OHSU expands Bangkok footprint

OHSU's South Waterfront campus

The university’s Asian research arm expands, considers clinical trials for TB and HIV vaccines.  

Share this article!

Oregon Health & Science University is considering clinical trials in Thailand to test a new HIV vaccine. International trials could considerably lower costs, test a more relevant patient population and speed the vaccine’s journey to market. 

The possible trials remain relatively low on the list of OHSU’s priorities in Bangkok, where the scope of research has expanded dramatically over the past four years. OHSU’s partnership with top medical facilities in the Thai capital is by far its largest international venture, and the collaboration continues to grow.   

“We have for years been scattered around the world but nothing in-depth,” says Dr. Justin Denny, director of OHSU Global, Southeast Asia, a cross-cultural research hub based in Bangkok. “We have nothing as deep and well-funded as in Bangkok.”

OHSU Global Southeast Asia now oversees around 20 projects in three countries —Thailand, Laos and Mynammar. Focus areas include ophthalmology, nutrition, occupational health, nursing quality, pediatric care and infectious disease.

In Thailand research currently centers on tuberculosis and malnourishment. Researchers are also exploring the effects of dark grain rices on children’s health and cognition. In Myanmar, OHSU Global trained a new generation of eye surgeons to combat a blindess epidemic. In Laos, the Oregon research hub ramped up the number of trained dieticians from zero to twelve.

“We have for years been scattered around the world but nothing in depth,” Denny says. “We have nothing as deep and well-funded as in Bangkok.”

Nick Stanley, an investment banker at Veber Partners, sits on the board of OHSU GLobal Southeast Asia. He says HIV trials in Thailand could cut costs by about a third.

OHSU announced intentions to test a promising new HIV vaccine in 2016. But U.S. trials proved costly and inefficient; an Oregonian article published that year reported that getting the vaccine to market could take nearly a decade, millions of dollars and thousands of volunteers from across the country.

Deep-pocketed Vir Biotechnology, a San Francisco startup backed by the Gates Foundation, took over the technology in January 2017. But the venture remained financially risky. Worldwide, dozens of attempted vaccines have failed.

The lower costs in Thailand would allow researchers to run more trials, giving them a better chance of developing a marketable cure.

Thailand could also provide a better population for testing. The country has the highest HIV rate in Southeast Asia, according to the World Health Organization. Nearly 520,000 adults live with the disease. 

“The clinical trials need to line up with the potential users of the drug,” Stanley says. “HIV is a big problem in that part of the world.”

OHSU has discussed bringing the lead researcher on the HIV vaccine, Dr. Louis Picker, to Thailand to explore research options. For now, he’s busy working on first phase clinical trials in the United States. In the meantime, OHSU has sent several delegations to Thailand to explore patient demographics and medical issues. They have developed memorandums of understanding with Thai institutions and talked about how to ethically transport samples between countries. OHSU has also recruited a Thai internist for various projects, including exploring opportunites around vaccine development. 

IMG 1294Nick Stanley (far right) led an Oregon trade delegation to Thailand earlier this month. 

OHSU Global Southeast Asia, got off the ground in 2014. Working from regional contacts he developed through the World Health Organization, Denny forged a partnership with Bangkok Dusit Medical Services (BDMS), a hospital, and Mahidol University, a large medical school. 

Bangkok’s state-of-the-art medical facilities and schools have made it a hub for medical tourism and research. The Thai capital’s reputation as a hub for NGOs and public health organizations, Denny says, rounds out its profile as an ideal research base. 

Funding for OHSU’s public health projects in Southeast Asia totals around $3-4 million, Denny says, and comes from clinical enterprises in Bangkok. OHSU sends consulting teams to improve BDMS performance in cardiology, nursing management and occupational health.

A lack of funding is one of the roadblocks to major clinical trials for TB and HIV. To close the gap, the research hub is mining National Institute of Health grants and connections with major donors. 

Stanley is also doing his part to explore funding options. As an Honorary Thai Consul General, he works to increase Oregon investment in Thailand. On a recent Business Oregon trade mission to Bangkok, he asked the American Chamber of Commerce and Thai Board of Investment about grants and incentives for trials.

“One of the opportunities in the U.S.,” he told Board of Investment officers, “is to find more efficient ways to conduct those trials.”

Regulations are another hurdle. Before trials could begin, Stanley says, OHSU needs to ensure that Thai clinical trial regulations and safety standards match those of the U.S. Food and Drug Administration so the vaccine could be sold in the United States and Europe.

“The clinical trials need to line up with the potential users of the drug,” Stanley says. “HIV is a big problem in that part of the world.”

Stanley is also interested in Thailand’s potential for facilitating OHSU research into a controversial gene editing technology, CRISPR. The technology could eliminate hereditary diseases by altering specific genes, although critics fear its abuse would promote “designer babies.” An OHSU team led by Kazakhstan-born scientist Shoukhrat Mitalipov used the tool to correct a disease-causing gene mutation in human embryos.

U.S. regulators are skeptical. In Late May, the FDA paused one of the first U.S. clinical trials of CRISPR. Stanley thinks Bangkok might offer fewer constraints and more funding options.

“Thailand may offer a safe haven for us to do the ethically appropriate work in that area,” he says.

The cultural and scientific exchange between Bangkok and Portland runs both ways. Denny hopes the various research projects abroad will yield insights for OHSU’s staff back home. 

“We think growing internationally,” he says, “is good for our work in Oregon.”

To subscribe to Oregon Business, click here.

This article has been edited to reflect the following corrections: The OHSU budget for projects in Southeast Asia is $3-4 million, not $1 million. Dr. Mitalipov was born in Kazakhstan, not Russia.