Ebola Roadmap And U.S. Response Should Remind Us That It’s A Big Deal

By the best estimates of people at the World Health Organization (WHO), we are at least six months, and probably nine, away from successfully containing the current outbreak of Ebola (the largest outbreak ever recorded).

At least that’s the goal.

The agency released a roadmap in late August to outline the necessary response to the disease.  There have already been over 3,500 reported cases, and the death toll is approaching 2,000 (or has surpassed it, depending on your source), making this outbreak larger than any previous recorded outbreak combined).  The estimates within the roadmap are sobering, with the possibility of over 20,000 people suffering from the virus.  By the end of September the WHO will do all it can to establish full coverage of Ebola response activities in the affected countries.

The United States will contribute to the effort.  More than 100 experts, and $100 million, have been committed to the region, with more money and personnel expected.  The U.S. military will be involved, according to an interview with President Obama broadcast over the weekend.  This re-emphasizes the severity of the problem, in part because Doctors Without Borders typically eschews military involvement in outbreak responses.  But the organization is stretched too thin to turn down such help.  With much of the outbreak area emerging from civil war, infrastructure and institutions are either broken or strained close to breaking.  Perhaps this lack of capacity has contributed to the spread of the outbreak.  If this is true (and we simply don’t know), addition resources applied to the region in a systematic fashion should help contain and better understand this outbreak before the virus has an opportunity to mutate.

While I’m certain that the U.S. public health infrastructure is in better shape than it’s West African counterparts, this crisis has made me mindful that maintaining such infrastructure involves constant investment and participation.  Without the facilities, regular training, and meaningful information provided by patients using those facilities, it becomes much harder to track diseases and be in a better position to contain or anticipate outbreaks.  In other words, for the grace of preparation go us.

DARPA Wants To Fight A Bug

The Defense Advanced Research Projects Agency (DARPA) often uses challenges to stimulate research in challenging areas.  At least some of the current work in self-driving cars can be traced back to several of DARPA’s Grand Challenges in autonomous ground vehicles.

The latest challenge appears to be the first that DARPA has issued outside of engineering and/or information technology.  Last week it announced the CHIKV Challenge for teams to develop methods to track and predict the emergence of a virus (H/T ScienceInsider).  The competition is interested in the Chikungunya virus, which has appeared in the Western Hemisphere for the first time in decades.  It’s mosquito borne, and any challenge solutions proven successful could be used for other viruses, especially those carried by mosquitoes.

The competition starts on September 1, and run through February 1 of next year.  The contest involves predictions of disease spread over the Western Hemisphere.  Entrants must submit the methodology, along with an indication of data sources and related models, by September 1.  Over the next several months, teams will submit accuracy reports indicating how well (or badly) their predictions match the spread of the virus, and describing their prediction for the balance of the competition period.

The top six teams will receive cash prizes (unless they are part of a federally funded research and development center).  DARPA hopes to follow in the footsteps of the Centers for Disease Control, which held a comparable competition on predicting the timing, peak and intensity of influenza during the 2013-2014 season.

‘Secret’ Ebola Treatment And Other Stories

The outbreak of Ebola virus disease (formerly known as Ebola hermorrhagic fever) in western Africa is no laughing matter.  The way it’s been inserted into fights over immigration reinforces the need to fight misinformation.  (That one of the politicians concerned that Ebola will come into the U.S. via Central American immigrants is a retired doctor reinforces my belief that not all doctors are scientists.)

Here’s what the Centers for Disease Control (CDC) has to say (effective August 6).

“The World Health Organization, in partnership with the Ministries of Health in Guinea, Sierra Leone, Liberia, and Nigeria announced a cumulative total of 1711 suspect and confirmed cases of Ebola virus disease (EVD) and 932 deaths, as of August 4, 2014. Of the 1711 clinical cases, 1070 cases have been laboratory confirmed for Ebola virus infection.”

Contrary to the concerns of several elected officials and media outlets, there is no significant risk of Ebola in the United States.  Two researchers with the disease were evacuated to the United States for treatment at Emory University in Atlanta.  As long as a hospital follows CDC infection control recommendations and can isolate the patient, it can contain the disease.

There is word of a ‘secret serum’ that the U.S. has, but is not currently going to send over to Africa.  This likely refers to the experimental treatment ZMapp, which has not undergone testing on humans.  While it was used in connection with one of the U.S. cases, neither the National Institutes of Health nor the CDC were involved in procuring the experimental treatment or getting it to the infected person in Africa. Continue reading

Google’s Baseline Study – Will It Avoid 23andMe’s Pitfalls?

Last week The Wall Street Journal reported on a new project from Google.org – the Baseline Study (H/T ScienceInsider).  Starting with a pilot group of 175, the study would collect anonymous genetic and molecular information (according to the article) to construct a more comprehensive data-based model of what a human is.  Such a picture would ideally help researchers better identify symptoms and causes of various diseases.  A desired outcome would be the ability to find markers of various diseases much earlier in people than is currently possible.

Of course, such a long-term study is not new.  What would be different here is the potential scope of the project, should it expand beyond the initial population of 175.  The project is lead by Dr. Andrew Cohen, a molecular biologist whose previous major achievement has been in high-volume HIV tests of blood plasma.  Working in volume is something he’s comfortable with.  The project is mindful of the need to preserve anonymity, and has stated information will be used strictly for health and medical purposes and not shared with insurance companies.  Institutional review boards will be involved with the study, and once it grows beyond the initial group of 175, boards at the medical schools at Duke and Stanford Universities will be involved in controlling access and use of the information.

For reasons that escape me, I can find little mention of the project on the Google.org website.  Even the mentions found on Google + don’t connect to the organization.  It would seem to me that the Wall Street Journal article, and the subsequent press on it, could be part of an effort to gauge public interest and concerns with the project.  The lack of details (the articles have little more to go on than the information provided to The Wall Street Journal) are frustrating.

And then there’s 23andMe.  Continue reading

The National Institutes Of Health Has An (Im)Modest Grant Proposal

The National Institute for General Medical Sciences (NIGMS), part of the National Institutes of Health (NIH), issued a Request for Information (RFI) last week on a new kind of research funding program (H/T Science magazine – $ for full version).  The deadline for comments is August 15.

The input NIGMS receives from the comments and other input from stakeholders will inform a funding opportunity announcement for a pilot of this program, which would link funding to a lab/principal investigator more than to a single project. As the RFI describes it (in part) (a link has been removed):

“An NIGMS MIRA would provide support for a lab’s research program, which represents a compilation of the investigator’s NIGMS research projects (research areas supported by NIGMS are outlined at our website). Researchers would have the freedom to explore new avenues of inquiry that arise during the course of their work as long as those avenues are relevant to the mission of the Institute and do not require additional review for regulatory compliance (e.g., new human subjects research).”

Now, I’m not a research scientist, but this program would represent a notable change in how research funding is normally disbursed in the U.S.  Grants are typically considered primarily on the basis of scientific merit and broader impacts and associated with discrete research projects.  By aggregating support to the level of a research lab (and the associated principal investigator), NIGMS will be, if only indirectly, putting more stock into the past work and future promise of the lead researcher than it has before.

Continue reading

PCAST Meets To Take A Deep Dive

When I first posted about tomorrow’s meeting of the President’s Council of Advisors on Science and Technology (PCAST), it was without benefit of an agenda.  Now that I have seen it, my mildly informed speculation has been confirmed.

The meeting will start at 9:15 Eastern time tomorrow in Washington.  A webcast will be available, as usual.  Simply visit the PCAST meetings page tomorrow.  The morning starts with progress updates (and perhaps final approvals) on PCAST reports on the National Nanotechnology Initiative (NNI) and antibiotic resistance.  The NNI report is required every other year by law, so PCAST will be returning to somewhat familiar territory.

The presentation part of the meeting concludes with a panel on oceans policy.  As I guessed, Beth Kertulla, Director of the National Ocean Council, will be part of the panel.  She will be joined by other leaders in the ocean science research community: Robert Gagosian, President of the Consortium for Ocean Leadership and Anthony Knap, head of the Geochemical and Environmental Research Group at Texas A&M University.

As usual, there is time set aside for public comment.  The public session is scheduled to end by lunchtime.

NIH Translational Center Scores Drug Development Deal

One of the goals of the National Institutes of Health’s (NIH) National Center for the Advancement of Translational Sciences (NCATS) has been to facilitate the conversion of research output into clinical inputs (treatments, medicines, and other tools to help patients).  Today it announced its first success in this area where drug development is concerned (H/T ScienceInsider).

The development comes through the center’s Therapeutics for Rare and Neglected Diseases (TRND) program.  Resources in this program are to encourage collaborations between NIH researchers and outside researchers working on conditions that due to rarity or other circumstances don’t receive my attention through traditional drug development channels.  The drug at the heart of today’s announcement addresses the underlying molecular mechanism of sickle cell disease.  The company that collaborated with NCATS staff, AesRx, has been acquired by Baxter International.  Before working with TRND resources, AesRx was having difficulty obtaining private investment in early-stage development.

This is, of course, not the only translational research program NCATS supports.  It’s not even the first TRND program to be completed.  But it does appear to be the first to lead to commercial acquisition.  In an era where economic impacts of scientific research are given greater scrutiny (not necessarily with additional understanding), this is certainly a positive development.  It’s also a validation of the need to look at all aspects of the research process to facilitate innovation.  The ‘valley of death’ (the gap between initial development and commercialization) is not just a challenge in technology.