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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. Sarah Alexander—director of external relations for the Global Alliance to Prevent Prematurity and Stillbirth—writes about the recent groundswell of momentum surrounding maternal and child health and the role research and development (R&D) can play in helping more babies have a healthy start to life. Researchers at the University of Tokyo are bioengineering rice to transform it into a low-cost storage and delivery mechanism for drugs to combat cholera, rotavirus, and other infectious diseases and contagious illnesses. The researchers say that bioengineering the vaccines or antibodies into rice would allow them to be stockpiled and stored at room temperature, avoiding cold chain issues that exist with existing vaccines. Geno de Hostos—director of research and preclinical development at PATH’s Drug Development Program—writes about how an integrated approach to tackling diarrheal disease can save thousands of children’s lives each year. He argues that R&D efforts focused on new drugs and vaccines hold tremendous potential, and there is a need to sustain appropriate funding to achieve more progress. The Bill & Melinda Gates Foundation announced funding for 55 projects through its Grand Challenges Explorations initiative program which funds innovative ideas to address global health and development problems. Grant recipients include several projects to improve condom design, “cologne” for cows that alters their smell to mimic humans in order to divert disease-carrying insects from people, and two projects to improve the vaccine cold chain, among others. Dr. Margaret Hamburg—commissioner of the US Food and Drug Administration (FDA)—writes on the FDA Voice blog about the World Health Organization’s passage of a resolution to strengthen regulatory systems. She notes the unique challenges and opportunities faced by regulators because of globalization and the extraordinary increase in the global supply of medical products, and she discusses the increasing efforts by nations to collaborate to share information and reduce system inefficiencies.

In this post—which originally appeared on the DefeatDD.org blog and PATH’s Drug Development Program blog on June 4—Geno de Hostos—director of research and preclinical development at PATH’s Drug Development Program—reflects on themes in the organization’s new video “Defeat diarrheal disease? Together, we’ve got it covered” . He discusses how an integrated approach to tackling diarrheal disease can save thousands of children’s lives each year. The uneasy reality When you walk into a diarrheal disease health clinic in a place like Bangladesh, the reality of the disease strikes you immediately. It’s the rows of bright orange bed covers drying in the sun, long lines of women with children waiting to be seen, and the patients—most of them too young and vulnerable to be already fighting for their lives. Diarrhea takes the lives of more than 1,600 children every day before they can grow to see their fifth birthday. Photo: Jonathan Torgovnik © The onslaught of diarrhea is sudden and loss of fluids is copious. Mere inconvenience quickly turns to a daily struggle for life as you fight off dehydration that diarrhea causes. A child is rushed to a hospital where lifesaving oral rehydration solution (ORS) is administered, usually by a mother or a care provider. Spoon by spoon, lost fluids are slowly restored, though weakness can persist for several weeks, and repeated bouts of diarrhea are common. The reality is that despite rapid progress in reducing child deaths from diarrhea over the last decade—a decrease by more than 50 percent, from almost 1.3 million in 2000 to approximately 600,000 in 2012—there is a lot more to be done. And as long as diarrhea continues to take the lives of more than 1,600 children every day before they can grow to see their fifth birthday, there is no time we can allow ourselves to waste. Power of an integrated approach Another reality is that it doesn’t have to be this way. Effective, proven solutions for tackling diarrhea— safe drinking water and improved sanitation, adequate nutrition, rotavirus vaccines, ORS, and supplemental zinc, combined with continued feeding—are already in our hands. We need to work harder to scale them up and find new methods to deliver them to those who need them. Research and development (R&D) efforts focused on new drugs and vaccines hold tremendous potential, and we need to sustain appropriate funding and efforts on that front to continue with our progress forward. Together, these critical solutions form a network of approaches to diarrheal disease that reinforce one another and form a solid foundation for a healthy life. That’s why at PATH, we work to address diarrhea on multiple fronts. Our drug development team is developing new treatments to shorten the severity and duration of diarrhea before it becomes fatal, while also working to improve the effectiveness of proven diarrhea therapies like ORS. PATH is also working to develop new vaccines against the leading causes of diarrheal disease, partnering with countries to increase access to existing vaccines for rotavirus, developing and delivering safe water treatment and storage products, advancing health devices, and strengthening behaviors like breastfeeding education. R&D efforts focused on new drugs and vaccines for diarrheal diseases hold tremendous potential, and we need to sustain appropriate funding and efforts on to further progress. Let’s keep going! Having worked in nonprofit drug development for nearly seven years, I am more heartened than ever before by the impressive gains being made in R&D of innovative health technologies to fight the leading causes of child death like diarrhea. I am also reminded of the critical value of sustained commitment to our children and the need to accelerate progress. A multipronged approach can help us get there—among other factors, development of innovative health technologies, opening access to needed vaccines, drugs, clean water and sanitation, adequate nutrition, and education will continue to push us forward. It’s time we change the reality of diarrheal disease. More information Defeat diarrheal disease? Together, we’ve got it covered Defeat DD: Simple solutions to fight a common killer Targeting diarrheal diseases

In this guest post, Sarah Alexander—director of external relations for the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS)—writes about the groundswell of momentum surrounding maternal and child health and the role research and development (R&D) can play in helping more babies have a healthy start to life. You may have noticed maternal and child health has been garnering a lot of attention lately. At the Saving Every Woman Every Child Global Summit in Toronto last week, the focus was on ending preventable deaths of mothers and children under 5, and the government of Canada pledged $3.5 billion toward those efforts. The week prior marked the launch of the Every Newborn series in The Lancet, as well as the endorsement of the Every Newborn Action Plan by the World Health Assembly in Geneva. Later this month, the Partnership for Maternal, Newborn & Child Health’s Third Annual Partners’ Forum will be held in Johannesburg. All of these events are building on each other and creating a groundswell that will help forge a blueprint for the post-Millennium Development Goal era.The momentum these efforts have gained is impressive, and great strides have been made in saving the lives of mothers and babies around the world. As the global health community looks toward the next 15 years, we are encouraged that more and more plans are incorporating R&D as pillars of a maternal and newborn health agenda. A focus on R&D will allow researchers to look upstream and investigate new ways of preventing problems from occurring in the first place—exemplifying the maxim that prevention is better than cure.There has been a groundswell of momentum for maternal and child health. There are many opportunities for high-impact R&D as part of the agenda. Photo: PATH/Mike WangAt the GAPPS—an initiative of Seattle Children's—we understand and advocate for all the great work that is being done to treat newborns—especially in low-resource settings—to give them a better chance of survival. With our focus on preterm birth and stillbirth, we envision a scenario where instead of treating infants born prematurely or laying to rest nearly 3 million stillborn babies every year, we could instead identify issues in utero and develop therapies to prevent preterm birth, stillbirth, and other pregnancy complications before they occur.Babies born too soon can face lifelong health complications, including respiratory issues, vision and hearing loss, cerebral palsy, developmental delays, and more. Stillborn babies are often not acknowledged with birth or death certificates, or prioritized in health efforts. While it’s essential that known interventions are scaled up to help save the lives of mothers and newborns, we are glad to see a comprehensive R&D movement picking up steam.There are many opportunities for high-impact R&D in maternal and newborn health. For example, new technologies allow for increased biomarker discovery and therapeutics development, which could allow doctors to screen for and treat conditions in pregnant women and their babies before birth, helping more babies have a healthy start to life.With so much momentum building around maternal and child health, we’re glad to see R&D into prevention is being prioritized so that one day every birth can be a healthy birth.