Hannah Sachs-Wetstone

A new report launched at Davos, from the World Economic Forum and the McKinsey Health Institute, refocused the spotlight on women’s health back in January. The report found a stark gap in health between women and men, adding up to 75 million years of life lost annually due to poor health or early death. This health gap is incredibly costly—closing it would benefit 3.9 billion women and would boost the global economy by $1 trillion by 2040 due to reductions in early deaths and health conditions, as well as the greater capacity for women to make socioeconomic contributions.In recognition of International Women’s Day, GHTC is spotlighting technologies, both available and still in development, that could help close the gender health gap and move us toward gender equity by both addressing the leading causes of morbidity and mortality for women and girls and empowering them to take control of their health and future. 1. CAB-LA and the dapivirine ring for HIV preventionHIV remains a major global challenge, especially for women and girls, who account for more than half of the 37.7 million people living with HIV and 46 percent of new infections in 2022. While the introduction of oral pre-exposure prophylaxis (PrEP) has helped drive significant declines in HIV infections globally, challenges adhering to the regimen of daily pills, as well as issues of stigma, have limited its impact in certain populations, including adolescent girls and young women. Long-acting cabotegravir (CAB-LA), developed by ViiV Healthcare, is a HIV prevention option administered by injection once every two months. CAB-LA offers an option that for many is easier to consistently use and also more discreet to receive than daily oral PrEP, which can reduce a barrier to use for those who fear stigmatization if their HIV status is exposed.The dapivirine ring, developed by the nonprofit International Partnership for Microbicides, is a flexible silicone ring inserted in the vagina that slowly releases the antiretroviral medication dapivirine over one month to reduce the risk of HIV infection. The ring offers an alternative discreet, user-controlled prevention option for women at high risk of HIV who are unable or prefer not to use other prevention methods.2. HPV vaccine and self-sampling for cervical cancer prevention and treatmentCervical cancer is the fourth most common cancer in women globally, but 90 percent of deaths from cervical cancer and more than 80 percent of cases occur in low- and middle-income countries (LMICs). This is mostly due to lack of access to human papillomavirus (HPV) vaccination (nine out of every ten cases of cervical cancer are caused by persistent HPV infection) and cervical screening and treatment services. Ensuring girls and women have access to HPV vaccines and testing can help to address the persistently high burden of preventable HPV cases and cervical cancer deaths.As of 2023, there are six vaccines for HPV available globally, which all protect against the highest-risk types of HPV that cause the most cervical cancers. While there have been many studies demonstrating the safety and efficacy of HPV vaccines, a new study published in January of 2024, which was the first to monitor a national cohort of women over a significantly long period of time (the study looks at women born between 1988 and 1996), found zero cases of cervical cancer—reinforcing HPV vaccines as a lifesaving tool that has and will continue to be a game changer for women’s health. Regular screenings for cervical cancer are globally recommended and are crucial because cervical cancer can be cured if diagnosed and treated early on. Yet 67 percent of women between 20 and 70 have never been screened for cervical cancer (by HPV or other tests). HPV self-sampling, an approach recommended by the World Health Organization (WHO) for women 30 to 60, has been shown to be about as reliable as sampling by health care providers. Additionally, it has also been shown to nearly double use of cervical cancer screening services because it offers privacy and convenience, requires little time and effort, and reduces any embarrassment, pain, or anxiety that may be associated with sampling done by health workers. 3. Next-generation contraceptivesAn estimated 257 million people globally who want to avoid pregnancy are not using safe, modern methods of contraception, leading to unintended pregnancies and then unsafe abortions, which cause up to 13 percent of all maternal deaths. Unacceptable or unsuitable contraception options are one of the leading causes of unintended pregnancy. An estimated 40 percent of women in LMICs who use a contraceptive stop within a year because of challenges, including side effects, the burden of sticking to a daily regimen, and the time and monetary cost of having to travel, sometimes far distances, to get new prescriptions. Introduction of the daily oral birth control pill helped contribute to a major increase in contraceptive use globally over the past 50 years, but contraception technology has not seen major innovations in generations, and the field is deeply underfunded, highlighting the need for new, less burdensome contraceptive options.Lyndra Therapeutics is developing a once-monthly contraceptive pill, currently in preclinical development, that could serve as one such alternative. Researchers are also developing longer-acting injectable contraceptive products, including a six-month injectable contraceptive being advanced by FHI 360. Microarray patches are another novel contraceptive option in early-stage development—they work by releasing hormones over several months and are discreet and easy to use at home. Contraception, and specifically access to a variety of contraceptive options that fit varying needs, allows women and girls to have autonomy over their bodies and lives. There remains a gap in further research into nonhormonal contraceptive options that cause fewer uncomfortable side effects or contraceptives for men that take the burden off of women.4. AI-enabled ultrasoundsAlmost 800 women died from preventable causes related to pregnancy and childbirth every day in 2020. While there are many contributing factors, one significant challenge is lack of access to diagnostic tools like ultrasounds. Fifty percent of women in LMICs received no ultrasound scans during the course of their pregnancy. Even where ultrasounds are available, they are usually bulky, expensive, and require specializing training or knowledge to operate, forcing patients to travel to specific health care facilities to access them. New technologies like Philip’s Lumify Handheld Ultrasound, which can be connected to a mobile device, offer a more compact, portable option in emergency situations or in low-resource settings when traditional ultrasounds are not available or are not feasible. The Bill & Melinda Gates Foundation is funding Philips to accelerate the adoption of artificial intelligence (AI) algorithms that can be used with the scanner to simplify the identification of key pregnancy abnormalities, with results already showing that the AI-enabled technology helped to improve informed decision-making in the care of pregnant women in rural, underserved communities. Nimble, compact technologies like this ensure that more women have access to basic, lifesaving technologies and that women, along with their health care providers, can make informed decisions about their health and pregnancy, reducing the likelihood of death from preventable causes.5. Postpartum bleeding solutionsPostpartum hemorrhage (PPH), or excessive bleeding after childbirth, is the world’s leading cause of maternal death and can lead to lasting disability and psychological trauma, despite being preventable and treatable. Adolescent pregnancies carry a higher risk of postpartum hemorrhage because adolescent uteruses are not fully developed enough to sustain a healthy pregnancy—pregnancy complications, as well as unsafe abortions, are the leading cause of death among 15- to 19-year-old girls globally.PATH and Sinapi developed a technology, called the Ellavi uterine balloon tamponade, which builds on a low-cost solution some health care providers had been using to combat PPH called a “condom catheter,” which uses items commonly found and self-assembled in a clinic to insert a condom into the uterus and then fill it with water to exert pressure on the uterine walls and stop the flow of blood. The Ellavi device was optimized to be a high-quality, simple-to-manufacture and -use, and affordable version of the “condom catheter” that could be deployed globally to save even more lives. Another simple, inexpensive solution to PPH comes in the form of a plastic sheet with a pouch to collect and measure the volume of blood loss. This tool helps health care providers better recognize when women are in danger and take action. In one large-scale study in Africa, this sheet, when used in combination with other WHO-recommended treatment options for PPH, reduced the number of women experiencing severe bleeding by 60 percent and also reduced the number of deaths from PPH.These innovative but simple and low-cost technologies are not moneymakers, but they can greatly reduce preventable maternal deaths, particularly among adolescents, illustrating a paradox in women’s health—the gap persists because many technologies that could have a tremendous impact, particularly in LMICs, do not necessarily yield the greatest profit.While these five solutions highlighted have the potential to save lives and empower women, it is clear that closing the cavernous gender gap in health will require many more new tools and improved access to existing ones. Greater investment in R&D for conditions that specifically affect women and girls and expanded roles for women and girls to engage and lead across the R&D sector can help ensure more breakthroughs are realized in our lifetimes and that resulting tools are designed with the diverse needs of women and girls in mind.

Interested in more global health innovation news? Every week GHTC scours media reports worldwide to deliver essential global health R&D news and content to your inbox. Sign up now to receive our weekly R&D News Roundup email. The Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator (CARB-X) last week announced $467,000 in funding to GlyProVac to develop a maternal vaccine that targets Escherichia coli, the bacteria mainly responsible for neonatal sepsis, which is the leading cause of death among infants and a particular challenge in low- and middle-income countries. The funding will specifically support the development of the vaccine candidate GPV02, which offers protection to newborns through the antibodies passed on by vaccinated expectant mothers in utero and through breast milk after birth. GPV02 uses a unique approach compared to other attempted protein-based bacterial vaccines because it involves previously undiscovered natural sugar modifications and uses BEMAP technology to allow the vaccine to imitate E. coli, preparing the immune system to recognize the bacterium in the case of future infection.Last week, the Advisory Group on Immunization Practices at the US Centers for Disease Control and Prevention (CDC) recommended Valneva’s Ixchiq chikungunya vaccine for some travelers and laboratory researchers at risk of contracting the mosquito-borne virus. The United States records about 100 to 200 chikungunya cases a year in people infected abroad by the virus, which is mainly found in parts of Central and South America, Africa, and Asia. The vaccine was licensed by the Food and Drug Administration last fall for adults—the first vaccine approved for chikungunya. CDC has indicated that it may later expand the recommendation for people living in US territories where the virus may spread.A new extensive, long-term analysis from the Icahn School of Medicine at Mount Sinai found that COVID-19 vaccines induce long-lasting antibody responses, debunking previous claims that mRNA-based vaccine immunity wanes quickly. The researchers examined in over 8,000 samples collected over three years in New York City how antibody responses changed after infections, during the first series of vaccinations, during booster vaccinations, and during breakthrough infections. They concluded that the major reason for breakthrough infections is the virus evolving to evade immunity rather than waning immunity. The results will, hopefully, not only encourage people to continue to get vaccine boosters but also to continue research into new vaccines and viral variants.

Interested in more global health innovation news? Every week GHTC scours media reports worldwide to deliver essential global health R&D news and content to your inbox. Sign up now to receive our weekly R&D News Roundup email. Last Friday, the World Health Organization (WHO) announced the prequalification of a novel typhoid conjugate vaccine, developed through a global public-private partnership between SK bioscience and the International Vaccine Institute. Clinical trials in the Philippines and Nepal showed that the vaccine was safe to administer in infants and children as young at 6  months to two years and offered long-term protection with a single dose. As the rising global threats of climate change and antimicrobial resistance amplify the risk of typhoid, which causes between 120,000 and 160,000 deaths globally every year, this vaccine could help grow the global supply of typhoid conjugate vaccines and improve access in low- and middle-income countries through public procurement markets.Researchers have discovered a potent antibody, 95Mat5, that can neutralize a key type of neurotoxin produced by four deadly snake species in South Asia, Southeast Asia, and Africa. Currently, the standard treatment for snake bites, which kill an estimated 81,000 to 138,000 people globally every year and primarily occur in low- and middle-income countries, is antivenoms that consist of a variety of animal-harvested antibodies. These antivenoms can vary in efficacy and can also cause adverse immune reactions because the antibodies they use come from animals. Continued development of 95Mat5, which was synthetically created, could lead to a new antivenom that could be used to treat bites from the world's most dangerous venomous snakes and would be less likely to cause side effects because the antibody is human-derived.FHI 360 is leading a Phase 1 clinical trial of the biodegradable contraceptive implant Casea S, the first trial for a biodegradable contraceptive implant in more than 20 years. Casea S is implanted in the arm and works by releasing a synthetic hormone to prevent pregnancy for 18 to 24 months before dissolving. If proven successful in future trials, Casea S could serve as an alternative contraceptive option in the growing toolkit of products necessary to address the diverse needs and lifestyles of contraceptive users. Currently available implants are highly effective and safe and increasingly popular. Casea S could be an even better option, especially in low- and middle-income countries where users can face barriers to receiving care, because it dissolves by itself, eliminating the need for a removal procedure by a trained medical provider.  

Interested in more global health innovation news? Every week GHTC scours media reports worldwide to deliver essential global health R&D news and content to your inbox. Sign up now to receive our weekly R&D News Roundup email. Last week, the Coalition for Epidemic Preparedness Innovations (CEPI) announced that it will give up to $14.9 million in funding for a new four-year project led by FIND to identify the most reliable tests to detect Lassa and Nipah virus infections, two zoonotic diseases that have, respectively, led to outbreaks in West Africa and South and Southeast Asia. The hope is the initiative will lead to the licensing and widespread availability of tests to help identify and contain future outbreaks early on, reducing cases and deaths of these serious diseases. This project will contribute to CEPI’s broader 100 Days Mission of rapidly developing tools against pandemic threats, as both diseases are among CEPI's priority pathogens.Researchers have developed a new synthetic antimicrobial compound, cresomycin, which can target many strains of antibiotic-resistant bacteria, including multidrug-resistant strains of Staphylococcus aureus and Escherichia coli. Many antibiotics work by binding to components of the bacteria that make proteins and disrupting them, but some bacteria have adapted resistance mechanisms to prevent this effect; cresomycin has improved binding ability. The researchers hope future studies will show that cresomycin and other compounds like it are safe for use in humans and effective against a variety of deadly resistant bacteria, paving the way for new solutions to stem the rising threat of antimicrobial resistance.A new study shows that Merck’s Ervebo Ebola vaccine was able to substantially lower the risk of people dying if they still developed the disease compared to those who were unvaccinated, even if they received the vaccine after they had already been infected. It is the first study to show that in addition to preventing infections, the vaccine can also save the lives of people who are already sick. The study, which looked at data from the 2018-2020 Ebola Zaire outbreak in the Democratic Republic of the Congo, found the fatality rate was halved among those vaccinated two or fewer days prior to illness compared to those who were unvaccinated. In addition to confirming the effectiveness of post-exposure use of Ervebo, the study also combated concerns that there might be interference between Ebola antibody treatments and the vaccine by showing that people who developed Ebola after being vaccinated were treated as effectively with antibody products as those who had not been vaccinated.

Interested in more global health innovation news? Every week GHTC scours media reports worldwide to deliver essential global health R&D news and content to your inbox. Sign up now to receive our weekly R&D News Roundup email. Two new reports from the AMR Industry Alliance, a coalition of companies and trade unions in industries working to combat antimicrobial resistance (AMR), highlight both progress and setbacks in the field of antimicrobial resistance research and antibiotic development, as the threat of AMR rises globally. A survey of members demonstrated positive findings, including many industry members having implemented measures to support antimicrobial stewardship and efforts to increase antibiotic access in lower-resource countries, as well as having invested in AMR-relevant R&D. On the other hand, there has been a decline in AMR researchers over the last few decades, leading to less published research on AMR and fewer patents on new antibiotics, the decline particularly acute when compared to cancer and HIV/AIDS. The findings highlight the need for government and private sector incentives to provide adequate funding and investment for AMR research and novel antibiotic development, as well as for efforts to introduce young scientists to the field.The Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator (CARB-X) recently announced $1.8 million in funding to biotechnology company Visby Medical to develop a portable rapid diagnostic test that detects Neisseria gonorrhoeae, the pathogen that causes gonorrhea, as well as its susceptibility to ciprofloxacin, an oral antibiotic that was formerly a go-to treatment, which can no longer treat resistant forms of the pathogen. The test would allow health care providers to rapidly test and refer patients to the right treatment while hopefully ensuring that ceftriaxone, the only remaining effective antibiotic against resistant N. gonorrhea, is properly managed. The funding will also support the development of a test for N. gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis in men based on urine samples.The Coalition for Epidemic Preparedness Innovations (CEPI) will provide up to $2 million in funding to German biotech company LenioBio GmbH for a preclinical proof-of-concept for using its commercially available, plant-based, and cell-free technology to produce proteins for use in clinical trials testing vaccines against epidemic and pandemic threats in 20 to 40 days. If proven successful, this approach could greatly reduce the time it traditionally takes to manufacture vaccine proteins using other methods, which would be a major boon to CEPI’s 100 Days Mission to develop vaccines against novel pathogens with pandemic potential within 100 days of identification. The easy-to-use technology could also be rolled out for use in remote or low-resource settings, allowing greater availability of and access to future vaccines in those settings. 

Interested in more global health innovation news? Every week GHTC scours media reports worldwide to deliver essential global health R&D news and content to your inbox. Sign up now to receive our weekly R&D News Roundup email. Last Wednesday, the World Health Organization and the Medicines Patent Pool announced a new nonexclusive license agreement with SD Biosensor for the firm’s rapid diagnostic testing technology, which, through a phased technology transfer plan, will allow sublicensees to manufacture the technology, with additional benefits for the broader effort of manufacturing capacity-building in low- and middle-income countries. The agreement was negotiated under the COVID-19 Technology Access Pool (C-TAP), which was launched at the beginning of the COVID-19 pandemic, but it includes a broad range of diseases, including HIV, malaria, and syphilis. The rapid testing technology is the basis of SD Biosensor’s COVID-19 antigen test and is ideal for low- and middle-income countries because it has no equipment requirements and is easy to use with high sensitivity. The announcement also coincided with the unveiling of a new business model, the Health Technology Access Pool, which will succeed C-TAP and address other priority health issues beyond COVID-19.A new project—FLAVIVACCINE—from a diverse consortium of partners aims to increase the European Union’s ability to combat epidemic and viral threats in Europe and globally by supporting the development of a pan-flavivirus vaccine candidate that could protect against multiple flaviviruses, such as dengue, yellow fever, Zika, and West Nile. Beyond seeking a vaccine candidate, the project also aims to provide support across the R&D value chain, offering a boost to the broader global pandemic preparedness and response capability. The project is being organized by public and private institutions, including universities, research institutions, and a vaccine developer, spanning seven countries in Europe and the United States.A new grant to the Drugs for Neglected Diseases initiative (DNDi) from the Bill & Melinda Gates Foundation will support the development of innovative new drugs for sleeping sickness and river blindness. Specifically, the $20 million grant spanning until 2027 will support a single-dose cure for sleeping sickness and a short-course new treatment for river blindness, both diseases with a major footprint in sub-Saharan Africa and for which new tools are urgently needed to accelerate progress toward elimination, despite enormous progress in controlling them in recent years. These investments build on earlier-stage research also supported by the Gates Foundation.