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GHTC member OneWorld Health (OWH) recently announced that its treatment for kala-azar, or leishmaniasis, was registered for use in Nepal. In this guest post, OWH explains why this announcement is so significant for global health. Today we are thrilled to announce that our antibiotic Paromomycin Intramuscular Injection (PMIM), developed to treat visceral leishmaniasis (VL or kala-azar), has been registered by the government of Nepal. This is the second registration for PMIM in South Asia. It was previously registered with the government of India and added to the National Lists of Essential Medicines of India, Nepal, and Bangladesh. It was also added to the World Health Organization’s Model List of Essential Medicines. Now that the treatment is registered in Nepal, OWH will move forward with our partners on public health studies to help the government determine the best way to distribute and use the treatment in its public health system throughout the VL-endemic regions. What is visceral leishmaniasis? With approximately 500,000 new cases occurring annually, visceral leishmaniasis is the world’s second most deadly parasitic disease after malaria. Fatal if untreated, the official death toll for VL each year is between 50,000 and 60,000. VL is endemic in 79 countries, and primarily afflicts rural, resource-poor populations in India, Nepal, Bangladesh, Ethiopia, Iraq, Sudan, and Brazil, where affordable therapies are needed. Learn more about kala-azar: Kill or Cure: Kala-Azar Now that the treatment is registered in Nepal, OWH will move forward with our partners on public health studies to help the government determine the best way to distribute and use the treatment in its public health system throughout the VL-endemic regions. Photo credit: OneWorld Health What is Paromomycin Intramuscular Injection? An off-patent aminoglycoside antibiotic, paromomycin is an established drug with an extensive history of use and a well-characterized safety profile. OWH developed PMIM as an effective, inexpensive, and safe treatment for VL, and worked with the Indian government and Indian pharmaceutical company Gland Pharma to manufacture and distribute the treatment. PMIM is administered as a once-a-day injection for 21 days. The cost of a course of treatment with PMIM is less than US$20, which is significantly lower than other currently approved VL therapies. Please visit our website for more information – www.oneworldhealth.org.

Research!America, a member of the GHTC, recently conducted analyses in target states to measure the health and economic impact of global health research and development (R&D), highlighting its benefits for states across the nation and strengthening the evidence base for Congress’ support of federal investments in global health R&D. Mandy Goldberg, MPH, global health R&D advocacy intern, shares the organization’s findings in New Jersey. This is the fifth post in a series. When people think of hotspots for global health R&D, the state of New Jersey may not immediately come to mind. But it should. Despite ranking eleventh in population size, New Jersey ranks third in R&D investment among states, thanks mainly to robust private-sector investment. Health R&D is a pillar of New Jersey’s economy and is critical to economic growth in the state. Despite the current economic climate, R&D spending in New Jersey increased by 11.4 percent in 2010, and global R&D spending was up by $1.4 billion, according to a 2011 report by the Healthcare Institute of New Jersey, implying even more future economic benefits for the state. New Jersey is home to 17 of the 20 largest pharmaceutical, medical technology, and diagnostic companies in the world, including the national headquarters of Johnson & Johnson, Merck, Novartis, and Sanofi-Aventis. The private-sector plays an important role in the development of new and improved vaccines, drugs, and diagnostics for diseases that affect the world’s most vulnerable populations, both through its own R&D work and through its involvement in product development partnerships. New Jersey is a surprising hotbed for global health R&D activity in the United States. It ranks third in R&D investment nationwide and is home to 17 of the 20 largest pharmaceutical, medical technology, and diagnostic companies in the world. Photo: Evelyn Hockstein/PATH One noteworthy example of a New Jersey company engaged in global health R&D is Temptime. The company, at the prompting of global health partners, created a small sticker that changes color to show whether a vaccine has been exposed to temperatures that make it unsafe for use. The sticker, originally intended for another use, was repurposed for use with medical products such as vaccines, which need to be kept within a stable temperature range from manufacture until use to remain safe and effective. Temptime’s partnership with PATH and the US Agency for International Development allowed the company to become a world leader in monitoring temperature-sensitive vaccines, enabling the delivery of an additional 140 million doses of vaccines and helping save 140,000 lives worldwide. Past Global Health Council CEO Jeffrey Sturchio referred to New Jersey last year as the “silicon valley of global health research and development,” and 94% of New Jersey residents believe it is important for their state to be a leader in health R&D. Given increasing investment in global health R&D in other countries, continued investment from both the public and private sectors is needed for New Jersey and the United States to preserve their status as leaders in global health R&D and maintain rich economic benefits for the state and nation as a whole.

Phil Carroll is PATH’s Senior Policy Communications Associate. He spent two weeks in India last fall visiting PATH programs related to maternal and child health, tuberculosis, immunizations, and safe water and diarrheal disease. India is a country that changes dramatically from place to place, something I experienced firsthand while on a two week trip there this past fall. One day I was listening in on a mothers’ group meeting in one of the poorest villages in Uttar Pradesh state, and less than 24 hours later I was standing in one of the world’s most technologically advanced airports in Hyderabad—often referred to as the ‘Silicon Valley’ of India. It was during this leg of my journey where I was further convinced of the need for sustained investment in research and development. In a laboratory on the outskirts of the city, I met a handful of Indian doctors and researchers who are doing some pretty amazing, albeit subtle, things in health. Thanks to a small, less than $100,000, investment by the US Agency for International Development (USAID), the Blue Peter Public Health & Research Centre upgraded its tuberculosis (TB) lab to a higher level of biosafety. Improvements like better equipment and infrastructure and enhanced safety measures have enabled researchers here to diagnose a case of multi-drug resistant tuberculosis (MDR-TB) in a matter of days, a process that used to take the same team several months. Click on the photo to look at the full “Fast TB diagnosis helps save lives in India” slideshow. Photo: PATH/Gabe Bienczycki This is significant for a host of reasons. Diagnosing TB on the early side can help get patients on treatment faster, thereby reducing further deterioration of their lungs and other organs and ultimately save their lives. Catching TB early on can also curtail the spread of this incredibly contagious disease to others. India, which has the highest incidence of TB in the world, and 20 percent of the world’s burden, needs these sorts of advancements now more than ever. Currently, the government of India, as part of its National TB program, is only reaching 25 percent of MDR-TB patients with diagnosis. However, by 2013, it is aiming for 100 percent coverage, or around 2 million TB patients. While this goal might appear daunting, it should hardly be seen as insurmountable. As evidenced by its incredible response to polio in the last few years, the Indian government—with the help of key partners like PATH—is capable of pulling off some amazing global health feats when it resolves to do so. The government of India, under its National TB Laboratory Scale-Up plan, is in the process of upgrading other labs like the Blue Peter Public Health & Research Centre lab throughout the country. PATH is helping to make these labs airborne infection control compliant, thereby reducing the spread of TB. This, combined with other TB-control interventions and sustained advocacy at the national level, has the promise to one day make this disease a distant memory for the people of India. Look at the full “Fast TB diagnosis helps save lives in India” slideshow.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. President Obama releases his fiscal year 2013 budget with mixed reviews for global health research and development. The Centers for Disease Control and Prevention is making headway in tuberculosis research in Kenya. New ways of preserving vaccines are about to enter field trails in Vietnam. This technology could be used around the world. Data sharing can be the catalyst to more research and development for neglected tropical diseases. Scientists show how some cells in the body can repel attacks from HIV.