Global Impact of

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Global Impact of Prematurity Stillbirth Opportu
nities in Our Own Backyard to Make a World of
Difference
Craig Rubens, MD, PhD Executive Director
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Seattle ChildrensHospital Research
Foundation

• Mission prevent, treat and eliminate
  pediatric disease
• One of nations top 10 childrens hospitals
• Leading advocate for children
• Provides world-class care for all children
• Research Institute is at frontiers of medicine
• Pioneering major research initiatives to benefit
  children globally

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Seattle Childrens

• Serves patients in Pacific Northwest and beyond
• One of areas top 5 nonprofit recipients of
  NIH funds
• Further positions WA state as global leader in
  life sciences
• Established leader in collaborative partnerships
• Seattle Cancer Care Alliance - translating
  discovery into prevention, diagnosis, treatment
  and cure (with Fred Hutch., UW Medicine)

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GAPPS Initiative of Seattle Childrens

• Childrens identified prematurity and stillbirth
  as research priorities
• Many patients suffer prematurity-related
  disabilities
• Under-researched local and global problems
• Global Alliance to Prevent Prematurity
  and Stillbirth (GAPPS)
• Launched in 2007

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• Mission

GAPPS will lead a collaborative, global
effort to increase awareness and accelerate
innovative research and interventions that will
improve maternal, newborn, and child health
outcomes.
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Every year around the world
More than 1 million babies die from prematurity
More than 3 million are stillborn
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Premature Birth Rates
North America 11
Europe 6
Asia 9
LAC 8
Africa 12
Oceania 6
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Premature Babies 13M Annually

• Leading cause of newborn death
• Increased risks
• Life-threatening infections
• Cerebral palsy
• Brain injury
• Respiratory problems
• Learning and development problems
• Vision and hearing problems
• Birth defects

Severity dependent on gestational age at time of
birth
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Little-Known Facts

• Prematurity stillbirth cause about a third of
  all under-5 deaths globally
• More than TB, malaria, HIV/AIDS combined
• 1 in 8 babies in U.S. is premature
• Rate has risen 36 since 1981
• Half a million each year
• WA state 8000 cases/yr
• Stillbirths 10x more common
• than SIDS-related deaths in U.S.

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Large Disparities in U.S. Prematurity RatesRates
for all are increasing
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Costs of Prematurity

• Government (U.S.)
• WA State costs exceed 400M/yr
• Medical care, delivery, and special education
• More than 1M each day
• U.S. costs exceed 26B/yr
• Businesses
• 5.7B/yr in lost labor and productivity
• Families (Global)
• Psychological toll stress taboo topic, broken
  families
• Economic burden of healthcare costs lost income
  to care for premature newborn decreased job
  performance

Source National Academy of Sciences (2007)
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Average U.S. Medical Costs for Birth Year (2005)
Source National Academy of Sciences 2007
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3.2M Stillbirths Each Year Death of fetus older
than 22-28 wks

• Actual stillbirths likely much higher
• 99 occur in developing countries
• 30 occur during labor and delivery
• Most of these are preventable
• 25,000 stillbirths per yr in U.S.
• Families suffer in silence

Photo Credits Carol Guzy/The Washington Post
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Gates Foundation Grant GAPPS Comprehensive Report
on PTB SB

• What we know and need to know and do
• Discovery Science
• Intervention Development
• Health Service Delivery
• Advocacy
• Ethics and Social Justice
• Next Steps A Global Action Agenda
• Commissioned by Gates (2007) to inform their
  investment strategy
• Sent to Gates Foundation for review (Aug 09)
• Published in Fall/Winter by BioMed Central

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International Conference Seattle, May 2009

• Co-conveners
• GAPPS, Bill Melinda Gates Foundation, March of
  Dimes, PATH, Save the Children, UNICEF and the
  World Health Organization
• Connected 200 global experts
• Maternal, newborn and child health
• NGOs, funders, policy makers, advocates
• Created collective global action agenda
• Short- and long-term milestones
• Success metrics

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GAPPSs Strategic Initiatives

• Advance Discovery Science
• Magnitude, causes consequences of PTB SB
• Accelerate Development Delivery
• Proven, effective interventions
• Increase Global Advocacy Communications
• Support broad range of efforts
• Establish Support Global Infrastructure
• GAPPS Repository
• Establish Foster Strategic Partnerships
• Achieve global action agenda goals

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Interdisciplinary Approach
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Collaborative Partnerships

• All India Institute of Medical Sciences
• Bill Melinda Gates Foundation
• First Candle
• Hospitals in Washington state (5)
• Family Care International
• International Stillbirth Alliance
• March of Dimes
• National Institutes of Health
• National Bureau of Asian Research
• PATH
• PREBIC
• Save the Children
• UNICEF
• Universities around the world, including UW
• USAID
• U.S. Centers for Disease Control and Prevention
• World Health Organization
• U.S Coalition for Child Survival

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Global Health Partnerships WA State

• University of WA
• Fetal growth and newborn nutrition
• WA State Prematurity Network
• Swedish, UW, Deaconess, Kadlec, Yakima
• Fred Hutchinson Cancer Research Center
• Institute for Systems Biology
• PATH - health innovation in non-traditional
  setting
• Preemie Pack / low-resource settings
• Diagnostic tools / maternal infections

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Supporting Global Research GAPPS Infrastructure
/ Repository

• Based at Seattle Childrens Research Institute
• Maternal data and specimens
• Collect, track, store, and distribute
• Fosters leading-edge global health research
• Causes and solutions
• Funding, education is critical
• Significant, global research resource

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Accelerating InnovationWA State

• Promote global health as part of life sciences
• Streamline technology transfer
• Leverage opportunities for commercialization
• Diagnostics
• Biomarkers
• Devices
• Ventilator
• Therapeutics
• Oral Surfactant

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Communitys Success Reflected in Health of
Mothers Babies

• We have an opportunity to address prematurity and
  stillbirth locally and globally
• Improves prosperity in our own backyard
• Health
• Innovation
• Technology
• Jobs
• Promote WA state as an innovator in Global Health

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200
deaths occurred in the past 20 minutes from
prematurity and stillbirth
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Together, we can help all families have healthy,
full-term babies.
www.gapps.org