EXPLORING THE FRONTIERS
OF INNOVATION TO TACKLE
MICROBIAL THREATS
PROCEEDINGS OF A WORKSHOP
Edith Amponsah, Gillian Buckley, Julie Pavlin,
and Anna Nicholson, Rapporteurs
Forum on Microbial Threats
Board on Global Health
Health and Medicine Division
THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu
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This activity was supported by contracts between the National Academy of Sciences and Aetna Foundation, The California Endowment (#10002009), Health Resources and Services Administration (DHHS-10002817), New York State Health Foundation (#10001272), The Rippel Foundation, and Robert Wood Johnson Foundation (#10001270). Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.
International Standard Book Number-13: 978-0-309-67533-8
International Standard Book Number-10: 0-309-67533-2
Digital Object Identifier: https://doi.org/10.17226/25746
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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2020. Exploring the frontiers of innovation to tackle microbial threats: Proceedings of a workshop. Washington, DC: The National Academies Press. https://doi.org/10.17226/25746.
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PLANNING COMMITTEE ON EXPLORING THE FRONTIERS OF INNOVATION TO TACKLE MICROBIAL THREATS1
KENT E. KESTER (Co-Chair), Vice President and Head, Translational Science and Biomarkers, Sanofi Pasteur
RAFAEL OBREGÓN (Co-Chair), Chief of Communications for Development, United Nations Children’s Fund
KEVIN ANDERSON, Senior Program Manager, Science and Technology Directorate, U.S. Department of Homeland Security
GREGORY ARMSTRONG, Director, Advanced Molecular Detection, U.S. Centers for Disease Control and Prevention
RICK BRIGHT, Director, Biomedical Advanced Research and Development Authority (BARDA), U.S. Department of Health and Human Services
JOHN BROWNSTEIN, Chief Innovation Officer and Professor, Harvard Medical School
ANDREW CLEMENTS, Deputy Director, Pandemic Influenza and Other Emerging Threats Unit, U.S. Agency for International Development
PETER DASZAK, President, EcoHealth Alliance
LORI FOSTER, Professor, Industrial-Organizational Psychology, North Carolina State University
EVA HARRIS, Professor, Division of Infectious Diseases and Vaccinology; Director, Center for Global Public Health, University of California, Berkeley
ELIZABETH D. HERMSEN, Head, Global Antimicrobial Stewardship, Merck & Co., Inc.
JAMES LAWLER, Associate Professor, Department of Internal Medicine; Director, International Programs and Innovation, University of Nebraska Medical Center College of Medicine
JONNA A. K. MAZET, Professor of Epidemiology and Disease Ecology; Executive Director, One Health Institute, School of Veterinary Medicine, University of California, Davis
THOMAS W. SCOTT, Distinguished Professor, Department of Entomology and Nematology, University of California, Davis
PAIGE E. WATERMAN, Colonel, U.S. Army, Assistant Director, Biological Threats Office of Science and Technology Policy, Executive Office of the President
___________________
1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the rapporteurs and the institution.
MARY E. WILSON, Clinical Professor of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine; Adjunct Professor, Global Health and Population, Harvard T.H. Chan School of Public Health
Health and Medicine Division Staff
GILLIAN BUCKLEY, Senior Program Officer (from March 2020)
EDITH AMPONSAH, Associate Program Officer
HANNAH GOODTREE, Senior Program Assistant
CECILIA MUNDACA SHAH, Project Director (until December 2019)
V. AYANO OGAWA, Senior Program Officer (until December 2019)
YAMROT NEGUSSIE, Program Officer (until November 2019)
STEPHEN CHUKWURAH, Senior Program Assistant (until December 2019)
JULIE PAVLIN, Director, Forum on Microbial Threats; Senior Director, Board on Global Health
FORUM ON MICROBIAL THREATS1
PETER DASZAK (Chair), President, EcoHealth Alliance
KENT E. KESTER (Vice Chair), Vice President and Head, Translational Science and Biomarkers, Sanofi Pasteur
MARY E. WILSON (Vice Chair), Clinical Professor of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine; Adjunct Professor, Global Health and Population, Harvard T.H. Chan School of Public Health (until December 2019)
KEVIN ANDERSON, Senior Program Manager, Science and Technology Directorate, U.S. Department of Homeland Security
RICK BRIGHT, Director, Biomedical Advanced Research and Development Authority (BARDA), U.S. Department of Health and Human Services
TIMOTHY BURGESS, Director, Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences
CRISTINA CASSETTI, Deputy Division Director, Division of Microbial and Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health
ANDREW CLEMENTS, Deputy Director, Pandemic Influenza and Other Emerging Threats Unit, U.S. Agency for International Development
MARCOS A. ESPINAL, Director, Communicable Diseases and Environmental Determinants of Health, Pan American Health Organization
KEIJI FUKUDA, School Director and Clinical Professor, The University of Hong Kong School of Public Health (until December 2019)
EVA HARRIS, Professor, Division of Infectious Diseases and Vaccinology; Director, Center for Global Public Health, University of California, Berkeley
ELIZABETH D. HERMSEN, Head, Global Antimicrobial Stewardship, Merck & Co., Inc.
CHANDY C. JOHN, Director, Ryan White Center for Pediatric Infectious Diseases and Global Health, Indiana University School of Medicine
RIMA F. KHABBAZ, Director, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention
MICHAEL MAIR, Acting Director, Office of Counterterrorism and Emerging Threats, U.S. Food and Drug Administration
___________________
1 The National Academies of Sciences, Engineering, and Medicine’s forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteurs and the institution.
JONNA A. K. MAZET, Professor of Epidemiology and Disease Ecology; Executive Director, One Health Institute, School of Veterinary Medicine, University of California, Davis
SALLY A. MILLER, Professor of Plant Pathology and State Extension Specialist for Vegetable Pathology, Ohio Agricultural Research and Development Center, The Ohio State University
SUERIE MOON, Director of Research, Global Health Centre, Graduate Institute of International and Development Studies, Geneva
DAVID NABARRO, Advisor, Health and Sustainability, 4SD–Skills, Systems, and Synergies for Sustainable Development
RAFAEL OBREGÓN, Chief of Communications for Development, United Nations Children’s Fund
KUMANAN RASANATHAN, Board Member, Health Systems Global
GARY A. ROSELLE, Chief of Medical Service, Veterans Affairs Medical Center; Director, National Infectious Disease Services, Veterans Health Administration
PETER A. SANDS, Executive Director, The Global Fund to Fight AIDS, Tuberculosis and Malaria
THOMAS W. SCOTT, Distinguished Professor, Department of Entomology and Nematology, University of California, Davis
JAY P. SIEGEL, Retired Chief Biotechnology Officer, Head of Scientific Strategy and Policy, Johnson & Johnson (until January 2020)
ALAN TENNENBERG, Chief Medical Officer, Johnson & Johnson Global Public Health
MATTHEW ZAHN, Medical Director, Division of Epidemiology and Assessment, Orange County Health Care Agency
National Academies of Sciences, Engineering, and Medicine Staff
GILLIAN BUCKLEY, Senior Program Officer (from March 2020)
EDITH AMPONSAH, Associate Program Officer
HANNAH GOODTREE, Senior Program Assistant
CECILIA MUNDACA SHAH, Project Director (until December 2019)
V. AYANO OGAWA, Senior Program Officer (until December 2019)
YAMROT NEGUSSIE, Program Officer (until November 2019)
STEPHEN CHUKWURAH, Senior Program Assistant (until December 2019)
JULIE PAVLIN, Director, Forum on Microbial Threats; Senior Director, Board on Global Health
Reviewers
This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.
We thank the following individuals for their review of this proceedings:
Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by DAVID R. CHALLONER, University of Florida. He was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteurs and the National Academies.
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Acknowledgments
The workshop summarized in this proceedings is the product of many valuable contributions. Special thanks go to the presenters and discussants who gave generously of their time and expertise to make the event possible. A full list of the speakers and moderators and their biographical information may be found in Appendix C.
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Contents
Organization of the Proceedings of the Workshop
2 PIVOTAL ROLE OF INNOVATIONS IN TACKLING MICROBIAL THREATS: LESSONS FROM PAST OUTBREAKS
Lessons Learned from Innovation in Polio Eradication
Advancing Innovation on the Ground in the Fight Against Ebola
3 HARNESSING LESSONS FROM EMERGING SCIENTIFIC, TECHNOLOGICAL, AND SOCIAL INNOVATIONS
The Role of Innovation in the Evolution of Global Vector Control Response
Applying Modeling to Inform Infectious Disease Surveillance and Outbreak Response
Unbiased Metagenomics Sequencing to Counter Microbial Threats: Lessons from Bangladesh
4 OVERCOMING BARRIERS IN THE FIELD TO BOLSTER ACCESS AND PRACTICAL USE OF INNOVATIONS
Digital Innovation to Improve Immunization Service Delivery
Using Data and Modeling to Improve Detection and Response
Outbreak-Related Data Sharing and Collaboration: Challenges and Opportunities
Addressing Health Challenges with Behavioral Insights and Tools
5 SYSTEMS APPROACHES TO SPUR INNOVATIONS IN TACKLING ANTIMICROBIAL RESISTANCE
Applying Lessons from One Health Surveillance to Tackle Antimicrobial Resistance
Sparking Antibiotic Discovery Through Data Sharing and Scientific Collaboration
Incentivizing Novel Diagnostic Tests to Counter Antibiotic Resistance
Strengthening Systems to Overcome Barriers to Innovation
6 BREAKING DOWN BARRIERS AND FOSTERING PARTNERSHIPS TO ENABLE INNOVATION
Enabling Biotechnologies Through Partnerships
Fostering New Partnerships to Enable Innovation
Private-Sector Partnerships to Address Global Health Needs
7 NURTURING INNOVATIONS THROUGH NOVEL ECOSYSTEMS TO ACCELERATE RESEARCH AND DEVELOPMENT
Biomedical Advanced Research and Development Authority
Decoding the Human Immune System to Transform Human Health
Nurturing Innovation to Accelerate Research and Development
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Boxes and Figures
BOXES
3-1 Case Example of Innovation in Vector Control: New Nets Project
5-1 Shared Platform for Antibiotic Research and Knowledge (SPARK)
FIGURES
3-1 WHO’s global vector control response framework
3-2 Optimal use of new approaches depends on epidemiological context
4-1 Behavioral insights from Nudge Lebanon randomized controlled trials
Acronyms and Abbreviations
AFP | acute flaccid paralysis |
AI | artificial intelligence |
AMP Health | Aspen Management Partnership for Health |
AMR | antimicrobial resistance |
BARDA | Biomedical Advanced Research and Development Authority |
CDC | U.S. Centers for Disease Control and Prevention |
CDDEP | Center for Disease Dynamics, Economics & Policy |
CEPI | Coalition for Epidemic Preparedness Innovations |
CHRF | Child Health Research Foundation |
cVDPV | circulating vaccine-derived polio virus |
DARPA | Defense Advanced Research Projects Agency |
DoD | U.S. Department of Defense |
DRC | Democratic Republic of the Congo |
EHP | Ebola Host Project |
ESKAPE pathogens | Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species pathogens |
ETU | Ebola treatment unit |
FDA | U.S. Food and Drug Administration |
FIND | Foundation for Innovative New Diagnostics |
HBV | hepatitis B virus |
HCV | hepatitis C virus |
HIV | human immunodeficiency virus |
HPV | human papillomavirus |
IPV | inactivated polio vaccine |
JJDC | Johnson & Johnson Development Corporation |
JPEO-CBRND | Joint Program Executive Office for Chemical, Biological, Radiological and Nuclear Defense |
LMIC | low- and middle-income country |
MERS | Middle East respiratory syndrome |
NAP-AMR | national action plan for antimicrobial resistance |
NGO | nongovernmental organization |
NGS | next-generation sequencing |
OPV | oral polio vaccine |
PCR | polymerase chain reaction |
PHEIC | public health emergency of international concern |
qPCR | quantitative polymerase chain reaction |
SPARK | Shared Platform for Antibiotic Research and Knowledge |
USAID | U.S. Agency for International Development |
VAPP | vaccine-associated paralytic polio |
VDPV | vaccine-derived polio virus |
WHO | World Health Organization |