Global Health: Time to Pay Attention to Chronic Diseases

Graph of projected deaths by cause in low income countries

Caption: Projected deaths (in millions) by cause in low-income countries. Note increase in non-communicable diseases (orange).
Credit: Adapted from Beaglehole R, Bonita R. Lancet. 2008 Dec 6;372(9654):1988-96.

Greetings from China. I’m here in Shanghai with other biomedical research leaders for two major meetings. The first one, which is the topic of my blog today, is on global health. So, you might expect there to be a lot of talk about malaria, influenza, MERS-CoV, Ebola virus, sleeping sickness, dengue fever, tuberculosis, HIV/AIDS, and other infectious diseases. And those are most certainly topics of intense interest to NIH and our colleagues around the world. But this particular meeting is about a different kind of global health threat that’s becoming a rapidly growing problem: chronic diseases.

While infectious diseases remain a significant problem in the developing world, cancer, heart disease, obesity, diabetes, and other non-communicable diseases are now among the fastest growing causes of death and disability around the globe. In fact, nearly three-quarters of the 38 million people who died of chronic diseases in 2012 lived in low- or middle-income countries [1].

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Print-and-Fold Origami Microscope for 50 cents

Using the Foldscope

Caption: Here I am checking out the Foldscope at the White House Maker Faire on June 18. Very cool!
Credit: Manu Prakash, Stanford

When Stanford University bioengineer Manu Prakash traveled to a mosquito-infested rainforest in Thailand a couple of years ago, he visited a clinic with a sophisticated, $100,000 microscope that sat unused in a locked room. It was then Prakash realized that what global health workers really need is an ultra-low cost, simple-to-use, portable microscope that could be deployed in the field to diagnose disease—and he took it upon himself to develop one!

The result is the Foldscope, a ‘use and throwaway’ microscope that Prakash demonstrated last week at the first-ever Maker Faire at the White House. While I saw many amazing inventions and met many incredible inventors at this event, I came away particularly impressed by the practicality of this device and the ingenuity of its maker.

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Bionic Pancreas for Type 1 Diabetes

Ed Damiano and son David

Caption: Boston University researcher Ed Damiano with his son David, who has type 1 diabetes, in 2002.
Credit: Toby Milgrome

From taking selfies to playing Candy Crush, smart phones are being put to a lot of entertaining uses. But today I’d like to share an exciting new use of mobile health (mHealth) technology that may help to save lives and reduce disability among people with type 1 diabetes—an advance inspired by one researcher’s desire to help his son.

By teaming a smart phone with a continuous glucose monitor and two pumps designed to deliver precise doses of hormones, a team from Boston has created a bionic pancreas that appears to control blood glucose levels in people with type 1 diabetes more effectively than current methods. That is a significant achievement because if blood glucose levels are either too high or too low, there can be serious health consequences.

In a healthy body, the pancreas masterfully regulates blood glucose levels by orchestrating the secretion of insulin and another hormone, called glucagon, which raises blood glucose. These hormones work together like an automatic thermostat, raising and lowering blood glucose when appropriate. However, in type 1 diabetes, the pancreas produces little or no insulin, leading to increased levels of glucose that gradually damage blood vessels, kidneys, and nerves, raising the risk of blindness and amputations.

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NIH Common Fund: 10 Years of Transformative Science

Common Fund 10th Anniversary LogoHappy 10th Anniversary to the Common Fund! It’s hard to believe that it’s been a decade since I joined then-NIH Director Elias Zerhouni at the National Press Club to launch this trans-NIH effort to catalyze innovation and speed progress across many fields of biomedical research.

We’re marking this milestone with a special celebration today at NIH’s main campus. And, for those of you who can’t make it to Bethesda to join in the festivities, you can watch the videocast (live or archived). But allow me also to take this opportunity to share just a bit of the history and a few of the many achievements of this bold new approach to the support of science.

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Drug Discovery from A to Z … Arrhythmias to Zebrafish!

Healthy and mutated zebrafish

Caption: Healthy zebrafish (top) compared to zebrafish with arrhythmia-causing mutation (bottom). Their hearts are shown to the right, with enlargement indicating a weaker heart. The heart’s outflow tract is marked OFT; atrium, a; and ventricle, v.
Credit: Asimaki et al. Science Translational Medicine

Arrhythmia is a condition in which the heart loses its regular rhythm, beating either too rapidly or too slowly. Occasional irregular heartbeats are harmless, but if sustained they can cause dizziness, fainting, and even sudden death. There are a number of drugs available that can prevent arrhythmias, but none are perfect. Implanted devices can help—pacemakers can keep the heart from beating too slowly, and defibrillators can reset the heart’s rhythm with an electrical shock if a dangerously rapid rhythm develops.

But new treatments are needed. Now, an NIH-funded research team has created an animal model that is advancing efforts to find new drugs to prevent arrhythmia.  Led by Jeffrey Saffitz at Beth Israel Deaconess Medical Center, Boston, researchers used genetic engineering techniques to produce zebrafish with genetic mutations identical to those in some people who suffer from a rare inherited disease called arrhythmogenic cardiomyopathy (ACM). In humans, ACM leads to dangerous arrhythmias that can cause sudden cardiac death, usually in people under the age of 35.

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