Awards

Ayokunle Olanrewaju, and collaborators Ashleigh Theberge and Erwin Berthier, of the University of Washington in the U.S. will develop a platform for at-home self-collection of blood, serum separation, and sample stabilization at sufficient sample volumes for comprehensive HIV monitoring. An existing device for home blood collection will be expanded with the development of serum separation using a simple filtration system and connected to a standard blood collection tube with serum-stabilizing reagents. The device design will be optimized to ensure that over 1 mL of blood can be processed. The resulting design will then be tested for its effectiveness for RNA and protein analysis to monitor HIV viral load and biomarkers associated with HIV treatment and care. Performance of the device will be compared to standard blood processing, using blood from healthy volunteers spiked with either HIV RNA or C-reactive protein as a model biomarker. They envision a system that can readily integrate with standard laboratory or point-of-care diagnostic workflows to enable maximal deployability.

Lisa Rohan of the University of Pittsburgh in the U.S., with Thesla Palanee-Phillips of the Wits Health Consortium (Pty) Ltd in South Africa, will develop a vaginal film technology for the sustained release of the hormone levonorgestrel as a product that provides contraception and reduces heavy menstrual bleeding. Levonorgestrel is a progestin, a synthetic hormone that mimics the effects of progesterone. They will create and compare vaginal films with differences in mechanical properties, mucoadhesion, and drug release profiles to design a product that is low-cost, self-administered, and active for one month. They will also conduct a pilot trial of two prototype placebo films without levonorgestrel, evaluating them for safety, acceptability, and mucoadhesion in 20 women in South Africa, half with heavy menstrual bleeding.

Joyce Were of the Kenya Medical Research Institute in Kenya will develop a screening tool for assessing heavy menstrual bleeding that is adapted for use in Kenya by integrating two globally used questionnaires, adding material to incorporate the impact on women in the Kenyan context, and translating it into the locally spoken languages Swahili and Luo. Through consultations with experts, the tool will combine the Menstrual Bleeding Questionnaire (MBQ) with the Screening Assessment and Measurement of Atypical and Normal Menstrual Patterns Tool for Adolescents and Adults (SAMANTA), and it will incorporate new questions. The tool will be iteratively modified through small pilot tests. It will then be administered to adolescent girls and young women in Western Kenya as part of the Health and Demographic Surveillance System (HDSS) of the Kenya Medical Research Institute (KEMRI), with 70,000 participants surveyed with either the new tool or the MBQ or SAMANTA tools for comparison.

Jennifer Anyanti of the Society for Family Health with Clara Ejembi from Ahmadu Bello University, both in Nigeria, will evaluate patient experiences and treatment outcomes in women with heavy menstrual bleeding in Nigeria, with a focus on increasing the effectiveness, acceptability, and accessibility of hormonal contraceptives as treatment. Clinical data will be collected for a cohort of women receiving care for the condition in Kaduna state in Nigeria, together with qualitative data from interviews with patients, care providers, and supply chain managers. This information will be used to design and pilot targeted interventions to increase access to acceptable and effective treatment, such as community health education, supply chain improvements, and treatment programs. Such interventions can be iteratively improved with the original evaluation framework, generating a sustainable data management system to guide improvements in patient-centered care for heavy menstrual bleeding.

Anne Beatrice Kihara with Moses Madadi, both of the University of Nairobi in Kenya, will pilot a multipronged approach to support research and development for women’s health in Kenya. They will co-develop a policy and regulatory framework that integrates gender equity, working with government stakeholders, including the Ministry of Health and regulators, as well as civil society groups and women-led organizations. They will develop case studies of healthcare technologies for women’s health, focused on how accessible these technologies are for women in underserved communities; launch community-based campaigns to increase awareness and understanding of women’s health and healthcare solutions; and train healthcare professionals in applying an equity perspective in women’s health research and care. Community feedback will guide an iterative approach throughout these efforts.

Mathew Njoroge of the University of Cape Town in South Africa, with Roslyn Thelingwani of the African Institute of Biomedical Science and Technology in Zimbabwe, will analyze liver tissue from an African patient biobank to characterize the variability in drug metabolism in African populations. The analysis will combine genotyping, in vitro physiology studies, and pharmacokinetic modeling. Using the biobank samples, they will perform targeted sequencing of genes known to be associated with drug absorption, distribution, metabolism, and excretion, and then use the genotyped samples for in vitro analysis of drug clearance. This data will be combined with data modeling to predict the variability of drug pharmacokinetics in vivo to guide drug development and inform the design, monitoring, and interpretation of clinical trials.

Denali Dahl of Kalia Health, Inc. in the U.S. will evaluate Activin A and Inhibin A as urinary biomarkers for prediction and detection of preeclampsia early in pregnancy. This work builds on an ongoing biomarker validation study in Bloemfontein, South Africa. Through collaborations, clinical studies will be performed with blood and urine sampling in cohorts of pregnant women. Studies in Stellenbosch, South Africa will assess how levels of the two proteins vary in urine during pregnancy, and studies in Bloemfontein, South Africa will assess how early in pregnancy they can serve to predict preeclampsia risk. Activin A and Inhibin A levels in urine will be measured by MSD, and their diagnostic value will be compared to a standard assay for the biomarker protein ratio sFlt1/PIGF in blood and to clinical diagnosis by the treating physician.

Cliveland Ogallo of the Center for Public Health and Development (CPHD) with Anne-Beatrice Kihara of the University of Nairobi, both in Kenya, will assess the impact of heavy menstrual bleeding on the health and well-being of adolescent girls in an underserved community in Kenya. Girls in the Kibera urban informal settlement will be surveyed, along with guardians and health workers, to assess the prevalence of self-reported heavy menstrual bleeding; menstrual health literacy and associated cultural narratives; hygiene practices; access to healthcare products and services; and impacts including anemia, school absenteeism, and psychosocial well-being. Small-scale interventions will also be piloted, such as introducing menstrual kits with educational packets and dedicated physical spaces for menstrual hygiene.

James Beeson of the Burnet Institute with Stephen Scally of The Walter and Eliza Hall Institute, both in Australia, will develop candidate malaria mRNA vaccines designed to confer multiple types of immunity over multiple lifecycle stages of the malaria parasite. They will start with lead candidates that target Plasmodium merozoites, screening them with a human organoid model of the germinal center for their ability to activate B cell responses. Based on these tests, they will add antigens and test the resulting multi-antigen vaccines in animal models to create candidates that confer anti-merozoite, anti-sporozoite, and transmission-blocking immunity.

Brian Sullivan of Arcturus Therapeutics, with Sean Murphy of the University of Washington Foundation, both in the U.S., will pilot test a self-amplifying mRNA vaccine technology as a platform for developing malaria vaccines. They will use a mouse model of malaria, establishing infections in parallel with two different Plasmodium parasite species. They will test preventive treatments in this model, comparing self-amplifying mRNA vaccine technology to conventional mRNA and comparing intramuscular versus intravenous administration. They will assess the ability of each test vaccine to protect against liver-stage infection, determining the number of liver-stage parasites and how well the vaccine elicits potent, malaria-specific T-cell responses in the liver. The prolonged antigen expression characteristic of self-amplifying mRNA vaccines could be particularly valuable in inducing long-term protection against malaria.

Neha Lasure of Intignus Biotech Pvt. Ltd. in India will develop an affordable point-of-care diagnostic platform for prediction and detection of preeclampsia early in pregnancy. The diagnostic test is a lateral flow immunoassay that detects two key preeclampsia biomarker proteins in blood: sENG and PIGF. They will generate monoclonal antibodies against these proteins, manufacture test kits, and train frontline health care workers to administer and interpret the test. They will then perform a pilot study with 2,000 pregnant women in the Indian states of Pune and Mumbai, evaluating prediction accuracy compared to clinical outcomes and standard existing clinical tests.

Sarah Leeber of the University of Antwerp in Belgium, with Marie Josiane Kenfack of the Center for Research on Emerging and Reemerging Diseases (CREMER) in Cameroon, will add DNA sequencing analysis of the vaginal microbiota as a component for a set of clinical trials of menstrual hygiene products in Belgium, Switzerland, Cameroon, and Peru. The longitudinal trials compare use of different menstrual products, with participants using either the same product over time or different products in sequence, including pads, tampons, cups, and underwear. Surveys and group discussions will be used to gather data on user perceptions of the products and how acquiring knowledge of the microbiome may influence attitudes and practices. Shotgun metagenomic sequencing from self-collected samples will reveal changes in the vaginal microbiota associated with different products. Together, this data will provide a more comprehensive understanding of both the biological and behavioral dimensions of menstrual product use.

Almaz Negash of the African Diaspora Network in the U.S. will build an AI-augmented collaboration hub that matches senior African scientists with experienced researchers and innovators in the African diaspora. The hub will include AI-assisted profiling of skills and needs, focusing on areas including pharmacogenetics, pharmaceutical manufacturing for preclinical and clinical trials, infectious disease control, and data science. The hub will host monthly masterclasses and peer-learning sessions, and it will support co-designed research, co-supervision of students, joint grant applications, and technology transfers. It will be launched with an inaugural cohort of Africa-based scientists, including the Calestous Juma Fellows as an existing network of science leaders already embedded in African universities and research centers.

Margaret Ilomuanya of the University of Lagos in Nigeria will develop a multifunctional microneedle patch for delivery of agents that treat heavy menstrual bleeding while preventing disease from sexually-transmitted viral infections. The patch will be designed for use on the abdomen or thigh, and it will have a layered architecture to deliver multiple drugs: tranexamic acid and the progesterone-mimic levonorgestrel to reduce bleeding (with levonorgestrel also having contraceptive activity) and the antiviral drug tenofovir. Microneedle-delivered tranexamic acid and levonorgestrel will be tested, both for their safety and their ability to control bleeding, in assays including clotting in vitro, a rat model, and a rabbit model of menstruation. Women experiencing heavy menstrual bleeding will be engaged for group discussions to assess the acceptability, usability, and desirability of the microneedle patch compared to existing treatment options, such as oral tranexamic acid and hormonal intrauterine devices.

Sara Khalid of the University of Oxford in the United Kingdom will use large data sets from Kenya, Pakistan, and the United Kingdom to better understand the health impact and treatment challenges associated with heavy menstrual bleeding in low-resource settings. The project is a collaboration between Oxford University, Aga Khan University Kenya, and Aga Khan University Hospital Pakistan, with analysis of existing data sets in these three countries covering over twenty years of data for women diagnosed with heavy menstrual bleeding. For Kenya and Pakistan, analysis will encompass disease burden and epidemiology; patterns in treatment access, adherence, and effectiveness; and risk factors, with a risk prediction tool generated for heavy menstrual bleeding and its adverse outcomes. Equivalent analysis will be performed with data from the United Kingdom stratified by ethnic group to identify unique and shared features of the condition across settings.

Brandon DeKosky of the Massachusetts General Hospital, with Carole Long of the National Institute of Allergy and Infectious Diseases, both in the U.S., will develop a high-throughput, microfluidic screening platform to identify antibodies active against blood-stage malaria parasites. The platform is based on individual droplets containing a mix of Plasmodium parasite-infected and uninfected red blood cells together with mammalian cells secreting monoclonal antibodies. Each droplet serves as a parasite neutralization assay: antibodies that block parasite invasion of new red blood cells limit growth of the parasite population, and this is readily quantified using parasite-specific protein activity. With miniature droplets assayed in parallel, mammalian cells expressing a library of monoclonal antibodies can be rapidly screened for antimalarial activity.

Nadia Diamond-Smith of the University of California San Francisco in the U.S. will characterize the prevalence and impact of heavy menstrual bleeding as well as treatment preferences in a cohort of women in the state of Rajasthan in India. Building on an ongoing survey, new data will be acquired from 1,500 women in Rajasthan, including newly married women and their mothers-in-law. The prevalence of heavy menstrual bleeding will be determined, and the data will be modeled for its impact on women's physical and mental health. Twenty-five in-depth interviews will be performed, with the information used to design and launch a discrete choice experiment through a survey of 300 women from the cohort with heavy menstrual bleeding. This survey will uncover women's preferences across treatment options for the condition, including their willingness to pay for them, setting the stage for designing treatment programs based on the local context.

Ianessa Morantte of Prolific Machines Inc. in the U.S. with Arif Jetha of Radiant Biotherapeutics Inc. in Canada, are combining complementary platforms to enhance the production of broadly neutralizing antibodies (bnAbs) against HIV. Radiant has developed the Multabody platform™, which uses a self-multimerizing scaffold to multimerize antibody fragments. These fragments will be expressed using Prolific's proprietary Photomolecular Biomanufacturing Platform, which leverages light-controlled (optogenetic) cell lines that provide tunable gene expression control, facilitating expression of complex biotherapeutics. Stable, optogenetic host cell lines will be engineered by Prolific Machines to express multimers, each with a different combination of antibody fragments. The system will be assessed for its ability to increase Multabody yields by separating growth and production, and provide control over antibody fragment ratios with light, with the goal to pursue scale-up at a cost low enough to broadly increase access.

Annie McDougall of the Burnet Institute in Australia will develop a digital tool for point-of-care prediction of preeclampsia risk early in pregnancy, using data from clinical trials in Sub-Saharan Africa. A predictive model will be developed and validated using data from an ongoing set of clinical treatment studies in Ghana, Kenya, and South Africa: the PEARLS trial (Preventing Preeclampsia: Evaluating Aspirin Low-Dose Regimens Following Risk Screening). This model will be used to develop a tool for automated preeclampsia risk stratification to support clinical decision making by antenatal care workers. It will be designed for integration into existing digital health platforms, including real-time patient data entry. The tool will be evaluated for usability, feasibility, and acceptability through interviews and workshops with patients and care workers in two of the PEARLS trial countries.

Javan Esfandiari of Chembio Diagnostics, Inc. in the U.S. will develop an affordable point-of-care diagnostic platform for prediction and detection of preeclampsia early in pregnancy. The diagnostic test is a semi-quantitative lateral flow immunoassay to monitor the level of the key preeclampsia biomarker protein sFlt1 in whole blood from a finger prick. The test will discriminate between two levels of the biomarker, identifying patients at either low, medium, or high risk of developing preeclampsia, and it will be integrated into a low-cost, portable reader device. Through local collaboration, the prototype device will be tested in France, Nigeria, and Benin. In each country, 100 women with identified risk of preeclampsia will participate. For comparison with the diagnostic test results and predicted preeclampsia risk, patient clinical outcomes will be recorded, and serum samples will be tested at a central laboratory, using existing tests to measure sFlt1 and the sFlt1/PIGF biomarker ratio.

Brandon Wilder with Daniel Streblow, both of Oregon Health and Science University in the U.S., will develop a vaccine platform based on virus-like vesicles (VLVs) as a vaccine vector that can be launched in vivo from nucleic acids and express proteins that elicit cellular and humoral immunity. They will optimize in vitro-generated VLVs for expression of an established Plasmodium berghei antigen and for immunogenicity in a mouse model of malaria. They will then vaccinate mice with gene gun-delivered, optimized plasmid DNA to demonstrate that VLVs can be generated in vivo, to assess their persistence and tissue distribution, and to test whether immunity can be boosted by a second vaccination.

Irene Njuguna of Emory University in the U.S. will determine the prevalence and impact of heavy menstrual bleeding in adolescent girls and young women in a variety of community settings in Kenya, as well as the barriers to treatment delivery and uptake. Two thousand adolescent girls and young women aged 10-24 across rural and urban communities in Kenya will be surveyed to determine heavy menstrual bleeding prevalence, and their hemoglobin levels will be measured to assess for anemia as a consequence. Interviews and focus group discussions with participants as well as with care providers will be performed to assess the available options for care and treatment of the condition, including patient referral pathways, and to identify barriers hindering patients from seeking care and providers from delivering it.

Maneesha Inamdar of the Institute for Stem Cell Biology and Regenerative Medicine in India will develop a standardized organoid model of the human endometrium, together with a reproducible and scalable process for generating these organoids. Protocols for deriving endometrial organoids from established human pluripotent stem cell lines will be optimized. This includes generating fluorescent reporter cell lines as visible readouts of secreted products to monitor development and differentiation of the input cells, as well as determining the assays for comparing organoid function with that of human endometrial tissue. The resulting model system will enable automated analysis with equipment for routine cell culture and without the need for human clinical samples, and it will facilitate human endometrial biology research to identify therapeutic targets and treatments for heavy menstrual bleeding.

Jianghong Rao of Stanford University in the U.S. will develop a magnet-based system for capturing and concentrating the TB bacterium from sputum biosamples to facilitate TB diagnosis. The system is based on conjugating magnetic nanoparticles to bacteriophage specific to Mycobacterium tuberculosis, so that a simple magnet can capture phage-bound TB bacteria from patient sputum. This process will be optimized, including the stability and activity of the magnetized phage in a lyophilized powder form and at a high ambient temperature. A prototype device for the magnetic phage system will be designed and tested for its ability to generate purified target bacteria ready for lysis and PCR-based diagnostic testing. Initial tests will use a non-TB Mycobacterium species, and subsequent tests in collaboration with Niaz Banaei at Stanford Health Care Clinical Microbiology Laboratory will use clinical TB patient samples.

Suman Chakraborty of the Indian Institute of Technology Kharagpur in India will develop a membrane filtration system for Mycobacterium tuberculosis lysis and DNA purification from patient samples to enhance TB diagnosis. A paper-based membrane will be impregnated with two chemical agents, each in a separate layer, for sequential sample processing. Cell lysis will be performed in the first layer by zinc oxide nanoflowers, nanoscale structures that lyse bacterial cells through both mechanical and chemical mechanisms. DNA purification will be performed in the second layer by silica nanoparticles. This membrane system can be attached to a DNA amplification chamber with lyophilized reagents for colorimetric Loop-Mediated Isothermal Amplification (LAMP). This instrument-free, integrated process for TB diagnosis will be tested in a research setting and a clinical pathology laboratory setting.

Liya Wassie of the Armauer Hansen Research Institute in Ethiopia, with Richa Vashishtha of the Biotechnology Industry Research Assistance Council (BIRAC) in India, will develop resources for investigators in low- and middle-income countries (LMICs) to integrate ethical principles into the design and deployment of health-related AI technologies. They will establish and coordinate a multi-country AI ethics working group to develop a practical ethics guide for AI innovators, and the guide will be finalized through two public workshops. They will also launch public discussion sessions on key AI topics, such as algorithmic bias and data privacy, and coordinate an internship program on AI ethics for early- and mid-career LMIC investigators.

Sweta Kanavaje of the Myna Mahila Foundation in India will evaluate the effectiveness of the Myna Bolo chatbot in providing confidential, culturally sensitive, and medically accurate guidance on heavy menstrual bleeding to women in poor urban communities in Mumbai. The chatbot incorporates Large Language Models and currently provides tailored sexual and reproductive health information through multiple platforms in local languages. The chatbot will be evaluated specifically for advice on heavy menstrual bleeding through a randomized controlled trial with 400 women from Mumbai, comparing the chatbot to standard in-person counseling and to telehealth counseling. Primary outcomes of the trial, assessed through questionnaires and focus groups, include diagnostic accuracy compared to clinical assessments, reduction in time to seek and begin treatment, and improved understanding of menstrual health.

David Erickson of Cornell University in the U.S. will develop a device for heat inactivation and mechanical lysis of Mycobacterium tuberculosis from patient samples to enhance TB diagnosis. A prototype device will be engineered, using a non-TB Mycobacterium for testing as a proxy. The device combines an alternating magnetic field and magnetic beads to inductively heat inactivate bacterial samples and actuate lysis by a bead-beating mechanism. The protype will be pilot tested in a collaboration at the Infectious Diseases Institute in Kampala, Uganda where patient samples with presumptive TB will be processed with the standard protocol for TB diagnosis and in parallel with the prototype.

Sam Nugen of Cornell University in the U.S. will develop a bacteriophage-based system for the rapid concentration and lysis of Mycobacterium tuberculosis from patient samples to enhance TB diagnosis. A mycobacteriophage will be engineered to express the streptavidin protein, enabling low-cost magnetic particles to capture and concentrate the phage along with the TB bacterium to which it naturally binds. The phage will also be engineered to accelerate lysis of the TB bacterium after it is bound, and phage replication genes will be deleted to ensure that the phage can only replicate in a modified host bacterium or an in vitro system, not self-replicate. This low-cost, easily propagated system provides a streamlined, instrument-free solution to improve the efficiency of TB diagnosis in resource-limited settings.

Moses Madadi of the University of Nairobi in Kenya, with Annettee Nakimuli of Makerere University in Uganda, will establish a platform for coordinated advocacy to reduce the burden of postpartum hemorrhage, a major cause of maternal mortality and morbidity. The platform will build on the inaugural advocacy meeting called Run for Her, which was held in Kenya in 2024. This meeting brought together an international group of healthcare practitioners, politicians, policy makers, students, and religious leaders to raise awareness about postpartum hemorrhage. They will establish an African continent-wide network, expanding from Kenya to ten additional African countries, with annual advocacy events to directly engage local communities and other key stakeholders. The platform will raise awareness and inform data-driven policies for procuring essential medications and therapies, training and reskilling healthcare workers, and establishing systems for ongoing data collection.

Lily Telisinghe of University Hospitals Plymouth NHS Trust together with Ben Swift at PBD Biotech Ltd in the United Kingdom will develop a system combining a biological agent and mechanical disruption for the rapid lysis of Mycobacterium tuberculosis from patient samples to enhance TB diagnosis. Tests will be performed to determine if there are constraints for two biosample types, tongue swabs and blood, on how soon after sampling they must be analyzed. These sample types will then be spiked with the BCG vaccine strain and used to determine the optimal combination of factors for cell lysis. This combination of conditions will then be used to test how the lysis system performs for TB diagnosis in patients in the United Kingdom and Indonesia.

Meng Sun of the Zymeron Corporation in the U.S. will develop a small, handheld, low-cost device for rapid plasma separation from whole blood for HIV diagnostic testing. Existing versions of the device will be modified to be able to process a larger volume of blood and deliver 100-200 microliters of plasma. The device is designed for untrained users. It can readily be modified to connect with blood drawing devices, including automatically sampling a fixed volume of blood to process, either by capillary action or direct loading, and delivering a fixed volume of plasma. It can also readily be integrated to deliver plasma to different diagnostic platforms, such as those based on microfluidics and lateral flow systems.

Salus Discovery in the U.S. will optimize a prototype of their simple and inexpensive SnapTab platform technology for processing of finger-prick blood for HIV diagnostic testing. SnapTab components and chemistry will be optimized for blood plasma separation, viral lysis, and in a final step, nucleic acid purification and stabilization. The output can then be directly used in standard quantitative PCR amplification reactions for HIV detection. To evaluate the performance of SnapTab for HIV, sample extraction/purification results will be compared against existing approaches including the plasma separation card and traditional bead-based processing of plasma.

Jeffrey Burke of Prompt Diagnostics, Inc. in the U.S. will develop a low-cost, automated platform integrating blood sample input, plasma separation, and HIV RNA extraction for HIV diagnostic testing. The platform will be based on magnetofluidic cartridge technology in which sequential bioassay steps are conducted via transfer of magnetic beads between reagents: red blood cell-binding beads in the plasma separation step and RNA-binding beads in the virion lysis step. A prototype cartridge will be built and optimized, including reagents in shelf-stable formats, and a low-cost, battery-powered device will be built to house the cartridge and drive the transfer of magnetic beads. The prototype platform will be tested for RNA quality and extraction efficiency, using blood samples spiked with HIV virions and comparing directly to standard clinical laboratory procedures.

Rainer Ng of Baebies, Inc. in the U.S. will develop a system for finger-prick blood self-collection and sample processing that yields a sample ready for HIV diagnostic testing either at the point of care or after delivery to a central laboratory. A simple, disposable sample collection device will incorporate a membrane for plasma separation. Squeezing the device delivers plasma to a tube in which HIV-binding magnetic beads concentrate virions and reagents stabilize them. The prototype system will be optimized to ensure it generates over 100 microliters of plasma from self-collected blood, captures virions of sufficient quality and quantity to enable standard RT-PCR testing, and stabilizes virions sufficiently for diagnostic testing over three days after sample collection.

Atunga Nyachieo of the Kenya Institute of Primate Research (KIPRE) in Kenya, with Alfred Botchway of Attentive Science in the U.S., will perform a pilot study as a first step in creating an integrated, preclinical, toxicology testing hub at KIPRE to accelerate drug discovery. The pilot will begin with a toxicology study in rodents to assess existing protocols, including those for dose formulation, oral administration, observation and recording of clinical signs of toxicity, collection and processing of blood and tissue, and histopathology review of tissue slides. This assessment will identify gaps as well as guiding the development of standard operating procedures and of specialized training programs in toxicology and related disciplines.

Christopher Love with Hadley Sikes of the Massachusetts Institute of Technology in the U.S. will develop a biomanufacturing platform for low-cost production of monoclonal antibodies based on a multidomain synthetic protein enabling both capture and purification of the antibody in a chromatography-free process. The synthetic protein will concentrate and recover antibodies in a single, mobile fluid phase, based on studies of the liquid-liquid phase transition of proteins into condensates that occur naturally in key cellular processes. They will design and test protein agents for affinity-based capture and condensation of monoclonal antibodies including the antimalarial MAM01, assess the co-expression of the synthetic protein and the target antibody product in a microbial expression system, and determine conditions for continuous recovery of the product. They will also create models of the technical and economic factors required for low-cost production from either microbial or mammalian cell expression systems.

This grant is one of three grants that are funded and administered by LifeArc.

Rohini Nair of Gujarat Biotechnology University in India will explore the cellular heterogeneity and molecular pathways associated with heavy menstrual bleeding to better understand the condition, using single-cell transcriptional profiling of the endometrium in patients. In collaboration with Rohina Aggarwal of the Institute of Kidney Diseases and Research Centre in India, 60 premenopausal women with self-identified heavy menstrual bleeding will be recruited: one subgroup with irregular menstrual cycles (half with uterine fibroids and half with adenomyosis) and one subgroup with regular menstrual cycles and no discernible pelvic pathology. A control group of women without clinical symptoms will also be recruited. Single-cell RNA sequencing will be performed on endometrial samples taken during participants' menstrual period to reveal potential biological mechanisms shared and unique across patients with the condition.

Tim Bull of City St George's University of London in the United Kingdom will develop a system for the non-mechanical lysis of Mycobacterium tuberculosis from patient samples to enhance TB diagnosis. The system is based on lytic peptides that are active against host cells and can release intracellular TB bacteria, plus a combination of agents that directly lyse the TB bacterium, with candidates including a mycobacteriophage, antimicrobial peptides, and the lytic enzyme from the phage. Experiments will be performed to determine the components and conditions that optimize the speed and efficiency of lysis. These conditions will be used to test lysis across different sample types, using mock samples spiked with defined bacterial loads and focusing on sputum and tongue swabs. The mycobacteriophage will also be explored for selective capture of the TB bacterium in samples prior to lysis to improve the sensitivity of detection.

Lilian Okeke of the African Field Epidemiology Network in Uganda will develop a health index as a comprehensive, integrated measure of women’s health in Nigeria. The index will be based on existing datasets, including Nigeria’s Demographic and Health Surveys and its Health Management Information System as well as World Bank gender data, with new data collection to fill gaps where feasible. Health outcomes across women’s life course will be stratified by geography, socioeconomic status, and gendered barriers. The index will integrate factors such as education, employment, social protection, and gender-based violence; and data modeling and statistical methods will be incorporated to reveal hidden inequities. The index will be piloted in two Nigerian states, testing its ability to generate actionable evidence to guide health policy, resource allocation, and targeted interventions for more equitable women’s health outcomes.

Getachew Tilahun of Haramaya University in Ethiopia will develop a health index as a comprehensive, integrated measure of women’s health in Ethiopia. Health indicators will be developed that incorporate the sociocultural and economic context of women across their life course. Based on data from Ethiopia’s Demographic and Health Surveys, these indicators will be used to create a series of health indices, each specific for an age group. New data covering mental health will be integrated by adding questions to the household surveys conducted regularly under Ethiopia’s Health and Demographic Surveillance System. The age-specific indices will be aggregated into a composite index, spanning early childhood to late adulthood. Data modeling will be used to predict the effects on the women’s health index of changes over time in climate, land use, health policy, and health interventions.

Lyn-Marie Birkholtz with Erick Strauss, both of Stellenbosch University in South Africa, will develop antimalarial drugs that work by targeting parasite proteins for degradation rather than inhibiting their activity. This strategy involves creating proteolysis-targeting chimeras (PROTACs), which are linker proteins designed to bind specific parasite proteins and target them for degradation by an endogenous intracellular protease. This project builds on ongoing work with the approach applied to bacterial proteins for TB drug development. They will design and synthesize PROTACs against essential Plasmodium falciparum proteins, then evaluate their activity in phenotypic assays using drug-sensitive and drug-resistant parasite strains as well as multiple stages of parasite development. They will validate that any observed activity is due to the predicted PROTAC mechanism of action, as well as using in vitro assays to measure how effectively the parasites resist the antimalarial activity.

John Metcalfe of the University of California San Francisco in the U.S. will improve the turboLysis device for mechanical lysis of Mycobacterium tuberculosis from patient samples to enhance TB diagnosis. This device uses magnet-actuated steel beads to disrupt bacterial cells. A redesigned lower-cost version of the existing device will be built, and improvements will be tested, such as adding epoxy-coated paramagnetic beads in a sample cleanup step that eliminates the need for later centrifugation to remove cell debris. Patient samples in multiple formats will be tested for direct use in the device, including the tips of oral swabs and a filter with TB bacteria captured from sputum. Device performance will be compared to a commercial bead-beating device, including testing the turboLysis device in parallel to the standard protocol in an ongoing clinical trial in South Africa.

Susan Ontiri of the International Centre for Reproductive Health Kenya in Kenya will explore AI-enabled ultrasound for diagnosis of structural causes in the uterus of heavy menstrual bleeding, as well as exploring multiple treatment options for the condition. A cohort of 120 women with heavy menstrual bleeding will be recruited at the Coast General Teaching and Referral Hospital in Kenya. Participants will receive the standard clinical assessment together with an ultrasound evaluation. The accuracy and feasibility of the two diagnostic methods will be compared, and the ultrasound images will be annotated by experts and used to develop an AI-based model to enhance diagnosis by ultrasound. A pilot treatment trial will also be performed. Treatments including hormonal therapy, tranexamic acid, and non-steroidal anti-inflammatory drugs (NSAIDs) will be assessed, comparing feasibility, acceptability, adherence, and effectiveness.

Mathias Wipf of MOMM Diagnostics GmbH will improve their préXclude test to better enable its use in low- and middle-income countries (LMICs) as an affordable point-of-care diagnostic platform for prediction and detection of preeclampsia early in pregnancy. The existing test is contained in a single-use cartridge connected to an inexpensive handheld reader. It is based on an electrochemical enzyme-linked lateral flow immunoassay that quantifies the levels and ratio of two key preeclampsia biomarker proteins, sFlt1 and PIGF, in whole blood from a finger prick. Multiple aspects of the test will be improved to enhance usability and analytical performance, with the goal of developing a prototype platform that meets a target product profile appropriate for LMIC settings.

Sébastien Mazzuri of the EspeRare Foundation in Switzerland and its partners will reposition an oral drug previously evaluated in cardiovascular patients as a treatment candidate for early-onset preeclampsia. The drug has an extensive data package and advanced to Phase 3 trials before discontinuation for lack of superiority over standard of care. Leveraging preliminary research suggesting it could beneficially rebalance key physiological disruptions underlying preeclampsia, EspeRare will drive translational proof-of-concept studies in established preclinical models and coordinate advisory board consultations to guide the clinical trial design. The goal is to confirm the drug's therapeutic potential in preeclampsia and accelerate regulatory clearance for clinical evaluation. Ultimately this new therapeutic approach aims to significantly improve survival and health outcomes for pregnant women and their unborn children, with a focus on accessibility in high-burden regions.

Katherine Rucinski of Johns Hopkins University in the U.S. will develop a platform for understanding the determinants of women’s heath inequities in South Africa and for modeling the effects of health interventions. The project will be implemented through collaboration with the Pan African Centre for Epidemics Research, which is part of the University of Johannesburg and the South African Medical Research Council. Machine learning will be applied to datasets publicly available in South Africa to identify the factors underlying the co-occurrence of chronic health conditions that disproportionally affect women. Data modeling will then be performed to identify interventions that most efficiently and effectively reduce these health disparities. This approach will be integrated into a web-based simulation tool for epidemiological modeling of women’s health across diverse contexts.

Garry Pairaudeau of DaltonTx Limited in the United Kingdom, with Gemma Turon of the Fundació Ersilia Open Source Initiative in Spain, will develop a computational platform for analyzing large, in silico, chemical libraries to identify chemical starting points for drugs that target Mycobacterium tuberculosis. They will use AI-based protein structure modeling focused on the several-hundred known proteins whose targeting can inhibit M. tuberculosis growth. They will incorporate information on ligand binding from available databases of chemical library screening experiments and the ChemBL database of bioactive molecules with drug-like properties. Together, this information will highlight the target proteins and the binding sites most likely to be amenable to in silico screening. This predictive modeling will be distilled and deployed through the Ersilia Model Hub platform as an open resource for virtual screening of compound libraries for tuberculosis drug discovery.

Anne Yonkeu of the Clinton Health Access Initiative in Cameroon will develop a health index as a comprehensive, integrated measure of women’s health in Cameroon. Using existing national data sources that reflect the multidimensional determinants of women’s health, health indicators will be developed and integrated into a composite index. These determinants will include factors such as reproductive health, gender-based violence, unpaid care work, nutrition, and access to services. Data modeling and statistical methods including geospatial analysis will be incorporated so that the index can serve as a digital tool for revealing and visualizing hidden inequities in women’s health at the subnational level and strengthening gender-sensitive health monitoring. The tool will be piloted, testing its ability to generate actionable evidence at the national and subnational levels to guide health policy, resource allocation, and targeted interventions for more equitable women’s health outcomes.

Offer Erez with Gil Shalev of Ben-Gurion University of the Negev in Israel, in collaboration with Diomede Ntasumbumuyange of the University of Rwanda in Rwanda, will develop an affordable point-of-care diagnostic platform for prediction and detection of women at risk for preeclampsia early in pregnancy. The sensor system is an electronic biochip composed of biological field-effect transistors (bio-FETs) incorporating antibodies to sFlt1 and PIGF, two key preeclampsia biomarker proteins. It will be designed for simultaneous (multiplex) monitoring of blood and urine levels of these two biomarkers, accommodating whole blood and not requiring pre-measurement processing of the sample or the sensor, making it suitable for out-of-hospital use. They will evaluate the system with an existing inexpensive read-out device, testing it with samples of whole blood and urine spiked with the biomarker proteins, as well as samples collected from pregnant women in Israel and in Rwanda, and compare these clinical sample test results to those using a conventional FDA approved ELISA.

Alphonsus Neba of the African Population and Health Research Center in Kenya will develop a health index as a comprehensive, integrated measure of women’s health. Using existing global and regional data sources that reflect the multidimensional determinants of women’s health, life stage-specific health indicators will be developed and integrated into a composite index. These determinants will include factors such as unpaid care work, gender-based violence, access to services, reproductive autonomy, and mental health. Data modeling and statistical methods including geospatial analysis will be incorporated so that the index can serve as a digital tool to reveal and visualize hidden inequities in women’s health at the subnational level. The tool will be piloted in Kenya, Brazil, and India, testing its ability to generate actionable evidence to guide health policy, resource allocation, and targeted interventions for more equitable women’s health outcomes.

Qudsia Uzma of the World Health Organization in Pakistan will develop a health index as a comprehensive, integrated measure of women’s health in Pakistan. In collaboration with Pakistan’s Ministry of Planning Development & Special Initiatives, relevant existing data sources will be used to develop indicators that incorporate the sociocultural and economic context of women’s health across their life course. The indicators will reflect the intersection of diverse factors underlying inequities in women’s health and wellbeing, including communicable and non-communicable diseases, nutrition, education, empowerment, mental health, poverty, climate vulnerability, autonomy and personal rights, access to services, and gender-based violence. The indicators and the degree to which they each improve or worsen annually will be integrated into a composite index to guide health policy, resource allocation, and targeted interventions for more equitable women’s health outcomes.

The team at Isolere Bio, a Donaldson Life Sciences business in the U.S. will develop a biomanufacturing platform for low-cost production of monoclonal antibodies based on a multidomain synthetic protein enabling both capture and purification of the antibody in a chromatography-free process. The synthetic protein includes an antibody-binding affinity tag, and it enables liquid-liquid phase separation and selective concentration of the bound antibody. Key steps in the biomanufacturing process will be targeted to decrease costs and improve performance. This includes high-throughput experiments to identify conditions that improve the recycling of the synthetic protein, as well as tests to optimize the removal of viral contaminants during the purification process. Subsequently, larger-scale production will be piloted to identify the critical parameters required to scale up the platform.

Kelvin Lee of the University of Delaware in the U.S. will develop components of a biomanufacturing platform for low-cost production of monoclonal antibodies. The project will be implemented through the National Institute for Innovation in Manufacturing Biopharmaceuticals (NIIMBL) headquartered at the University of Delaware, with John Erickson of NIIMBL. It will focus on economic modeling, development of a mammalian cell line for expressing the antimalarial monoclonal antibody MAM01, and a head-to-head comparison of two antibody purification approaches, including isoelectric point purification (IPP) and continuous precipitation operations that reduce the number of process steps. Based on these tests, the platform components could be integrated into an end-to-end continuous processing system and co-developed with a next-generation facility design and regulatory strategy.

Liat Shenhav of New York University Grossman School of Medicine in the U.S. will develop a diagnostic platform, based on non-invasive retinal imaging, for prediction and detection of preeclampsia early in pregnancy. Previous results with a U.S.-based cohort of 1,400 pregnant women showed promise in using retinal vasculature features in the first trimester to predict the risk of preeclampsia. With local collaborators, the current study will recruit 2,000 pregnant women in clinical research centers in Belagavi and Nagpur in India, part of the Global Network for Women’s and Children’s Health Research. Each participant will get a retinal scan in the first and second trimester and be followed through pregnancy to determine clinical outcomes. An AI-based model will be developed to predict preeclampsia risk from the retinal scans, guided by parameters used in modeling for the U.S.-based cohort to help ensure generalizability.

Young Kim of Purdue University in the U.S. will develop a diagnostic platform for prediction and detection of preeclampsia early in pregnancy. The project is based on non-invasive imaging with an unmodified smartphone of the conjunctiva of the eye, and it will be a collaboration with Edwin Were of the Moi University Teaching and Referral Hospital (MTRH) in Kenya and Martin Were of Vanderbilt University Medical Center in the U.S. A cohort of 1,600 pregnant women at 12-15 weeks of gestation will be recruited from MTRH antenatal clinics, and they will be followed through pregnancy and delivery to determine clinical outcomes. Participants will get a conjunctival photo taken at enrollment, using a custom-made color chart to standardize images, and an AI-based model will be developed to predict preeclampsia risk from the vasculature features in the imaging data.

Gina Ogilvie of the BC Women's Health Foundation in Canada, with Carolyn Nakisige and Priscilla Naguti of the Uganda Cancer Institute in Uganda, will use community outreach to determine the prevalence and impact of heavy menstrual bleeding in women in rural Uganda, with a focus on better understanding the condition for perimenopausal women. Outreach will build on an existing mobile health program in Uganda for cervical cancer prevention and reproductive health. Village health teams will recruit 5,000 women, aged 30-49, across 15 villages. They will use a set of questionnaires to survey this age group, which includes women's transition to menopause (perimenopause) for which less is known about heavy menstrual bleeding. The survey will include assessment of the health, social, and economic impacts on women and their children; menstrual hygiene and product use; quality of life; and treatment availability and acceptability.

Muzungu Sylvain of the Ministry of Health in Rwanda will develop a health index as a comprehensive, integrated measure of women’s health in Rwanda. The index will be based on Rwanda’s National Health Intelligence Center that consolidates real-time and historical data from electronic medical records of all health facilities, the District Health Information System, Civil Registration and Vital Statistics, national surveys, and social protection databases. It will integrate factors encompassing the gendered burden of disease and health conditions, sexual and reproductive health, as well as economic and social determinants of health. The index will inform the design of equitable benefit packages under Rwanda’s Community-Based Health Insurance system and guide gender-sensitive strategies to improve women's health and wellbeing.

Ling-Jun Li of the National University of Singapore in Singapore will develop a diagnostic platform for prediction of preeclampsia early in pregnancy for women at high-risk of developing the condition. Two, existing, Singapore-based pregnancy cohorts will be used to develop and validate an AI-based risk prediction model for hypertensive disorders of pregnancy including preeclampsia. A non-invasive, preeclampsia screening test will then be developed, combining retinal imaging to identify vasculature features plus epidermal detection of the preeclampsia biomarker proteins PIGF and PAPP-A using a wearable forearm patch with a solid-state sensing system. The feasibility and acceptability of this test will be assessed with 60 pregnant women recruited at National University Hospital in Singapore, integrating the clinical data with the AI-based risk prediction model to guide further evaluation of the diagnostic platform.

Manel Mendoza of The Fetal Medicine Foundation in the United Kingdom will validate the safety and efficacy of giving aspirin prophylaxis to 30% of pregnant women at high risk of preeclampsia and discontinuing treatment before the end of pregnancy. Through collaborations, pregnant women at hospitals in Ghana, Senegal, and The Gambia will be screened in the first trimester for preeclampsia risk based on a combination of biomarkers and maternal characteristics. After the feasibility and suitability of this screening is validated, cohorts in the same three countries will be enrolled in a randomized controlled trial testing for non-inferiority of stopping aspirin treatment at 24-28 weeks of gestation versus at the end of pregnancy. These trials build on results from equivalent existing clinical trials in Spain and the United Kingdom. The shorter treatment duration could reduce the risk of negative side-effects and simplify treatment compliance.

Antti Aalto with Pedro Gonçalves of VTT Technical Research Centre of Finland Ltd in Finland will develop a biomanufacturing platform for low-cost production of the antimalarial monoclonal antibody MAM01 using the filamentous fungus Trichoderma reesei as the protein expression system. They will create candidate production strains, incorporating different expression cassettes for synthetic MAM01 sequences and pairing them with different host strain genetic backgrounds optimized for expression. The resulting strains will be cultivated in small-scale bioreactors, testing multiple bioprocess conditions from cultivation through sequential steps for antibody capture and purification. They will create models of the technical and economic factors required for low-cost production, as well as an analysis of environmental impact, including water usage and waste generation of the production process, comparing this impact with available data for antibody production using mammalian cell culture systems.

This grant is one of three grants that are funded and administered by LifeArc.

Christian Richardson of RiffTX in the U.S. will develop minibinder proteins targeting sFlt1 as a candidate preeclampsia treatment and a drug manufacturing process suitable for low- and middle-income countries (LMICs). Preeclampsia is a placental disease whose pathologies converge on elevated levels of sFlt1. The project will generate small, high-affinity binding proteins (minibinders) to inhibit sFLT1 function along with minibinders for human serum albumin (HSA) and for neonatal Fc receptor (FcRn) to maintain a long drug half-life in circulation. A manufacturing process will be developed to produce a high-quality drug while ensuring the cost and complexity of the process is suitable for implementation in LMICs. Drug candidates will be tested for an extended half-life using transgenic mice expressing HAS and human FcRN, and they will be tested for restoration of blood pressure and kidney function levels normal for pregnant rats using a rat model of preeclampsia.

Jennifer McIntosh of the Medical College of Wisconsin, Inc. in the U.S. will test the mitochondria-targeted antioxidant MitoQ as a treatment for preeclampsia. MitoQ is a nutritional supplement that has been used in human clinical trials for conditions other than preeclampsia, and it has been shown to reverse symptoms in a mouse model of preeclampsia. Two, pilot clinical trials will be performed with pregnant women with preeclampsia at 23-32 weeks of gestation: 30 in-hospital patients with severe symptoms not requiring immediate delivery and 50 outpatients without severe symptoms. All participants will be randomized to receive either oral MitoQ or a placebo, with standard care for preeclampsia continuing unchanged. Participants will be monitored regularly with a measure of endothelial dysfunction (brachial artery flow-mediated dilation) as primary outcome, and including measures of cutaneous circulation, blood-borne biomarkers of preeclampsia and oxidative stress, and post-delivery placental samples to measure vascular function and oxidative stress biomarkers.

Ashutosh Chilkoti of Duke University in the U.S. will develop a biomanufacturing platform for low-cost production of the antimalarial monoclonal antibody MAM01 based on a fusion protein enabling both capture and purification of the antibody in a chromatography-free process. The fusion protein will comprise an antibody-binding affinity tag fused to an elastin-like polypeptide (ELP) enabling liquid-liquid phase separation of the protein. It will be engineered to optimize its secretion by Chinese Hamster Ovary (CHO) cells and its reversible phase separation via its ELP domain. Protein co-expression strategies for antibody production will also be optimized, including comparing genomic integration of the fusion protein and MAM01 sequences in the same cell line versus in separate cell lines in the same bioreactor. These tests will be used to determine the purification strategy that maximizes MAM01 yield while minimizing process cost.

This grant is one of three grants that are funded and administered by LifeArc.

Alfredo Rubio of Monod Bio, Inc. in the U.S. will develop an affordable point-of-care diagnostic platform for prediction and detection of preeclampsia early in pregnancy. The assay system will use reporter proteins, designed de novo, for simultaneous (multiplex) monitoring of serum levels of two key preeclampsia biomarker proteins: sFlt1 and PIGF. The reporter system consists of a pair of proteins designed to bind different epitopes of the biomarker, together with a split luciferase reporter protein. It will be incorporated into a single-use microfluidic cartridge with a readout device for a rapid, one-step assay. This prototype device will be tested with human serum and whole blood samples spiked with the biomarker proteins. It will also be tested, in collaboration with Stephen McCartney of the University of Washington in the U.S., with 40 serum samples collected from the University of Washington Pregnancy Biorepository, half from patients with preeclampsia, comparing these clinical sample test results to those using a conventional ELISA.

Kolawole Akinjiola of mDoc Healthcare in Nigeria will build on mDoc’s digital health platform for maternal self-care to pilot test a wearable, vital signs monitor for real-time monitoring of preeclampsia risk during pregnancy. The project will be a collaboration with the University of Purdue in the U.S. and Corsano Health in The Netherlands. A cohort of pregnant women at 20 weeks of gestation will be recruited in two Nigerian cities, 250 participants in Ikorodu and 50 in Kano, and they will be followed through pregnancy and delivery. Women will be given a Corsano wearable device for passive, continuous monitoring of vital signs and wireless transmission to mDoc’s CompleteHealth application. Data modeling will be used to develop a preeclampsia risk prediction model, and a subset of the cohort will be tested to determine if the key underlying model data can be captured with simpler inexpensive wearable monitors.

Anurag Rathore of the Indian Institute of Technology (IIT) Delhi with Abhishek Mathur of Enzene Biosciences Limited, both in India, will pilot test a continuous processing platform for monoclonal antibody biomanufacturing for its advantages compared to batch processing. The pilot will build on lessons from the platform operating at the Center of Excellence for Biopharmaceutical Technology at IIT, Delhi. It will demonstrate that the existing biomanufacturing platform in an academic setting can be scaled up in a commercial setting. It will validate the decreased cost of goods and increased production relative to batch manufacturing, and it will provide technical and economic data, with details on integrating operations from cell culture through final formulation into a seamless, automated process. This data will guide efforts to increase access and affordability of monoclonal antibody products by manufacturing them in low- and middle-income settings.

James Brown of Bondi Bio Pty Ltd with Jake Baum at UNSW Sydney, both in Australia, will develop a biomanufacturing platform for low-cost production of the antimalarial monoclonal antibody MAM01 using the photosynthetic cyanobacterium Synechococcus as the protein expression system. They will engineer a cyanobacterial strain to express MAM01, grow it in high-density batch cultivation, optimize cell lysis and clarification to ensure maximum product yield and integrity, and purify fully assembled MAM01 by standard column chromatography. Purified MAM01 will be analyzed to confirm it has the correct mass, folding, and assembly, including complete disulfide bond formation and the expected glycosylation, and the strain will be engineered further where required. They will also use these experimental results to outline a facility design and an economic model for MAM01 biomanufacturing, focusing on the initial process steps of batch cultivation, centrifugation, and cell lysis.

Michael Betenbaugh with Honggang Cui of Johns Hopkins University in the U.S. will develop a biomanufacturing platform for low-cost production of the antimalarial monoclonal antibody MAM01, combining a fungal expression system with a nanofiber-bound peptide technology for antibody capture and purification. Collaborating with Dyadic International and with Thermo Fisher Scientific, they will optimize the fermentation media and bioprocess conditions in the expression system, which uses the thermophilic filamentous fungus Thermothelomyces heterothallica C1. They will also optimize conditions for the selective capture, separation, and recovery of the antibody along with recycling of the antibody-binding peptide. They will integrate these conditions, assess and further optimize them to reduce production costs, and demonstrate the scalability of the platform.

Cristiana Boi with Ruben Carbonell of North Carolina State University in the U.S. will develop a purification system for the antimalarial monoclonal antibody MAM01 that uses an all-membrane chromatography process with single-use membranes made from low-cost nonwoven materials. This system will be combined with a protein expression system using the thermophilic filamentous fungus Thermothelomyces heterothallica C1 to create a low-cost biomanufacturing platform. Collaborating with Dyadic International, they will obtain MAM01-containing supernatants from the expression system and analyze its components to guide development of the purification system. Based on these results, small-scale purification experiments will be performed, testing suitable membrane-coupled ligands, membrane configurations, purification conditions and steps, and integration of the system into single-use cassettes. They will also determine the process requirements to scale up the platform.

Jennifer Harikrishna of the University of Malaya in Malaysia will collect genetic resources from wild banana relatives in different regions across Malaysia, with a focus on Musa acuminata subspecies, and characterize their genotypes and associated phenotypes, including abiotic and biotic stress tolerance. Samples will be collected through field expeditions and in a citizen science initiative with sample and data collection by the public guided by a mobile app. Seeds will be tested for desiccation tolerance, and germinated plants will be assessed for drought and salinity tolerance and resistance to the fungal pathogen Fusarium Tropical Race 4 and to the nematode parasite Meloidogyne incognita. Based on these studies, selected species will be characterized by molecular marker genotyping and whole-genome sequencing. Banana breeders in Uganda, Tanzania, and Cameroon will be engaged early in the project for sharing knowledge and strategic approaches.

Vijayalakshmi Ramshankar of the Cancer Institute (WIA) in India will perform a study of air pollution's effects on lung cancer in India. To focus on the links specifically with air pollution they will recruit non-smoking lung cancer patients in the city of Chennai. They will screen these patients for EGFR driver mutations, known to promote air pollution-related lung cancer, and measure the cytokine and miRNA profiles in their blood through periodic sampling. They will also perform this blood analysis in patients' asymptomatic household family members, who will be offered further testing (low-dose spiral CT scanning) for early cancer detection. Air pollution will be assessed in these households using a device for continuously monitoring indoor exposure. They will perform statistical analysis combining the biological and environmental data to better understand how air pollution affects lung cancer risk and to identify a high-risk signature to guide early screening.

Ani Varghese of ZeroEarth Private Limited in India will pilot test a climate-smart dairy farming platform supporting rural women farmers in the Indian state of Tamil Nadu. Through partnerships with financial institutions, they will set up mechanisms facilitating farmers' access to credit to sustainably increase their farming income. They will launch a pilot business center, which will provide training in entrepreneurship and climate-smart farming practices; centralized access to veterinary services; and coordination between dairy, calf-rearing, and fodder farmers. Farming practices supported by the center will include those to improve the health of soil for growing fodder; to optimize feed to minimize greenhouse gas emissions and enhance milk quality; and to efficiently manage manure, with the launch of a biogas plant to generate electricity.

Satadal Saha of the Foundation for Innovations in Health in India will develop an AI-based platform to support public health interventions for women living in the Sundarban Biosphere Reserve, focusing on anemia, urogenital tract infections, and anxiety and depression. The Reserve is a river delta region highly susceptible to climate change-driven severe weather. The project will build on the team's existing digital platform for health data that supports community health workers deliver primary care to island communities. They will collect environmental data, including data for weather and air and water quality, and expand the platform with software enabling regular monitoring and integrated analysis of health and environmental data. This includes incorporating an AI-based predictive model to guide the proactive design and implementation of public health interventions for vulnerable women in this region.

Raghuram Dharmaraju of the I-Hub for Robotics and Autonomous Systems Innovation Foundation in India will improve heatwave forecasting using AI approaches and develop an early warning system for the Indian state of Karnataka to enhance preparedness for heat-induced health risks. The improvements in forecasting will encompass increases in accuracy, lead time, and spatial resolution. The early warning system will use web-based dashboards, mobile apps, and social media platforms to communicate heatwave alerts in local languages. It will include messages tailored to particularly vulnerable groups as well as alerts to healthcare providers to actively monitor these groups. It will also send notifications to relevant government agencies about the potential severity of health impacts. This system will guide public health interventions while helping establish data collection mechanisms for ongoing improvement of the system.

Tavpritesh Sethi of Indraprastha Institute of Information Technology Delhi in India will develop an AI-based platform to support responses to vector-borne diseases in the face of climate change in the Indian state of Uttar Pradesh. They will establish a comprehensive database that integrates climate data with data from existing programs for the control of vector-borne diseases (malaria, dengue, chikungunya, Zika, and Japanese encephalitis). Data will be at the block level of local government in Uttar Pradesh and will include real-time data. For analysis, they will develop an AI-based platform, named Sanketak, that includes modules to capture data, provide automated alerts, visualize changes in disease incidence, and identify early warning signs that predict disease hotspots. They will pilot test the platform, evaluating its potential to preempt, detect, and manage vector-borne disease outbreaks in a timely and effective manner.

Tavpritesh Sethi of Indraprastha Institute of Information Technology Delhi in India will develop an AI-based platform for AMR surveillance and management across a broad network of public and private hospitals in India. The platform will extract weekly data on AMR from the All India Institute of Medical Sciences, New Delhi (AIIMS Delhi) hospital and the Max Healthcare hospital network, including patterns of antibiotic prescriptions across the network. It will use a federated data analysis approach (joint analysis without sharing the data itself), and they will develop and integrate AI-based models to identify and predict trends in AMR. They will also create applications driven by these models to widely and effectively communicate the analyses to healthcare professionals. This will support antibiotic stewardship and data-driven AMR management at both the local and regional levels.

Sai Raj Reddy of Daia Tech Private Limited in India will develop a program to increase access to health education and related resources for adolescent girls in rural areas of the Indian state of Karnataka. The program will be developed in partnership with the Karnataka Health Promotion Trust, building on their ongoing work with local schools, healthcare providers, community leaders, and government agencies. After engaging community members to understand the local context, they will develop resources for adolescent girls including life skills courses and health education workshops and pilot test the program in selected villages. They will integrate AI tools across the program to broaden participation and to broaden the range of health outcomes improved for adolescent girls.

Chiranjay Mukhopadhyay of the Manipal Institute of Virology in India will perform a two-year longitudinal study in the Western Ghats region of India, focusing on sentinel surveillance of tick-borne pathogens and their transmission dynamics. This mountain range region is known for its high biological diversity, and they will sample across 12 sites representing diverse ecological habitats where people and wild and domestic animals interact most frequently. They will collect host-seeking ixodid ticks, screen them for eight tick-borne pathogen groups, and perform whole-genome sequencing for the pathogens identified. Corresponding weather data will be collected from the Indian Meteorological Department. They will combine this longitudinal data to develop statistical models that predict the spatial and temporal transmission of tick-borne pathogens and the corresponding disease risk, which will guide public health interventions.

Bruno Mmbando of Kampala International University in Tanzania will model the combined impact of malaria chemoprevention strategies and vaccines on the burden of childhood malaria in Africa. A modeling focus will be on determining the level of vaccine uptake at which chemoprevention strategies cease to be cost-effective in settings with moderate to high malaria transmission. Data modeling will include the short- and long-term effects of parasite antimalarial drug resistance on the combined impact of chemoprevention and vaccines. The multidisciplinary team will include data modelers, health economists, clinical trialists, and epidemiologists. They will work closely with malaria decision-making organizations, leading to tools and processes that better support the use of malaria data modeling to inform public health interventions.

This grant is funded by The Wellcome Trust.

Karthik Sasihithlu of the Indian Institute of Technology Bombay in India will map urban heat islands across India and test radiative cooling paint on building rooftops to reduce temperatures, heat-related illnesses, and energy consumption for cooling. Urban centers in India face extreme summer temperatures, worsened by the heat island effect in developed areas relative to rural areas and by heatwaves increasing in frequency because of climate change. Radiant cooling paint, because it does not require structurally modifying buildings, could be an affordable and sustainable intervention to reduce the negative health and economic impacts of heat. Heat islands will be mapped using satellite imagery, and radiative cooling paint will be tested in the severe heat islands identified.

Arup Ghosh of CSIR-Central Salt and Marine Chemicals Research Institute in India will design a feed additive for Indian cattle that combines algae and bacteria to reduce enteric methane emission, improve livestock health, and enhance agricultural productivity. From Indian sources, they will select seaweed, marine microalgae, and bacteria, screening them for their ability to inhibit methanogenesis in vitro and in the rumen of cattle. They will also assess their effect on the rumen microbiota and on cattle physiology and productivity. Candidate products made from these additives will be evaluated for their economic viability, including their potential for large-scale cost-effective production, storage, and distribution, as well as for their benefits to farmers relative to existing solutions.

Belehalli Pavan of Strideaide Private Limited in India will develop an AI-based platform to increase timely access to diagnosis and treatment for diabetic foot ailments. Early detection of peripheral neuropathy, peripheral arterial disease, and diabetic foot ulcers would enable interventions that reduce the need for limb amputation. The platform will build on their existing network of podiatry clinics located in a variety of public spaces. These clinics are staffed with a paramedic providing treatment guided by diagnostic tools including a foot mat with a plantar pressure sensor to help predict and assess foot-bottom ulceration. Existing and new digital data from these clinics will be used to build a diabetic foot registry, to improve automated assessment through AI-based analysis, and to train an LLM with a chatbot interface for clinical decision support across the podiatry clinics.

Amrita Mahale of ARMMAN in India will incorporate an LLM-based chatbot into the Kilkari mobile health service to answer questions about pregnancy and infant care. Kilkari currently provides weekly pre-recorded messages on preventive care, and it is implemented in partnership with India's Ministry of Health and Family Welfare. They will assess different available LLMs and train the best candidate with the Kilkari database of vetted content. They will pilot test the model with Kilkari users through WhatsApp, engaging users in Delhi and in the state of Jharkhand to encompass diverse participants spanning urban, rural, and tribal populations. The test will include regular surveys to measure the service's accuracy, relevance, and usability.

Mohanasankar Sivaprakasam of the Healthcare Technology Innovation Centre at the Indian Institute of Technology Madras in India will develop an AI-based platform to support diagnosis and report generation for endoscopic gastrointestinal exams. They will use curated datasets of annotated endoscopic images to develop an AI-based model for diagnosing gastrointestinal abnormalities, such as polyps and ulcers. The data will also be used to train a Large Language Model (LLM) to generate diagnostic reports of endoscopic exams including representative images and text descriptions. This will improve report quality and consistency for better diagnosis and more accurate, detailed patient records, with the report automation reducing the time and personnel required. Together, these platform components will improve patient care in gastroenterology, including more efficient care across more patients.

Ntombifikile Mtshali of Shout-It-Now with Elona Toska of the University of Cape Town, both in South Africa, will pilot test use of ChatGPT to provide information on sexual and reproductive health that helps young women and adolescent girls in South Africa make informed decisions and effectively access health services. They will test integration of the chatbot into Shout-It-Now's existing platforms: a tablet-based platform in mobile clinics staffed by young women and a mobile phone app. They will train ChatGPT to provide information on sensitive topics, including gender-based violence, HIV infection risk, and pregnancy, using existing materials and guided by a workshop with mobile clinic staff. Users' perception of the chatbot and the chatbot's effectiveness in increasing the use of health services will be assessed using on-line questionnaires and phone surveys across five demographically different districts.

Vijay Sai Trap of OnionDev Technologies Pvt. Ltd. in India will develop an AI-based platform to provide accurate and private automated answers to questions on sexual health and mental well-being for youth and women in rural India. They will generate a dataset of community-generated questions on these topics during a mental health awareness campaign in the Indian states of Uttar Pradesh, Madhya Pradesh, and Tamil Nadu. With the support of subject matter experts, they will add answers to these questions from the relevant literature. They will then create a master dataset of questions and answers, including translations using an existing LLM trained on local Indian languages. This dataset will be used to compare different AI-based models to identify the one best able to effectively answer questions on these sensitive topics.

Himanshu Sinha of the Indian Institute of Technology Madras in India will develop an LLM-based chatbot to provide personalized reliable guidance on antenatal care in multiple Indian languages, particularly for mothers without regular access to health care. The chatbot will use an open-source LLM and will be incorporated into a mobile phone application. The project will begin by surveying pregnant women seeking care in a variety of health care settings and across all three trimesters, asking them what features they would want in a pregnancy app. The LLM will be trained with information from textbooks, clinical manuals, government health resources, and guidelines from professional organizations. Initially the chatbot will function in Hindi and Tamil, with additional Indian languages to follow. The app will track pregnancy milestones and deliver relevant evidence-based advice.

Roanne Gardoce of the University of the Philippines Los Baños in the Philippines will characterize the wild banana relative Mus acuminata ssp. errans to explore its untapped potential in banana breeding. This Mus subspecies, locally known as Agutay, is endemic to the Philippines and Indonesia. They will compare its growth in an upland and lowland location in the Philippines, with a focus on genotype-by-environment interactions. They will sequence the genomes of the Philippine and Indonesian Agutay, compare them to wild banana reference genomes, and develop chromosome-scale genome assemblies. They will perform genetic studies of resistance to the key disease Banana Bunchy Top Disease, using crosses between Philippine M. balbisiana (which is resistant) and M. acuminata (which is sensitive). They will also analyze the pollen biology of Philippine Agutay and M. balbisiana to guide efficient breeding and characterize their seeds to guide their long-term storage for conservation.

Ananda Kumar Mishra of Cowbit Technologies Pvt Ltd in India will pilot test the Cowbit, a wearable device for real-time monitoring of dairy cow health. They will test the device across farms in different states in India, along with a mobile app in local languages for user-friendly readout of the data. The device's sensors will measure elements of cow health particularly relevant for guiding farm management. This includes measurements such as udder temperature for early diagnosis of mastitis and prompt veterinary treatment. It also includes behavioral measurements to identify cows without typical signs of estrus (silent heat) who are ready for insemination to maximize breeding efficiency. They will collaborate with farmers and other stakeholders to ensure the device is relevant for increasing farm productivity and has potential for broad uptake.

Kavitha Sairam of FIB-SOL Life Technologies Private Limited in India will develop mulch sheets that are biodegradable and can be tilled into the soil or composted. Mulch sheets can improve crop yields while reducing the need for irrigation and addition of agricultural chemicals. Traditional polyethylene mulch sheets, however, need to be removed each crop cycle, which is labor intensive, and they are a source of plastic pollution. To develop a biodegradable mulch product, they will explore various materials and fabrication technologies. They will characterize the physical and chemical properties of the candidate product and pilot test its performance and rate of degradation in the field with two different crops as compared to a commercial polyethylene sheet.

Anandkumar Naorem of the ICAR-Central Arid Zone Research Institute, Jodhpur in India will perform polyhouse farming experiments in the Indian state of Rajasthan to identify soil conditions that reduce emission of the greenhouse gas nitrous oxide. Polyhouses are greenhouse-style but enclosed in polyethylene rather than glass. They will grow tomato plants as a vegetable test crop, adjusting soil properties by varying factors including the type of mulch, irrigation frequency, the type of nitrogen compound added, and whether biochar is added. They will assess soil health through analysis of its physical, chemical, and biological properties, focusing on how they relate to nitrous oxide emission. The results will guide improvements in polyhouse farming particularly relevant as a sustainable agricultural strategy for arid regions.

Sujatha Sunil of the International Center of Genetic Engineering and Biotechnology in India will determine the temperature preference of Indian Aedes aegypti mosquitoes to build a mathematical model that predicts their prevalence across the country as well as hotspots for the arboviral diseases they transmit. To understand temperature preference, they will study laboratory-adapted Aedes aegypti, assessing their physiology and development in the laboratory across the mosquito life-cycle at a range of relevant temperatures. They will also sample mosquitoes across sites in Delhi, recording their physical and physiological features and their carriage of arboviruses, together with weather data from nearby weather stations and arboviral disease incidence data from nearby hospitals. The laboratory and field data will be integrated to build predictive models to identify areas in India most at risk of arboviral epidemics.

Sean Stowell of Brigham and Women's Hospital in the U.S. will analyze the human antibody repertoires targeting microbes in the female genital track (FGT) to guide the design and use of live biotherapeutic products for bacterial vaginosis. They will use their microarray platform, consisting of an array of antigens from FGT microbes, to analyze genital tract samples from a cohort of women in an HIV drug clinical study in South Africa. They will define the association between FGT antibody levels and specificity with FGT microbial colonization and inflammation. They will also perform experiments to explore potential mechanisms for antibody-mediated microbial attachment and colonization, focusing on antibody interactions with FGT mucin proteins. Together, the results will set the stage for using the microarray platform to identify patient-specific variables as biomarkers to predict the success of live biotherapeutic products.

Saliou Fall of the Institut Senegalais de Recherches Agricoles in Senegal will develop techniques to estimate biological nitrogen fixation (BNF) by legume crops to guide their use as alternatives to nitrogen fertilizers for more sustainable agriculture. They will assess BNF by estimating three underlying components. Crop biomass and the proportion that is nitrogen will be estimated by AI-based models, and the nitrogen fraction that comes from BNF will be estimated by measuring the levels of a stable isotope of nitrogen in the soil and in the plants. As test crops for data to train the AI models, they will grow groundnut and cowpea as staple legumes, with an adjacent non-nitrogen-fixing crop, and crotalaria as a cover crop. They will acquire images of the crops from drones or mobile phone applications, and perform laboratory analyses, including measuring biomass, analysis by near-infrared spectroscopy and wet chemistry, and measuring the natural isotope of nitrogen.

Sasivimon Swangpol of Mahidol University in Thailand will collect genetic resources from two banana progenitor species (Musa acuminata and Musa balbisiana) in Thailand and Laos, characterize their genotypes and associated phenotypes, and test and store seeds. The project includes collaboration with Kasetsart University and the Thailand Institute of Scientific and Technological Research, both in Thailand, and the National Agriculture and Forestry Research Institute in Laos. They will analyze the population genetics of plants from both countries, and they will collect and store seeds. Seeds from Thailand will be germinated and banana plants analyzed for agronomic traits and resistance to two key diseases: Banana Bunchy Top Disease and Banana Blood Disease. Genetically diverse and fertile wild Musa species offer untapped potential for introducing new traits, especially disease resistance, into breeding programs for this staple crop plant.

Daniel Kwaro of CREATES in Kenya will develop an early warning system for malaria outbreaks, floods, and heatwaves in Siaya County in Kenya, co-designing it with the local community. They will incorporate health and demographic surveillance system data, including a specific focus on maternal health indicators and birth outcomes, as well as data from automated weather stations, wearable devices, and mosquito traps. Through secondary data analyses, they will assess the probability and consequences of climate-related hazards, including identifying vulnerable communities, high-risk geographical areas, and occurrence patterns of climate-sensitive diseases. They will actively involve Siaya County residents, healthcare providers, and relevant local authorities in co-designing the early warning system paired with multiple mechanisms for communication to ensure the system is accessible and effective in responding to local needs.

Smit Gade of the Good Business Lab Foundation in India will perform a study in India to better understand the constraints for working mothers in accessing employer-provided childcare and the effects of increasing uptake of this childcare on working mothers and their children. They will perform a randomized controlled trial, recruiting sewing machine operators at a garment factory and unemployed women that will be offered job interviews at the factory. The factory offers free on-site childcare, but uptake is low. The trial arms will test the effect of subsidizing the cost of traveling with children to work, of providing information on the quality of the free creches at the factory, or of both combined. They will determine if the study treatments increase working mothers' uptake of childcare services and encourage unemployed women to interview for work. Trial outcome measures will include assessment of women's quality of life and of their children's welfare.

Avishek Banik of Presidency University in India will identify a bacterial consortium that can protect tea crops from Fusarium fungal pathogens. The global rise in temperature threatens tea crops in part through increased humidity that favors proliferation of disease-causing Fusarium. To develop a biocontrol strategy for these pathogens, they will isolate Fusarium species from tea plants in tea plantations in the Dooars region of West Bengal as well as bacteria growing on and in the plants. They will use these isolates to characterize the fungal disease process in high-humidity growth conditions in the laboratory and to screen for bacteria that can inhibit it. They will characterize the mechanism of inhibition, including analysis of plant gene regulation, to guide development of an antifungal bacterial product.

Anurag Agrawal of Ashoka University in India will develop an LLM-based platform to support medical decision making by home healthcare workers in India who are meeting the growing demand for home-based palliative care. The platform will use an existing proprietary LLM to extract and summarize relevant clinical information, connecting it with an existing open-source AI chatbot to generate advice in a conversational format for healthcare workers. They will test the platform using a dataset they will build of palliative care scenarios, focused initially on care for lung diseases, and they will compare outputs from several different open-source LLMs to guide the platform's final configuration. Expert clinicians will evaluate the clinical advice generated by the platform for its factual accuracy and relevance to the Indian sociocultural context.