangerous animal they could encounter, mosquitoes pose a far greater threat. She emphasized that DoD’s investments in malaria R&D are critical as both military strategy and the malaria parasite evolve. .⁦@wrair⁩ COL Teyhen: forget sharks, mosquitoes are what we should really be afraid of! @astmh #mosquitowranglers pic.twitter.com/AlZBM40EjC— Karen A Goraleski (@goraleskik) September 24, 2019 According to COL Teyhen, commander @WRAIR, as military teams get smaller and more specialized, the health of each team member is vital—this is why enduring biologic solutions against threats like #malaria are critical, and “we’re not there yet.” pic.twitter.com/JeVeLGJhjn— GHTC (@GHTCoalition) September 24, 2019 @WRAIR and @NavalMedicalRC have led the research charge against #malaria 🦟 with astounding progress. But with malaria always evolving, investment in new #globalhealth technologies are always needed. @ASTMH pic.twitter.com/nkTfsj0MBz— GHTC (@GHTCoalition) September 24, 2019 Senator Chris Coons (D-DE) stopped by after Colonel Teyhen spoke to share his deep personal commitment to the fight against malaria and commend DoD for its important work. He also received a fashionable malaria-themed tie.  So pleased to have ⁦@ChrisCoonsforDE⁩ at @astmh senate briefing in DoD work in malaria. TY Sen Coons and ⁦@SenatorWicker⁩ for your deep and personal commitment to end the scourge of malaria and NTDs. #malariadelendaest pic.twitter.com/wsffksQxpS— Karen A Goraleski (@goraleskik) September 24, 2019 What was once unthinkable is now a common goal that we are working together to achieve. I plan to continue to fight every step of the way as we seek to achieve Alan Magill’s bold vision of a world without malaria.— Senator Chris Coons (@ChrisCoons) September 24, 2019 "There is very little that would make a more lasting impact than eradicating malaria." @ChrisCoons at @ASTMH briefing on work of @DeptofDefense in the fight against #malaria. Thank you, @WRAIR, & @DTeyhen for your leadership in protecting our service members deployed globally. pic.twitter.com/xgGGzJnf5K— Nothing But Nets (@nothingbutnets) September 24, 2019 .@astmh Pres-elect Joel Breman takes off his malaria tie and gifts it to ⁦@ChrisCoons⁩. Fashion meets science meets a Senator. pic.twitter.com/ETx713JK74— Karen A Goraleski (@goraleskik) September 24, 2019 After Senator Coons’ remarks, the panel continued with an overview of DoD’s prolific contributions to malaria R&D, sharing more fascinating facts and insights.  Did you know investments by @WRAIR in #malaria #research has generated over 3,000 biomedical publications, making it one of the top four US contributors to #malaria #research — @ASTMH briefing— GHTC (@GHTCoalition) September 24, 2019 According to Dr. Eileen Villasante, head of malaria research @NavalMedicalRC, the #malaria parasite is not only outsmarting 💊 but also diagnostics. More 🔬 is needed — @ASTMH briefing— GHTC (@GHTCoalition) September 24, 2019 The briefing was an excellent opportunity for congressional staff, researchers, and advocates to gather, learn, and discuss DoD’s historic role in malaria R&D and the opportunities for continued US leadership in this area of vital importance for our troops and communities around the world.