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In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. The release of antibiotics into the environment is a significant environmental threat, according to a new United Nations Environment Programme report. The presence of antibiotics have been found in soil deposits, lake and river sediment, and wastewater facilities around the world, suggesting industrial, human, and pharmaceutical disposal leads to traceable amounts of antibiotic compounds in the environment. This issue alarms experts because even minimal traces of antibiotics may lead to the continued evolution of antimicrobial resistant bacteria. While more research is needed on the consequences of antibiotics in the environment, experts suggest various strategies to help mitigate the problem including deploying improved methods to treat wastewater, treating animal waste before using it as fertilizer, and improving antimicrobial stewardship. An Army-developed Zika vaccine candidate (ZPIV) performed well across three Phase 1 clinical trials, according to new findings published in The Lancet. The three studies were designed to elicit information on background immunity, vaccine dosage, and vaccine schedule in adult populations. A total of 67 participants received two injections four weeks apart, and researchers found more than 90 percent of participants who received the ZPIV vaccine had an immune response to the virus. The Army developed the vaccine candidate in response to the 2015 outbreak, noting the need for a Zika vaccine not only to advance global health, but also to protect US service members and their families. Countries are restricting use of the world’s only dengue vaccine—Dengvaxia— following an announcement by developer Sanofi Pasteur raising safety concerns. The company discovered, from data analysis, that the vaccine could raise the risk of a deadly form of dengue for people who had not been exposed to the virus prior to vaccination. In response, the Philippines ceased an ongoing, mass immunization campaign, and Brazil tightened restrictions on the vaccine. While Sanofi stressed there were no reported deaths related to the dengue vaccine, they believe more severe cases of dengue may occur if an immunized individual, who was not previously infected before receiving the vaccine, is then subsequently infected with dengue. This rare complication leaves children at a higher risk of contracting the severe form of dengue, as they are less likely to have been exposed to infection before receiving the vaccine. Dengue sickens hundreds of millions of people and kills more than 20,000 every year, underscoring the need for a safe, effective, vaccine.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week A tech nonprofit, WeRobotics, is seeking to deploy drones to deliver hundreds of thousands of sterile mosquitoes into Zika hotspots across Latin America to assist with mosquito population control. Existing research suggests releasing sterile mosquitoes into the wild may eventually reduce populations by as much as 90 percent, though actual mosquito introduction has proven challenging. To solve this, WeRobotics developed small, temperature-controlled drones designed to deploy mosquitoes in rural and hard-to-reach locations, ensuring all affected areas receive the sterile mosquitoes. The drone’s cool temperature leaves the mosquitoes in a deep sleep state, protecting them during the journey, and the drone then releases the mosquitoes from a controlled height to ensure they do not die from impact. WeRobotics plans to deploy these drones soon and will educate local communities about the project. The World Health Organization (WHO) recently announced that about 11 percent of all medicines circulating in low- and middle- income countries are substandard or counterfeit. WHO estimates between 72,000—169,000 children may die from pneumonia and 116,000 may die from malaria every year after receiving falsified or substandard products, suggesting this is a widespread and alarming problem in the world’s poorest countries. Experts believe majority of these cases remain unreported, compounding existing issues with counterfeit or substandard medicine monitoring across affected countries. This is the first time WHO has assessed in-depth the global scope of the problem. In 2013, the agency set up a voluntary global monitoring system for substandard and fake drugs, which has helped bring to light the extent of the issue. An estimated 50 million doses of antibiotics are prescribed for typhoid every year, with overuse or misuse of these drugs contributing to the global rise of antibiotic-resistant bacteria. In the city of Karachi, Pakistan—a typhoid-endemic country—antibiotic resistance is rising by 30 percent per year, and 100 percent of typhoid cases are expected to be multi-drug resistant by 2020. A new typhoid vaccine may be the solution to this growing problem. The typhoid conjugate vaccine (TCV) is more effective in preventing typhoid than its predecessor and may protect individuals for up to five years—longer than the previous vaccine. Most importantly, TCV may be given to children under the age of two, expanding the level of coverage to infants who are in critical need of a vaccine. With rising levels of antibiotic-resistant bacteria, having an effective and inclusive typhoid vaccine may save thousands of lives.

Esteemed leaders from across the US government, industry, and the global health and medical research communities gathered at the Newseum in Washington, DC yesterday for GHTC’s Innovating for Impact Awards to celebrate US commitment to global health research and development (R&D) and honor Senator Chris Coons (D-DE) and Congressman Tom Cole (R-OK) for their congressional leadership on this issue. GHTC also recognized the partnership that developed the dapivirine microbicide ring—a woman-centered HIV prevention tool—for its efforts to advance this groundbreaking new technology. GHTC honored Congressman Cole with a Congressional Champion Award, recognizing his leadership— as Chairman of the House, Labor, Health and Human Services Appropriations Subcommittee—in championing key US agencies engaged in global health R&D, including the National Institutes of Health (NIH) and Centers for Diseases Control and Prevention (CDC). In his acceptance remarks, Congressman Cole emphasized the importance of US leadership in this field: “We have capacities and capabilities that quite honestly no one else in the world has….Others will help, others want to help, but they have to have us in this area to lead because we have the resources, the talent, and the technological expertise.” He noted the value of global health research from both a practical and humanitarian perspective. “You represent a cause that fundamentally is absolutely the right thing for this country to be doing…but it’s also the smart thing to do….Disease is an awfully expensive thing, and I see the payback for this,” he said. View video honoring Congressman Tom Cole.  GHTC also honored Senator Coons with a Congressional Champion Award for his longstanding commitment to US global health initiatives and championing the role of R&D and innovation in furthering their impact. “Whether it’s eradicating malaria, whether it’s sustaining our progress against HIV/AIDS…whether it’s making real progress in understanding the core causes of disease here and then exporting that, I’m convinced that investments in R&D will be returned and repaid many, many times over,” Senator Coons emphasized in accepting his award. He stressed that “by investing proactively in R&D…we will continue to push back on disease and advance the boundaries of human kindness, of human health, and of human prosperity.” View video honoring Senator Chris Coons. Dr. Zeda Rosenberg, founder and chief executive officer of the International Partnership for Microbicides (IPM), accepted the Partnership Award on behalf of the many industry, government, and nonprofit partners who supported the development of the dapivirine microbicide ring—a monthly vaginal microbicide ring that delivers antiretroviral drugs. As the first long-acting HIV prevention product designed specifically for women, the dapivirine ring is poised to be the next breakthrough tool in the fight against HIV/AIDS. “It was a partnership from start to finish,” Dr. Rosenberg said in discussing how these various organizations came together to develop a tool to serve the needs of women at high risk of HIV/AIDS. Dr. Rosenberg emphasized the value of these multisector partnerships in bringing critically needed health technologies to market. “The HIV/AIDS epidemic is such a challenge that the only way we will be able to control this epidemic long-term is through partnership,” she underscored. View video honoring the dapivirine microbicide ring. Dr. Rosenberg was joined onstage by David Stanton, Acting Deputy Assistant Administrator of the Bureau for Global Health at USAID, and Jami Taylor, Senior Director of Global Public Health Systems Policy and Partnerships at Johnson & Johnson, for a short dialogue discussing the role of the US government, Johnson & Johnson, IPM, and other partners in advancing development of the dapivirine ring. Attendees also heard from Jamie Bay Nishi, director of GHTC, and Senator Patty Murray (D-WA), who welcomed attendees to the event via video. Dr. Tom Friedan, former Director of the CDC and current President and CEO of Resolve to Save Lives, also spoke about the power of multisector partnerships in advancing R&D and what actions are needed to tackle emerging global health threats. Among the distinguished guests in attendance were: Dr. Rima Khabbaz, Director of the Center for Emerging and Zoonotic Infectious Diseases at CDC; Dr. Rebecca Martin, Director for the Center for Global Health at CDC; Dr. Roger Glass, Director of the NIH Fogarty International Center; Dr. Carl Dieffenbach, Director of the Division of AIDS at the National Institutes of Allergy and Infectious Diseases at NIH; Mary Fogarty McAndrew, daughter of John E. Fogarty for whom the Fogarty International Center is named; David Milestone, Acting Director of the Center for Accelerating Innovation and Impact (CII) at USAID; and numerous other nonprofit, private sector, and government leaders. The Innovating for Impact Awards were created by GHTC to mark both the organization’s 10th anniversary and honor the multisector partnerships and policymakers helping transform breakthrough scientific research into lifesaving drugs, diagnostics, vaccines, and other health tools for unmet global health challenges. This year’s award selection committee included Holly Wong [chair], Vice President of the Global Health Advocacy Incubator and former Principal Deputy Assistant Secretary for Global Affairs at the US Department of Health and Human Services; Carolyn Reynolds, Vice President of Policy and Advocacy at PATH; Wendy Taylor, former Director of CII; Gavin Yamey, Director of the Center for Policy Impact in Global Health at Duke University; and GHTC Director Jamie Bay Nishi.