Hearts under stress need to work harder, and cardiac cells bulk up to facilitate this output. But healthy heart cell growth, caused by exercise or pregnancy, occurs by a different mechanism than so-called pathological growth, induced by heart attack or high blood pressure.

To better understand the difference, and possibly to uncover a way to preferentially encourage healthy growth, cardiologist Leslie Leinwand of the University of Colorado in Boulder studied Burmese python hearts, which balloon by 40% after the snakes’ monthly meal without incurring harm. In a paper published today in Science, Leinwand and her colleagues identified a mixture of three fatty acids in the pythons’ blood that were activated during cardiac growth: myristic, palmitic, and palmitoleic acids. And, when she injected them into mice, their hearts exhibited healthy growth — although they expanded by less than 10%.

The next step is to study whether this fatty acid mixture can heal or treat diseased mouse hearts and then, eventually, human. “The question is whether this growth is truly physiological and is it going to help the heart function better,” says Rong Tian, who studies cardiovascular metabolism at the University of Washington in Seattle.

Image: Burmese python digesting, courtesy of Stephen M. Secor

Diseases that disproportionally afflict the world’s poor provide few incentives for profit-seeking drug companies. In the past couple years, collaborative patent sharing schemes have popped up to remedy this by helping drugmakers develop low-cost medicines for less developed nations. Last year, for example, UNITAID launched the Medicines Patent Pool (MPP), which focuses on HIV drugs.

Yesterday, the World Intellectual Property Organization (WIPO), a Geneva-based arm of the United Nations, unveiled its Re:Search database, a new open-access resource aimed at tackling malaria, tuberculosis and neglected tropical diseases. The database was launched in partnership with the Washington, DC-based non-profit BIO Ventures for Global Health (BVGH). Since 2009, BVGH has administered the Pool for Open Innovation against Neglected Tropical Diseases formed by the British drug giant GlaxoSmithKline.

But organizers hope that Re:Search will grow to ultimately supplant that database. Like GlaxoSmithKline’s effort, WIPO’s resource compiles intellectual property beyond patents, including assets related to many steps in the drug development process, such as research tools, manufacturing technology, as well as both experimental and marketed compounds. However, it is far more extensive, as eight major pharmaceutical companies and a dozen non-profit research organizations from around the world have contributed. The database is available to all scientists and drugmakers free of charge as long as they agree that any therapies stemming from the information are sold at cost of production to the UN’s list of the 48 least developed countries in the world.

Stephen Maurer, who studies innovation and science policy at the University of California–Berkeley School of Law, thinks that sharing non-patented proprietary information, previously held hostage by institutions, is the database’s major contribution. “This is a good first step in terms of getting out of this problem that intellectual property does nothing for the developing world,” he says.

However, Michelle Childs, director of policy and advocacy at Médecins Sans Frontières’ Campaign for Access to Essential Medicines in Geneva, worries that by only making drugs available to the most impoverished nations, Re:Search — like other patent pools before it — could leave out people in middle-income countries who can’t afford full-price meds (see Nat. Med. 17, 1023–1023, 2011).

“Restricting access to the least developed countries is just ignoring where people with neglected tropical diseases live,” Childs says. “By agreeing to licensing terms that have such an unacceptably limited geographical scope, the UN — a norm setting agency — is setting a bad precedent for future licensing arrangements.”

And without concrete targets, some experts worry whether the initiative will actually deliver on its stated goal of promoting the development of new drugs, vaccines and diagnostics. “Statements of goodwill made in good faith are not good enough,” says MPP head Ellen t’ Hoen. “Actual action needs to be put behind it.”

In 1988, health groups and governments around the world launched the Global Polio Eradication Initiative (GPEI), a public-private partnership aimed at eradicating the poliovirus by 2000. That year has come and gone, and still the contagious virus plagues many parts of the world, with ongoing outbreaks in China, Pakistan and Madagascar, just to name a few countries.

The program has made great progress over the past 23 years, though. For example, the number of polio infections worldwide has decreased by more than 99% since 1988, with only around 1,350 cases of wild polio in 20 countries last year. Buoyed by that success, in June 2010 the GPEI published a new strategic plan, laying out guidelines to terminate polio in two of four endemic countries (Afghanistan, India, Nigeria and Pakistan) by the end of 2011 and to end wild polio transmission in countries that had active outbreaks in 2009 by 2012.

But the end is not yet in sight, according to an independent evaluation of the strategic plan published earlier this month. Virus control in India has made great strides, the new report notes, with only one case reported in 2011 thus far — a considerable accomplishment considering that, less than a decade ago, India accounted for 85% of polio cases worldwide. However, Afghanistan and Nigeria, two of the three remaining endemic countries, have had more cases in the first nine months of this year than in 2010 altogether. Several other countries targeted by the plan have also seen more cases to date this year compared to this time in 2010. Additionally, polio had popped up in countries where it had previously been eradicated — notably China, which went polio-free for 11 years until this summer.

With so little progress, the report concludes that “the GPEI is not on track to interrupt polio transmission by the end of 2012 as it planned to.”

Problems with the GPEI “run so deep,” the report continues, “that nobody should believe that ‘more time’ is the solution to them.” Instead, the evaluation recommends that the program should receive higher priority — in other word, more funding. But is throwing more money at the problem really going to wipe out polio for good? As we’ve noted many times before in the pages of Nature Medicine, millions have been invested to make polio history, but the virus remains. On this World Polio Day, shouldn’t we be searching for novel solutions?

Image: Oral polio vaccination in Guinea in 2009. By Julien Harneis via flickr under Creative Commons