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Nick Taylor is the program assistant at the GHTC. On Wednesday, he attended a briefing on Capitol Hill hosted by the Office of the Global AIDS Coordinator. Wednesday’s briefing—co-hosted by the Foundation for AIDS Research (amfAR), the President’s Emergency Plan for AIDS Relief (PEPFAR), and the Center for Global Health Policy at the Infectious Diseases Society of America —convened several HIV physicians and scientists to discuss PEPFAR and the evidence-based HIV prevention methods that the program implements in countries with high rates of HIV and AIDS. This briefing was the first in a series that will be held leading up to the International AIDS Conference this summer in Washington, DC. For thirty years, HIV and AIDS have proven to be among the most difficult public health threats the world has ever seen. While there have been many successes in combating HIV in recent years, most recognize that there is still a lot more to be done in order to achieve the goal of an AIDS-free generation. On Wednesday, members of the HIV and AIDS community gathered in the Kennedy Caucus Room in Washington, DC, for a briefing on PEPFAR and combination prevention treatments. Panelists stressed the importance of research and development (R&D) in the fight against AIDS and noted the successes of PEPFAR in expanding access to HIV and AIDS prevention. Last year, the world watched as President Obama said that “we can end this pandemic” and Secretary of State Hillary Clinton declared that we can get the number of mother-to-child transmissions of HIV to near zero by 2015. These powerful statements—along with the International AIDS Conference occurring in Washington, DC, this year—have put a renewed focus on innovation and research for preventing and treating HIV. Dr. Diane Havlir—a professor of medicine at the University of California, San Francisco, and panelist at Wednesday’s briefing—stated that investing in research allowed scientists to determine how to treat HIV with antiretroviral treatment (ART), which has saved millions of lives. In fact, according to Dr. Havlir, because ART has helped to keep people healthier, many societies have saved significant funds that would otherwise have been spent on medical care. This is surely a sound economic incentive to invest in research more often. Research and innovation need to play a key role in the global effort to achieve an AIDS-free generation. Photo: Evelyn Hockstein/PATH.. The briefing highlighted some of the most recent innovations that have been developed to prevent HIV. There is no question that ART has been successful in treating people infected with HIV, but studies have also shown that we can use treatment as prevention for HIV as well. If patients are put on ART at an earlier time than is normally recommended, the transmission rate from one HIV-positive person to a HIV-negative person can be reduced by more than 90 percent. Medical male circumcision has also proven to be an extremely effective way of preventing the spread of HIV. PEPFAR alone has provided funding for over four million male circumcisions since its inception, and panelists reported that the cost savings of those and the millions of circumcisions funded by nongovernmental organizations and other government programs has been nearly $16 billion. There are new tools in the pipeline that are making male circumcision faster, cheaper, and most importantly, safer. These devices require no anesthetic, no sutures, and do not need to occur in a sterile setting—which is often too hard to find for many men. This July, when the International AIDS Conference convenes, all eyes will be on Washington. Much will be said about the pandemic, and grand declarations will surely be made. What we’re all hoping to hear is that research and innovation will play a key role in fighting, and eventually ending, the HIV and AIDS pandemic.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. Two GHTC members announced they are making critical gains in the development of new tools to treat and prevent tuberculosis. Several groups announced their commitment and financial support to control or eliminate 10 neglected tropical diseases, including support for research and development. After studies demonstrate how effective medical male circumcision is as a tool for HIV prevention, public health experts are working to make the process safer, more efficient, and more cost effective. Bill Gates has penned an op-ed for the New York Times urging continued investments in foreign aid funding, which is critical for global health and development efforts.

Research!America, a member of the GHTC, recently conducted analyses across a select group of 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. Danielle Doughman, program manager for global health R&D advocacy, shares the organization’s findings in Georgia. This post is the second in a series in which Research!America will profile various states from around the country. Is Atlanta the next Seattle or Geneva? With continued federal investment, the global health community may soon be talking about Atlanta, Georgia, as one of the new global health capitals of the world. On many measures, Georgia—and its capital city in particular—is at the crossroads of global health. Bioscience is one of the state's fastest-growing industries; from 2001 to 2005, the number of Georgia bioscience firms grew by 38 percent, versus 13 percent in other industries. The state is home to the Centers for Disease Control and Prevention (CDC), which employs more than 15,000 people. The CDC, in partnership with the Department of Defense (DoD), was also the first to identify the H1N1 flu virus in its Atlanta labs, working closely with its international partners to limit the virus’ spread. Georgia’s world-class universities keep a steady stream of scientific talent flowing to the state’s public- and private-sector health industries. In 2010, Georgia received more then $433 through NIH for research, which helped create 6,700 new jobs in the state. Photo: Evelyn Hockstein/PATH. The Georgia Research Alliance (GRA) brings together Georgia's research universities, business community, and state government to create opportunities to grow Georgia's economy through scientific discovery. GRA has also been instrumental in recruiting top researchers to the state, including renowned scientist Rafi Ahmed to the Emory Vaccine Center. The creation of the Vaccine Center in turned spurred the creation of new private industry. Smyrna’s GeoVax is an HIV vaccine R&D company, which in turn conducts research with contracts from the National Institutes of Health (NIH). And Georgians increasingly recognize the health and economic value such research brings to the state. According to a June 2011 poll, 74 percent of Georgians think global health research is important to the state’s economy, especially in terms of jobs and incomes. And they’re right: in 2010, Georgia received more than $433 million in federal funds from the NIH for research. In turn, this helped create 6,700 new jobs in the state. Plus, research jobs typically pay well above the average annual salary. Georgians are also concerned about military health. A full 87 percent said that they are concerned about the military’s exposure to diseases overseas, and slightly more (88 percent) recognize that civilians also benefit from such health research. Funding for the CDC and the DoD allow research on infectious diseases and biosecurity to keep Georgia’s 100,000 military personnel—and their families—safe. However, while Georgia ranks ninth in population, it ranks just 15th in federal R&D funding. There is tremendous potential to grow the R&D enterprise in Georgia, and to contribute to the long-term investment that this sector brings for Georgia’s economy. Strong federal support for the US agencies working to improve our health and economy with evidence-based science is needed. Investment in global health R&D is not only the right thing to do for the world, it’s also the smart thing to do for Georgia.

Danielle Doughman is a program manager for global health research and development (R&D) advocacy at Research!America, the nation's largest not-for-profit public education and advocacy alliance committed to making research to improve health a higher national priority. Research!America is a member of the GHTC. Yesterday in London, some of the biggest players in global health committed to a renewed and intensified focus on neglected tropical diseases (NTDs), a group of diseases affecting the world’s poorest people. One in six people, or 1.4 billion people around the world, has an NTD and one in three people is at risk. Though NTDs don’t always kill, they cause disabilities, making it difficult or impossible for children to attend school and for adults to work and support their families. The international, cross-sector meeting marked collaboration between governments, the World Health Organization (WHO), the World Bank, the Bill & Melinda Gates Foundation, pharmaceutical companies, and global health nongovernmental organizations. It is also a historic pledge that brings new promise and hope to those affected and advances science and health for all. Sir Andrew Witty, CEO of GlaxoSmithKline, noted that the variety of different commitments across sectors demonstrates these collaborations want to “travel far” to end NTDs. “If you want to travel fast, travel alone. If you want to travel far, travel as a group,” he said, quoting an African proverb. Making the best use of existing tools to combat diseases will only get us part of the way. The collaboration's goals are achievable only with new tools—including drugs, vaccines, and diagnostics. Nine of the ten targeted NTDs require new investment in R&D. To take just one example, visceral leishmaniasis (VL) is almost always fatal if untreated, and there are approximately 500,000 cases each year, largely in South Asia and the horn of Africa. The cost of treatment plus loss of income due to one case of VL represents at least 50% of the average spent per family member per year. What’s worse, more than half of people who seek treatment must do so more than once to cure the disease. Available therapies are sometimes toxic or ineffective. New, more effective medicines are needed, at a lower cost and with fewer side effects. A consortium project led by the Drugs for Neglected Diseases initiative, in partnership with California-based OneWorld Health and TDR, WHO’s Special Programme for Research and Training in Tropical Diseases, aims to establish and implement new treatment modalities as successful tools to control and support the elimination of VL in most endemic regions of South Asia. California-based pharmaceutical company Gilead is investing in further research to reduce the cost of treatment. In addition to narrowing funding gaps, new licensing or collaboration agreements have opened up “libraries” of scientific knowledge and research compounds. As a result, one pharmaceutical company recently shared 300 compounds with a lab in Argentina to conduct research on Chagas, an NTD common in rural parts of Central and South America and sometimes found in poor parts of the United States. Something as ambitious as this takes commitment from the public, private, and philanthropic sectors, but the general public must become increasingly engaged as well. The names of diseases like visceral leishmaniasis don’t exactly roll off the tongue of those of us in developed countries, and fewer people could tell you why the condition is so devastating. To increase public awareness and advocacy of NTDs, the Sabin Vaccine Institute-based Global Network’s new END7 campaign aims to end seven of the most common NTDs as a public health threat by 2020. It’s going to take an increased effort on all our parts to make NTDs a thing of the past.