Drug development to prevent infectious disease & poor nutritional outcomes DAVID SHOULTZ, MS, PHD, MBA

Transcription

1 Drug development to prevent infectious disease & poor nutritional outcomes DAVID SHOULTZ, MS, PHD, MBA GLOBAL PROGRAM LEADER

2 Leveraging the Seattle Nutrition Community: From Ideas to Action Child Nutrition & Infection Malnutrition >> Human-Animal Interactions>>Drug Development Scaling Up Through Technical Assistance Remote Sensing>>Scale-Up>>Iodine Deficiency>>Strategic Partnerships Food Systems: Health & Nutrition Global-local linkages that shape food systems

3 Child Nutrition & Infection Improving malnutrition inpatient and post-dc outcomes Human-animal interactions and impact on child nutrition, microbiome, and growth Drug development to prevent infectious disease and poor nutritional outcomes

4 Drug development in this context PREVENTING & TREATING DISEASE Communicable diseases Non-communicable diseases Prevention Treatment Pathogen-specific Broad-spectrum Disease-specific Probiotics Other POOR NUTRITIONAL OUTCOMES Probiotics Other nutritional products Immunologic boosters Antibiotics? Obesity & other NCDs Disease-specific nutrition Micronutrient deficiencies Other

5 Drug development in this context PREVENTING & TREATING DISEASE 1. Intestinal parasites 2. Environmental enteropathy 3. Cryptosporidium 4. Moderate-to-severe diarrhea

6 Drug development in this context POOR NUTRITIONAL OUTCOMES 1. Emerging consumer products 2. Environmental enteropathy 3. Probiotics 4. Fortified foods & crops

7 Drug development case studies: preventing and treating disease SOIL TRANSMITTED HELMINTHS Include hookworm, ascariasis, and whipworm More than 1 billion people infected with at least 1 Coverage with MDA improving but still inadequate PATH leading an effort to register and WHO PQ Tribendimidine Drug also effective against liver fluke infection Source: Crompton & Neisheim. Annu. Rev. Nutr :35 59

8 Drug development case studies: preventing and treating disease SOIL TRANSMITTED HELMINTHS Include hookworm, ascariasis, and whipworm More than 1 billion people infected with at least 1 Coverage with MDA improving but still inadequate PATH leading an effort to register and WHO PQ Tribendimidine Drug also effective against liver fluke infection Source: First WHO Report on NTDs (2010)

9 Drug development case studies: preventing and treating disease CRYPTOSPORIDIUM DRUG ACCELERATOR Diarrheal disease is a leading cause of morbidity and mortality Chronic, sub-clinical infection may be an important source of morbidity, including EED Cryptosporidium now recognized as an important, quite prevalent pathogen: o GEMS o MAL-ED Only one FDA-approved drug PATH has launched the ACCORD cryptosporidium drug accelerator

10 Drug development case studies: poor nutritional outcomes EMERGING CONSUMER PRODUCTS 1. DiaResQ, as an example 2. Marketed as a medical nutrition product 3. Delivers micro- and macronutrients, 4g protein, amino acids, fats, carbohydrates 4. Made through a proprietary process that includes bovine colostrum and products from immunized hen eggs 5. Partnership with Dr. Reddy s 6. Launched in India, US; planning market launch in Africa 7. Clinical studies ongoing. Results expected Spring Source: Innovation Countdown 2030 Report; ic2030.org Source: diaresq.com; pantheryx.com

11 Drug development case studies: poor nutritional outcomes ENVIRONMENTAL ENTEROPATHY Possible Treatment options for EED: Mesalazine (anti-inflammatory, phase I) Rifaximin (no benefit demonstrated) Budesonide (anti-inflammatory) Larazotide (decreased intestinal permeability) Glutamine (intestinal barrier function) Other options Antibiotics Probiotics Agents that promote gut healing Source: Petri et al. BMC Medicine 2014, 12:187.

12 Intervening along a spectrum of opportunities? Prevention & Nutrition Early Intervention for Infection & Diarrheal Disease Late Intervention for Infection, Diarrheal Disease, and early EED Intervention for EED & Moderate Malnutrition Chronic EDD & Malnutrition Morbidity & Mortality

13 Or in a complex system that we are only beginning to understand? Dewey & Mayers. Mat Child Nutr (2011), 7 (Suppl 3), pp

14 Opportunities for further engagement Please contact me at if you re interested in participating in either or both.