Taylor Capizola

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week.Two male health workers on a motorcycle carrying a vaccine carrier and supplies, pulling up in front of a building where women and children are waiting. (PATH/Doune Porter)A breakthrough leprosy vaccine candidate will soon enter a Phase I clinical trial. The vaccine—LepVax—is the first vaccine specifically developed for leprosy, marking a critical step forward in efforts to eradicate the disease. Leprosy is a painful bacterial disease that causes nerve damage, skin disfiguration, and issues with mucous membranes. While treatment options exist, there are many side effects, and these treatments are not capable of reversing the permanent skin and nerve damage. Early results from the trial should be available in 2018. A massive cholera immunization campaign recently launched near the border of Bangladesh in an effort to provide emergency immunizations to host families and displaced Rohingya families and children. Over 200 mobile vaccination teams delivered 900,000 cholera vaccines to the border regions currently affected by both a cholera outbreak and a refugee crisis. A main target of the campaign is children ages one to five, though individuals of all ages will receive vaccines. This immunization campaign follows a recent global pledge to end cholera by 2030. Results from a clinical trial launched in 2015 at the end of Liberia’s Ebola outbreak have demonstrated that two Ebola vaccine candidates are safe and effective in promoting an immune response. The first vaccine—ChAd3—developed by the National Institute of Allergy and Infectious Diseases and GlaxoSmithKline, resulted in an immune response in 64 percent of recipients one year-post vaccination, while the second vaccine—VSV-EBOV—developed by Merck and Canadian scientists resulted in an immune response in 80 percent of recipients at the one-year mark. These results will help inform continued development of both vaccines.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. A new study suggests the Nanopatch vaccine delivery system is more efficacious in protecting against poliovirus than typical syringes or needles. Nanopatch, defined as “a microscopic vaccine delivery platform,” targets immune cells in the outer layers of the skin, as opposed to typical syringes and needles, requiring injection into the muscle. The change from muscle to immune cells results in easier administration of the vaccine as well as a reduction in the required dosage. While initial data on Nanopatch is promising, more research is needed. The World Health Organization has warned that an increase in antibiotic use in livestock will result in increased antibiotic resistance humans, potentially causing one of the biggest threats to human health. The agricultural sectors in both Europe and North America are advancing efforts to curb antibiotic use, but many countries are still lagging behind in efforts to scale back use of antibiotics. While new policies and reform around livestock antibiotic use are needed, experts note there is still a need to treat health complications in livestock, through antibiotic alternatives like animal vaccines, as well as a need for improved diagnostics. The World Health Organization, numerous aid agencies, and relevant stakeholders have announced the first global pledge to end cholera by 2030, following one of the worst outbreaks of cholera in modern history. Cholera is considered a “disease of the poor,” affecting individuals living in areas with poor sanitary and water conditions. The recent outbreak is associated with and exacerbated by weak health systems, poor infrastructure, and a lack of necessary supplies to prevent, diagnose, or treat cholera. The pledge will focus on a multifaceted approach involving improving water and sanitation as a long-term solution and use of an oral, three-year cholera vaccine to provide immediate protection.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week.A new low-cost and heat-stable vaccine—ROTASIL—has been found effective against severe rotavirus in phase III clinical trials. The vaccine, which was developed by the Serum Institute of India and tested in partnership with PATH, had an efficacy of nearly 39 percent in children with severe rotavirus and 55 percent against a very severe form of rotavirus. The vaccine is a hybrid of bovine and human rotavirus and is capable of targeting all five rotavirus serotypes. Indian children face a high burden of rotavirus, as the country accounts for 22 percent of all rotavirus deaths worldwide. {% component type: A GeneXpert machine. (Photo: PATH/Georgina Goodwin)India is rolling out a new program to expedite the diagnosis of pediatric tuberculosis (TB) and multi-drug resistant TB cases to speed treatment. While children generally respond well to TB treatments, a pediatric TB case is usually severe and requires a quick, accurate diagnosis to ensure effective treatment. FIND and the Revised National Tuberculosis Control Program have worked in India to establish an infrastructure to aid in accurately and quickly diagnosing children, developing a courier system to quickly relay samples from clinic to lab for diagnosis and relay results back to the health provider via text message within 24 hours. The organizations have also led an initiative that has added over 600 GeneXpert diagnostic machines throughout India. India’s goal is to make the GeneXpert machines a front-line tool for TB diagnosis.Research conducted by the National Institutes of Health (NIH) and Sanofi has created an antibody capable of killing 99 percent of HIV strains. Fighting HIV is difficult because of the virus’ ability to mutate quickly, which often results in the presence of numerous different HIV strains in a single patient. NIH and Sanofi harnessed the natural defense system of a small number of people who produce broadly neutralizing antibodies,” which can kill up to 90 percent of HIV strains in the body. The researchers combined three antibodies to produce a tri-specific antibody that has proved to be more effective than any naturally occurring antibody yet discovered. The first human clinical trial is planned for 2018.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. Sanofi Pasteur’s announcement that it will cease work on its Zika vaccine candidate has raised concerns about the future of Zika vaccine development. While the World Health Organization has reported 40 Zika vaccine candidates in development, with six candidates in phase 1 clinical trials, Sanofi was the only major pharmaceutical company working on a vaccine against the virus. Its exit from this space raises questions about who will fund clinical development if these candidates show further promise. Additionally, many unanswered questions remain about the virus’s epidemiology and the target population for a vaccine. While the number of Zika cases is now falling, Zika epidemics will likely reoccur in the future. Because of this risk, developing an effective and low-cost Zika vaccine must remain a priority. Johnson & Johnson and the Biomedical Advanced Research and Development Authority (BARDA) have formed a partnership to develop vaccines and drugs to protect against pandemic influenza. Among its projects, the partnership is seeking to develop a “universal” flu vaccine that protects against all or most influenza strains. This collaborative effort highlights a larger trend in partnerships between the private sector, the US government, and nonprofits to develop vaccines and technologies against emerging health threats for which there is currently limited commercial market. Pakistan has launched its first nationwide vaccination drive for polio, aiming to immunize over 37 million children. Pakistan is one of just three countries where polio cases remain, so this nationwide drive is an important step toward eradication. While polio still remains endemic in Pakistan, the number of cases has reduced dramatically in recent years from 306 cases in 2014 to just 4 today. Pakistan has experienced obstacles in its attempts to eradicate the virus, which include efforts by extremists to target immunization campaigns.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week.  Researchers at MIT are working to create an all-inclusive vaccine for infants that can protect against diphtheria, whooping cough, polio, measles, meningitis A, B, and C, and more. The researchers have designed a promising micro-particle that could combine all of these vaccines into one single shot. The shot has not yet been tested on humans, though results were promising in a trial on mice. If this micro-particle proves effective and safe in human trials, this all-inclusive vaccine will be useful for infants in developing countries—as reducing the  number of vaccines necessary for infants in low-resource settings means fewer clinic visits. Mobile technology has the potential to help save the lives of newborns and their mothers in Tanzania. Researchers and phone developers are hoping to reduce rates of maternal mortality by launching a new service called “Text to Treatment” that uses toll-free texting to provide women with information that facilitates access to treatment centers. For instance, this service allows users to send money for travel to free clinics. Similarly, the “Mobilising Maternal Health” program also aims to provide better access to health care services by connecting women to transportation services, such as ambulance taxis and other travel to free clinics. Both of these programs have saved lives, with a 40 percent increase in female patients visiting treatment centers due to the “Text to Treatment” service and 30 percent reduction in maternal deaths due to the “Mobilising Maternal Health” program. These services have the potential to help bridge the rural-urban divide that impacts access to timely, high-quality health care for new mothers. Researchers at the University of Alberta, Canada have discovered the malaria parasite uses tagged carbohydrates to avoid detection and continue the spread of the disease in humans—especially in the liver. The researchers believe if treatments can be improved to account for the tagged carbohydrates, then these solutions may weaken the parasite to the point where it cannot survive within the host. They also believe these findings may help improve malaria vaccine design. Malaria remains one of the leading killers in the developing world, with about 650,000 annual deaths due to the disease.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week.Sanofi, a major vaccine developer, ceased their Zika vaccine program, highlighting how difficult it is to develop an effective vaccine for Zika. The US Biomedical Advanced Research and Development Authority reduced funding to Sanofi for the vaccine program last month, and Sanofi announced in early September it will no longer seek funding to continue its vaccine research. Smaller companies are in clinical stages of testing different Zika vaccine candidates, but Sanofi was the first major US pharmaceutical company to begin research on a potential vaccine for the virus. A female Culex quinquefasciatus mosquito (CDC/ James Gathany)The Infectious Diseases Data Observatory, a research observatory based out of the University of Oxford in the United Kingdom, is developing a data-sharing platform to compile and share Ebola data to aid in the response to future outbreaks. Researchers are seeking to engage local African leaders in the platform's creation to provide cultural context and ensure the resulting system improves the capacity of African researchers to conduct research in outbreak scenarios. Organizers agree that developing the platform now—during a period of no active outbreaks—is critically important, as having the platform available for aid workers and medical professionals before the next Ebola outbreak may aid in saving lives. A new, low-cost tool has been introduced in disadvantaged areas to treat newborn asphyxia. Newborn asphyxia is highly prevalent in low-resource settings, with about 20 percent of all newborn deaths in India caused by the condition. Therapeutic hypothermia—which reduces an infants body temperature—is a common treatment, but hypothermia-inducing machines are typically too costly for low-resource settings. Dr. Niranjan Thomas of Vellore, India created the MiraCradle, a fast-acting, low-cost device made of several phase changing materials—substances that absorb and release thermal energy—that is used as a regulation agent to keep a newborn hypothermic. The MiraCradle is currently being used in about 125 hospitals throughout India and South Africa.