💉 Japan's Ono partners with US' Twist; Wellcome's 7-year grant for Africa Health Research Institute; India looks to privatise Indian Medicines Pharmaceutical Corp
#419 | Fungi to make fruit fresh again; Lung tumours on a vitamin diet; The climate change prequel
Hello there. Welcome back to The Kable for the last time this week. In South Africa, yesterday was the deadline for the government to reveal details of its Covid vaccine contracts with international pharma companies and agencies, as per a landmark High Court ruling. This lawsuit, filed by the Health Justice Initiative, may blow the lid off suspected healthcare corruption in the country.
Also in South Africa, the Africa Health Research Institute, based at the University of KwaZulu-Natal, has secured a 7 year, R1.6 billion grant from Wellcome Trust. This funding will benefit research concerning HIV, TB, new infections like Covid-19, and mental health disorders.
As Africa marks a year without wild poliovirus type 1 detection, health leaders have pledged to enhance efforts to eliminate all forms of the virus.
A pan-African initiative for healthcare supply chain startups, Investing in Innovation Africa (i3), has announced a call for applications for early and growth-stage health tech innovators to join its second cohort. The programme connects African-led supply chain innovators to donors, industry partners, and government partners; it also provides them with a $50,000 grant. It is focused especially on women-led companies and companies operating in Francophone regions.
In Nigeria, traditional medicine use is higher than 80%. Now, the federal government is working with international partners and embassies like China and India to mobilise evidence-based actions to develop traditional medicine for both local use and commercialisation.
The WHO claims that if efforts to end cervical cancer by 2030 are stepped up, roughly 70,000 deaths from the disease could be averted in the African region. To stay on track, vaccination coverage should reach 90% of women and girls in 20 countries by 2024, screening rates should be at least 25% of 30- to 49-year-old women in no less than 10 countries, and treatment rates should increase to 25% in these countries.
Yesterday, the Government of India invited bids to privatise the Indian Medicines Pharmaceutical Corporation which makes alternative medicines. The government intends to sell its 98.1% stake; the Uttarakhand state-owned Kumaon Mandal Vikas Nigam, which owns the remaining 1.89%, also intends to sell. This isn't the first time a sale is being attempted – the government had tried to sell in 2019 as well. This time around, interested buyers can submit their initial bids by 15 October.
Japan's Ono Pharmaceutical is partnering up with US-based Twist Bioscience. Under this agreement, the companies will discover and develop novel antibodies to treat autoimmune diseases.
Still in Japan, the Environment Ministry has earmarked about ¥500 million to research the harmful effects of "forever chemicals". Their import into Japan has already been banned, but high levels of PFAS, far exceeding the government's provisional level, have been detected in rivers and elsewhere.
Meanwhile, Korea has come a long way in its anthrax vaccine research journey which began in 1997. Korea is expected to become only the third country in the world (after the US and the UK) to have independently developed an anthrax vaccine. After completing the second step of its phase 2 trial, the Korea Disease Control and Prevention Agency plans to apply for a product license from the Ministry of Food and Drug Safety in October.
In the US, the FDA has revealed its latest quality management maturity (QMM) programme to incentivise drug quality at manufacturing establishments. The hope is that companies will go above and beyond cGMP requirements.
The FDA has also issued guidance for industry on using of real-world data and evidence to support regulatory decision-making for drug and biological products.
And finally, Germany's BioMed X has announced the commencement of its first research collaboration with Sanofi. The AI project will accelerate drug development with a versatile computational platform that can predict the efficacy of first- or best-in-class drug candidates in virtual patient populations.
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The Week That Was
This week was a pretty good one for vaccine research, essential drug access, and Africa updates, especially given the ongoing WHO Regional Committee for Africa.
Monday kicked off with news of Walter Sisulu University and North-West University in South Africa's combination vaccine against tuberculosis and Covid which demonstrated unprecedented 100% protection in vaccinated animals! The researchers plan to move quickly into human trials for this vaccine.
Also, a novel trial for a generation of HIV vaccines entered its latter stages. Called PrEPVacc, this "last roll of the dice" trial is being coordinated out of Entebbe, Uganda with international support. The trial is testing two vaccines alongside two forms of pre-exposure prophylaxis. One vaccine is a combination of pieces of synthetic HIV DNA with a protein base; the other one is a combination of DNA, MVA (a weakened pox virus), and a protein base. Neither of these regimens has gone into an efficacy study before this.
On Tuesday, a report published by the University of Chicago's Energy Policy Institute claimed that rising air pollution can cut a person's a life expectancy by over five years in South Asia, which is one of the most polluted regions in the world. Bangladesh is seeing the worst of it, with everyone here risking the loss of 6.8 years of life on average by merely existing. In central and western Africa, too, growing energy consumption has increased the particulate pollution problem, resulting in a health threat on par with HIV/AIDS and malaria.
The other important update from Tuesday was more optimistic. The COVID-19 Technology Access Pool, or C-TAP, announced three new global, transparent, and non-exclusive licensing agreements acquired through the Medicines Patent Pool or MPP. As part of the first, Medigen Vaccine Biologics is offering its patent and know-how for a Covid vaccine which has been administered three million times across 7 countries. Under the second, the Spanish National Research Council (CSIC) shares a license for its Covid vaccine prototype. And the University of Chile is sharing its tech for a Covid assay to quantify neutralising antibodies. Already, the first license on a serological test has resulted in a sub-license to Biotech Africa from CSIC to develop their diagnostic technology.
On Wednesday, we wrote of senior Africa health officials, donors and development partners calling for an increase in investments to end malaria, which has caused nearly 600,000 deaths in the region.
African Health Ministers also endorsed a regional strategy to fortify action against antimicrobial resistance or AMR. Their new resolution hopes to improve coordination, governance, awareness, and surveillance relating to AMR.Â
Meanwhile, The New Times highlighted all the investments Rwanda is making to realise its ambitions of becoming a medical tourism hub for people from across the continent and the world.
Yesterday's Kable covered the Stop TB Partnership's announcement that both Johnson & Johnson and India's Lupin will supply their versions of the TB drug Bedaquiline at significantly lower prices in LMICs. The new prices will represent a 55% and 33% reduction, respectively.
Promisingly, TB drugs have company. The Global Fund to Fight AIDS, Tuberculosis and Malaria will, for the first time ever, be able to offer a lifesaving HIV treatment for less than $45 per person per year. This 25% reduction in the cost of TLD will allow governments in resource-constrained settings to expand HIV treatment access.
And finally, South Africa's Aspen announced new agreements with three global companies to package drugs at its French facility. By 2025, these agreements are predicted to contribute 2 billion rand to Aspen's top line. This is in addition to Aspen's agreements with the Serum Institute of India and Eli Lilly.
Newsworthy
WHO's operational handbook on TB. There seem to be positive updates on the TB front all round. After yesterday's news of price reductions for essential TB drugs, the WHO is now releasing an operational handbook on TB infection prevention and control. This handbook provides practical advice to complement its evidence-based guidelines – it includes best practices, checklists, and job aids for the implementation and monitoring of protection measures. These measures apply not only to health facilities but also to prisons, refugee camps, homes for the elderly, and other settings with high TB transmission risk.
With this new guidance, the WHO is calling on governments to strengthen TB prevention and control by allocating sufficient human and financial resources. It highlights the importance of Ministries of Health collaborating with other public and private authorities. Most significantly, rather than isolated implementation of individual recommendations, the WHO is encouraging the integrated implementation of interventions. Ultimately, with coordinated multisectoral action, TB prevention and control should be central to all national TB programmes.
(WHO)
R&D
Killing hidden HIV. In people living with HIV who are on antiretroviral therapy (ART), the HIV-1 virus persists indefinitely. Stop ART and HIV-1 makes a reappearance, rebounding from latently infected cells. But in a study from down under, researchers used a humanised mouse model of HIV-1 infection and CD4+ T cells taken from HIV patients on ART. They found that the blood cancer drug Venetoclax depleted cells latently infected with HIV. This could mean a potential cure for HIV or at least an extended time to viral rebound when ART is interrupted.
(Cell Reports Medicine)
Finding loopholes. Ion channels are tunnel-like structures found in cell membranes; their job description includes controlling the flow of charged molecules into and out of cells, which is needed for many biological processes. Because they are so crucial to health and disease, ion channels are promising drug targets. But there's a catch: scientists haven't been able to selectively target specific ion channels. Scientists from Weill Cornell Medicine and Australia's RMIT University may have just the solution: they've discovered that ion channels called BK channels have unique openings in their sides. Drug molecules may be able to access these openings, which means that in future, we could have a whole range of treatments that target the BK channel to treat different diseases including hypertension and epilepsy.
(Nature Chemical Biology)
Predicting cancer risk. In yet another piece of research from Australia, scientists at the University of South Australia have used machine learning (ML) to examine UK Biobank data and identify 84 features - including metabolic biomarkers and clinical, behavioural, and social factors - which could help predict cancer risk. Their study also identified markers associated with chronic kidney or liver disease; this emphasised the importance of investigating the pathogenic mechanisms underlying these diseases and their potential connections to cancer. High urinary microalbumin levels, an indicator of kidney disease, were the highest predictor of cancer risk. Further research is needed to confirm causation and clinical relevance, but these findings could, in future, lead to cancer risk being assessed via simple blood tests.
(European Journal of Clinical Investigation)
Short-term forecasting. Our last research update today isn't from Australia, but it is another ML-based study. Researchers at the University of Waterloo and Dalhousie University have devised a method to forecast the short-term progression of an epidemic even when there's very little data available. Called SPADE4, which is short for the Sparsity and Delay Embedding-based Forecasting model, this ML model was tested on simulated epidemics and real data from the fifth Covid wave in Canada. The model was able to successfully predict epidemic progression with 95% confidence. This research differs from the more complex models traditionally built by epidemiologists; unlike traditional models, this new one does not require complex demographic information, so it can be useful even at the beginning of an outbreak.
(Bulletin of Mathematical Biology)
The Kibble
The apple healer we need. Researchers in Japan have found a game-changing fungus that can break down patulin, a toxic substance that's often in damaged fruits like apples and pears. Patulin's not good for us - it can cause all sorts of health issues, even increasing cancer risk. Usually, it's a headache to deal with, especially in places where food hygiene isn't top-notch. But this new fungus, called TUS-MM1, can turn patulin into something way less harmful. This could be a big deal for making our food safer, especially for babies who are extra sensitive to stuff like this. Isn't science awesome?
(MicrobiologyOpen)Â
Vitamins C and E: Tumour's BFFs? Hey, so some surprising research just came out about antioxidant supplements like vitamins C and E. You'd think they're all good, right? Well, not so fast - especially if you're dealing with lung cancer. A study involving mice showed that taking these supplements might actually help lung tumours grow by boosting blood vessel formation within them. The research isn't saying to ditch antioxidants from your diet, but it's cautioning against taking more than what's necessary, especially in supplement form. This could even open new avenues for cancer treatment, focusing on regulating blood vessel growth. So, maybe think twice before you down that extra vitamin C tablet.
(The Journal of Clinical Investigation)
Bottom line
Human Extinction: The Prequel. The possibility of human extinction or severe population decline isn't a new concept; it turns out our ancient ancestors came alarmingly close to a wipeout too. A recent study by scientists in the US, Italy, and China filled in a big gap in the African and Eurasian fossil record by discovering that human ancestor populations dramatically shrank between 800,000 and 900,000 years ago. Using a new method called FitCoal and analysing modern-day human genomic sequences, they estimate that only about 1,280 breeding individuals were alive at that time, resulting in a loss of nearly 99% of the population and 65.85% of genetic diversity. The likely culprits? Extreme climate changes, severe droughts, and dwindling food sources. Interestingly, this bottleneck might have triggered a speciation event, contributing to the formation of chromosome 2 in modern humans and shedding light on our last common ancestor with Denisovans and Neanderthals. The research opens up a slew of new questions and areas for future study, from understanding how this tiny population survived to the broader strokes of early human evolution.
(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.