USAID’s latest report to Congress demonstrates how strategic health-related research and development investments are driving positive global health outcomes and saving American taxpayers money

By Matt Barnhart, senior medical and scientific officer, USAID’s Bureau for Global Health

From the development of new drugs for malaria and tuberculosis to the mapping of debilitating but preventable diseases, research and development (R&D) can be a catalytic force for scaling up impact. Many of USAID’s global health successes in preventing child and maternal deaths, controlling the HIV/AIDS epidemic and combating infectious diseases can be partially attributed to breakthrough research and development that altered the course of an illness or accelerated diagnostics and treatment through breakthrough innovation and ingenuity.

This year’s report to Congress coincides with our new five-year strategy, which focuses on three interrelated goals. Our first goal is to accelerate the development, introduction, scale-up and sustained use of new technologies, health tools and approaches; secondly, we want to influence the adoption of priority life-saving health and development interventions; and finally, we want to strengthen the capacity of people, systems and partnerships to conduct research and utilize results to improve health outcomes.

A lab technician in Rwanda. Photo credit: Riccardo Gangale for USAID/ Courtesy of Photoshare.

Although R&D can take years to come to fruition, when it does, it can save lives and be a total game changer. Take malaria for instance. One of the most notable areas of R&D investments for the Agency is the development of new vaccines, medicines and insecticides for malaria prevention and control, as well as research to improve malaria programs. Many lives have been saved since the launch of the U.S. President’s Malaria Initiative in 2005, but continued success depends on strategic R&D investments.

Last year, the sustained efforts of many partners paid off and led to the development of three new classes of malaria drugs, including the drug Tafenoquine, which if approved, could be the first new medicine to treat relapsing malaria in more than 60 years. In Cambodia, research on the safety and tolerability of single, low-dose Primaquine, a drug used for reducing malaria transmission, has been recommended for adoption in areas moving toward malaria elimination.

Another health challenge with the potential for high returns on investment in terms of R&D is multidrug-resistant tuberculosis (MDR-TB). The Agency knows from experience that this is a very complex and expensive disease to treat because of its severity and long-term treatment plan, which is why the Agency has been supporting several clinical studies evaluating the efficacy of shorter drug regimens.

Drugs for multidrug-resistant TB treatment, courtesy of USAID Kyrgystan.

For treatment that can last for as long as two years, medicine adherence has been a huge challenge in combating MDR-TB. Shorter and simpler to administer regimens may help increase adherence and acceptability, while decreasing side effects and transmission. Interim results from STREAM Stage-1, one of the Agency-supported studies of shorter MDR-TB regimens, have potential to inform global guidelines and improve the lives of millions of people.

Along with high-quality research, the Agency has continued to invest in ground-breaking tools and innovations that have been deployed in countries around the world. These cost-effective tools have not only saved lives, but also millions of taxpayer dollars. They have also contributed to strengthening our national security by enabling countries to mitigate impact and contain the spread of infectious diseases.

During the 2015–16 Zika outbreak in Central and Latin America, for instance, the Agency supported 26 innovations to combat Zika and future threats through the Combating Zika and Future Threats Grand Challenge. Innovations range from mosquitoes infected with Wolbachia, a naturally-occurring bacteria that prevents the transmission of diseases to humans, to a disease surveillance digital platform that could protect vulnerable communities from becoming hot spots not only for Zika, but also for malaria, dengue, Chikungunya and other infectious diseases, including currently known and unknown threats.

School students in Paris, Colombia, participate in growing and releasing their own Wolbachia mosquitoes as part of a science project. Photo credit: World Mosquito Program Colombia.

The Grand Challenges enable us to adopt an open-source model that empowers more people from all walks of life to offer solutions to global health problems. Research and partnerships spur innovation, which in turn harnesses the ingenuity and expertise of an increasingly diverse global development community. The Agency facilitates this process and opens the door for new ideas.

Supporting innovative research approaches in disease mapping is another way for the Agency to maximize global health impact. Knowing where diseases are most prevalent can shed light on their root causes, strengthen programs and more effectively target interventions.

Lymphatic filariasis (LF), for instance, is a parasitic disease spread by mosquitoes and one of seven neglected tropical diseases that the Agency prioritizes. Last year, the Agency supported the expanded roll-out of a new survey protocol to assess the LF in low prevalence settings. In Ethiopia, the study mapped the disease in 45 districts, and results showed that only three of them warranted treatment. This finding saved millions of dollars that may have otherwise been spent to provide treatment in areas where the disease was not endemic. The World Health Organization has endorsed the new survey protocol to be used in other areas of uncertain disease prevalence, including Vietnam and Cameroon.

These handful of tools and research projects are only a small fraction of the global health R&D portfolio that the Agency has supported around the world. Despite the fact that the Agency investments in health R&D are often working behind the scenes, their contribution to saving and improving lives is significant. These types of strategic investments continue to change the way communities think about what is possible in disease prevention and health promotion. You can download a copy of the Agency’s latest Health-Related Research and Development Report to Congress.