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In this guest post, Eve Lackritz, MD—senior program officer with the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS), an initiative of Seattle Children’s—writes about new research projects to develop innovative prevention products and strategies for preterm births worldwide. With more than 15 million babies born preterm every year, of which one million will die in infancy, preterm birth is a global health crisis that must be elevated and prioritized on an international scale. Although preterm birth is the second-leading cause of death for all children under age five worldwide, preterm research ranks 99th in National Institutes of Health funding. Causes of preterm birth are multiple and poorly understood; the majority have no known cause, and 80 percent cannot be prevented with current interventions. It is a critical time to advance a global prevention research agenda to understand the biology of pregnancy, how multiple social, biological, and clinical factors cause adverse birth outcomes, and test new and innovative strategies for prevention. In India, there are 3.5 million preterm births every year, more than anywhere else in the world. Photo credit: Paul Joseph Brown / GAPPS. Last week, GAPPS announced five projects funded through the Preventing Preterm Birth initiative (PPB), part of the Bill & Melinda Gates Foundation’s Grand Challenges in Global Health. The initiative seeks to discover biological mechanisms that lead to preterm birth and develop novel interventions for prevention. A core objective of the PPB is to advance research that will have the potential to translate results into novel solutions for low- and middle-income countries, including requiring that new products be practical and affordable for global impact. While preterm births occur worldwide, developing countries often lack the healthcare infrastructure needed to keep preemies alive, and therefore bear the greatest burden of infant mortality. In high-income countries where premature babies are more likely to survive, they can face lifelong health problems, including cerebral palsy, developmental delays, and asthma. One of the projects funded through the PPB will work to develop a diagnostic test to detect inflammation in the uterus early in pregnancy. Conducted by Dr. David Olson of the University of Alberta and an interdisciplinary team, the investigators will work to develop new diagnostics and therapeutics that can identify women at risk, alter the inflammatory response, and prolong pregnancy. Tests and treatments such as these could have an important impact and lessen the burden of prematurity worldwide. Infection and inflammation are important contributors to preterm birth. Dr. Sam Mesiano from Case Western Reserve University School of Medicine is investigating ways to enhance the body’s anti-inflammatory processes through the study of the body’s receptors for progestin-based therapies. The long-term goal of this project is to develop an inexpensive oral therapy that will reduce the prevalence of preterm birth worldwide. Finding ways to prevent preterm birth will be a long and difficult challenge. Projects like these are an important start, but there is a long way to go. Increased awareness of this leading cause of child death is critical to attracting the public and private funding needed to discover new solutions. Time and again, we have seen that investment in research results in solutions, and in this case, will help make every birth a healthy birth.

It’s not much of a surprise that Monday night’s presidential debate, which focused on foreign policy, was consumed by a discussion of defense spending, and security and trade policies regarding the Middle East, North Africa, and China. While not unexpected, it’s still disappointing that both Barack Obama (D) and Mitt Romney (R) were relatively silent on issues like global health, research, and international aid. We’ve written previously about how critical it is for the candidates to address these issues, given the impact of presidential policies on funding for global health research and other development programs. While there have been some brief mentions during the debate season of the role of science and technology—both candidates have discussed how science and technology can help create domestic jobs and tackle issues like energy and climate change—it’s critical to also address the role of science in international health and development. Indeed, there’s been some reaction from the international development community regarding the lack of foreign aid and assistance in Monday night’s debate. Devex provides a summary of some clues offered up by both Romney and Obama regarding foreign aid and development in Pakistan, the Middle East, North Africa, and South Asia. But as this word cloud from the US Global Leadership Coalition indicates, health, research, and science—among a host of other topics—were missing from the debate. Perhaps Josh Barro from Bloomberg puts it most succinctly: “The biggest problem with this debate, as with the previous ones, is what wasn’t discussed. There was no discussion of Europe or sub-Saharan Africa and only a brief mention of Latin America by Romney (who, as Matt Yglesias notes, got his key factoid wrong). The candidates did not discuss immigration, the drug war, global health, climate change or the international financial system.” He adds that “apparently ‘foreign policy’ has come to mean ‘places in the Middle East and North Africa where we are or might be bombing people, plus some really stupid and demagogic discussion of trade with China.’” With the election now less than two weeks away—and domestic issues such as jobs and the economy taking center stage—it seems increasingly unrealistic that either candidate will offer up much on global health, research, or other development topics soon. But no matter what the outcome is in two weeks, the next president must demonstrate more support for global health and foreign aid than the candidates displayed during Monday night’s debate.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. A new article in Science assesses President Obama’s record on promoting international scientific collaboration through the lenses of diplomacy, international development, and the operational requirements for scientific exchange. Devex examines how pharmaceutical companies are undertaking new research and development models to create products for developing countries, including forming product development partnerships with nongovernment organizations and foundations. A new issue of the Lancet includes a profile piece on the National Center for Advancing Translational Sciences (NCATS) at the National Institutes of Health. NCATS aims to “cut the time, cost, and failure rate of bringing laboratory research through to successful clinical medicine.” An inexpensive liquid test that could help detect low levels of viruses and some cancers has been developed by researchers from Imperial College London, who say that the test could lead to more widespread testing for HIV and other diseases in parts of the world where other methods are unaffordable. Several recent studies on the influenza virus indicate that seasonal flu shots could become a thing of the past, replaced by long-lasting vaccines.

In this guest post, Richard Hatzfeld, communications director for the Sabin Vaccine Institute, writes about a special report on neglected tropical diseases in the Financial Times, and the need for increased research, partnerships, and support to combat these diseases. Last Thursday, October 11, the Financial Times featured a special report on neglected tropical diseases (NTDs). Despite the fact that NTDs impact about one in six people around the world, many people—even some of those working in global health—have never heard of them. We’re hopeful that the efforts of organizations in our community, as well as features in publications such as the Financial Times, are helping to change this. As the report describes in a number of comprehensive articles, global partnerships to combat these diseases have made huge strides in changing the way the public views NTDs. Research investment in NTDs has increased from $268 million in 2007 to $418 million in 2011. In January, the London Declaration hosted by the Bill & Melinda Gates Foundation represented a new era of cooperation in the work to address NTDs, with leaders from 13 pharmaceutical companies, governments of the United States, United Kingdom, and United Arab Emirates, as well as the World Bank and other global health organizations offering increased support. These recent efforts are a big step in the right direction, but there is still great need in the fight to eliminate NTDs. Despite increased awareness, donations, and effort, only 0.6 percent of international development assistance for health issues is given to NTDs, according to the Financial Times report. The Financial Times special section led off with an article on the economic impact of NTDs, and pinpointed this as a reason behind the increased interest in exploring investment solutions. The Honorable John A. Kufuor (president of the Republic of Ghana, 2001-2009), NTD special envoy for the Global Network for Neglected Tropical Diseases—a program of the Sabin Vaccine Institute—highlighted this in one of the report’s articles, saying “[i]f the people are not healthy, they cannot be productive.” Drs. Peter Hotez and Maria Elena Bottazzi in the Sabin PDP lab in Houston, Texas. Photo credit: National School of Tropical Medicine at Baylor College of Medicine. Several articles in the special section reported on research and development projects that are being led by Sabin and our partners—particularly those addressing neglected diseases such as Chagas disease, dengue fever, and leishmaniasis. For most of these projects, partnership is the rule rather than the exception. Currently, the Sabin Vaccine Institute Product Development Partnership (Sabin PDP) has commenced Phase 1 clinical trials for a hookworm vaccine, and is projected to reach that point in 2013 for a schistosomiasis vaccine. And through our partnership with Eisai, Co. Ltd., Sabin has initiated pre-development and research phases for vaccines for Chagas disease and leishmaniasis. Increased research and funding has done more than raise NTD awareness—it has also led to opportunities across the global health sphere. For example, the Financial Times highlights leishmaniasis research that may have cancer treatment implications. It is important to continue such research efforts, not only for the goal of reducing the burden of NTDs on poor communities, but for the greater benefit of advancing scientific discovery that carries the potential for broad-reaching improvements in global health and development. Read the full Financial Times report here.