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Scientists at Karolinska Institutet in Sweden have identified the protein that explains why people with blood type O are protected from coma and death resulting from severe cases of malaria. Plasmodium falciparum, the parasite responsible for nearly all fatal cases of malaria, releases the RIFIN protein, which causes red blood cells to stick to one another and restrict blood flow, resulting in tissue damage and death. The study, published last week, establishes that the RIFIN protein insufficiently attaches to type O blood cells, despite its strong adherence to type A blood cells. This results in different health outcomes for those with type O blood, as they avoid the severe effects of the parasite. An article in Al Jazeera explored the history of Ebola vaccine research and development (R&D) and the barriers to conducting clinical trials in Sierra Leone today. While Ebola vaccine research began more than ten years ago, multiple promising vaccine candidates have remained in limbo due to a paucity of funding. Last fall, the US government partnered with pharmaceutical companies to expedite the R&D of experimental Ebola vaccines in light of the epidemic in West Africa. The US Centers for Disease Control and Prevention (CDC) and pharmaceutical company Merck & Co. are preparing for clinical trials in Sierra Leone involving 6,000-8,000 health workers. Health workers have expressed concern regarding the safety of the vaccine, and outreach to health workers and potential participants—which the CDC plans to conduct a few weeks prior to the start of the trial—may present a greater challenge than originally anticipated. A new diagnostic device, called the Microlife Vital Signs Alert, could save up to 70,000 mothers each year by alerting health care workers when a woman is at risk of going into shock due to blood loss during childbirth, or if her blood pressure is dangerously high. The device, which only costs US $20, is easy to use and interpret, enabling health care workers—regardless of education and training—to identify when a woman needs to be taken to a hospital with a simple red light.

The US Agency for International Development (USAID) announced last week that Ariel Pabos-Mendez, the assistant administrator for Global Health, will serve as the coordinator for Child and Maternal Survival. USAID stated that his "dual role" will ensure that maternal and child health remains a “central priority” of the Bureau of Global Health. Katie Taylor, who served as the interim coordinator, was named deputy coordinator, and will continue to serve as deputy assistant administrator for Global Health. Researchers at Johns Hopkins University made a groundbreaking discovery about the pathogen that causes tuberculosis, which could ultimately lead to the development of more effective drugs and vaccines. The bacteria generates pieces of DNA that—to the immune cells—resemble and behave like a virus, and thus the immune system responds to the bacteria as though it were a virus. That virus-like piece of DNA, known as c-di-AMP, elicits the production of INF-beta proteins as part of the immune response. The scientists infected mice with tuberculosis bacterium that was manipulated to release elevated numbers of c-di-AMP molecules, and the mice survived twice as long as those infected with normal tuberculosis bacterium. Last week, the US Food and Drug Administration approved LILETTA™, a hormonal intrauterine device developed by Medicines360, a nonprofit biotech company focused on women’s health. Medicines360 is partnering with Actavis to market and lead sales for the device. While the article notes the paucity of nonprofit pharmaceutical companies, it highlights OneWorld Health, which recently merged with PATH and whose founder also founded Medicines360. The organization, which relied on donors throughout the research and development (R&D) of LILETTA™, intends to sustain itself on sales moving forward. The Council on Foreign Relations took an in-depth look at the history of artemisinin, the leading agent used to treat malaria, from discovery through R&D for effective drugs. The search began when the Plasmodium falciparum parasite, which is responsible for the vast majority of malaria cases, developed resistance to existing treatments. In 1967, the Chinese government established a team of nearly 500 scientists, who identified and researched an extensive list of herbs and traditional medicines, ultimately confirming the efficacy of artemisinin in treating malaria. The article is part of a series, the next of which will focus on the market landscape and dynamics for artemisinin-based products.

A new compound has successfully protected monkeys from HIV, according to a study published in Nature last week. The compound stimulates the production of claw-shaped proteins that are able to simultaneously block the two different parts of white blood cells—the CD4 and CCR5 binding sites—to which the HIV virus normally attaches. After scientists at the Scripps Research Institute “vaccinated” monkeys with the compound, they repeatedly tried and failed to infect the monkeys with large doses of varied HIV strains over the course of a year. The team will next test if they are able to slow the replication of virus and the progress of the diseases in monkeys infected with HIV, before starting human trials. Last week, the World Health Organization approved the ReEBOV Antigen Rapid Test for Ebola, which requires only a test tube and a piece of paper and can provide results in approximately 15 minutes. The test is simple to administer and interpret, with the lead developer explaining “a drop of blood is placed on the paper, and if two lines appear, then it’s positive for Ebola.” The use of blood, however, requires a ‘biosafety cabinet’ in the form of either a box or a tent that can protect health workers from the virus. The test also has specificity and sensitivity issues, only detecting 92% of cases and with approximately 15% of uninfected people testing positive for Ebola. CBS correspondent Bob Simon investigated ZMapp, an experimental drug for Ebola, as part of his final story for 60 minutes before his death last month. Prior to the current Ebola epidemic, ZMapp had only been tested on monkeys; however, last summer, it was used to treat seven patients, five of whom survived. The US National Institute of Allergy and Infectious Diseases commenced clinical trials for ZMapp in Liberia on Friday. ZMapp is created using tobacco plants, which are saturated with a gene that stimulates the production of Ebola-fighting antibodies. As the plant grows, increasing rates of antibodies are produced—a process Simon likened to “a Xerox machine for antibodies.” Secretary of State John Kerry testified before the House Foreign Affairs Committee last Wednesday on the US Department of State’s 2016 budget proposal. The Committee’s Ranking Member Eliot Engel (D-NY) emphasized the importance of global health “research, infrastructure, and personnel,” in preventing future epidemics such as the Ebola crisis in West Africa and expressed his dismay at “proposed cuts to global health programs dealing with tuberculosis [and] neglected tropical diseases.”

The TB Alliance, a member of the Global Health Technologies Coalition, announced last week that it will be starting Phase 1 clinical trials for a new tuberculosis (TB) drug candidate. The drug, known as TBA-354, is the first new TB drug to advance to clinical trials in six years, despite the paucity of highly effective and easily administered TB treatments. TBA-354 was developed by the TB Alliance, in partnership with the University of Auckland and the University of Illinois-Chicago, using compounds from the nitroimidazole class of chemicals, which are known to be effective against drug-resistant strands of TB. The World Health Organization (WHO) estimates that US$2 billion per year is needed for TB research and development (R&D), yet in 2013, only $676.7 million was invested. The Atlantic took an in-depth look at gaps in reproductive health R&D, highlighting common side effects of leading contraceptives and reviewing the results of clinical trials conducted between 2008 and 2011 for a contraceptive injection for men. The article also identifies contraceptive technologies currently in the pipeline, including a reversible version of a vasectomy, an improved diaphragm, a remote-controlled implant, and more. A drug-resistant form of malaria endemic to Cambodia and found in Southeastern Myanmar has spread north to the border Myanmar shares with India. While the strain is resistant to artemisinin, the most effective agent against malaria, it can still be combatted with other drugs. Dr. Charles Woodrow, the lead author on the study, explained that in Cambodia, treatment for the resistant strain involves "combining three drugs, extending courses from three days up to five days." Scientists fear that if this new strand were to establish a foothold in India, it could rapidly spread across the globe. WHO estimates that US$750 million annually is needed to prevent and treat neglected tropical diseases (NTDs), yet current foreign aid amounts to only $300 million per year. Due to the financial climate in donor countries, WHO is calling for increased domestic funding in countries where NTDs are endemic. Dirk Engels, Director of the Department of Control of NTDs at WHO, has stressed the importance of interventions that combat multiple NTDs, such as large-scale, affordable vector control programs and diagnostic interventions.