💉 The Asia-Africa cholera corridor; Mpox joins China's Category B; J&J sheds its old skin
#429 | Giving brain cancer a death wish; Fighting acne with animal meds; Fighting emissions with $$$$
Hello! Welcome back to The Kable for one final time this week.
Before we begin, The Kable has a brand new report this week - a comprehensive 60-page journey through the labyrinthine healthcare landscapes of sub-Saharan Africa, the Middle East and North Africa. This exhaustively researched, curated report by Team Kable uncovers the profound challenges these regions face and the seismic shifts brought about by digital health innovations.
Our Reports, free for all our premium Kable subscribers can also be purchased independently for distribution. Write to cyri@thekable.news for details.
With support from the EU, CEPI is investing $28.5 million in clinical trials of a Rift Valley fever (RVF) vaccine, DDVax, in Tanzania. Led by the University of California at Davis, these will be among the first CEPI-funded trials conducted in regions where RVF is endemic. Phase 1 of the trial is set to begin in 2024. CEPI also intends to fund tech transfer of assays and samples to Tanzanian labs and regulatory engagement to pave a path to license the vaccine.
Pakistan’s Searle yesterday announced its intentions to expand its Middle East footprint, having won licenses from UAE authorities. Searle, a pharma and consumer product manufacturer, is now authorised to conduct lab testing, packaging, storage, and product release in the UAE.
Researchers from the Chinese University of Hong Kong have developed a magnet-powered micro-robot which can eliminate 99% of dangerous bacteria inside medical devices like catheters and stents. We have just one question: what about the remaining 1%?
Moderna, meanwhile, is getting in on some Korean action, collaborating with Korea University Medical Centre and Chosun University Industry-Academic Cooperation Foundation. The objective? To expand to Korea its global public health initiative, mRNA Access, designed to expedite mRNA vaccine development worldwide.
To ensure pharma quality, safety and efficacy in India, the Drug Controller General of India (DCGI) intends to review pharma manufacturing standards. The DCGI will meet with industry associations to review GMP before upgrading Schedule M, which defines GMP in the country, to international standards. Better late than never.
About one in 10 patients experiences harm in healthcare facilities; annually, there are over three million deaths globally due to unsafe healthcare. Wednesday marked the end of a WHO-hosted global patient safety and engagement conference. At the conference, stakeholders agreed on the first-ever Patient Safety Rights Charter, which lays out the core rights of all patients about the safety of healthcare.
Johnson & Johnson has rebranded to evolve with the times. No, this isn’t about making more fair and transparent contracts. It isn’t about more equitable pricing for essential drugs. The company is just shedding its 136-year-old logo. Apparently, the new “refreshed, bright, and contemporary” colour says something about J&J’s ability to respond to health challenges and the updated ampersand captures a “caring, human nature”. The company is also dropping the Janssen name for its pharma division, calling it J&J Innovative Medicine instead.
Oh, and while it tries to shed its old identity, J&J is also facing a probe in South Africa. The country’s Competition Commission is set to investigate J&J amid allegations that it is charging South Africa more than twice as much as it charges the rest of the world for its TB drug Bedaquiline.
In a bid to strengthen in-house capacity and capabilities, Tokyo-based Astellas has revealed its plans to expand its Irish presence. It will invest over €330 million (~$354 million) in a new manufacturing facility in Tralee.
In the past, Sandoz has claimed to have 25 future biosimilars in its development pipeline. Now, ahead of its market debut next month,the Sandoz CEO has announced plans to launch at least five biological drugs in the next couple of years.
Meanwhile, Bristol Myers Squibb intends to expand its research pipeline by doubling the number of treatments it tests in clinical trials. BMS will focus on cell therapies over the next year and a half.
And finally, Microsoft has introduced EvoDiff, a general-purpose framework to generate high-fidelity, diverse proteins given a protein sequence. The open-source AI platform could be used to create enzymes for new therapeutics and drug delivery methods. But there’s still a long way to commercial use of the framework.
The Week That Was
This week kicked off with a lighter-than-usual Monday. We covered USAID’s decision to prematurely end a $125 million programme to identify viruses with pandemic potential, thanks to the fear of viruses jumping from animals to human hosts.
Researchers from the University of Oxford and the Woodwell Climate Research Centre developed a realistic threshold for when the world will become dangerously hot for us humans. Parts of the world have already crossed this threshold. Under current climate change conditions, 8% of the world by land area experiences danger zone conditions once every decade. With current warming projections, over a quarter of the world will experience these conditions at least once every 10 years.
Tuesday was all about malaria, the SDGs, and another potential pandemic in the making.
Scientists from Brown University and other institutes detected new strains of malaria-causing parasites in Ethiopia. These strains are not only resistant to current treatments including artemisinin, but they also evade detection by common diagnostic tests. This could increase malaria cases and deaths in the country and make eliminating the disease a lot tougher than it already is.
A week ahead of the UN Summit on the SDGs, the Bill & Melinda Gates Foundation released its 7th annual Goalkeepers Report to assess where the world has fallen short and where innovation and investment can have the most impact. This year's focus is the fight against the global maternal and child mortality epidemic, with new data revealing the potential of scaling up global access to 7 innovations and practices.
Scientists from the Duke-NUS Medical School and other institutes identified several novel strains of swine flu viruses. These strains found circulating in Cambodian pigs, include viruses which have jumped from humans to pigs. Scientists are concerned that we may potentially have another pandemic on our hands in the future.
We told you about Google throwing money at the SDG problem on Wednesday. Announced last year as part of its Global Goals Impact Challenge, the company’s philanthropy arm, Google.org is distributing $25 million in grants to use AI to achieve the SDGs in Kenya, South Africa, the Philippines, India, and elsewhere.
In a promising development for global antibiotic access, the Global Antibiotic Research & Development Partnership (GARDP) and India’s Orchid Pharma inked a sublicense agreement to manufacture Cefiderocol, which is an antibiotic used to treat certain Gram-negative infections; it is on the WHO’s Model List of Essential Medicines. This agreement builds on a June 2022 collaboration between Shionogi, GARDP, and the Clinton Health Access Initiative (CHAI) which aims to provide access to Cefiderocol in several countries, mainly LMICs.
We also shared with you a Reuters investigation into the wave of toxic cough syrups originating from India.
Coming to Thursday. The Director-Generals of the WHO, WTO, and WIPO agreed to shift the focus of their trilateral cooperation from Covid response to TRIPS flexibilities for health technologies.
And finally, Health Policy Watch provided an overview of the need for Africa to strengthen its medicines regulatory framework to achieve its local vaccine production goals.
Newsworthy
Cholera quite likes aeroplane travel. What do floods in Pakistan have to do with cholera in Malawi? Last year, massive floods submerged a third of Pakistan, fueling its largest cholera outbreak in decades. Malawi, too, suffered from flooding and Cyclone Freddy, both of which led to its largest cholera outbreak ever. Recent genomic surveillance has linked the two crises, demonstrating that the deadly cholera bacteria strain, which was new to Malawi, matched the strain circulating thousands of miles away in Pakistan (where it was also new).
In Pakistan, cholera was making the rounds between June and October 2022. The strain was introduced to Malawi, most likely by an air traveller, in July 2022. But this was the country’s dry season, so case transmission remained low. The caseload amplified exponentially as soon as the monsoons hit in late November. The displacement of people due to the floods and cyclone also contributed to the wide transmission of the strain.
It turns out cholera quite likes air travel. This isn’t the first time a cholera strain has travelled across the Indian Ocean from South Asia to Africa. It has happened for decades. The author of the research says that seeing this connection is key to preparing for repeats in the future. When a new strain of cholera takes South Asia by storm, African public health authorities should ramp up surveillance.
(Devex)
Joining Covid in Category B. Come September 20, China will begin to manage mpox in the same way it handles infectious diseases like Covid. Since the first imported case in September 2022, 20+ Chinese provinces have reported mpox cases. After detecting 501 mpox cases just last month, the country’s National Health Commission has decided to upgrade the management of the disease to Category B protocols. This means China could introduce emergency measures like restricting gatherings 😢, suspending work and school (yay!), or sealing off areas where the disease has broken out. With this new categorization, mpox is now in the same boat as not only Covid, but also AIDS and SARS.
(Reuters)
R&D
Strength in diversity. No, this isn’t a political lesson for India. It’s research about why immune checkpoint blockade (ICB) immunotherapy doesn’t always succeed at its job of killing cancers with a high tumour mutational burden (TMB). Researchers from EMBL’s European Bioinformatics Institute and their collaborators investigated the molecular mechanisms underlying resistance to ICB in tumours with DNA mismatch repair deficiency (MMRd). These kinds of tumours are usually most responsive to ICB therapy, but in this new study, intratumoral mutation heterogeneity dampened immune responses and diminished ICB effectiveness. Understanding this large variety of mutations spread across a tumour has progressed scientists’ cellular-level understanding of immune evasion by cancers with high TMB. These findings call for personalized oncology treatment approaches.
(Nature Genetics)
Tumoural hara-kiri. Some glioblastomas, or brain tumours, are particularly hard to treat. Since it’s so hard to kill them, these researchers at the University of Nottingham had the brilliant idea to induce them to kill themselves. They’ve devised a novel way to target and kill cancer cells in certain brain cancers. All it takes is some bio-nanoantennae or gold nanoparticles coated with specialised active molecules to trigger self-destruction in cancer cells on electrical stimulation. Moreover, this innovation could even be developed into a spray treatment for use during surgery. This is thought to be the first quantum therapeutic that uses quantum signalling to fight cancer. The research team has filed a patent and intends to translate the tech towards clinical application.
(Nature Nanotechnology)
Doing away with acne. Now that we’re done with research into petty concerns like cancer, let’s face the real important issues: acne, the cause of suffering for teenagers (and young adults 😓) the world over. In the most promising research update in today’s edition, scientists from the University of South Australia have found an effective acne treatment. Narasin, a new antibacterial compound encased in soft nanoparticles and applied to targeted acne sites in gel form can help you bid adieu to acne. Want more proof? Narasin is commonly used in livestock and have you ever seen a pig with pimples?
(Nanoscale)
The Kibble
Near-death brain: Memory's last stand. Researchers from NYU Grossman School of Medicine, in collaboration with 25 mostly US and UK hospitals, recently published a study suggesting that some patients resuscitated up to an hour after cardiac arrest recall experiencing aspects of death and show brain patterns related to thought and memory. Of the 567 CPR-receiving patients studied, fewer than 10% fully recovered, but 40% of the survivors remembered some form of consciousness during CPR that wasn't registered by usual methods. The study observed that nearly 40% of a specific group underwent brain monitoring and showed almost normal brain activity after flatlining. These experiences differed from typical hallucinations or dreams. The researchers hypothesise that as the brain nears death, it releases inhibitory systems, potentially unlocking access to all stored memories viewed through a moral lens. Study authors believe this study challenges the belief that the brain undergoes irreversible damage 10 minutes post-cardiac arrest.
(Resuscitation)
Bottom line
Trillions needed for 1.5°C goal. To prevent global temperatures from rising above 1.5°C this century, a Wood Mackenzie report states that a yearly investment of $2.7 trillion is crucial to reach net-zero emissions by 2050. Although the goal is to limit the global temperature increase to 1.5°C to avert severe climate change impacts, current governmental pledges are insufficient. Most countries are unlikely to meet their 2030 emissions targets, much less the 2050 goals. The term net zero means drastically reducing emissions, with any leftover emissions being balanced by natural absorbers like oceans and forests. The existing commitments by governments would still result in a temperature rise of over 1.5°C, possibly reaching 2.5°C by 2050. The report emphasises the need for renewables to be the primary power source and mentions that oil and gas will gradually deplete but still play a part in the transition towards net zero.
(Wood Mackenzie)
Oh, and Gopal Nair doesn't want you to see this.
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