After a decade in emergency medicine, 5 years as a diplomat and policy analyst with the Australian Department of Foreign Affairs and Trade, and 3 years as Director of Medecins Sans Frontieres Access to Essential Medicines Campaign, and 4 years with the George Institute as Health Policy Director, Dr Mary Moran set up Policy Cures to focus on research and policy solutions for emerging issues related to neglected disease R&D. We sat down with one of our most illustrious, accomplished, and also delightful clients to understand more about her important work.
Mary, you have dedicated so much of your professional and personal life to advocating for vaccines for neglected diseases like malaria, TB, HIV, pneumonia, sleeping sickness and helminth infections. In this age of global connectivity, great public and private wealth, and technological advances, how do we still have neglected diseases? The old vaccines for these neglected diseases are almost relics, historical markers, that are intrinsically linked to 20th century events. Take the main malaria drug, which precludes the 1930s. After that, with the retreat of British colonialism, it was no longer imperative for Westerners to spend money on new vaccines and treatments. And the last drug for Asia-Pacific malaria was created during World War II. After the war ended there was no commercial or moral imperative to keep up with the new improved vaccines. As another example, the last Tuberculosis drug created was from when the TB epidemic stopped in the west, but in developing countries new drug-resistant strains continue to claim hundreds of thousands of lives. In a sense, Western consciousness has moved on and we have ignored that these diseases persist and still claim millions of lives, simply because there are no commercial drivers or moral imperatives when it’s not happening it us. The problem is not just disease but our rigidity to see what is happening.
How bad is the problem? Neglected diseases represent almost 60% of deaths in our Asia Pacific region. In 2015 HIV/AIDS killed 1.1 million, Tuberculosis 1.8 million, and Malaria 500,000 around the world.
There are so many causes and claims on public and private funding. How do you try to convince governments, corporations, foundations and private donors to put funds towards issues that aren’t happening in our own backyard? There are three key reasons I talk about. Firstly, Humanity. Don’t let people die if you can save them. That needs no further explanation. Secondly, Economics. 11% of economic growth linked to increased life expectancy thus reason to improve life for global good. 68% of this increase in life expectancy comes from new medicines. Our research has also shown that, in America, for every dollar that is invested in global health research, 66 cents goes back into the economy – to their researchers, their universities, their own production and manufacturing companies. Its an economic stimulant that is also helping save lives. This important research came from the Policy Cures Research team led by Dr Nick Chapman. Thirdly, Efficacy. We are wasting money on old treatments that are tedious and expensive to administer, and have high failure rates. If we had the foresight to invest up front we could find newer, cheaper and more successful medicines. I’ll use drug resistant TB as an example. The drugs haven’t evolved over the last half a century. Treatment is up to 2 years of tablets and injections – 7 pills a day – with a failure rate of 50-85%, meaning 4 out of 5 people with TB will die. There are new treatments which are 90% effective but there aren’t enough funds to finish the trials and get the medicines to the people in need.
How do Australia’s aid credentials stack up against the rest of the world? Australia hasn’t had a great track record with global health R&D however recently they’ve increased their commitment which is great. I hope to see more Australian R&D Investment into vaccines, HIV, Haemorrhage in Childbirth, Reproductive Health, and Childhood Diarrhoeal Deaths for our poorer neighbours. When disease and disaster is happening off our shores, its easy to think this ins’t our responsibility, and we think there’s not enough money. But, we need to remember that Australia is the world’s 13th largest economy and one of the most powerful countries in our region. Global health R&D must become a consistent and increasing part of Australia’s aid programme. Our global health R&D spend should include all major regional killer diseases as well as women’s needs. 1.5-2% of the aid budget needs be invested in making new, more effective global health tools to generate savings in lives and dollars. The best part is that our economy will benefit too.
In the field of neglected diseases, you represent and are expert adviser to some of the leading global health institutions: World Health Organisation, European Commission, the Bill & Melinda Gates Foundation and Wellcome Trust. What are some great projects that you have been involved in? There’s a wonderful project out of Monash University that received funding from the Bill & Melinda Gates Foundation’s Grand Challenges Explorations (GCE) initiative. Every year 150,000 women in developing countries die at childbirth from postpartum haemorrhage. Lifesaving oxytocin can only be administered via injection by a trained healthcare professional and the vials must be kept refrigerated. This poses a major barrier for women in developing countries, where refrigeration is limited and more than 50 per cent of women give birth at home. Led by Dr Michelle McIntosh, researchers from the Monash Institute of Pharmaceutical Sciences (MIPS) have created a dry powder formulation of oxytocin in an aerosol inhalant format. The project received US$1million in phase II funding which allowed the team to conduct extensive clinical trials, stabilise the pharmaceutically engineered particles of oxytocin, and find a manufacturer for the small plastic inhaler. So, we now have a product that can save a mother from bleeding to death after childbirth, and that will also give her child the best chance for survival because we know that children in developing countries without a mother are more likely to die before the age of five. The next step is to get funding to mass-produce this life-saving device.
That’s an incredible account but of course, there is still a lot more to be done before we see this in the hands of the women who need it. We all admire the important work that you and the Policy Research and Policy Cures teams are doing to champion these often-overlooked global health crises. For more information please go to www.http://policycures.org/