The quintessential made-in-India vaccine ‘Rotavac’
has made its debut into the Indian market, and more importantly into our
collective imagination. It is an example of eunoia or ‘beautiful
thinking’ in science. The story begun in the pediatric wards of the All
India Institute of Medical Sciences (AIIMS), when Dr MK Bhan discovered
a new strain of the rotavirus ‘116E’ that infected newborn babies but
did not cause disease. Meanwhile Dr Durga Rao of the Indian Institute of
Science (IISc), Bangalore discovered a similar strain ‘I321’. Both these
strains caused no disease but in fact led to a strong protective immune
response in the newborns. For two decades, the two research teams worked
independently along with US partners like the Centers for Disease
Control (CDC) and Stanford University to continue the study of these
promising vaccine strains.
In 2000, a consortium of partners including Bharat
Biotech, CDC, National Institute of Health (NIH), AIIMS, Stanford
University, and IISc, submitted a proposal to PATH and DBT for support
to move the two vaccine candidates through production, testing, and
surveillance. In 2001, the Bill and Melinda gates Foundation-funded
program started supporting them with technical knowhow. In 2003, the
first adult trials of the vaccine started in AIIMS. In the next two
years, trials in children and infants were completed, and in 2008 the
Phase Ib/IIa demonstrated a robust 89% immune response in children. The
Phase III trial in Delhi, Mumbai and Vellore started in 2011 were
published in The Lancet in June 2014.
In March this year, the Health Minister, JP Nadda,
launched ‘Rotavac’ officially into the Universal Immunization Program.
It is being introduced in a phased manner, first in four Indian states:
Odisha, Himachal Pradesh, Haryana and Andhra Pradesh. It is being touted
as the world’s cheapest vaccine. But the learning and intellectual
growth of the various institutions and scientists who contributed to the
development of this vaccine is priceless. Results in science are not
after brief dalliances but persistent, enduring partnerships.
(The Hindu 27 March 2016).
Universal Vaccine Against Cancer
An international group of researchers have published
a trail blazing paper which may open the doors to a universally
applicable method of immunotherapy against cancer cells. They extracted
RNA from cancer cells, placed them into nanoparticles of fat, and
injected them intravenously into three patients with advanced malignant
melanoma. The results were encouraging to say the least. All patients
produced alpha-interferon and T killer cells against the tumor antigens.
In one patient, scans before and after the vaccine showed that the tumor
had shrunk. One patient who had his tumors removed surgically before
vaccination remained tumor-free seven months later. The third, who had
eight tumors with pulmonary metastasis, had no increase in those tumor
size.
The phase 1 human trials were preceded by trials in
mice. Similar studies in the past with tumor antigens in fat
nanoparticles had failed. But this time they found that adjusting the
proportions of fatty acids to RNA in the nanoparticles affected their
electrical charge, which allowed them to be directed to the areas with
maximal dendritic cells. In the mouse studies, all mice given the
vaccine before being injected with cancer cells remained cancer-free,
while all untreated mice died within 30 days.
The article is ebullient about the potential of this
technique announcing that this type of vaccine is "fast and inexpensive
to produce" and "virtually any tumor antigen can be encoded by RNA".
It’s called the Trojan Horse strategy based on the story in Greek
mythology where the Greeks enter Troy using a wooden horse.
(Nature 1 June 2016).
How Thailand Eliminated Mother-to-child HIV
Transmission
In the 1980’s and 1990’s Thailand was in the grip of
a huge HIV epidemic with 143,000 new infections in 1991. Committed and
intensive programs on awareness and condom use slashed new infections to
just 8,100 in 2013. Then Thailand took a momentous decision to provide
all pregnant women – including undocumented migrant workers – free
antenatal care, delivery and services for HIV and syphilis. This had
dramatic results. In 2000, there were 1000 children who were infected
from their mothers, and it dropped to just 85 children in 2015. Such low
levels of transmission are no longer considered a public health problem.
According to the Thai Ministry of Public Health, 98% of all pregnant
women living with HIV have access to antiretroviral drugs, and the rate
of mother-to-child transmission of HIV has been reduced to less than 2%.
On June 7, the WHO announced that Thailand is officially the first Asian
nation to eliminate mother-to-child transmission of HIV and syphilis. (The
Lancet 9 June 2016).