PROJECTS

 

 

 

 

 

 

 

 

 

 

Benin: Medical InterAction: Linking Sustainable Ecology and Medial Innovation

 

 

Contacts and relationships have been developed with colleagues in Benin that crosscuts various areas: health and illness, poverty and sustainability, environmental concerns, traditional and medical sciences/health treatment and education. We plan to develop a scientific and economic mechanism of researching the medicinal properties of specific plant materials used by our Benin partners (university scientists and traditional healers) to further develop medicines and use the resultant knowledge in order to refine the compounds to have fewer side-effects and improved dosing characteristics, and to develop that intellectual property into concomitant economic value that will provide for economic sustainability, self-sufficiency, and independence for on-going research.

 

This project is unique in that it cross-cuts various issues: health and illness, sustainability and poverty, environmental concerns, traditional and medical sciences/health treatment and education. We plan to develop a scientific and economic mechanism of researching the medicinal properties of specific plant materials used by our Benin partners (scientists and traditional healers) to further develop medicines and use the resultant knowledge in order to refine the compounds to have fewer side-effects and improved dosing characteristics, and to develop intellectual property that brings along concomitant economic value that would provide for economic sustainability, self-sufficiency, and independence for on-going research, along with agreement for making all products available to impoverished in need as well. We seek to establish not only a ground-breaking mechanism to ensure the perpetuation of traditional medicines but also to further develop medicines for local and global benefit. This project can serve as a pilot study that can generalize and scale as a global model for others to mimic.

 

This project is unique in that it cross-cuts various issues: health and illness, sustainability and poverty, environmental concerns, traditional and medical sciences/health treatment and education. The western African country of Benin has concerns with the advancements of urbanization of ancient villages developing into cities and the concomitant risk of losing medicinal plants of traditional healers (or "Tradi-practitioners") as an unintended result. Thus, this project seeks to establish not only a "Garden of Medicinal Plants" but also a scientific and economic mechanism in which to further develop medicines for not only local but global benefit. The ability to license the resultant intellectual property will act to further aid in the economic sustainability and self-sufficiency of their research and development processes.

 

Infectious diseases killed 54 million people in 1998. Not surprisingly, developing countries are particularly hard hit. For example, over 350 million people are at risk of Leishmania infection in 88 countries around the world. Despite the incredible toll exacted by such diseases, "Few safe and effective treatments exist for many of the conditions that primarily affect people in developing countries" (Casper, 2001). In fact, in the past two decades only three tenths of the new medications developed have been for neglected diseases (Casper, 2001). It is our goal to change this.

 

We plan to develop a scientific and economic mechanism of researching the medicinal properties of specific plant materials used by our Benin partners (scientists and traditional healers) to further develop medicines and use the resultant knowledge in order to refine the compounds to have fewer sideeffects and improved dosing characteristics, and to develop intellectual property that brings along concomitant economic value that would provide for economic sustainability, self-sufficiency, and independence for on-going research -- along with agreement for making all products available to impoverished in need as well. We seek to establish not only a ground-breaking mechanism to ensure the perpetuation of traditional medicines but also to further develop medicines for local and global benefit. This project can serve as a pilot study that can generalize and scale as a global model for others to mimic.

 

Developing countries are not prioritized venues for large pharmaceutical companies due to an often limited market for resultant medications, in addition to a lack of the latest in medical technology infrastructure in such countries (both the talent and the equipment). This is why the implementation of the Medical InterAction Project proposed herein offers an elegant solution. Our methods provide for another unique aspect for the potential for "leapfrogging" over much of the time consuming and costly procedures that pharmaceutical companies previously had to employ during medication discovery research. An additional benefit of this project is the provision of education that could never have been possible otherwise, and that knowledge can only grow. Such can stop the scientific "braindrain" of individuals who may wish to pursue such work, but could not without leaving their home countries for not having an adequate lab to work in (e.g., 60,000 of Africa's PhDs no longer reside in Africa).

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The Other Technology Divide


There is much discussion about the problem of the "digital divide" between those with technology and those without - but this typically refers to computer availability and internet access. But there is also a divide between the haves and have-nots of medical technology and knowledge. In an article in Science (5 October, 2001), Singer and Daar warn that we must not deny those in the developing world from the promise of genome-related biotechnology in the area of health. Leaders of the G8 industrial nations will be developing an action plan to support implementation of the New African Initiative, and there is a hope that the "...G8 leaders could signal their intention to prevent a health genomics divide from developing in the first place. This opportunity was lost in information technology and agricultural biotechnology; it must not be lost in the area of human health" (p. 87).

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The Model, Originality, Readiness, and Implementability

 

The Medical InterAction Project's goal is to enhance the functioning of the labs in Benin and knowledge-base of the scientists and local practitioners in order to aid in the development of their own vigorous methods of medication discovery and subsequent therapeutic interventions and enhancements of currently used compounds (i.e., increased purity, improved dosing profile, additional treatment applications, etc.). Additionally, this will provide a method in which to bring promising compounds into the medication development pipe-line of global pharmaceutical companies and/or the Institute for OneWorld Health in order to maximize the economic potential of the Benin scientist practitioner group's intellectual property, as well as being new medications to market.

 

This project does not compete with established medication distribution programs. It takes a different, adaptive approach focused on medical science and treatment self sufficiency. It provides the tools and education to empower a country's scientists to initiate their own research targeted to the identified healthcare needs of a country or region while simultaneously creating an indigenous and robust medical technology education model that can continue to grow and develop. This project provides a mechanism allowing indigenous scientists to then focus on the disease states most important to them, in order to have a mechanism to help create therapies, develop medications, vaccines, and antibiotics for their own needs, and establish sustainable linkages with pharmaceutical companies to support and distribute the results. Thus we have already developed on-going collaborative relationship with Northwestern University's Falk Center for Molecular Therapeutics and to minimize fragmentation. Contacts between US and Benin constituents are ready to commence.

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Scalable Model

 

This model can generalize and scale as a globally replicable method that can enhance labs and scientists in order to develop their own vigorous engines of discovery for diagnostic methods and subsequent therapeutic interventions, in each country involved. What is required is a local scientific institution (a medical school, a state-organized or operated laboratory, or an academic institution with a graduate program in biochemistry or genetics), a cooperative government (or at least one that doesn't intrusively get in the way), and the lab equipment (along with funding to purchase the technology and conduct the training). This unique model also provides the ecological benefit of saving, maintaining, and identifying indigenous plants that hold medicinal promise from becoming forever lost as an iatrogenic consequence of industrial development.

 

The independence provided by a sustainable model eliminates a country's fear of being victimized by the orphan drug phenomenon, or as being dependently beholden as a "charity du jour." Our goal is to establish a means of increased scientific investigation and resultant medication-development into the local Benin system and then let it blossom on its own. The idea is facilitated independence and sustainability. The additional hope is that such a model can then serve as a motivation for similar scientists and practitioners in other countries and for the center to then do likewise on a global state, where appropriate. In this project, the Center can function as an incubator and in a facilitative role.

 

With the expected success of the Medical InterAction Project, potential "next steps" this work could foster a shift into that of pharmacogenomic medication development. "Gro H. Bruntland, the Director General of the World Health Organization (WHO), recognized the huge potential of advances in genomics and other critical areas of biotechnology for improving human health in her opening address to the World Health Assembly in May 2001. She has asked WHO's highest scientific body, the Advisory Committee on Health Research, to prepare a Special Report on Genomics and World Health.... This report will highlight the importance of genomics for the health of people in developing countries and prepare WHO to be an advocate for improving the health of the disadvantaged and underprivileged" (Singer and Daar, 2001, p. 88).

 

This project would follow the guidelines established by the Swiss Commission for Research Partnership with Developing Countries (KFPE) which identify principles for research partnerships with developing countries as well as Institutional Review Board/Protection of Human Subject standards if clinical trials were to be carried out locally.

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Current Benin Activities

 

The Research Programme managed by the Benin Association For the Well being of Orphans and Abandoned Children (A.BE.E.A) has a program of triennial activities that represents a sub program titled "The African medicine to the poor people service" which, due to the expense and limited availability of "modern medicine" is not available to the poor. Thus, a group known as "Tradi practitioners" are organized in this Programme and work with people with the following problems: Fibroma without surgical intervention, Incurable wounds, Hypertension, Difficult childbirth, Mental Illnesses (schizophrenia), Jaundice and hepatic disease.

 

In the vernacular of the Setto ethnic group of South Benin, the words "health" and "peace" are designated by the same word: "Djidjohogbe." This expresses the importance of peace and health in the life of a human being that they hold important. In their words: AWithout health we would be unable to speak of peace. Those that are sick and that cannot move are not able to work. They cannot live if they have not assistance. They become unhappy. It brings us to understand the necessity of health. This health, we must search for it if we want peace. It justifies the expression according to which health doesn't have price."

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The first steps include:

  1. Establish the "Garden of Medicinal Plants,"
  2. Formalize working relationships between US-based and Benin-based teams,
  3. Articulate intellectual property rights, ensuring financial viability of Benin-based team as well as assurances that resultant products will be available to Benin citizens,
  4. Target disease states to be treated by currently identified compounds,
  5. Initiate agreements with pharmaceutical companies to conduct pre-clinical and clinical-trials. (With some diseases, it may be necessary to construct a regional and/or international scientific conference in order to conduct the scientific due diligence and epidemiological studies necessary.)

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Sustainability

 

There is the added potential of data mining and bioinformatics that would have keen market value (and enhance sustainability), so we need to be smart and careful in these nascent phases as to ensure proper intellectual property ownership and technology transfer agreements. Intellectual property of the information extracted from the patient/subject data and the plant compounds used for analysis would be retained jointly by the Benin Team and the Center. The Benin team would retain ownership of the intellectual property with the Center receiving a percentage of royalties or licensing in this partnership in return for the expenses involved in the filing costs for the patents, marketing, and partnership development.

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Outcomes/Deliverables

  1. Health Impact via:
    • Developing treatments, cures, and policies that reduce the morbidity, mortality, and socioeconomic burdens of illness.
    • Establishing or enhancing sustainability of medical scientific outputs.
  2. Medical Technology/Sciences/Education Impact via:
    • Enhancement of local labs, while building capacity and diminishing fragmentation.
    • Minimizing medical technology and pharmaceutical sciences brain-drains by providing both the education and the adequate laboratories needed for local specialists to do their work, make their careers, and thus remain in their own home-countries.
    • Establishing ongoing methods of scientific medical education at levels that perhaps would otherwise have never been possible, or certainly not as quickly. Such activity can also serve as an accellerant to socioeconomic development as others may come to their site to learn, as well as improved health status against endemic diseases.
    • Providing globally available, specifically relevant and scalable scientific education.
    • Establishing or enhancing the sustainability of medical research training outputs.
    • Deploying equipment (where needed) and where possible, support the area's economy by using supplies available locally.
    • Conducting international conferences to disseminate findings and foster share knowledge and collaborations.
    • Aiding in research analyses.
    • Establishing global and regional linkages between scientists, mentors, physicians, healthcare workers, government officials, public health representatives, relevant business leaders and entrepreneurs, policy wonks, and others, as well as means for ongoing communication and collaboration via on line networking and consultation.
    • Production of white papers and peer reviewed scientific papers in order to contribute to and advance science as well as to expand awareness and opportunities for assistance.
    • Collaboration with representatives from appropriate educational institutions and government agencies in order to build partnerships with local leadership and all interested parties.
    • Provide opportunity to pursue traditional mechanisms of academic funding via scientific grants.
    • Establishing and maintain a volunteer program network (for scientific faculty and local expertise; fund-raising, conferences, organizational, and other needs).
    • Ongoing technical advice availability.
  3. Health Policy and Public Health Impact via:
    • Specifically relevant and scalable training in capacity building and the integration of health science with policy and advocacy.
    • Establishing epidemiological baseline studies (where needed).
    • Developing a "global faculty" having various expertise in the relevant and currently identified scientific, policy, public health, economic, and advocacy areas.

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Benefits to be Realized

  1. Benin will be benefited by:
    • Saving the lives of those people who are ill and those at risk for becoming ill, with the health problem being addressed
    • Improving morbidity.
    • Decreasing the death rate in the country.
    • Decreasing medical costs by eliminating the formerly associated costs in the palliative treatment of the health problem.
    • Decreased burden on the country's healthcare system.
    • Increase in the healthy citizens to be productive in the workforce (both beneficial to a country's economy and for the individual and his/her family) and thus aid in socioeconomic development and poverty reduction.
    • Establishment of education, tools, and labs to continue to foster work on other health problems important to their people, on-going.
    • Creation of jobs (similar to that of computer programmers outsourced in India, there can be lab techs in a developing country trained in PCR that conduct outsourced procedures).
  2. Benin Scientists and Practitioners Benefit from:
    • Enhancement of regional labs and tools.
    • Increase knowledge of medical, biological, and health sciences and other techniques.
    • Increase likelihood that regional scientists may stay and conduct their work and build their careers in their community/country without having to leave to work elsewhere (minimize their medical technology and sciences brain-drains).
    • Establishment of education, tools, and labs to continue to work on the health problems important to them evermore.
    • Creation of an indigenous and robust medical technology education model that will continue to grow and develop.
    • Serving as a site where others may come to learn.
    • Help in developing additional relationships for scientific collaborations as well as opportunities for models of economic sustainability and entrepreneurism.
    • Enhancement of labs while building capacity and diminishing fragmentation.
  3. Science is benefited by:
    • Advancements in areas of critical health importance.
    • Peer reviewed journal articles.
    • White papers.

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