Marissa Chmiola

President Obama discussed global health and innovation in the 2015 State of the Union address. Photo: Official White House Photo by Pete Souza While others were playing State of the Union bingo or creating pretty word clouds, GHTC was closely watching the State of the Union address to see what President Barack Obama would say about US engagement in global health and America’s leadership in science and innovation. GHTC was glad to see the President highlight American involvement in combatting Ebola and underscore the need for a more effective global effort to address future health crises. Obama said: “In West Africa, our troops, our scientists, our doctors, our nurses and healthcare workers are rolling back Ebola — saving countless lives and stopping the spread of disease. I couldn’t be prouder of them, and I thank this Congress for your bipartisan support of their efforts. But the job is not yet done — and the world needs to use this lesson to build a more effective global effort to prevent the spread of future pandemics, invest in smart development, and eradicate extreme poverty.” The President also emphasized how American investments in research and innovation have saved lives and contributed to the economy. He said: “21st century businesses will rely on American science, technology, research, and development. I want the country that eliminated polio and mapped the human genome to lead a new era of medicine — one that delivers the right treatment at the right time.” GHTC was pleased to see America’s Commander-in-Chief draw attention to the US role in advancing innovation to save lives. For more information on why US policymakers should invest in global health research and development, check out our recent blog post, “10 reasons why US policymakers should support global health research and development.”

There are many reasons why US policymakers should support global health R&D. Photo: NIAIDAt the Global Health Technologies Coalition, our mission is to advance—through advocacy—the research and development (R&D) of new tools to prevent, diagnose, and treat global diseases. So in that spirit, here’s our list of the top ten reasons why US policymakers should support global health research and development: Global health R&D saves lives Thanks to US support for global health R&D, millions of people around the world are living longer and healthier lives. Breakthrough technologies have led to the elimination of smallpox and the near eradication of polio, and they have dramatically extended the lives of those living with HIV and AIDS. The fruits of investment in global health innovation are undeniable—since 1990, the under-five child mortality rate has been cut in half, maternal deaths have declined by 45 percent, and deaths from infectious diseases have dropped by around 25 percent. Global health R&D creates jobs and drives economic activity in the United States Around 64 cents of every dollar spent by the US government on global health R&D goes directly to US-based researchers and product developers, creating jobs, building US research and technological capacity, and providing a direct investment into the US economy. Across the nation, the life sciences field is responsible for more than seven million jobs and contributes US$69 billion annually to the US gross domestic product. Global health R&D improves our nation’s security and keeps Americans safe Infectious diseases like Ebola, HIV and AIDS, and pandemic flus know no borders. In today’s increasingly globalized world, the health of Americans and the health of populations abroad are interdependent. To keep Americans safe, it is essential that we have the tools to detect, prevent, and treat global diseases. To achieve this, the United States must invest in R&D now so we are fully prepared to tackle global health threats when they emerge in the future. Global health R&D is a smart investment that promotes cost-savings The development of global health innovations like vaccines can product cost savings long term. Photo credit: PATHInvestments in global health research not only saves lives but also produces cost savings and efficiencies in the long term. For example, past research has led to the creation of a polio vaccine that has nearly eradicated the disease globally. It is estimated that polio vaccinations have saved over US$180 billion in direct treatment costs in the United States alone over the last half century. A new meningitis vaccine introduced in 2010 is expected to save about US$570 million over the next decade, and new treatment regimens under development for drug-resistant tuberculosis (TB) could reduce the costs of treatment by up to 90 percent. Global health R&D drives economic growth in developing nations By producing technologies that make people healthier and increase their productive years, global health research can drive economic growth in developing nations. The Lancet Commission on Investing in Health found that nearly one quarter of all economic growth in low- and middle-income countries between 2000 and 2011 was attributable to increases in individual health and productivity brought about through improvements in health systems and investments in health innovation. As developing nations continue to work in partnership with the United States to strengthen their health systems and economies, the need for US assistance will be reduced over time. Global health R&D protects US troops and citizens who work or travel abroad US investments in the development of new tools to prevent, diagnose, and treat diseases such as TB, dengue, and malaria can help protect US citizens serving in the military, traveling, or working abroad in regions that put them at risk. The US Department of Defense (DoD) has been instrumental in advancing a variety of global health technologies for that purpose. For example, the agency supported the development of the first vaccine for Japanese encephalitis and the malaria vaccine candidate RTS,S. DoD programs also conduct ongoing research toward the development of an HIV and AIDS vaccine and new prevention and treatment options for malaria and other tropical diseases. Investments in global health R&D demonstrate America’s character and strengthen US relations around the world Investments in global health R&D demonstrate our nation's character. Photo: PATH/Gabe BienczyckiThe United States is the largest supporter of global health R&D in the world. US investments in global health research are an expression of our nation’s compassion and dedication to improving human lives worldwide, as well as an important instrument of foreign policy and diplomacy. US-led global health knowledge-sharing and capacity-building activities enhance our diplomatic relations with other nations, and US-supported global health innovations can strengthen fragile states by promoting improved health, economic development, and stability. US investments in global health R&D have a multiplier effect To support global health product development, the US government works in partnership with the pharmaceutical and biotechnology industries and academic and philanthropic sectors to leverage US investments in global health R&D and enable partners to bring their complementary skills, capabilities, and comparative advantages to bear. Investments made by the United States are matched with inputs from other sectors, meaning the impact of each US government dollar invested is multiplied. Global health R&D helps the Unites States maintain its long-term competitiveness in medical innovation While the US is undoubtedly the global leader in medical innovation, other traditional funders—and emerging nations like China—are increasing their investments and competitiveness in the industry. For example, China’s share of the global pharmaceutical industry output increased seven-fold between 1995 and 2010—from 2.5 percent to 18.3 percent—while America’s share remained steady around 26 to 27 percent. If the United States wants to remain the global leader in medical innovation, our government must continue to support strong investments in medical research, including funding global health research and product development. A majority of Americans support US investment in global health R&D There is strong support among both the American people and businesses for the United States to invest in new global health advancements. A 2011 poll commissioned by Research!America found that 78 percent of Americans believe it is important for the United States to support global health research. The same poll found that 76 percent of Americans believe that global health research and development is important to the US economy.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. Last week, Policy Cures released its annual G-FINDER report, which analyzes global investment in neglected disease research and development (R&D). The report revealed a US$193 million (6.2 percent) decrease in global funding from 2012 to 2013 primarily due to the US budget sequester, which led to a $188 million (13 percent) decline in funding for the US National Institutes of Health (NIH), the largest funder of neglected disease R&D worldwide. The United Kingdom’s Review on Antimicrobial Resistance released its first report, which warned that, by 2050, up to 10 million people could die each year from drug-resistant infections, costing the global economy US$100 trillion annually. Economist Jim O’Neill, chief author of the report, believes that this crisis can be mitigated through increased R&D into new antimicrobial drugs and changes in drug-use practices. Two announcements were recently made that could benefit pharmaceutical companies working to develop Ebola vaccines. Last Tuesday, Secretary of the Department of Health and Human Services Sylvia Burwell announced that drug makers developing Ebola vaccines would be offered legal and financial immunity through the Public Readiness and Emergency Preparedness Act, and she urged other nations to follow suit to ensure that “legitimate concerns about liability do not hold back the possibility of developing an Ebola vaccine.” Last Thursday, Gavi, the Vaccine Alliance announced that it would commit $300 million to purchase Ebola vaccines once the World Health Organization approved a product. Gavi hopes this move will incentivize pharmaceutical investment and development. The Atlantic takes an in-depth look at the slow and often frustrating work of developing new drugs and treatments. The article explores the careers of leading scientists—including NIH Director Dr. Francis Collins and Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases at NIH—illustrating how their work requires patience, resilience, and the ability to constantly live with and learn from failure.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. According to a recent study out of Oxford University, rapid evolution of the HIV virus is slowing the virus’s ability to cause AIDS. In this study of 2,000 women in South Africa and Botswana, researchers found that the HIV virus had evolved to adapt to a specific gene known as HLA-B*57, which provides some protective effect against HIV, slowing the progress to AIDS. As the virus has adapted to reduce this protective effect in individuals, the virus has also reduced its ability to replicate, making it less virulent over all. Last Thursday, the UN Secretary-General launched his synthesis report for the sustainable development goals. In this report, Secretary General Ban Ki-moon reaffirmed his support for the 17 goals and 160 targets proposed by the United Nations Open Working Group, despite concerns from some member states that the current list is too long. Of the 17 proposed goals, two contain targets related to the research and development of new technologies. Researchers are developing a powdered form of the measles vaccine which could make it easier and safer to deliver the vaccine to people in developing nations. The current FDA-approved measles vaccine is a live virus that has been freeze-dried into a powder, which requires reconstitution with water before being administered via syringe. The new vaccine under development is a powder that can be inhaled. This new formulation would eliminate the need for sterile water and needles, as well as cold-chain storage. A modified regimen of the HIV vaccine candidate RV144 was shown to be safe and capable of inducing a robust immune response in safety trials in South Africa. RV144—which was developed by the US and Thai military—showed early promise in clinical trials, but it was found to lose efficacy over time. This new regime is the same earlier RV144 vaccine regime with an added booster shot one year later. Further clinical trials of this new regime are set to begin in South Africa in early 2015.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. In the spirit of the Thanksgiving holiday, GHTC’s communications officer Marissa Chmiola put together a list of ten global health advancements she’s thankful for this holiday season. The list includes advancements toward polio eradication, new Ebola treatments, vaccine candidates against hookworm, dengue fever, malaria, and much more. The Bill & Melinda Gates Foundation announced a new policy that will require all research it funds to be published in a manner that is free for the public to access. Vox gives the lowdown on how this new policy could impact researchers. Since this Gates Foundation policy is in conflict with the practice of top scientific journals who charge access fees for their articles, Gates-funded scientists could have to stop publishing their articles in these top journals. On the other hand, it’s also possible that since the Gates Foundation funds so much research—spending US$900 million each year—these journals may have to change their policies or lose out on publishing potentially important research. The New Yorker takes an in-depth look at how the growing global vaccine market is spurring companies to pursue development of an Ebola vaccine. According to the author, companies have realized that while vaccines can be more difficult to develop than prescription drugs, that difficulty can also be an asset because it is then harder for generic companies to produce copycat versions. While an Ebola vaccine likely won’t become a big money maker for pharmaceutical companies, with government and aid agencies offsetting some of the development costs, companies could break even on their investments and gain some positive publicity in the process. This past week saw lots of great articles for World AIDS Day discussing progress on fighting HIV and AIDS. The International Partnership for Microbicides’ Chief Executive Officer Dr. Zeda Rosenberg discusses the need for new products such as microbicides which will help women protect themselves from HIV. AVAC’s Executive Director Mitchell Warren argues that more precision is needed in setting the prevention targets to meet UNAIDS five-year goal of reducing HIV infections by 500,000, including research into new prevention and treatment options.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. Last week we learned just how much pharmaceutical companies think a fast track review by the Food and Drug Administration (FDA) could be worth. Gilead Sciences paid US$125 million via auction to purchase a priority review voucher from Knight Therapeutics. This voucher will allow Gilead to shave four months off of the FDA review time for a drug of its choice. The priority review voucher system was created in 2007 to incentivize development of drugs for neglected diseases. Bloomberg reports on a recent study out of the Tufts Center for the Study of Drug Development which found it costs pharmaceutical companies on average $2.56 billion to bring a new drug to market. This is more than twice the cost it took 11 years ago. According to the study’s author, this higher cost results from larger and more complex clinical trials, as well as the number of drugs that fail in development. The Bill & Melinda Gates Foundation last week pledged $5.7 million to test potential treatments for Ebola. The research being funded will examine the effectiveness of using blood plasma taken from Ebola survivors to treat those infected, as well the effectiveness of an experimental antiviral drug called brincidofovir. While it has been common practice for decades for doctors to use blood donations from Ebola survivors as a form of treatment, there has not yet been rigorous studies conducted to examine the effectiveness of this practice until now. The US Department of Health and Human Services last Wednesday unveiled new proposed reporting requirements or clinical researchers registering and submitting results to ClinicalTrials.gov. The most significant proposed change is that companies will be required to submit summary results from trials even if the product has not been approved or licensed for use in the United States.