Experts at a Tufts meeting with Her Royal Highness Princess Chulabhorn of Thailand describe alternatives that would integrate veterinary and human medicine to help improve health for all
The vast majority of drugs that reach human clinic trials end up failing, an unsustainable record that contributes to high drug costs worldwide. But there are better ways to develop new medications and rein in costs—by integrating human and animal medicine, an idea called One Health, panelists said at a health summit at Tufts on April 18.
That was one of the topics at the event, which was organized around a visit to Tufts by Her Royal Highness Princess Chulabhorn Krom Phra Srisavangavadhana of Thailand. She is founder and president of Chulabhorn Research Institute in Bangkok and a professor of chemistry at Mahidol University, where she joined the faculty in 1985.
Among her interests are veterinary research and One Health initiatives, and concerns about how to increase affordable availability of medicines in less developed countries, said Dan Jay, dean of the Graduate School of Biomedical Sciences at Tufts and an organizer of the event.
Panelists included two high-level administrators from the U.S. Food and Drug Administration, a pharmaceutical company executive, and Tufts faculty from Cummings School of Veterinary Medicine and the School of Medicine.
“It was our privilege to host Prof. Dr. Her Royal Highness Princess Chulabhorn, members of the distinguished Thai delegation, and colleagues from the FDA and Greater Boston academic community at Tufts for this important health summit,” said Tufts President Anthony P. Monaco. “I hope that this visit is a catalyst for future possible collaborations between Tufts and research institutes in Thailand on One Health-based initiatives.”
New Approaches with One Health
While drug development enterprises are good at innovation and productivity, “pharmaceutical and biotechnology companies are not good at managing the process of innovation—that is really where we struggle,” said Ken Getz, executive director of the Tufts Center for the Study of Drug Development and a professor at the School of Medicine. “It takes us longer and longer to move a candidate through clinical testing, and a very high percentage will fail during that period of time and will not reach the marketplace,” which adds to overall costs, he noted.
But there is a way to help improve that process, one centered on the collaborative nature of One Health, said Cheryl London, associate dean for research at Cummings School.
As it is now, “there’s something really broken in the drug development paradigm, and at least in part, that’s due to a very heavy reliance on rodent models,” she said. Mice in labs, she pointed out, are genetically identical—unlike humans—and diseases are accelerated in lab mice, unlike human diseases, which progress over time. And then there are other factors. “Mice, for example, don’t vomit,” she noted, so it’s hard to determine certain medication side effects that might occur in humans.
It turns out, she said, there are better models—the dogs and cats that so many of us have as pets. They spontaneously develop many of the same diseases we do, and present an opportunity to try new and different treatments, potentially helping the pets that develop illnesses and providing lessons for human health. Cummings School has been a leader in that effort, said London, who is Anne Engen and Dusty Professor in Comparative Oncology at Cummings School.
Dogs, for example, are “a great model of osteosarcoma and lymphoma, while cats like humans get asthma. We also see lots of cardiovascular diseases that mimic the human disease,” said London. “For example, there’s a disease termed arrhythmogenic right ventricular cardiomyopathy (ARVC) that occurs in Boxer dogs. This syndrome, which causes acute heart arrhythmias and sometimes sudden death is known to be genetically driven in this breed. ARVC also occurs in humans and approximately 50% of the cases have an underlying genetic cause as well. We also see heart toxicity in dogs from some chemotherapy agents that accurately model these effects in human cancer patients.”
It’s possible through clinical trials in companion animals, London said, to do “lots of advanced studies in our patient population and give our pet owners access to advanced state-of-the-art therapeutics they wouldn’t normally have.” The veterinary researchers then share information about expected and unexpected side effects of new combination therapies with researchers working on the human side, “with the hope that it’ll help with decision making about a future therapeutic.”
Among their many efforts, Cummings School researchers worked with a multi-disciplinary, multi-institutional team to help build the Integrated Canine Data Commons, a genomics repository for canine tumor genomics that links directly to the human cancer genomics work in the National Cancer Institute (NCI) Cancer Data Commons, she said.
Cummings School researchers, in partnership with investigators at Tufts Medical Center and Tufts University School of Medicine, also received a grant from the NCI to study cardiovascular toxicities across mice, dogs, and humans to better understand the drivers of these side effects and develop more effective ways to prevent their development, London said. “It’s really a truly One Health collaborative,” she noted.
Pandemics Past and Future
Panelists also spoke about lessons learned from the COVID-19 pandemic, and what should be done now to prepare for other pandemics. Janet Woodcock, principal deputy commissioner of the FDA, spoke about her work on Operation Warp Speed and the work to develop a vaccine for the COVID-19 virus. “The way we do things now is not the way we have to do them in the future,” she said.
She added that she thinks “we can anticipate in future outbreaks that biologics may be the fastest thing we can intervene with,” she said. “However, worldwide we do not have capacity to respond, to scale up and to treat our citizens.”
Jonathan Runstadler, professor and chair of the Department of Infectious Disease and Global Health at Cummings School, spoke about efforts he and his colleagues are making to track potential emerging diseases in animals, such as highly pathogenic avian influenza (HPAI), among others.
HPAI is part of a group of similar viruses that have come into North America, presumably spread by wild birds. Initially it mainly affected gulls and raptors, but then hit other bird populations, including terns and duck species, and then returned again to gulls and raptors. It’s also spilled over to mammalian species. Runstadler’s group focused on its effects on the seal population in northeastern North America.
There were major stranding events for seals in that region in the summer of 2022, as the seals were affected by the virus, he said. “We’ve been able to sequence lots of those viruses that came out of both the birds and the seals,” he said. “What’s of concern is the adaptations that have occurred in those viruses within the seal hosts.”
As they continue that work, what they are discovering in terms of viruses “both here in the Northeast and across the U.S. is feeding into therapeutic and vaccine development efforts for this virus, hopefully in advance, not of a pandemic, but in preparation for one,” Runstadler said.
The challenges faced in the human and animal spaces “are really not so different,” said Ellen Hart, director of the FDA’s Veterinary Medical Office. “Both would benefit from increased innovation and the development of new products. Both would benefit from a continued focus on global harmonization and standardization efforts. . . And both would benefit from a focus on health equity, including communication and understanding that meets people where they are and considers their relationship to animals.”
The “magic of One Health,” Hart added, “is identifying solutions and approaches that work for everyone and maximizing the tools that are available.”