Prevention To Go

Robert Malkin's invention looks like a packet of ketchup commonly found at fast-food restaurants. What it delivers, though, is far more inspiring than artificial tomato flavor.

The packet is called the Pratt Pouch, named for Duke's Pratt School of Engineering, where Malkin M.S.E. '90, Ph.D. '93 is a professor of the practice of biomedical engineering. It's designed to contain anti-retroviral drugs such as nevirapine, which can prevent the transmission of HIV from mothers to newborns—provided they are administered in time.

"It is well-established that if these newborns can get anti-retroviral drugs within several days of birth, their chances of developing the disease decrease significantly," says Malkin, who directs Duke's Developing World Healthcare Technology Laboratory. "However, many of these babies in Africa are born at home and can't always get the medicine in time." The World Health Organization estimates that more than 90 percent of new cases of AIDS in Africa were attributable to mother-to-child transmission.

Malkin's team spent three years coming up with a low-cost, convenient way to address that problem. The Pratt Pouch, made of foil and lined with plastic, can be filled by local pharmacists with a single dose of anti-retroviral medication and then handed out to HIV-positive pregnant women during prenatal screenings. Once her baby is born, a mother rips open the pouch and squeezes the medication into the infant's mouth.

Last fall, the U.S. Agency for International Development awarded the Duke team a $250,000 grant to advance the pouch's development. As part of a two-year trial, the pouch will be distributed to HIV-positive mothers in Tanzania to gauge whether they are able to use it successfully.

"The pouch itself has been undergoing modifications over the years, and our main focus now is fine-tuning its design to make sure it is easy to open, especially since the people who will be using it likely will not have seen anything like it before," says Amanda Britt '12, a mechanical engineering student who has been working on the project. "We'll be looking at such things as notches along the side, or arrows or dotted lines—anything that will make the process as uncomplicated as possible for the mother."