💉 AfDB's country reports to guide climate talks; Yamaha revs into healthcare; Routine immunisation rebounds
#439 | Potential new NASH treatment; Fighting TB better; A new avenue for Alzheimer's research
Hello and welcome to our final Kable of the week. Ahead of COP28, the African Development Bank Group has launched country-wise economic reports to guide African policymakers in their discussions at the climate change conference. The reports provide verified analysis and policy recommendations on mobilising private sector and natural capital finance to drive green growth and climate resilience on the continent. You can download the individual country reports here.
The Saudi Authority for Industrial Cities and Technology Zones, or Modon, has inked an agreement with Eva Pharma to build an industrial complex comprising an R&D centre and five pharma manufacturing factories. Under the agreement, Eva Pharma will receive over 50,000 m2 of industrial land in the Sudair Industrial and Business City to produce over 150 pharma products including vaccines, biologics, immunosuppressants, and oncology drugs. By 2026, the facility will manufacture 990 million units annually to deliver pharmaceutical security to Saudi Arabia.
Countries across Southeast Asia are rolling out the SEAHEARTS initiative to reduce the region’s cardiovascular disease burden. The initiative aims to bring all NCD reduction and management programmes onto a single platform. Countries have set targets to scale up primary care capacities to tackle hypertension, diabetes, and other chronic conditions.
Meanwhile, Bangladesh is still reporting a large number of new dengue cases daily. 2,357 new hospitalisations and 9 deaths were reported in the 24 hours leading up to Thursday morning, bringing the year’s total fatalities to 967.
In neighbouring India, three states in the South of the country – Kerala, Karnataka, and Telangana – are also reporting very high numbers of dengue cases.
Do you like surprises? If you’re an Indian pharma company, you might wanna get used to them. Reports claim that the US FDA will be stepping up its unannounced inspections of pharma plants in India.
India’s Sun Pharma currently holds 75% of Sun Pharma de Mexico. The company is now acquiring the remaining 25%, buying out its local partner Indi Pharma for over Rs 75 crore.
The Hindu reports that roughly 90% of visually impaired or blind people live in LMICs. In India alone, at least 100 million people need spectacles but cannot access them.
Novo Nordisk is aiming to bring its weight loss drug Wegovy to India in 2026, subsequent to regulatory approvals and ensuring sufficient supply. Illegal copies of the drug are already being sold online, but Nordisk has been unable to track down the counterfeiters.
German life sciences group Sartorius is partnering with UK-based startup SPARTA Biodiscoveryon its analysis platform which helps speed up the development, manufacture, and quality control of nanoparticles for biopharma drugs. Through its corporate investment unit Sartorius Ventures, the company is investing up to 3.5 million GBP to gain a minority shareholding in SPARTA.
In an interesting turn of events, Yamaha Motors is entering the healthcare space. It has established Tuning Fork Bio in Delaware, USA, which will undertake antibody profiling i.e. analysing antibodies in blood to visualise people’s health conditions. This will aid healthcare professionals in choosing the best drugs for their patients and also help pharma companies conduct new drug research. Tuning Fork’s target markets are the US and Japan.
USAID has awarded the South African Medical Research Council a contract for HIV vaccine R&D.
And finally, in news that is hardly surprising, researchers in Japan have found microplastics in clouds, from where they are likely affecting the climate in as yet inexplicable ways.
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The Week That Was
This was a busy, busy week. It started with disheartening news about BioNTech's change of plans in Africa. Bloomberg reported that BioNTech is no longer moving forward with its plans for a manufacturing facility in South Africa. The company is discussing developing a smaller-scale manufacturing site or potentially an R&D centre in Senegal. Rwanda appears to be mostly immune to this plan change. It received six containers for BioNTainer modules in March this year and work is already ongoing to establish commercial-scale vaccine facilities.
Then there was the WHO's Cholera Statistics for 2022 which provides a comprehensive look at the scale and spread of the current cholera outbreaks worldwide. Current data suggests the global upsurge isn’t relenting, with 24 countries currently experiencing active outbreaks. The WHO has appealed for $160.4 million to respond using its global strategic preparedness, readiness and response plan, while $16.6 million has already been released from the WHO Contingency Fund for Emergencies for the cholera response this year and the next.
Plus, the UK government unveiled new funding initiatives to address future pandemics, advance vaccine research, reduce deaths from infectious diseases, and prevent the avoidable deaths of mothers, newborns, and children. £103.5 million will be allocated to the UK Vaccine Network for creating cost-effective new vaccines to curb infectious diseases. An investment of £295 million will enhance R&D for rapid response to disease outbreaks and to enhance maternal and child health. The UK will also allocate £95 million to the Tackling Deadly Diseases in Africa Programme II and £5 million to the TB Alliance.
On Tuesday, we learned that quality crises can be contagious. Stealing the spotlight from India, Pakistan is investigating two local distributors of Roche's cancer drug Avastin after 12 diabetic patients lost their vision after receiving the medicine. Roche claimed that authorities have identified this as a case of contamination by a third-party supplier. The Drug Regulatory Authority of Pakistan (DRAP) said that the suspected batches had been created illegally and in the cases concerned, Avastin had been used off-label to treat diabetes-associated eye conditions.
Wastewater surveillance used to be a fairly small field, with researchers in the domain focused on drug testing or microbial mapping in relatively limited regions. Enter Covid, and wastewater surveillance took centre stage. This Science News article took a trip down the drain to explore how wastewater testing works, the pandemic-induced boom in the field, how surveillance could provide early warnings of new surges of Covid and other diseases, and the challenges to using sewage surveillance data to effectively inform policy.
On Wednesday, India revealed its ambitions to transform from a cost-based pharma industry into a value- and innovation-based one. The government announced the National Policy on Research and Development and Innovation in the Pharma-MedTech Sector in India and a Scheme for the Promotion of Research and Innovation in the Pharma MedTech Sector (PRIP). The policy focuses on facilitating innovation, incentivising private and public investment, and building an enabling ecosystem to support cross-sectoral research. The Rs 5000 crore PRIP scheme encourages the production of more high-value drugs in the country.
All while an Access to Medicine Foundation report pointed out that although 90% of WHO-categorised essential medicines are off-patent, generics and biosimilars are still out of reach of many patients in LMICs.Â
Meanwhile, a Reuters review of regulatory alerts has found that the US FDA is cracking down on lax testing practices by dozens of manufacturers of health and consumer products. The agency has reprimanded at least 28 companies this year for failing to prove sufficient testing of ingredients used to make OTC drugs and consumer products for the now infamous ethylene glycol (EG) and diethylene glycol (DEG). US-based companies and exporters from India, South Korea, Switzerland, Canada, and Egypt are in the line of fire.
Yesterday, the Clean Air Fund’s report on global air quality funding revealed that only a teeny tiny proportion, just 1% of international development funding and 2% of international public climate finance, was allocated to reducing air pollution between 2015 and 2021. And 86% of the investments went to just five countries – China, the Philippines, Bangladesh, Mongolia, and Pakistan. All of Africa, which has five of the top 10 countries in terms of average PM2.5 exposure, received only 5%. Overall, global spending on air quality improvements is not enough or well-targeted at present.
We also covered the US' announcement of Defeating Antibiotic Resistance through Transformative Solutions, or DARTS - a $100 million research drive to fight deadly drug-resistant bacteria. The Advanced Research Projects Agency for Health, or ARPA-H, will fund the programme, which will develop diagnostic and experimental platforms to reveal insights into how antimicrobial resistance begins, search for new antibiotics, and identify the right antibiotic to be prescribed for a particular infection in real-time.
And finally, European drugmakers warned that the EU's proposed complete ban on PFAS would make it impossible for them to produce medicines or APIs in the region.
And now for today...
Newsworthy
A global success story. Gavi released its 2022 Annual Progress Report yesterday with some promising updates. Routine childhood immunisation services rebounded across 57 lower-income countries last year. Supported by Gavi, this progress was driven by historic levels of investment by these countries. Collectively, lower-income countries contributed $162 million last year to co-finance Gavi-supported vaccines; this amount is higher than ever seen before in Gavi’s history. What’s most promising is that despite a period of economic turmoil, all countries met their vaccine co-financing targets, except for three waivers due to humanitarian crises. It is evident that immunisation remains a top priority, with country co-financing projected to increase by over 30% this year. Still, there are some challenges: routine immunisation coverage and the number of zero-dose children in Gavi-implementing countries are not yet back to pre-pandemic levels, and progress across countries is uneven. Looking forward, countries must not lose sight of economic, geopolitical, and climate conditions that can affect health and immunisation advancements.
(Gavi)Â
R&D
A new cure for NASH? Scientists from Yale University have identified a protein, CYR61, that plays a significant role in the progression of Non-alcoholic steatohepatitis (NASH), a severe fatty liver disease. Due to the absence of specific medications, NASH, stemming from non-alcoholic fatty liver disease, is the primary reason for liver transplants in the US. The rise in NASH parallels increasing obesity rates. In their research, the team found elevated CYR61 levels in NASH-damaged livers, which triggered inflammation and worsened liver damage. However, by inhibiting CYR61, liver inflammation and scarring were reduced in NASH-affected mice, also indicating potential benefits for managing type 2 diabetes. This discovery suggests that targeting CYR61 could be a promising treatment for NASH.
(Science Translational Medicine)
Notch-ing up a win for bone mass. Researchers from NYU Grossman School of Medicine have discovered in a study on mice that blocking the Notch signalling pathway in ageing skeletal stem cells results in a significant increase in bone mass and rejuvenates the bone's healing capabilities. Their study revealed that as skeletal stem and progenitor cells (SSPCs) age, they produce fewer bone-forming cells and more fat cells, weakening the skeletal structure. The elevated Notch signalling in these ageing cells promotes this detrimental shift. By genetically modifying mice to lack Nicastrin, a crucial component of Notch signalling, they redirected the stem cells back to bone formation, surpassing even the levels observed in young mice. The team believes that targeting this pathway could offer therapeutic solutions for conditions like osteoporosis.
(Bone Research)
A new approach in the TB fight. A research team from Boston University has identified two compounds, Rocaglamide A (RocA) and a c-Jun N-terminal kinase (JNK) inhibitor, that can potentially enhance the body's ability to combat tuberculosis (TB) by modifying the activation of macrophage immune cells. The researchers pinpointed the genetic signatures of TB-susceptible and TB-resistant macrophage cells, and subsequently examined various compounds' capacities to transition vulnerable macrophages to a more robust state against Mycobacterium tuberculosis(Mtb), the bacterium responsible for TB. The compounds, both of which are prospective cancer treatments, demonstrated collaborative efficacy in controlling virulent Mtb within susceptible macrophages. This new approach could potentially be advanced to clinical trials by 2024, given the appropriate support and funding.
TB remains one of the world's deadliest diseases, with over a million fatalities each year. The current BCG vaccine, in use for over a century, offers limited protection, with its effectiveness dwindling over age. Additionally, antibiotics, which serve as the primary treatment, are facing increasing resistance. Experts suggest that thinking of TB as a mere battle between a pathogen and its host might not be productive, citing its evolutionary coexistence that eventually manifests as an incurable disease. The team's focus on macrophages' dual states – an active and regenerative one – could provide a novel approach to combating the disease.
(Science Advances)
Move over, Viagra. Scientists are eyeing the venom of the Brazilian wandering spider for its potential benefits in treating erectile dysfunction. A compound derived from this venom, BZ371A, has been synthesised by researchers in Brazil and is currently in the pipeline for pharmaceutical development. After a successful Phase I trial, the drug, which increases blood flow by boosting nitric oxide levels, is entering Phase II. The intriguing part? This spider's bite can cause prolonged erections. While existing drugs like Viagra are effective for many, they don't work for everyone, and BZ371A's unique mechanism might offer a solution for those individuals. Also, the company believes the compound might be useful in treating certain eye and lung conditions. So, in the future, better sex and potential medical treatments might be attributed to a spider's bite!
(Federal University of Minas Gerais)
The Kibble
New brain cells linked to dementia resistance. Researchers have discovered two types of brain cells associated with a decreased risk of dementia, even in those exhibiting Alzheimer’s disease indicators. Their study explored why not everyone with cognitive decline shows the amyloid protein build-ups typical of Alzheimer’s, and vice versa. After examining brain tissue samples from 427 deceased participants, scientists identified two cell types with markers linked to cognitive health. These cells, connected with reelin protein and the hormone somatostatin, were more abundant in those without cognitive issues, even if amyloid was present. Interestingly, these identified cells are inhibitory neurons, potentially offering a new understanding of cognitive function preservation. This discovery might shift the Alzheimer’s research focus from targeting amyloid build-ups to protecting these particular brain cells.
(Cell)
Bottom line
Pharma and lagging climate initiatives. The pharmaceutical sector has been slow in understanding and reducing its contribution to climate change. A recent analysis reveals that of the 100 largest pharmaceutical and biotech companies in the US, only 33 were actively working on reducing their carbon footprints. Most don't report their greenhouse gas emissions, and there is a lack of standardised metrics for those that do. Even though the healthcare sector is responsible for 8.5% of the US’ greenhouse gas emissions, pinpointing the exact impact of drug development remains challenging. There's hope, however, as more companies are beginning to report on their emissions and set targets. Yet, to ensure genuine progress and avoid greenwashing, there's a call for more transparency, benchmarking, and consistent reporting standards. This push for sustainability comes not only from climate experts but also investors, government agencies, and the companies' own employees. This report by Stat News, while not globally inclusive, is nevertheless an important measure in time of how drug companies stack up when it comes to fighting the good fight.
(Stat News)Â
Battling an urban heat crisis. In India's rapidly urbanising cities, soaring temperatures pose severe health and environmental challenges, particularly in densely populated, low-income areas. Rising temperatures, coupled with near-saturation humidity, are causing ailments ranging from headaches to heat stroke. India experienced a 55% surge in heat-related fatalities between 2000–04 and 2017–21, with cities' heat-absorbing infrastructure intensifying the issue. While traditionally focused on cyclones and floods, India's disaster planning began recognising heat waves as a national-level natural disaster in 2015. Now, researchers are partnering with local authorities to refine emergency responses and explore affordable retrofitting solutions for dwellings. Science takes a look at all the retrofits and low-tech solutions that aim to counter rapid urban expansion. Increasing emphasis on constructing climate-resilient buildings and drawing inspiration from traditional architectural principles that naturally mitigate heat are increasingly the way forward.
(Science)
Oh, and Gopal Nair doesn't want you to see this.
Every Friday, we relax our paywall so you can see for yourself the value of paying ₹500/month (or ₹4500/year) for a concise download of the day’s top news and events at the intersection of human and animal health, climate change and environmental science. Please consider becoming a paid subscriber.