Pratt team receives grant for HIV treatment ‘pouch’

Thousands of lives may soon be saved through an action as simple as tearing open a packet of ketchup.

Over the past three years, researchers at the Pratt School of Engineering have developed a small foil packet, called a “Pratt pouch,” that holds single drug doses to give to newborn babies of HIV-positive mothers—significantly reducing the babies’ chances of contracting HIV. In August the researchers received a $250,000 grant from the U.S. Agency of International Development to further research and implement the pouch, specifically in Tanzania in a two-year project beginning this Fall.

Since more than 50 percent of mothers in Tanzania deliver at home, they do not always have the opportunity to travel to a clinic to get anti-retroviral medicine, said Dr. Robert Malkin, leader of the research team and director of the Developing World Healthcare Technology Laboratory at Duke.

“An HIV-positive mother will receive the pouch and will be encouraged to return to the hospital, but if they can’t, they can give the medication to the HIV child themselves within 24 hours after birth,” said Malkin, professor of the practice of biomedical engineering.

The pouch will allow mothers to simply rip open the package and drip the medication into their newborn’s mouth, John Lipor, who conducted research for the Pratt pouch, wrote in an email Wednesday. This accessibility is crucial, he noted, because HIV-positive mothers are hesitant to travel soon after giving birth because they fear they will be stigmatized and logistics are difficult.

“The likelihood that a child who is delivered at home will receive the necessary [anti-retroviral medicine] is slim,” Lipor said.

The thin plastic lining on the inside of the pouch protects against water absorption, which had troubled earlier, syringe-based designs for the distribution of the drug, Malkin said.

The research team behind the pouch received an unprecedented $250,000 grant from USAID to further their research and distribute their product in Tanzania, where they currently have a group of engineers and doctors conducting research on the effectiveness of the pouch, Malkin said. The research team was honored at a six-day conference in Washington, D.C., in August.

The grant is all the more significant because the pouch has no market within the U.S. and would be unlikely to receive private investment, he noted.

“USAID has never funded technology development before,” he said. “The dominant mechanism for developing technology for the poor [in the pharmaceutical industry] has been to develop products for the rich and then let [them] trickle down to the poor.”

Senior engineering student Amanda Britt, who has worked in the Developing World Healthcare Technology Laboratory for three semesters, wrote in an email Saturday that the grant will fund a second trial of 100 mothers in rural Tanzania, who will receive the pouches from the Kilimanjaro Christian Medical Centre.

“My main concern right now is that the pouch is not always easy to rip open and requires some practice,” she said. “I am working to modify the design to make opening it as effortless as possible.”

Malkin said he hopes to expand deployment of the pouch far beyond the upcoming 100-mother trial group.

“I am very hopeful that by 2013, you will see a major rollout of the pouch in possibly more than one country,” Malkin said, “and a couple of years after that, perhaps all of Africa.”

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