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With the results of the presidential and congressional elections now almost two days behind us, there has been increasing reaction and speculation about what President Barack Obama’s second term and new congressional leadership could mean for foreign policy, international development, and global health. Below, we provide a round-up of some of the most interesting reads in the wake of the election results. Devex examines if Obama’s re-election is a “boon for US foreign aid.” While “Obama’s win is good news for the US Agency for International Development (USAID), which could have faced deep budget cuts in a Republican administration,” questions still “linger” over leadership. “Secretary of State Hillary Clinton is not expected to stay for more than a few months into Obama’s second term, if at all. Some Washington insiders also suggest that USAID Administrator Rajiv Shah is interested in pursuing a political career sooner rather than later.” According to the US Global Leadership Coalition (USGLC), the election has resulted in “broad bipartisan support for America’s global leadership and the International Affairs Budget,” although there are “challenges ahead to reconcile commitments to development and diplomacy with the need to address America’s fiscal crisis.” USGLC provides a detailed look at the new players in Washington and the likely playing field for the 113th Congress. The Center for Global Development identifies the “five things that should be at the top of the President’s global health agenda for the next four years.” These priorities include the President’s Emergency Plan for AIDS Relief, strengthening global health partnerships, and sustainability. Both National Journal and Foreign Policy examine how Rep. Howard Berman’s (D-CA) loss and a new Republican chair of the House Foreign Affairs Committee will shake up the foreign policy leadership in Congress. National Journal reports that one day “after the election ensured Republicans will keep their majority in the next Congress, Rep. Ed Royce (R-CA) made his first public play to secure the chairmanship of the House Foreign Affairs Committee.” And according to Foreign Policy, “Berman will be remembered for his decades of tireless work on foreign policy and his reputation as a legislator who sought to build consensus to push forward a bipartisan agenda.” Pharmalot looks at what the US Food and Drug Administration (FDA) will look like after the election results have settled. “Apart from an occasional reference, the agency is not part of the campaign dialogue.” However, the FDA will still be affected by the looming sequester, which would leave the agenda with about $320 million less to spend in Fiscal Year (FY) 2013 than it did in FY 2012. Pharmalot also examines what could happen to FDA leadership in the coming months.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. Secretary of State Hillary Rodham Clinton unveiled a blueprint for achieving an AIDS-free generation, which recognizes the need for research to develop new HIV and AIDS treatment and prevention tools. A new tuberculosis vaccine candidate has been given regulatory approval to begin clinical trials in Europe, making it the first of its kind to do so. An experimental vaccine based on a molecule that protects animals against influenza may one day offer a faster way to develop new vaccines for humans. At a recent World Health Organization meeting, member states agreed to focus on strengthening national regulatory capacities as part of a plan to promote the prevention and control of substandard medical products worldwide. In related news, WHO member states have also agreed to endorse a strategic work plan for global health research that includes proposals on the coordination, financing, and monitoring of research expenditures. A new report from the Milken Institute explores possible incentives and innovative financing mechanisms to develop treatments for diseases that primarily affect the developing world.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. President Barack Obama recently pledged to restore the United States to a position of global leadership in research and technology, but Nature examines how sequestration threatens research funding. GHTC members the Drugs for Neglected Diseases initiative (DNDi) and the Medicines for Malaria Venture (MMV) announced the identification of three chemical series that could lead to new treatments for neglected tropical diseases. The series were made possible by MMV's open access Malaria Box. The US Agency for International Development recently announced the launch of its Higher Education Solutions Network—a new partnership with seven top American and foreign universities designed to develop innovative solutions to global development challenges, including global health. Pharmaceutical companies Johnson & Johnson, Merck, and Eli Lilly plan to launch a one-stop database of global clinical trial sites aimed at streamlining paperwork and speeding the process for testing new drugs. A US Food and Drug Administration panel voted unanimously to recommend the effectiveness of a new hepatitis B vaccine but also raised concerns about its safety, asking for more data from studies on a wider population.

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.