When John Galgiani was completing his residency at Santa Clara Valley Medical Center, he became interested in immune-suppressed patients with fungal infections. He accepted a postdoctoral fellowship working with patients with coccidioidomycosis—Valley Fever—and entered the underserved world of medical mycology.
Valley Fever is a soil-borne disease from a fungus that grows in parts of California, Arizona, New Mexico and Texas. Anyone living in or traveling through the dry Southwest—especially during dust storms—is at risk of inhaling its spores. The disease causes anything from a flu-like illness to meningitis. Although many of the 150,000 infections per year do not require treatment, thousands of victims require hospitalization and dozens die. No cure exists: the experimental antifungal medication Galgiani’s new patients were receiving—miconazole therapy—merely contained the disease.
Galgiani made Valley Fever his lifework. “I was amazed at how little . . . was being done on this most important fungi infection,” he says. He took a faculty position at the University of Arizona Medical School in Tucson, where the dry soil was a perfect cocci incubator. During the next 20 years, Galgiani’s laboratory searched for a vaccine, as well as a more curative antifungal agent.
In 1996, Galgiani founded the Valley Fever Center for Excellence at the University of Arizona. After years of working on his plan to develop nikkomycin Z as a medication and possible cure for the disease, in 2005, VFCE struck a deal with the CSU-Bakersfield Foundation for Research (who owned the drug at the time), and acquired nikkomycin Z and the FDA documentation necessary to begin work.
Galgiani then turned from science to finance. Organizations like the National Institutes of Health and a group of Arizona pet lovers (animals, too, die from Valley Fever) have pulled together some money, but Galgiani needs $40 million to $60 million to guide nikkomycin Z through FDA trials and to develop the product. A pharmaceutical company could provide that, but an orphan disease with a limited customer base won’t lead to big profits. Galgiani, who never envisioned himself on the money side of the medical world, has taken charge of fund raising and is searching for a private business partner.
Last September he started a three-year, double-blind FDA safety trial (Phase II) of nikkomycin Z, including 60 participants with primary Valley Fever. After this trial, however, the program will be out of drug and out of money.
In the meantime, Galgiani works to lessen the investment risk for pharmaceutical partners. The University of Arizona biochemistry department is genetically modifying the bacteria responsible for manufacturing nikkomycin Z to make it cheaper to produce. Valley Fever’s recent appearance on a national list of bio-defense organisms increases its eligibility for further federal funds. Ever the optimist, Galgiani anticipates a day in the near future when he can announce a Valley Fever cure.
