As COVID-19 continues to be a public health burden with the lack of existing vaccines, the University of the Philippines - Philippine General Hospital (UP-PGH) with support from the Department of Science and Technology - Philippine Council for Health Research and Development (DOST-PCHRD) will conduct the project: “Convalescent Plasma as Adjunctive Therapy for Hospitalized Patients with COVID-19.”

 

Adjunctive therapy is a treatment used to support the main or primary treatment of diseases. As definite therapy for COVID-19 is still lacking, the project aims to evaluate the efficacy and safety of convalescent plasma transfusion as adjunctive therapy to prevent disease progression among hospitalized COVID-19 patients. Convalescent plasma is taken from the blood of patients who recovered from infection and contains neutralizing antibodies against it.

 

According to Dr. Michael Ryan, Executive Director of the Health Emergencies Program of the World Health Organization (WHO), the use of convalescent plasma transfusion is a valid approach in treating infectious diseases as demonstrated in previous outbreaks such as the H1N1 influenza virus pandemic, 2003 SARS-CoV-1 epidemic, and the 2012 MERS-CoV epidemic. In a press conference in Geneva last February, he explained that through the transfusion, “you're giving (the patients) a boost of antibodies to hopefully get them through the very difficult phase.

 

“For the past months, we have been mobilizing our resources and maximizing our capacities to help combat COVID-19. Through this project, we are hoping to provide supportive treatment to COVID-19 patients to avoid worst-case scenarios,” DOST-PCHRD Executive Director Jaime C. Montoya says. “If the project proves to be successful, we can also contribute to developing a treatment that will help reduce the mortality rate of COVID-19,” he adds.

 

Aside from potentially developing locally-produced convalescent plasma which may be used as part of the COVID-19 treatment regime, the project also aims to strengthen the capacities of healthcare professionals in its clinical use, not only for COVID-19, but also for other emerging infections in the future.

 

The team has started the call for blood donations from COVID-19 survivors last April 2020. The project will run for 12 months.

References:

Citing examples of health research frameworks from countries including the Philippines, the World Health Organization (WHO) highlights the role of establishing regional and international partnerships for stronger national health research systems in the report: “What is the evidence on policies, interventions and tools for establishing and/or strengthening national health research systems and their effectiveness?” by the Health Evidence Network (HEN).

 

Emphasizing the importance of continued commitment and adequate funding for health research, the report elaborated on how regional and international partnerships can help “generate benefits from combined resources and diverse perspectives.” 

 

“Building partnerships or regional initiatives or interventions through which countries analyse their situation and might collaborate with peers (will help) identify ways to strengthen the health research system of each country,” the report states.

 

Accordingly, the Philippine National Health Research System (PNHRS) is built through cross-cutting partnerships among international, national and regional agencies. Institutionalized in 2013, the PNHRS is implemented by four core agencies --- the Department of Science and Technology (DOST), Department of Health (DOH), Commission on Higher Education (CHED), and the University of the Philippines Manila.

 

Aiming to harness the potential of each region, the PNHRS framework is mirrored in all regions of the country through the Regional Health Research and Development Consortia (RHRDC). Each RHRDC addresses concerns relating to its health research agenda, development of human resource, conduct of researches, dissemination of research results, research utilization, resource mobilization, leadership and management addresses concerns related to health research, and mobilizes resources specific and abundant to each region.

 

The RHRDCs are the bridge of PNHRS to reach the communities. PNHRS connects with the communities through the RHRDCs to learn from them, understand their needs, and develop responsive health research initiatives," DOST-Philippine Council for Health Research and Development (PCHRD) Executive Director Jaime C. Montoya explains.

 

As one of the implementing agencies of the PNHRS, WHO also cites the partnership of DOST-PCHRD with the United States National Institutes of Health (US-NIH) and the United Kingdom Medical Research Council (UK-MRC) as an approach in line with the objective of “launching a proactive policy (which) will encourage and accompany consistent international collaborations,”   by Inserm--the National Institute of Health and Medical Research of France.

 

In 2017, DOST-PCHRD signed a partnership with the US-NIH for the establishment of the Regional Prospective Observational Research in Tuberculosis (RePORT) Consortium in the Philippines to create a platform for collaborative research on tuberculosis (TB) in the country. Meanwhile, DOST-PCHRD’s partnership with the UK-MRC through the Newton Agham Program in 2016, supports research projects which address diseases that impact the most vulnerable in the society such as malaria, HIV, schistosomiasis, dengue, antimicrobial resistance, tuberculosis, rabies, and diabetes.

 

DOST-PCHRD also pursued local and international partnerships to capacitate the country’s pool of experts. Together with the Asia Pacific Association of Medical Journal Editors (APAME) and the  Philippine Association of Medical Journal Editors (PAMJE), DOST-PCHRD organizes a biannual medical research writing program for Filipino researchers. DOST-PCHRD was also able to secure partnerships with the University of Trieste (UNITs) and Fondazione Italiana Fegato (FIF) in 2019, which allows the country to send scholars to UNITs for the PhD Program in Molecular Biomedicine.

 

The PNHRS is an integrated national health research framework which aims to provide an enabling environment for health research for the achievement of the country’s national health goals through partnerships, collaborations and cross-cutting strategies.

 

Through the continuous effort of the System and its implementing agencies, WHO cites the Philippines as among countries with important progress in health research and as an NHRS model for low- to middle-income countries in the same report by HEN.  Previous report can be read here: bit.ly/pnhrswho-report.

Noting how the severity of COVID-19 cases appear to significantly increase once pneumonia sets in, the Manila Doctors Hospital (MDH), with support from the Department of Science and Technology - Philippine Council for Health Research and Development (DOST-PCHRD) will conduct the project: “Melatonin as Adjuvant treatment for COVID-19 in Patients Requiring hospitalization (MAC19 PRO): A Randomized, Double-Blind, Placebo-Controlled Trial (RCT).

 

Known as a commonly available and inexpensive sleep-aid supplement, melatonin is also known for its anti-inflammation, anti-oxidation and immune-enhancing effects which may help alleviate acute respiratory distress caused by viral infections such as COVID-19.

 

To support the current efforts against the pandemic, the study seeks to probe whether administering high doses of melatonin (hdM) will lessen the need for intubation or ventilation support of hospitalized COVID-19 patients and ultimately improve the survival rate against the infection. The study will be the first RCT worldwide which will explore the effectiveness and safety of using hdM as adjuvant therapy on top of standard therapy in hospitalized patients with COVID-19 pneumonia. Adjuvant therapy is used in addition to primary or main treatment of diseases. Examples of adjuvant therapy are chemotherapy, radiation therapy, hormone therapy, among others.

 

“We are aiming to build on the use of melatonin as a commonly available supplement to support our fight against COVID-19,” DOST-PCHRD Executive Director Jaime Montoya says. “If the project proves to be successful, we may be able to de-escalate COVID-19 cases better, and possibly reduce the mortality rate of the infection.”

 

The pilot study done for the project has also been accepted for publication in the Melatonin Research Journal, which observed that patients given with hdM showed faster clinical improvement. The article will be released next month.

 

With support from DOST-PCHRD, the project will run for four months in selected hospitals in Metro Manila and Cebu City.

 

As the world continues to race to find a vaccine or a cure against COVID-19, hospitals across countries currently anchor the effective management of the infection on supportive and empirical treatments. In the situation report published May 2020, WHO highlights that almost 86.7% of cases recorded in the Philippines are mild.  Despite the low mortality rate, there are cases that lead to respiratory failure, septic shock, or even death especially for identified high-risk groups or the immunocompromised.

 

 

References:

The Association of Southeast Asian Nations (ASEAN) celebrates the ASEAN Dengue Day every 15th of June since its declaration in 2011. According to the World Health organization (WHO), the celebration aims to raise awareness on dengue, mobilize resources for its prevention and control, and demonstrate the region’s commitment to tackling the disease.

While the Department of Health (DOH) announced last January that there is a steady decline in cases of dengue in the country, DOH Secretary Francisco Duque reminded the public to not be complacent, remain vigilant, and sustain the gains of the enhanced 4S strategy to keep dengue at bay.

To further mitigate the threat of dengue, the Department of Science and Technology-Philippine Council for Health Research and Development (DOST-PCHRD) continues to support the DOH by funding relevant studies to improve the dengue situation in the country. Some of these studies are:

The Performance of an Innovative Auto Dissemination of Insecticides (InDAI) for Dengue Mosquito Control in the Philippines Program which aims to evaluate the efficacy of the InDAI trap in the reduction of mosquito densities in selected cities in the National Capital Region.

The Aedes Genomics Adaptation Program that investigates the genomic underpinnings of Aedes species’ adaptation to extreme temperature conditions. To date, the program is the first to publish the full genome of a female Aedes aegypti - a piece of data which will be key to understanding vector biology.

A program on Philippine land use change and arbovirus diversity surveillance and monitoring of viral pathogens in the country which sought to investigate how land use change in Barangays Bagong Silang, Lalakay, and Bayog in Los Baños, Laguna, have affected the transmission of dengue within the communities.

In the spirit of awareness, the Council encourages everyone to follow simple but effective steps like removing or covering all areas with stagnant water, installing screens on windows, using mosquito repellants, and wearing long-sleeved shirts when outdoors.

 

Sources:

https://www.who.int/philippines/news/feature-stories/detail/asean-dengue-day-the-philippines-leads-efforts-in-dengue-control-and-prevention

https://www.doh.gov.ph/doh-press-release/doh-reports-steady-decline-in-dengue-cases

https://www.nea.gov.sg/docs/default-source/resource/first-asean-dengue-day-with-inauguration-of-the-environmental-health-institute-as-a-who-collaborating-centre_1.pdf

The Department of Science and Technology (DOST) and the Philippine Council for Health Research and Development (PCHRD) met with the local pharmaceutical industry on Wednesday, June 9, 2020, to discuss plans for COVID-19 vaccine trials in the country.

Led by DOST Secretary Fortunato de la Peña with the sub-Technical Working Group of COVID-19 Vaccine Clinical Trials chaired by DOST Undersecretary Rowena Cristina Guevara, the online meeting was also attended by the vaccine expert panel led by Dr. Nina Gloriani, Professor Emeritus at the University of the Philippines Manila and representatives from 11 local Pharma companies.

Emphasizing that the government will only enter agreements which will highly favor the Filipino interest, the DOST and PCHRD discussed its plans to capacitate local vaccine manufacturing in the country if clinical trial results are favorable. 

The DOST has been in touch with several international partner institutions to collaborate on vaccine development so that we can participate in their clinical trials, as the country doesn’t have the capacity yet to develop vaccines on its own,” said Usec. Guevara. “Locally, we hope that the local pharma industry is open to the opportunity of capacitating our country in vaccines, not just for this pandemic, but to prepare for the future as well,” added Sec. de la Peña.

To give participants ideas on international discussions on COVID-19 vaccine, Dr. Gloriani presented the list of best vaccine candidates, the status of development, and vaccine platforms of nine international partners which expressed interest in conducting clinical trials in the country. 

As part of DOST’s business propositions to pharma industries, Dr. Jaime C. Montoya, Executive Director of DOST- PCHRD stressed that the government will provide support to the private sector’s conduct of clinical trials and assistance in product registration for pharma groups.

The Philippines will be dependent on global supply of vaccines if it will not be developed locally, so to get hold early, it will be beneficial for the country to require a license to manufacture for local pharmaceutical industries and to meet the local demand for vaccines,” said Dr. Montoya.

We should start investing now, as the country needs to be self-sufficient and capable for the future. The same virus will still appear, and we have to allocate like the other countries. This is the time to start now, and this public-private partnership is important,” added Dr. Mario Jiz, Immunology Department Chair of the Research Institute for Tropical Medicine (RITM) and member of the Vaccine Expert Panel.

Dr. Nancy Bermal, Medical Director of Unilab Inc., expressed her appreciation on DOST’s initiative to partner with private pharma groups and suggested that the government can especially help on registration processes with the Food and Drug Administration. Among the pharma groups who participated in the meeting were Lloyd Laboratories Group, Pascual Laboratories, Inc., Pascual Pharma Corp., Unilab – Synovate Pharma, Hizon Laboratories, Westfield Pharmaceuticals Inc., Rainiers Research and Development Institute Inc., New Marketlink Pharmaceutical Corporation, Merck Inc., IG Biotech Inc., and IP Biotech. Collectively, the local pharmaceutical companies expressed their support for the government initiatives and their willingness to be involved in the conduct of the clinical trials as well as the possible local manufacture of vaccines. 

Dr. Gloriani also reiterated that while the government aims to fast-track the provision of a vaccine, it needs to ensure that the vaccine candidate is safe and effective for the Filipino people. In closing, Usec. Guevarra emphasized that “DOST will be betting on the best manufacturers, and it is just a matter of who will be willing to help the country.”