For thriving societies, you need healthy communities. But despite significant advances in global health over the past decade, millions of people are still without access to basic healthcare. Every minute, a child in Africa dies from malaria. Every day, 800 women lose their lives in pregnancy or childbirth. One billion people are affected by so-called neglected diseases that can leave them in pain, disabled and trapped in poverty.
Old ways of working and low returns on investment have not always come up with the answers to these challenges. But that’s changing. Scientists are at the forefront of discovering and developing new ways to defeat diseases and preventable deaths in the world’s poorest countries. Innovative partnerships - bringing together these scientists with business, academia and charities - are breathing new life into combating some of the most intractable healthcare issues.
Healthcare company GSK believes that both fostering collaboration between different organisations and helping develop ideas born at the frontline of healthcare – often some of the best – is crucial. At Tres Cantos, near Madrid, GSK’s “open lab” has turned the traditional model of R&D – teams of researchers working behind closed doors – on its head to allow scientists from universities, not-for-profit partnerships and other research institutes to work with its scientists and world-class resources. The company also, vitally, provides potential access to its vast library of chemical compounds identified as having the potential to help create new malaria or tuberculosis (TB) medicines.
“These diseases represent some of the biggest killers so there’s a huge need to discover and develop new medicines,” says Dr Mike Strange, GSK’s head of operations for research and development into diseases of the developing world.
“But these are opportunities of limited commercial return and there’s been a distinct lack of investment in this space. We wanted to act as a catalyst for a new wave of innovation within this space. If we share our data, bright minds around the world will be looking at it in different ways.”
Grants from the Tres Cantos Open Lab Foundation, a UK charity established by GSK with a £10m investment, allow researchers to spend time - usually about 12 months - at Tres Cantos. By the end of last year, 15 projects had been completed and 19 more were under way. The results are shared with the broader scientific community. “It’s a very interactive environment, good for sparking ideas,” Strange says. “There’s a really special buzz around the place.”
Anuradha Kumar, a postdoctoral researcher from the Seattle Biomedical Research Institute, agrees. She spent six months at Tres Cantos in 2012 and 2013, leading a TB project. “Most of the developing-world diseases work is in the same building, so it’s very easy to meet people and have conversations with them,” she says. “We ended up working with lots of different people; it was extremely collaborative. It was really one large family.”
Access to the facility’s chemical compound library was a huge boost, Kumar says. “It meant we could test thousands and thousands of compounds in one day, rather than 90 or 100.”
After the success of the Tres Cantos Open Lab, GSK has created an open lab to increase understanding of non-communicable diseases (NCDs) in Africa. This will see its scientists collaborate with research centres across Africa from the company’s Stevenage hub.
“When we think about Africa we tend to think about communicable diseases, but NCDs, such as diabetes, cancer and hypertension, are emerging as the next big killers,” Strange says. “There’s evidence to suggest that African patients respond differently to some medicines. The open lab will look at what’s behind that and what that could ultimately mean for the future delivery and development of medicine, with the ideas and science coming from African researchers.”
Bringing together academia and business can help accelerate the development of new interventions. In a collaboration with Australia’s Monash University, scientists in GSK’s Academic discovery performance unit (DPU) and maternal and neonatal health unit are in the early stages of developing a low-cost inhaled form of oxytocin, a medicine that prevents dangerous bleeding after birth.
“The DPU was put together to make use of the enormous expertise that exists in the scientific community around the world, with GSK bringing its drugs development expertise,” project leader Susie Fowles says. “Every day about 800 women die from preventable causes related to pregnancy and childbirth in the least-developed countries, many as a result of uncontrolled bleeding during the later stages of pregnancy, giving birth or post-labour.”
In developed countries, oxytocin is used to stop that bleeding. But currently it can only be given by injection and must be refrigerated and administered by a healthcare professional – so for mothers in poorer countries it’s not an option.
“This is a major global health issue,” says Fowles. “If the mother dies the baby doesn’t thrive.” GSK’s experience with inhaled-delivery devices will be critical if the project is taken forward to the next stages of development. This is not always a given. The earliest stages of drug development are when a potential new medicine or vaccine is most at risk of falling through – partnerships help to share that risk.
Scientists at GSK are keen to join these types of project, Fowles says: “You’re working on something where there’s a massive patient need and you really feel you could make a difference. People become passionately involved.”
That passion is evident too in Professor Anna Coutsoudis, from the department of paediatrics and child health at South Africa’s University of KwaZulu-Natal. In partnership with global health organisation PATH and the University of Washington’s department of computer science and engineering, the team developed a simple mobile phone app that could play a game-changing role in getting life-saving donated breast milk to newborns. The FoneAstra monitor is one of this year’s winners of GSK and Save the Children’s Healthcare Innovation Award, which aims to help support and scale-up innovations coming out of developing countries that reduce child deaths.
Premature and low birthweight babies desperately need breast milk to help their underdeveloped digestive systems grow, and risk infection and death without it. HIV infection among mothers, high maternal mortality rates and large numbers of babies being abandoned mean that many go without.
Donated breast milk needs to be pasteurised, and with a price tag of $18,000-$20,000, commercial pasteurisers are simply too expensive for poorer countries. But for just $700, FoneAstra accurately monitors when the milk reaches the correct temperature via a probe, which then sends text messages to a mobile phone and prints labels confirming the results via Bluetooth.
Coutsoudis’s team now plans to scale-up provision, setting up “family health posts” that provide donated breast milk, promotes breastfeeding and teaches parenting skills. About 100 mothers at each post will be trained as breastfeeding counsellors who will then go on to train more women. “If you train-up a mum to be a counsellor it gives her more empowerment,” Coutsoudis says. “We really need breast milk for our babies. It makes a huge difference, and having community milk banks around the country is something we’ve always dreamed of. We’re so excited about it.”
This feature first appeared on The Guardian as part of a series exploring global health challenges.