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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. With the 69th session of the United Nations (UN) General Assembly going on this week in New York and the global community debating how best to refine the post-2015 development agenda, over 150 organizations and individuals signed a petition to UN Secretary General Ban Ki-moon and Member States urging the UN to keep the research, development, and delivery of new and improved health tools at the heart of the post-2015 development agenda. A new public-private partnership to fight against HIV and AIDS has been launched—part of a Clinton Global Initiative five-year Commitment to Action that will strengthen laboratory systems in sub-Saharan Africa. The $15 million, five-country collaboration—called Stronger Together—will leverage the expertise of each partner country to build up laboratory infrastructure, which remains critical to disease control and product development. This week, the Obama administration announced a new set of federal executive actions to combat antibiotic-resistant bacteria in an effort to protect public health. The administration will put forth an executive order that would direct the federal government to work both domestically and internationally to reduce the emergence and spread of antibiotic-resistant bacteria. Specifically for health research and development, the National Institutes of Health, Biomedical Advanced Research and Development Authority, and the Food and Drug Administration will launch a $20 million prize to facilitate the development of a rapid diagnostic test that can be used by health providers to identify highly resistant bacterial infections. GHTC member the Global Health Innovative Technology Fund (GHIT Fund) has awarded seven new grants totaling US$15.3 million to tackle malaria, Chagas disease, and dengue fever. The investments aim to speed up the development of promising drugs and vaccines to battle these three insect-borne diseases.

Photo: © 2011, Charlotte Raymond Photography for International AIDS Vaccine Initiative (IAVI) With the 69th session of the United Nations (UN) General Assembly opening this week in New York and the global community debating how best to refine the post-2015 development agenda, over 150 organizations and individuals signed a petition to UN Secretary General Ban Ki-moon and Member States urging the UN to keep the research, development, and delivery of new and improved health tools at the heart of the post-2015 development agenda. Specifically, the petition—which was circulated by GHTC, the Council on Health Research for Development, and the International AIDS Vaccine Initiative—requests that the “UN fully supports in the post-2015 Sustainable Development Goals [(SDGs)]-Framework the research, development, and delivery of new and improved medicines, vaccines, and other health tools for the diseases and health conditions that predominantly affect low- and middle-income countries as well as marginalized, vulnerable populations globally.” The signing organizations and individuals represent a diverse group of research and academic institutions, private sector entities, and nongovernmental organizations from all regions of the globe: Africa, Asia, Europe, Oceania, and North and South America. GHTC is pleased to see such broad and substantial support for the inclusion of health R&D components in the post-2015 agenda, and hopes that the Member States and officials who are shaping the agenda will take note. Below is the full text of the petition and list of signatories: Excellency, Secretary General Ban Ki-moon, Member States of the UN, We, the below signatory organizations request that the UN fully supports in the post-2015 SDG-Framework the research, development, and delivery of new and improved medicines, vaccines, and other health tools for the diseases and health conditions that predominantly affect low- and middle-income countries as well as marginalized, vulnerable populations globally.  Thanks to the leadership of the UN and investments by Member States, the current Millennium Development Goals have made major contributions to improving the health and lives of millions of people around the world. A sustained focus on some of the greatest global health challenges has led to enormous progress in many areas, including significant improvements in the development and delivery of health tools such as drugs to treat HIV and AIDS, tuberculosis (TB) and malaria. Efforts to tackle diseases have also helped underpin progress in other important areas, such as gender equality, child mortality, and maternal health. Millions of lives have been saved. However, major challenges remain, and the health burden imposed by poverty remains far too high. In this context, it is essential that the post-2015 development agenda retains a strong focus on eliminating poverty-related diseases and conditions. The post-2015 agenda must build on previous achievements to ensure that healthy lives and access to health services can be achieved in an equitable and sustainable way, leaving no one behind. This means ensuring universal access to proven health interventions. But it also means developing and delivering new health technologies which can help address the shortcomings of existing interventions and sustainably reduce morbidity and mortality over the longer term. This will require continued support for the research, development, and delivery of new tools to the combat major epidemics like HIV and AIDS, TB, and malaria, as well as other poverty-related diseases and conditions ranging from neglected tropical diseases to reproductive, maternal, and child health. Continuous investment of human and financial resources in science, technology, and innovation is essential to achieve both economic and social development for all. We are encouraged by the current inclusion of the need to support the development of new medicines and vaccines for diseases particularly affecting developing countries in the Zero Draft document of the SDGs. Concern remains, however, about the omission of medical devices and diagnostics which also contribute to improving health outcomes, the lack of clarity on how this effort will be funded, and how supporting policies, incentives, capacity building, collaboration, and knowledge and technology sharing will be defined and implemented. As organizations working to save lives and improve health, we urge you to commit explicit and full support to health research and related policies and capacity building as a core component of a new, post-2015 agenda for equitable health and sustainable development for all. We ask that you press Member States to offer similar support, and to formally assess how to measure progress towards this goal, and how to fully and sustainably finance and enable the research, development, and delivery of essential new and improved health tools. Sincerely, ACTION Aeras African Services Committee AIDS-Fondet Amsterdam Medical Centre, University of Amsterdam American Society of Tropical Medicine and Hygiene Asociacion Gestion Salud Poblacion Association of Commonwealth Universities AVAC Bishkek Feminist Collective SQ Boston University Canadian Coalition for Global Health Research Canadian HIV and AIDS Legal Network Caribbean Public Health Agency Caribbean Vulnerable Communities Ciflorpan, University of Panamá COHRED Comité Nacional Cubano de Bioética Community Health Evangelism Programme Commonwealth Human Rights Initiative Department of Epidemiology, University Hospital F Hached, Tunisia Department of Psychiatry, Chiang Mai University Dept of Paediatrics, IrruaTeaching Hospital Edo State Nigeria Deutsche Stiftung Weltbevoelkerung Development of People's Foundation Drug Discovery Unit, University of Dundee Drugs for Neglected Diseasesinitiative Duke University ECOM - Eurasian Coalition on Male Health Egerton University Estonian Network PLWHIV European Investment Bank European Public Health Association Euvadis Facultad de Quimica, Universidad de la Republica, Uruguay Faculty of Tropical Medicine Federal Teaching Hospital Abakaliki, Ebonyi State, Nigeria FIND FIOCRUZ Fiocruz Minas Friends Africa (Friends of the Global Fund Africa) GAT George Institute GESPAM GlaxoSmithKline Global Alliance for TB Drug Development Global Health Advocates Global Health Consulting Global Health Council Global Health Technologies Coalition Global HIV Vaccine Enterprise Government of Kenya gTt-VIH (Spain) Hanoi School of Public Health Health Reform Foundation of Nigeria Edo State Chapter, HKMU Hospital Nelson Piccolo Hospital Sionsberg Hubert Kairuki Memorial University icddr,b IHCAI Foundation INDEPTH Network Institute of Human Nutrition and Food Institute of Tropical Medicine Institute Tropical Medicine Antwerp Instituto de Investigaciones Epidemiologicas, Academia Nacional de Medicina, Buenos Aires Instituto de Observação da Terra Instituto de Salud Carlos III Instituut voor Tropische Geneeskunde Interagency Coalition on AIDS and Development International AIDS Vaccine Initiative International Consortium on Anti-Virals International Organization for Chemical Sciences in Development International Partnership for Microbicides International Vaccine Institute Johns Hopkins Bloomberg School of Public Health Kairuki Memorial University Kapkatet medical training Centre Kenya National Bureau of Statistics Koningklijk Instituut voor de Tropen Kyrgyz Indigo La Gazette Law Office of Laurel G. Yancey, P.C. Medical Research Council of Zimbabwe Medicines for Malaria Venture menZDRAV Foundation Micro Insurance Academy Ministry of Education and Sports, Philippines Ministry of Health and Social Welfare, Tanzania Ministry of Health, Barbados National AIDS Research Institute National Institute of Health Research & Development NEPAD Science, Technology and Innovation Hub Netherlands Health Research Organization Nige Academy of Science North Eastern Council, Health Adviser One child-one world One Family Health Oswaldo Cruz Institute Parviflora Research Organization PATH People’s Health Movement Philippine Council for Health Research and Development Philippine Department of Health Policy Cures Population Council Public Health Institute Public Private Partnership Health Society RALSA Foundation Research Department, National Hospital Rosales Research into Cultura and Reproductive Health For Sustainable Human Development (RECARDEV) RESULTS UK Royal Tropical Institute, Netherlands Rural Community Health Research SA Medical Research Council Sabin Vaccine Institute School of Population Health, University of Queensland Section of Infectious Diseases, Dept of Medicine, St Luke's Medical Center, QC, Philippines Sensoa South Africa-Department of Health South African Research Ethics Training Initiative STOP AIDS Swiss Tropical & Public Health Institute The Africa Centre for Health and Population Studies The Environment Ameliorators The University of Western Australia Tools To Work Treatment Action Group Uhamka University Unidad de Investigacion Cientifica, Facultad de Ciencias Medicas, UNAH Universidad del Valle Universidad Nacional Autonoma de Mexico Universidade de Sao Paulo University of Bergen University of Birmingham University of Brasilia University of Cagliari University of California, Irvine University of Cape Coast University of Edinburgh University of Health and Allied Sciences, Ho. Ghana University of KwaZulu-Natal University of Melbourne University of Nigeria, Nsukka University of Oslo University of the Witwatersrand Washington Global Health Alliance Y+ Network Individuals: Alix Beith Francesca Coloni Franko Family Wanjiku Kabiru Malcolm McNeil Ophelia Mendoza Ellene Mocria  

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. Now that members of Congress are back in their Capitol Hill offices after five weeks of recess, lawmakers must decide what to prioritize and what to push off in the few short weeks left in session before members hit the campaign trail for the upcoming November mid-term elections. In the latest post on Breakthroughs, GHTC Senior Policy and Advocacy Associate, Jenny Howell, provides a breakdown of what lawmakers should do to ensure global health research and development gets the support it needs. Federal funding in the United States for biomedical research has declined by more than 20 percent in the last decade. At the same time, more scientists are competing for a smaller pot of money. NPR highlights two stories of researchers forced out of science because they either can’t get research funding or “because the rat race has simply become too unpleasant.” Scientists at the National Institutes of Health (NIH) have discovered an HIV antibody that could be effective in fighting the deadly disease. According to the scientists, the antibody—called 35O22—can prevent 62 percent of known HIV strains from infecting cells. The NIH-led scientists also found that the antibody closely resembles antibodies that naturally occur in HIV, which could help in the development of an eventual vaccine. Results from a recent clinical trial could change the approach researchers take on the delivery and development of tuberculosis (TB) drugs in the future. While the REMoxTB trial did not successfully prove TB treatment times could be shortened from six to four months by substituting antibiotic moxiflacin for a currently used drug, it did prove that moxiflacin was safe to use to treat TB on its own. Also, because the trial was one of the largest ever for a new TB regimen, the trial left a stronger research infrastructure to conduct other trials in the future. The Bill & Melinda Gates Foundation has committed $50 million to fight Ebola in West Africa. According to Gates Foundation CEO Susan Desmond-Hellmann, the new money will be available for emergency operations and to help develop drugs, diagnostics, and vaccines to fight the disease. The Gates Foundation’s commitment is the largest sum to ever for one outbreak.

With only a few weeks left in session, lawmakers must decide what to prioritize and what to push off. Photo: Photo Phiend After a five week recess, members of Congress returned to their Capitol Hill offices on Tuesday night. Staffers who had enjoyed the brief freedom of wearing jeans to work returned to their suits, and lobbyists and constituents alike returned to waiting in long security lines to enter Congressional offices. With only a few weeks left in session before they hit the campaign trail, lawmakers must decide what to prioritize and what to push off. Here is what we expect Congress may address before session end. Keeping the government open Passing legislation to keep the government funded past September 30th is a top priority for Congress. Given the wrath lawmakers faced following last year’s government shutdown and the looming mid-term elections, it seems almost certain that policy makers will come to a short-term solution to keep the government open. Earlier this week, Chairman Hal Rogers of the House Appropriations Committee offered a stop-gap spending bill that would fund the government through December 11th. Finding funds to fight Ebola Lawmakers appear to be coming together to support additional funding to meet the needs of the Ebola crisis. Last month, the President requested an additional $88 million to bring much needed drugs and supplies to the West African countries ravaged by this deadly disease, and Chairman Rodgers has indicated that the full $88 million will be included in the House version of the continuing resolution (CR). A summary of this CR put out by the House Appropriations Committee notes that this funding will be used to “accelerate [Department of Health and Human Services’] research on Ebola therapies, and additional funding for the [Center for Disease Control and Prevention’s (CDC)] response to the growing outbreak in Africa.” Chairman Rodger’s budget is in line with the current budget cap of $1.012 trillion and would maintain current spending levels. Also included in the GOP-backed bill is $85.1 billion for overseas contingency funding, an extension of the Export-Import Bank through June 2015, and an extension of the Internet Tax Freedom Act through the CR. Strong language supporting global health R&D was included in many of this year's appropriations report, but will it make it into a more long-term budget deal? Caption Photo: PATH/Gabe Bienczycki Dealing with uncertainty GHTC is hopeful that we will not face another government shutdown—we know that funding for research and development (R&D) is best leveraged when there is consistent and certain financial support. Another short-term CR will continue to undermine potential game-changing discoveries and, as detailed in GHTC’s 2014 Policy Report, make planning for the future nearly impossible. Congress bucking at the traditional appropriations process also means uncertainty around what, if any, committee report language will be included in a more long-term budget deal. In previous blogs, GHTC reported on the strong language in support of global health R&D that was included in many of this year’s appropriations bills, including those put out by the subcommittees on Labor, Health and Human Services, Department of Defense, and State and Foreign Operations. We hope this language will be included in whatever final agreement takes place. While House and Senate fiscal year (FY) 2015 appropriators showed only lukewarm support in their funding for global health R&D, some accounts—like those for the National Institutes of Health and CDC’s Center for Global Health—saw funding requests from the Senate that were above both FY 2014 funding and White House requests. A CR means these recommendations for funding increases will continue to be put off. Preventing “the lamest lame-duck” With pending mid-term elections, it’s difficult to predict what this lame-duck session will bring. While Politico is already predicting that this will be the “lamest lame-duck session,” there are a number of common-sense, no-cost bills that Congress could and should pass before the end of the 113th session. The 21st Century Global Health Technology Act, a bill which establishes the US Agency for International Development’s mandate for global health R&D, as well as improves agency coordination, transparency, and reporting would be an easy way for Congress to leverage existing funds and programs without creating any additional spending. Additionally, the Patents for Humanity Program Improvement Act of 2013 would make it easier for American researchers to develop solutions to the world’s most pressing health issues and incentivize first-time researchers to apply their work towards addressing humanitarian needs. While preventing another government shutdown is a step in the right direction, we hope lawmakers will take seriously the need for longer-term solutions. With three months left in the 113th Congress, it’s time to get down to business.