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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.   In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. Researchers discovered a way to reprogram immune cells to attack tuberculosis (TB), potentially paving the way for new methods to combat the disease. Traditionally, TB vaccine research has focused on activating T cells, which has yielded overall mediocre results. In this case, researchers turned their attention to stem cells. They found that when they administered the current TB vaccine BCG to mice in a way that accessed the mice’s bone marrow, it was able to reprogram their stem cells to mobilize white blood cells capable of swallowing and killing TB-causing bacteria. Researchers were then able use this finding to dissect the genomic pathways involved in triggering this enhanced immune response. Though further research is needed on the potential of stem cells, researchers are hopeful this new method could lead to a more effective vaccine against the disease. A group of 180 scientists, malaria program leaders, and global policymakers recently updated the Malaria Eradication Research Agenda (malERA) Refresh Collection, a research and development agenda that aims to accelerate progress toward total malaria elimination and eradication. Launched in 2011, the original agenda aimed to identify key knowledge gaps and define tools needed to combat malaria. The updated version addresses progress made and identifies the main challenges remaining across the areas of basic science and enabling technologies; combination interventions and modeling; diagnostics, drugs, vaccines, and vector control; insecticide and drug resistance; characterizing the reservoir and measuring transmission; and health systems and policy research. The developers of the collection hope it will provide a framework for malaria-focused research funders, the World Health Organization, and impacted nations as they make programmatic decisions for malaria elimination and eradication. Scientists at the Yerkes National Primate Research Center believe the genomic sequence of the sooty mangabey monkey may provide useful knowledge in the fight against HIV and AIDS. Sooty mangabeys are natural hosts for the Simonian immunodeficiency virus (SIV)—a genetic relative of the HIV infection—yet the animals are able to maintain healthy levels of immune cells after infection, preventing any future progression to an AIDS-like disease. After sequencing the genome of the sooty mangabey and comparing it to the genomes of humans and other apes, scientists found two major differences in immune system proteins in the genome of the sooty mangabey, which may help scientists better understand why sooty mangabeys avoid AIDS-like illness despite SIV infection. Scientists hope that further research on these genomic differences will pave the way for improved long-term care of HIV-positive individuals, including pregnant women, and unlock new avenues for vaccine research.

  2018 is shaping up to be another important year for US policy related to global health and medical research. As Congress returns for a busy work session and the White House continues to roll out policy reforms, here are the top five issues GHTC will be following in 2018: 1. US funding for global health R&D President Trump’s fiscal year 2018 (FY18) budget proposal called for dramatic cuts to global health, medical research, and public health accounts across the National Institutes of Health, US Centers for Disease Control and Prevention, US Agency for International Development (USAID), and the Department of State. While legislators pushed back sharply on these proposed cuts, Congress has not yet passed final FY18 spending bills. This means that we still do not have a final picture of what US government funding for global health and medical research will look like for this year. As Congress tries to navigate budget caps and other pressures that may constrain overall government spending, GHTC will continue to advocate for strong, stable public funding for critical global health and medical research programs. We’re also looking ahead to the fiscal year 2019 (FY19) budget and appropriations process, and bracing for a proposal from President Trump that may include even more significant spending cuts than those proposed in FY18. Despite verbal acknowledgement from the Trump Administration that US global health and medical research programs remain critically important, as the Administration continues plans to streamline government activities and reign-in spending, we do not expect to see prioritization of these issues reflected in Administration-driven spending proposals. GHTC will closely monitor FY19 proposals in the coming months and continue to engage with Congress, who ultimately sets government spending levels. 2. USAID and State Department reorganization As part of the Trump Administration’s plans to streamline and reshape the federal government, it has announced plans to reorganize the State Department and USAID. USAID plays an important role in global health research and development (R&D), supporting late-stage clinical research and implementation research as well as operating Grand Challenges to identify and advance promising health innovations from around the world. USAID and the State Department submitted reorganization plans to the White House Office of Management and Budget on September 15, 2017, but details of those plans have not yet been made public and further information remains scarce. GHTC will continue to monitor evolving plans and policy and strongly advocate for continued leadership of USAID in global health innovation. 3. BARDA reauthorization The Pandemic and All-Hazards Preparedness Act (PAHPA), which authorizes the Biomedical Advanced Research and Development Authority (BARDA), is due for reauthorization this year by Congress. In recent years, BARDA has played an increasingly important role in the advanced development of medical countermeasures for emerging infectious diseases, like Ebola and Zika, and antimicrobial resistance. Reauthorization presents a potential opportunity to bolster BARDA’s role in the global health R&D space. GHTC will monitor the PAHPA reauthorization process and work with Congress to support a strengthened role for BARDA in the emerging infectious disease space. 4. Global health security GHTC is also watching US efforts to promote global health security, including continued support for the Global Health Security Agenda (GHSA)—an international partnership launched in 2014 to help countries strengthen their ability to respond to health threats. The United States is now funding GHSA through the one-time emergency Ebola supplemental funding, which expires in FY19, so future financing for the program remains uncertain. Without renewed commitment and financial support for global health security activities, the United States will have to pull back critical disease detection, prevention, and response operations around the world. GHTC will also work to include R&D in global health security policy decision-making. During the two most recent global disease epidemics, Ebola and Zika, a lack of proactive, sustainable funding for R&D meant that United States and the world did not have the drugs, diagnostics, and other tools needed to contain these diseases. Despite this, GHSA in its current form lacks any prioritization or commitment to R&D to detect, prevent, and respond to global epidemics. As domestic and global discussions on global health security continue, GHTC will advocate for R&D as a critical component of epidemic preparedness and response. 5. US engagement with key multilateral bodies Multilateral organizations and partnerships are vital mechanisms to help advance a healthier and more secure world. In our modern and increasingly globalized world, new, emerging, or long-standing health challenges, which do not respect borders, cannot be tackled by individual countries alone. Strong US leadership and funding for organizations like the United Nations (UN), the World Health Organization, and the Global Fund to Fight AIDS, Tuberculosis and Malaria are key to advancing global health and ensuring that these organizations function effectively in support of US priorities. Despite several senior Trump Administration officials expressing support for strong multilateral engagement, the United States’ role in pushing for a recent $285 million cut to the UN’s overall budget appears more indicative of how the United States can be expected to engage in the near future. While it is currently unclear exactly how these cuts will be implemented across the various UN health-related programs, GHTC anticipates significant impact on the various UN technical agencies’ ability to support global health, including R&D. GHTC is committed to leading strong, coordinated action to advance US leadership in global health R&D in 2018 and beyond. The United States has long been a leader in global health, development, and medical research, and we look forward to sustaining and bolstering this legacy in the years ahead.  

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. In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. Australian scientists solved a mystery about how malaria-causing parasites infect the human body, making a key discovery that could pave the way toward an effective vaccine for the disease. Researchers found that one of the malaria-causing parasites, P.vivax, infects humans by latching onto a protein that carries iron to young red blood cells. In response, researchers created antibodies designed to block this from taking place, thus halting the infection process. Future research on the antibodies’ effectiveness is needed, but researchers remain optimistic the discovery will lead to a potential vaccine candidate for P.vivax, though it could be another decade before clinical trials begin. In December, the World Health Organization (WHO) prequalified the first infant-safe typhoid vaccine—Typbar TCV—for global use. The move comes after years of research, including a high-profile “challenge trial” involving volunteers swallowing the live virus, which found the vaccine was 87 percent effective in preventing infection. This approval by WHO allows donors, including United Nations agencies, to purchase Typbar TCV—which is now priced atUS$1.50 a dose and could drop to $1.00 if donors order more than 100 million doses—for use in low-resource countries. Global use of the vaccine should help curb the use of antibiotics for treatment, mitigating the increasing threat of antibiotic-resistant typhoid. Vitamin C may shorten tuberculosis (TB) treatment time by killing more bacteria, according to a new study in Antimicrobial Agents and Chemotherapy. Researchers at Albert Einstein College of Medicine accidentally discovered that antioxidants, like vitamin C, stopped TB bacteria in test tubes from becoming “persisters”—or TB bacteria that become dormant during treatment and eventually cause reinfection. To test this discovery further, researchers conducted a mice study and found promising results: The mice given vitamin C in concurrence with TB drugs had ten times fewer bacteria in their lungs than the mice not given vitamin C. While human studies are necessary to confirm effectiveness, researchers agree that coupling TB drugs with vitamin C is a safe, accessible, and inexpensive choice.