A COMMENT FROM THE COORDINATOR
“Necessity is the mother of invention.” Dr. Roger I. Glass, author of this month’s Deep Breaths blog post, reminds us of this proverb and asks an important question: With so many children’s lives at stake, what better motivation can any of us have? We continue to struggle in reducing child deaths by pneumonia and the innovative approaches that we need to reduce this death toll are needed now. With the goal of reducing child deaths to at least 25 per 1,000 births (SDG, Goal 3.2), our members are leading impressive efforts in the fight against child pneumonia. Check out our up-to-date innovation and partner updates, details for upcoming pneumonia events and conferences, and recent publications to see our progress in the fight to end childhood pneumonia mortality through innovative approaches.
Mark your calendars:
The PIN is hosting its final webinar of 2018. The Ultrasound and child pneumonia webinar will be held on October 17, 2018 at 10AM EST. Webinar access information will be released via the PIN listserv next week. We hope you join us for talks from field experts.
DEEP BREATHS: BLOGS FROM PIN MEMBERS
Encouraging research innovations that improve health
by Roger I. Glass, MD, PhD; Director, Fogarty International Center and Associate Director for Global Health, National Institutes of Health
I find anniversaries can provide us with useful opportunities for reflection. As a diarrheal disease expert, I have recently been contemplating the impact of a research breakthrough that occurred fifty years ago—the discovery that oral rehydration therapy (ORT) could save thousands of people at risk of dying of cholera, for a treatment that cost just pennies to administer.
In 1968, a report from Bangladesh was published that described how oral rehydration solution (ORS) was used to successfully treat patients hospitalized in shock with cholera gravis, which untreated had a 40 percent mortality rate. Although research in the 1940s had demonstrated that administration of intravenous (IV) fluids was an effective approach, many cholera sufferers were located in low-resource settings where that was not available. For them, ORS was a miracle!
So what can we learn from this story of discovery that we could apply to other deadly diseases such as pneumonia?
Sometimes the solutions are simple: Previous research had shown that sugar and salt mixed with water helped cholera patients. But it also killed some of them. The young scientists working in Bangladesh decided to measure the patients’ output and use that as a basis to decide how much fluid to administer. That was the key to success.
Persistence in the face of failure: As I’ve learned in my rotavirus vaccine development career, setbacks are inevitable. By studying what went wrong, seeking advice from others and redoubling my efforts, I have managed to help produce some effective tools that prevent child deaths.
Necessity is the mother of invention: The American team of recently minted MDs found themselves in the unique setting of endemic cholera in the Ganges delta. People would literally die in front of them if the researchers didn’t find an affordable, yet effective treatment. This wasn’t a discovery made in a remote lab, it was made on the front lines of human suffering.
Optimism and fresh perspectives of youth: Established diarrheal disease experts knew ORS could be the answer but were perhaps intimidated with earlier failed clinical trials that resulted in some deaths.
Success breeds success: The 1968 article detailing the positive results was followed by a burst of research that increased the use of ORT for other diarrheal diseases and advanced new formulations that included zinc and encouraged feeding during diarrhea.
Oral rehydration therapy remains the mainstay of treatment for diarrhea worldwide—including in the U.S.—for both adults and children and can be used by parents at home, as well as in clinics and hospitals. Since the discovery of ORT in 1968, the estimated number of childhood deaths from diarrhea has declined from about 5 million deaths per year.
Perhaps there is also a simple treatment to prevent childhood pneumonia deaths that is awaiting discovery. I hope this story of success helps motivate some of today’s young scientists. With so many children’s lives at stake, what better motivation can any of us have?
PNEUMONIA INNOVATIONS NETWORK MEMBER AND PARTNER UPDATES
Racing with Merck, Pfizer wins FDA ‘breakthrough’ tag for 20-valent pneumococcal vaccine
By Eric Sagonowsky
Pfizer and Merck are racing to the market with their next-gen pneumococcal candidates, and Pfizer's program got a major boost. The FDA granted the company's 20-valent vaccine its Breakthrough Therapy Designation in adults as the drugmaker prepares for late-stage testing. With the breakthrough designation, Pfizer's program gets the perks of a FDA Fast Track designation, potentially including more frequent communications with the agency. The vaccine could win accelerated approval and priority review under certain circumstances. Meanwhile, Merck is already in phase 3 testing with its 15-valent program, dubbed V114.
Access the press release here.
High-quality health systems in the Sustainable Development Goals era: time for a revolution
The Global Health Commission on High Quality Health Systems has recently released a publication detailing their Commission to evaluate the quality of care available to people in LMICs across a range of health needs included in the SDGs:
"Health outcomes have improved in low-income and middle-income countries (LMICs) in the past several decades. However, changing health needs, growing public expectations, and ambitious new health goals are raising the bar for health systems to produce better health outcomes and greater social value. Staying on the current trajectory will not suffice to meet these demands. In need are high-quality health systems that optimize health care in each given context by consistently delivering care that improves or maintains health, by being valued and trusted by all people, and by responding to changing population needs. Quality should not be the purview of the elite or an aspiration for some distant future; it should be the DNA of all health systems. Furthermore, the human right to health is meaningless without good quality care because health systems cannot improve health without it. We propose that health systems be judged primarily on their impacts, including better health and its equitable distribution; on the confidence of people in their health system; and on their economic benefit, and processes of care, consisting of competent care and positive user experience.”
Read the full publication here.
ResApp Announces Positive Top-line Results from Australian Prospective Paediatric Clinical Study
ASX Media Release
Brisbane, Australia, 3 September 2018:
ResApp Health Limited (ASX:RAP), a leading digital health company developing smartphone applications for the diagnosis and management of respiratory disease, announced excellent top-line results from its Breathe Easy paediatric double-blind, prospective clinical study using machine learning algorithms to diagnose respiratory disease from cough sounds recorded on a smartphone. The algorithms were invented by Associate Professor Udantha Abeyratne and his team at The University of Queensland (UQ) and further co-developed by ResApp and UQ. Independent statistical analyses of the Breathe Easy study, performed by Curtin University health researchers, confirmed ResApp’s algorithms accurately diagnose a broad range of childhood respiratory diseases when compared to clinical diagnoses.
CEO and Managing director of ResApp, Tony Keating shares the exciting news: “The outstanding results delivered by the Breathe Easy prospective study are consistent with our expectations, and for diseases such as pneumonia and asthma have even exceeded our expectations. This formal confirmation of ResApp’s algorithms’ robust performance will allow us to provide key diagnostic products in an array of clinical settings, especially in telehealth - one of the fastest growing segments in healthcare - where up to 50% of consultations are respiratory related.”
View the full press release and study results here.