The Bill & Melinda Gates Foundation is providing more than $1 million in funding to repurpose technology behind Pfizer’s unsuccessful inhaled insulin product Exubera in the hopes of developing inhaled oxytocin as a therapy to curb the leading cause of maternal mortality: excessive post-partum bleeding. The problem is especially acute in Africa, where the World Health Organization estimates 10.5 percent of women experience post-delivery hemorrhage.

The effort by the foundation could advance a therapeutic delivery system that has the potential to transform healthcare in rural areas of the developing world. Through its Grand Challenges Explorations initiative, the foundation is funding researchers at Monash University in Australia in the hopes of resurrecting inhalers as therapeutic peptide delivery systems.

In the six years since Pfizer tried but failed to profit from its inhaled insulin Exubera, the non-invasive, quick, and inexpensive delivery of drugs via the lungs has advanced enough to forecast a promising future for inhaled therapy, says John Patton, one of the original inventors of Pfizer’s inhaled insulin technology system.“When you’re first, you take a lot of bullets. With the developments in the industry, it’s just a matter of time before we will be inhaling lots of medicine.”

Oxytocin, a naturally occurring brain chemical that helps the uterus contract after birth, is currently given by injection and works by stimulating muscles in the uterus to contract, closing off damaged blood vessels. “The injection works extremely well,” says McIntosh, “but in some parts of the world, the injection just isn’t always available.” The requirement for refrigerated storage and sterile needles has limited the hormone’s use in Africa.

The Bill & Melinda Gates Foundation grant will allow McIntosh to test a dry powder formulation of oxytocin in an inexpensive, inhalable form that does not require refrigeration and is suitable for use in remote areas. Her team modified the peptide hormone, only nine amino acids long, to improve its ability to cross the epithelial cell membrane once it gets into the lungs. The group’s disposable inhaler requires no training to use.

No non-invasive drug delivery route provides the speed of action that the inhaled route provides, critical in a case where a mother is bleeding uncontrollably after giving birth. The lungs also have only a fraction of the drug-metabolizing and efflux transporters of the gut and liver, so with inhalation delivery drug absorption is increased and drug metabolism into toxic byproducts is decreased.

McIntosh’s group plans to start testing their product in 18 healthy volunteers in Australia by early next year. “When Exubera was pulled, it was a huge hit to the whole inhaled-drug industry,” says Patton. Today, with developments from several companies and the Australian oxytocin research team, “it’s all coming back,” he says.