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A new initiative seeks to develop research capacity within Africa and create a regional hub with the ability to determine research needs and award grants. The Alliance for Accelerating Excellence in Science in Africa (AESA) will be launched this June out of the African Academy of Sciences in Nairobi, Kenya, with an initial grant of US$4.5 million from the Wellcome Trust, the United Kingdom’s Department for International Development, and the Bill & Melinda Gates Foundation. The Wellcome Trust may also transfer management of its Developing Excellence in Leadership, Training and Science program to AESA, a five-year, $60 million initiative. While AESA will solicit funding from both African and international donors, it will independently manage and allocate grants. The recent Ebola epidemic in West Africa caught the international community off guard; funding for and interest in Ebola was limited, and several promising vaccines for Ebola were suspended in the pipeline. However, an article in the New York Times suggests that we should have been prepared, citing research papers from as early as the 1970s discussing the threat of an Ebola outbreak. The research found the presence of Ebola antibodies in 10 to 26 percent of Liberian citizens, indicating that "medical personnel in Liberian health centers should be aware of the possibility that they may come across active cases [of Ebola.]" According to the authors, “the investigators collected their samples, returned home, and published the startling results in European medical journals.” They argued that inaction is primarily attributable to the lack of engagement of local scientists and officials. The article ultimately calls for investments in local capacity for research, delivery, and care to ensure equity in global health. Francis Collins, director of the National Institutes of Health (NIH), and Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases at NIH, wrote an editorial for Science Magazine on the value of research and development for global health. They expressed concern that certain members of Congress believe that the NIH should shift its focus to match the disease burden in the United States, calling it “unwise” as US investments in global health not only reflect an “enduring tradition of humanitarian concern,” but boost the economy and advance American diplomatic interests.

India is expected to add all of the drugs currently used in the government’s HIV and AIDS and tuberculosis (TB) control programs to its list of essential medicines within the next six months. These drugs are currently available for free in public clinics; many patients, however, prefer private clinics due to perceived discrepancies in quality of care. The list, which was last updated in 2011, sets price caps to ensure that treatments remain affordable—paramount in a nation where more than 70 percent of the population lives on less than US$2 per day. China’s investments in health-related research and development (R&D) are expected to surpass US funding by 2023. The government of China has invested $1.1 billion in drug development since 2011, due to a policy mandate requiring increased funding for life sciences, including the pharmaceutical industry. Meanwhile, US funding for global health R&D has declined or plateaued each year since 2009. China is currently the world’s biggest manufacturer of active pharmaceutical ingredients and is becoming a leading site for contract research organizations, which support preclinical and clinical research for major pharmaceutical companies. The World Health Organization (WHO) issued a guidance document last week regarding a leading medicine for hepatitis C. The new guidance will inform the design of bioequivalence studies, which determine whether a generic is comparable to a patented product. The drug, sofosbuvir, is patented by Gilead Sciences and can cost up to $1,000 per pill. Proof of bioequivalence will be critical for manufacturers aiming to produce a generic drug and ultimately seek WHO prequalification for their product. In her final speech as commissioner of the US Food and Drug Administration (FDA), Dr. Margaret Hamburg defended the agency’s rigorous drug approval process. “Innovation doesn’t matter if the product doesn’t work,” she noted, highlighting the risks of “unsafe and ineffective medical products.” Hamburg’s remarks come as the House of Representatives Energy and Commerce Committee is in the process of developing legislation—known as 21st Century Cures—that calls on the FDA to expedite the regulatory process using its “breakthrough therapy” designation. This designation, which ensures an accelerated review and increased guidance from the FDA, was granted to 31 drugs in 2014. The 21st Century Cures legislation would allow the FDA to review products based only on preliminary clinical trial data and would allow companies to hold off on long-term safety and efficacy trials until after the product was on the market.