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The Air Up There Vice President Research, Office of the Nov 30, 2008

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10 fall / Winter 2008 fall / Winter 2008 11 A deadly parasitic infection transmitted by sandfly bites, visceral leishmaniasis claims over 60,000 lives annually, mainly in India, Nepal, Bangladesh, Sudan and Brazil. In the Indian subcontinent alone, more than 500,000 people host the parasite. Worldwide, visceral leishmaniasis affects more than 200 million people in 62 countries and, if left untreated, is fatal within two years. The key barrier to treatment – echoing Vancouver’s outbreak of blood-borne fungal infections – is that most of the afflicted live far from hospitals where intravenous Amp B is readily available. Global access principles The discovery that Oral Amp B might be effective in the field against two distinct conditions was equivalent to striking pharmaceutical gold. A traditional next step might have been to form a lucrative spin-off company, but the unexpected intervention of former graduate student Rebecca Goulding helped to focus Wasan’s vision for Oral Amp B. Goulding is an active voice in the UBC chapter of the Universities Allied for Essential Medicines (UAEM), a student- led group with more than 25 chapters across North America that advocates improving global access to public health goods developed on university campuses. “She blew me away, made me feel guilty for even considering forming a spin-off company,” Wasan says. “She said, ‘you should think about doing this for the developing world.’” In late 2007, UBC’s University-Industry Liaison Office (UILO) – which oversees industry-sponsored research and the commercialization of UBC discoveries – launched the University’s new Global Access Principles, developed in collaboration with the UBC-UAEM chapter. This strategy for enhancing the equitable licensing of UBC’s intellectual property was a first among Canadian universities, and Wasan quickly engaged the UILO to negotiate the first licensing agreement under the new Global Access Principles with a local pharmaceutical company, iCo Therapeutics Inc. In return for the exclusive worldwide right to develop and sell Oral Amp B as a treatment for blood-borne fungal infections in the developed world, iCo Therapeutics has agreed to ensure a suitable formulation is available and accessible to developing nations, at subsidized prices, to treat leishmaniasis. Wasan and iCo Therapeutics are currently pursuing funding from a number of philanthropic organizations including the Bill and Melinda Gates Foundation to proceed with clinical testing of Oral Amp B against both blood- borne fungal infections and visceral leishmaniasis. “It’s a long way from our laboratory ‘home brew’ to getting someone in India to actually administer it,” Wasan says, “and the biggest challenge will be creating a formulation that is resistant to heat and long-term storage. But we’re not starting with a brand new drug; other formulations of Amp B have been effective for years. I’m optimistic that our development timeline can be accelerated.” Dr. Kishor Wasan’s research on Oral Amp B is funded in part by the Canadian Institutes of Health Research (CIHR). “ it’s quite rare in pharmaceuticals for a treatment to be effective against two separate conditions.” In 2002, the City of Delhi and the Supreme Court of India tackled the capital’s famously poor air quality in one legislative stroke. Over a multi-year grace period, thousands of diesel taxis, autorickshaws and transit buses were required to convert to cleaner fuels such as compressed natural gas (CNG). This dramatic shift in policy provided a convenient exogenous experiment for Dr. Milind Kandlikar, an Assistant Professor jointly appointed to the Liu Institute of Global Studies and the Institute of Asian Research at UBC Vancouver. Fluent in the languages of climate science and public policy, Kandlikar and his team analyzed environmental data collected before and after the policy shift to determine whether air quality had actually improved. The study zeroed in on particulate matter – scientific shorthand for any number of tiny, airborne particles, which, unlike greenhouse gases, do not have a universally accepted chemical composition. Particulate matter is so heterogeneous that it is nearly impossible to quantify, let alone predict its behavior or impact. “We found that it was difficult to detect changes in particulate matter concentrations that could be attributed to the CNG switch, suggesting that a portion of the air quality problem in Delhi was the result of particulate matter originating mostly from industry and biogenic sources,” says Kandlikar. “Air pollution in Delhi is not necessarily just a traffic problem – its causes are much broader.” As evidence, Kandlikar points to the notorious Asian brown cloud, a vast pall of polluted air that periodically envelops parts of Asia and the Indian subcontinent. Its causes are a complex stew of airborne particles and pollutants, released across an entire continent by industry and by the burning of agricultural residues and other biomass. “Our contribution was to look at the data and point out that focusing on transport alone is not going to solve Delhi’s air quality problems, at least with respect to particulate matter,” says Kandlikar. “This problem has regional and local characteristics with multiple sources.” Autorickshaw assessment In collaboration with Dr. Madhav Badami of McGill University and Dr. Geetam Tiwari of IIT Delhi, Kandlikar and his team of graduate students are conducting a series of interconnected projects combining policy analysis and empirical data gathering, with a view to providing a comprehensive analysis of air quality issues in Indian cities. A current study by doctoral student Conor Reynolds seeks to establish a baseline of emissions from autorickshaws, three- wheeled motorcycles that form a major component of India’s public transport system, and which make a poorly understood contribution to pollution. The study will also survey the attitudes of autorickshaw drivers toward maintaining their vehicles and thus reducing air pollution. Another element of Kandlikar’s research addresses the intersection of air quality and global climate change. In a recent paper published in the journal Environmental Science and Technology, Kandlikar and Reynolds showed that conversion of Delhi’s public transit fleet to compressed natural gas – which produces more carbon dioxide than diesel but less light-absorbing particulate matter – has had a net beneficial impact of reducing atmospheric warming. “Within India, there are piecemeal research efforts on air quality but still very little comprehensive understanding of the problem or how to address it in a coordinated way,” says Kandlikar. “We’re seeking to combine analyses of air pollution and climate change, and so to inform policies that provide solutions to both issues.” The collaborative research project, Air Quality in Indian Cities is funded by the Natural Sciences and Engineering Research Council of Canada (NSERC), the Social Sciences and Humanities Research Council of Canada (SSHRC) and AUTO21, a Network of Centres of Excellence. MiLind kandLikar is uncovering hoW deLhi’s air quaLity proBLeM isn’t necessariLy a traffic congestion proBLeM Ph ot o > Pi ct ur e C on ta ct  /A la m y


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