News

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. The Food and Drug Administration has approved the use of a new diagnostic test developed by the Centers for Disease Control and Prevention for earlier detection of dengue fever in the United States. Research!America has launched a new ad campaign that promotes US federal investments in driving research for new global health tools. A recent article in the Journal of Medical Microbiology discusses some of the scientific, financial, and ethical challenges in vaccine development. A new report by BIO Ventures for Global Health and the Biotechnology Industry Organization found that small- and medium-sized biotechnology companies are tackling the development of treatments, diagnostics, and other tools for neglected diseases. Congressman Edward Markey (D-Mass.) calls for a “detailed understanding of the harm” that mandatory cuts in the US federal budget to agencies such as the National Institutes of Health “pose to vital health programs upon which millions of Americans around the nation rely.”

Dr. Bríd Devlin is the executive vice president of product development of the International Partnership for Microbicides (IPM), a GHTC member. In this guest post, she writes about a new study IPM launched last week that will look at a new HIV prevention option for women. Last week, IPM announced The Ring Study, a Phase III efficacy trial to determine whether a monthly antiretroviral (ARV)-containing vaginal ring can safely and effectively help prevent HIV infection in women. This product could provide women with discreet, long-acting, and easy-to-use protection. In my role, I oversee IPM’s drug development projects. After working on a variety of drug delivery technologies for over 18 years, I cannot overstate how excited I am about a ring for prevention of HIV—this could be a real game-changer. The ring is a platform technology that has been used successfully for other medical purposes for decades. IPM has adapted the ring to potentially stem the spread of HIV to women in sub-Saharan Africa, the epicenter of the epidemic and where our studies show high acceptability for such a product. While highly effective, current HIV prevention options often cannot be used by women who are disproportionately vulnerable to infection. The ring is a promising way to expand women’s prevention options on multiple levels. First, several studies have shown that the same types of ARV drugs that successfully treat HIV may also protect against infection before it has a chance to take hold. In addition, by offering women sustained, monthly protection, it could overcome the burden of adherence, which is crucial to achieving the protective benefit offered by ARV-based prevention. As Sarah Boseley of The Guardian wrote in her recent blog, it’s a tool that “women can wear and forget about—at least for a month at a time.” The ring is also female-initiated and discreet. This means women can control their own HIV prevention without having to rely on a male partner’s cooperation or action. IPM has announced The Ring Study, a Phase III efficacy trial to determine whether a monthly antiretroviral (ARV)-containing vaginal ring can safely and effectively help prevent HIV infection in women. Additional studies in the field are looking at other approaches to female-initiated prevention, such as gels used around the time of sex and daily pills. It is important for women to have a range of options so that they can choose a product that best meets their needs and preferences. This year, IPM celebrates its 10th anniversary and a decade of progress in helping to advance HIV prevention for women. We have not arrived at this milestone alone. Partnership is at the core of our business model and mission. By working with partners across the public and private sectors, we amplify our individual resources and scientific ingenuity to help meet the health needs of women everywhere. For instance, the National Institutes of Health-funded Microbicide Trials Network will begin a larger Phase III “sister” study of the ring called ASPIRE in the coming months. Given its promise as a delivery mechanism, IPM is adapting the ring to meet the unique needs of women. With funding from the US Agency for International Development, we are developing a dual-purpose prevention ring designed to provide both HIV protection and contraception in a single product. We are bringing together global leaders to talk about the urgent need for multipurpose prevention technologies at Advancing the Integration of HIV and Sexual and Reproductive Health, a satellite session IPM is cohosting with Women Deliver at the upcoming International AIDS Society (IAS) conference. In late July, thousands of HIV scientists, policymakers, and activists will descend on Washington, DC, for the IAS conference. The theme is “turning the tide together” and one topic that will be highlighted is promising developments in HIV prevention. IPM looks forward to the ring being part of that conversation.

Combating preventable child deaths worldwide is an “investment that will pay dividends for years to come,” Deputy National Security Advisor Dennis McDonough said last week at a major conference at Georgetown University. At the conference, representatives from over 80 countries met to pledge their support for an exciting new global campaign for child survival. Hosted by the United States, UNICEF, and the governments of Ethiopia and India, the summit convened high-ranking government officials, members of the faith community, advocates, and private sector representatives. Over the last 50 years, child mortality rates have dropped by 70 percent. However, 7.6 million children under age five still die each year—far too many. In 2010, 57 out of every 1,000 children died before age five. The goal of the new program is to reduce that global rate to 15 deaths per 1,000 children by 2035. Under the program, UNICEF will house a small secretariat that will coordinate global activities to increase access to existing technologies and improve treatment guidelines, while partner countries like the United States will implement five strategic shifts to accelerate progress. As US agencies work with their partners to implement a new child health program, they must invest in R&D for new global health technologies. It’s critical that the program include a dedicated and distinct focus on global investments in research and development (R&D) for new tools to combat global child deaths, we still lack the vaccines, drugs, and other technologies needed to save children’s lives around the world. Indeed, research and innovation for new tools have been a huge factor in the success made against child mortality in the past 20 years, and must be prioritized by the new program. Several speakers at the summit praised the impact that technologies like the polio vaccine, oral rehydration solution to treat diarrhea, the MenAfriVac™ meningitis vaccine, and others have made in saving the lives of millions of children. Imagine if we had never invented a polio vaccine, or malaria drugs for children, or diagnostic tools for tuberculosis—what would global child mortality rates be today? A historic commitment to child health R&D helped create the tools that have already made a huge dent in global childhood deaths. For this reason, we should not only increase access to these existing technologies—the US Government and global partners must also continue to support R&D for the next generation of health products for children. If they don’t, the world will never reach the goals set by the new program. Fortunately, several US officials stressed the role of R&D in this effort last week. Secretary of State Hillary Clinton emphasized the commitment of the US Government to the development of new tools, saying, “We will support innovative research into new life-saving cost-effective measures.” Health and Human Services Secretary Kathleen Sebelius echoed the US role in basic research to support global health programs. Additionally, health officials from countries such as Bangladesh, Pakistan, and Nigeria highlighted the immense impact of global health technologies on their national child health programs. These achievements can be furthered by R&D-focused programs supported by the US Government, such as the second round of the Saving Lives at Birth program at the US Agency for International Development (USAID) and a joint USAID/National Institutes of Health initiative (NIH) that will provide grants to researchers in developing countries. As USAID and other agencies work with their partners to implement this important new program, they must invest in R&D for new global health technologies and plan for their delivery. USAID, NIH, and several other US agencies have a history of investment in innovation and are experts in catalyzing new research for huge impact. If we truly want to make the amazing progress we are promising to the next generation, the US must continue to expand its investment in global health R&D.

It’s exciting to see that research is a central theme of this year’s AIDS 2012 conference in Washington, DC. The biennial gathering of the world’s top HIV and AIDS scientists, advocates, and policymakers comes on the heels of some of the most significant research results for new HIV prevention and treatment tools in recent years, and the Breakthroughs blog will be at the conference from July 22 to 27, reporting on these research and development (R&D) advances. In a press release made public this week from the AIDS 2012 organizers, R&D efforts stand out as a critical component of efforts to turn the tide against the pandemic. The release recognizes that in the last few years, several trials—including HPTN 052, TDF2, Partners PrEP, and iPrEx—have demonstrated with “solid evidence the efficacy of HIV treatment as prevention, while other studies are currently investigating the possibility of a cure for HIV.” The official conference program, now available online, indicates that even more R&D advances in HIV and AIDS treatment and prevention could be announced at the conference. “Thanks to these scientific advances, for the first time we have a real opportunity to make a major dent in the epidemic,” said Elly Katabira, AIDS 2012 international chair and president of the International AIDS Society. The conference has also secured an impressive list of keynote speakers, including former US President Bill Clinton, US Health and Human Services Secretary Kathleen Sebelius, Sir Elton John, South African Health Minister Aaron Motsoaledi, and philanthropist Bill Gates. Thanks to scientific advances, for the first time the world has a real opportunity to make a major dent in the HIV and AIDS pandemic. Photo credit: PATH/Evelyn Hockstein. Make sure to follow us on Breakthroughs for the latest R&D announcements from the conference, as well as significant policy news and implications for HIV prevention and treatment tools. We’ll also bring you the latest updates from GHTC members supporting these new HIV and AIDS technologies, including AVAC, the International AIDS Vaccine Initiative, the International Partnership for Microbicides, and the Population Council. “AIDS 2012 represents a unique occasion to mobilize policymakers, governments, NGOs, scientists, people living with HIV, and civil society to join forces,” said Diane Havlir, AIDS 2012 co-chair and professor of medicine at the University of California. “Despite the global turbulent economic climate we cannot miss this historic moment, and it is vital to continue to attract funding to invest in AIDS research and promote programs based on effectiveness and efficiency in order to optimize the use of resources.” We at the GHTC couldn’t agree more, and look forward to sharing what promises to be monumental R&D and policy news from AIDS 2012.