Grand Challenges is a family of initiatives fostering innovation to solve key global health and development problems. Each initiative is an experiment in the use of challenges to focus innovation on making an impact. Individual challenges address some of the same problems, but from differing perspectives.
Sanjeev Kumar of The Goat Trust in India will develop animated mobile applications that provide information on improving productivity, veterinary and financial services, and markets for women goat herders in the Indian states of Uttar Pradesh and Bihar to increase their income. These women work in remote regions with limited support, and many are illiterate. They will develop simple applications with health, nutrition, animal husbandry, a marketplace, and management components, and integrate value-chain players such as products and services suppliers. In health, they will develop a decision support tool to help farmers identify diseases using 141 symptoms and to select the most suitable treatment in consultation with vets. For the marketplace, farmers will be able to order quality products and pay directly. There will also be a web-based platform for goat sales. They will develop the applications in consultation with farmers and other stakeholders, and perform pilot testing.
Esther Muiruri of Equity Group Foundation in Kenya will expand their Equity Online-Agriculture platform to provide information on agricultural best practices, including smart-farming innovations, as well as access to financing and markets to initially 200,000, and subsequently up to two million, small-scale farmers in Kenya to improve their productivity and income. They will build the platform to digitally disseminate agricultural information such as soil testing and pest and disease control, which will improve timely planting and crop and livestock management. They will also build in training in financial literacy targeted towards women, who make up the majority of agricultural workers, and access to financial support and tailored insurance products by implementing e-vouchers and loans, digital wallets and a credit scoring system. Market information and direct contacts with potential buyers will also be provided through an online platform.
Shafiq-ul Islam of ACME AI in Bangladesh will produce a smartphone-based system that uses computer vision and machine learning to accurately estimate the weight of cows and goats to help smallholder livestock farmers in rural Bangladesh maximize productivity and profits. Accurately determining livestock weight is challenging for these farmers but critical for determining the right amounts of food and medicines. They will develop a machine learning model and mobile application that uses the smartphone’s camera to process distance, height, and depth information and calculate the weight of the animal to within >90% accuracy. They will test three different business cases, including combining the computer vision-based weighing system with products and service providers, and evaluate the impact on food and medicine purchases, and animal growth and quality, which are directly linked with income.
Mukhlid Yousif of Wits Health Consortium in South Africa will sequence SARS-CoV-2 in sewage samples collected periodically from 40 wastewater treatment facilities across South Africa for the early detection of potentially dangerous variants to inform public health policies. Genome sequencing using sewage samples can monitor the molecular epidemiology and diversity of circulating SARS-CoV-2 variants, and also identify new variants even before they can be detected in the clinic. They will collect a total of 528 wastewater samples over a twelve-month period and process them for sequencing to identify novel mutations or mutations that are unique to variants-of-concern, especially those not yet reported in Africa. They will also compare these data with sequences of SARS-CoV-2 variants from local COVID-19 patients to support interpretation of wastewater sequencing results. Results will be immediately published online and communicated to provincial and national COVID incident management teams.
Francine Ntoumi of the Fondation Congolaise pour la Recherche Medicale in the Republic of Congo will set-up a national SARS-CoV-2 genomic surveillance system by increasing sequencing capacity to monitor viral variants-of-concern and determine the impact of vaccines on disease transmission to inform public health decisions. They will perform a cohort study by collecting oropharyngeal samples from patients at COVID-19 testing centers in the two largest cities, which account for 80% of the country’s new infections, and sequence around 60 SARS-CoV-2-positive samples per month to determine the prevalence of variants. These will be combined with existing COVID-19 epidemiological and clinical data to determine the virulence, transmissibility, and symptoms associated with new and existing viral variants-of-concern. They will also analyze blood samples from vaccinated and unvaccinated COVID-19 patients to evaluate their immune responses and combine these with socio-demographic and clinical data to determine vaccine effectiveness.
Fidele Ntie-Kang, a computational chemist at the Department of Chemistry, University of Buea in Cameroon, will establish a state-of-the-art drug discovery regional center for Central Africa that utilizes natural products from across the continent to identify new antiviral drugs suitable for resource-limited regions. Dr. Ntie-Kang is a pioneer in harnessing the diverse African flora for drug discovery purposes. His research group is building an online natural products database, which contains compounds isolated from plants, fungi, corals and bacterial species growing in Africa. He will set up a unique team of synthetic organic chemists, natural product chemists, computational chemists, microbiologists, biochemists and artificial intelligence experts, and build an open access pan-African library of naturally occurring compounds and a cloud-based computing platform. The team will combine virtual and in vitro screening techniques to identify natural compounds targeting the SARS-CoV-2 spike protein and the HIV Vpu protein, as well as promoting HIV latency-reversal. They will also train students to expand research capacity, and transfer the knowledge and technology developed during the project to other research institutes.
Annettee Nakimuli, Associate Professor of Obstetrics and Gynaecology and Dean of the School of Medicine at Makerere University in Uganda, will identify predictors of adverse pregnancy outcomes in Ugandan women with a focus on Great Obstetrical Syndromes (GOS), such as pre-eclampsia, to help develop context-relevant interventions for prevention and treatment. Dr. Nakimuli is an internationally-recognized research leader in maternal health for Africa. She performed the first genetic case-control study on pre-eclampsia among indigenous Africans, and identified different biological factors to those found in European studies, which helps explain the higher incidence. Building on her experience setting up cohort studies, she will prospectively collect biological samples and clinical data from a large cohort of 4,000 women throughout their pregnancies at Kawempe and Mulago Hospitals in Kampala to identify predictive biomarkers, and establish a biobank and database to facilitate future research. She will also implement artificial intelligence for data analysis to identify relevant socio-epidemiological, clinical, and biological features that contribute to the development of Great Obstetrical Syndromes.
Yaw Bediako, Founder and Chief Executive Officer of Yemaachi Biotech and researcher at the West African Centre for Cell Biology and Infectious Pathogens in Ghana, will bring together African biotech and academia with the Francis Crick Institute to provide important insights into how vaccines can be designed to work more optimally among African people. The African continent has the highest infectious disease burden in the world but almost no capacity for vaccine development or testing. Instead, most vaccines are tested in healthy Caucasian adults in high income countries, and many have lower efficacy among African populations. Dr. Bediako studies immune function in African populations and is devoted to building research capacity in Africa. He developed and successfully deployed the first national SARS-CoV-2 variant tracker on the continent, which displayed the distribution of viral variants in real-time. He will perform a prospective cohort study, and use molecular, cellular, and data-analysis approaches to investigate if the cellular and humoral immune responses to the AstraZeneca COVID-19 vaccine differ between Ghanaian and UK populations, and identify the effect of host genetic diversity on vaccine response. These data will support more rational vaccine design among African populations.
Abdoulaye Djimde, President of the Pathogens genomic Diversity Network Africa (PDNA), will work to better prepare Africa to fight infectious diseases and tackle those of the future. Dr. Djimde’s research group uses molecular and genetic approaches to study malaria, and their results have supported policy decision-making in Mali and the West Africa sub-region. His work on anti-malarial resistance led to a change in first-line therapy, and his group also serves as a training ground for many scientists in Africa. Recognizing the importance of collaborative research across the continent for studying infectious diseases, he established PDNA, which is an African-led research network spanning sixteen countries. PDNA investigates the genetic diversity of human pathogens to inform disease control and elimination strategies. He will set up a PDNA Pathogens Genomics Institute in Mali equipped with genetic and molecular epidemiology infrastructure. The Institute will train the next generation of scientists, and study the emergence and spread of malaria, SARS-CoV-2, and anti-microbial resistance, and identify novel pathogens. They will also focus on engagement with communities and health policy makers across the member countries to support public health on the continent.
Isabella Oyier, Associate Professor and Head of Bioscience at the KEMRI-Wellcome Trust Research Programme in Kenya, will establish a national malaria molecular surveillance platform that is integrated into the Division of National Malaria Programme (DNMP) to directly translate research into policy. The malaria burden in Africa is no longer declining due to the emergence of new variants that are undetectable by standard diagnostics and resistant to the frontline antimalarial drug. Dr. Oyier, a leader in malaria molecular epidemiology, is committed to eradicating malaria in Africa. She pursues a collaborative approach by sharing resources across laboratories and partnering with key stakeholders to ensure research impacts policy. This approach enabled her to make critical contributions to the genomics surveillance and testing efforts during the COVID-19 pandemic in Kenya. She will establish a national data repository and a working group to develop a sustainable next-generation sequencing platform that can be easily implemented across malaria-endemic regions where sentinel health facilities will be established to collect samples. She will also build user-friendly bioinformatics pipelines to examine parasite genetic diversity and the distribution of resistance markers, and to present actionable data for policy decision-making.
Mainga Hamaluba, Head of Clinical Research at the KEMRI-Wellcome Trust Research Programme in Kenya, will develop a pragmatic adaptive trial platform to evaluate key interventions for improving child survival in East Africa in real-life routine practice conditions as a faster and lower-cost alternative to traditional randomized controlled trials. Dr. Hamaluba has led a wide-range of complex clinical trials, including oversight of a complement of COVID-19 prevention and vaccine trials. She will use newborn care and hypoxic-ischaemic encephalopathy (HIE; also known as birth asphyxia) as a case study for the platform. HIE is the leading cause of admission in a network of Newborn Units in Kenya and causes severe neurological disabilities in survivors. Leveraging an existing and unique clinical surveillance framework and biobank at her institute, she will conduct a pragmatic platform adaptive randomized controlled trial of three licensed treatments to evaluate their effect on newborn survival. She will also establish procedures to increase the speed, rigor, and adaptability of regulatory approval protocols for clinical trials, and focus on training and mentorship of local healthcare workers in clinical research.
Iruka Okeke, Professor of Pharmaceutical Microbiology at the College of Medicine, University of Ibadan in Nigeria, will develop sequence-based methods and leverage genomics data to jumpstart the development of diagnostics and vaccines for neglected bacterial pathogens in African settings. Professor Okeke has devoted her career to studying neglected enteric bacteria that can cause potentially fatal bloodstream and diarrheal infections. She recognizes the power of genomics approaches to improve surveillance and better define pathogen virulence. She has been developing lower-cost and simpler methods to traditional culture-based techniques for detecting difficult-to-culture bacterial pathogens directly from blood samples in minimally-equipped laboratories. These methods incorporate nanopore sequencing together with target enrichment by the CRISPR-Cas9 system for rapid, direct-from-specimen diagnosis and genomic surveillance. She will adapt these methods for identifying a range of pathogens directly from stool, urine, and other clinical samples. She will also grow a community of experts to support this project by training African scientists in molecular science and bioinformatics.
Jesse Gitaka of Mount Kenya University in Kenya will develop a diagnostic device for iron deficiency anemia that is suitable for resource-limited settings. Iron deficiency anemia can cause maternal death, prematurity and stunting. Current diagnostic tests require expensive equipment or are not specific enough to distinguish between the different causes of anemia. They will develop a device that detects the low levels of hemoglobin found in immature red blood cells, called reticulocytes. The device will use magnetic beads and microfluidics to physically separate reticulocytes from whole blood, and then absorbance to measure the red color of hemoglobin and thereby determine levels. They will use samples from healthy donors to develop algorithms that can calculate the amount of hemoglobin per reticulocyte to provide an accurate diagnosis.
Collen Masimirembwa, Professor and founding President and Chief Scientific Officer of the African Institute of Biomedical Science and Technology (AiBST), Zimbabwe, will generate a research and innovation ecosystem, including training scientists and establishing centers of excellence in genomic medicine research, for the sustainable development of genomic and pharmaceutical medicine capability in Africa. Dr. Masimirembwa is on a mission to achieve world-class drug discovery and development capability in Africa. In 2002, he founded AiBST in Zimbabwe, and over the last ten years has organized a series of drug discovery and development courses across the continent to introduce the subjects and contextualize them for Africa. He will establish three centers of excellence in Zimbabwe, Kenya, and Nigeria to help launch an R&D biotechnology industry in Africa by forging partnerships with relevant stakeholders and training industry-focused scientists. He will also perform a prospective, multi-center clinical trial across several countries to determine the effectiveness of pharmacogenetic testing in reducing the incidence of adverse drug reactions and increasing treatment efficacy in African populations.
Jo-Ann Passmore, Associate Professor of the University of Cape Town in South Africa, will pilot the formation of the vaginal microbiome research consortium in Africa (VMRC4Africa) by establishing a network of researchers and centers of excellence for conducting research and clinical trials to promote women’s health across the continent. Dr. Passmore uses immune biomarkers and microbial-based approaches to study HIV and HPV pathogenesis and prevention in African women. Her work identified genital tract inflammation as a major predictor of HIV risk and pathogenesis, and revealed that inflammation reduces the efficacy of the anti-retroviral drug tenofovir, which is used to treat HIV. Her laboratory is a South African center of excellence in HIV prevention and she is committed to nurture and mentor young African researchers. She will establish the necessary infrastructure for African researchers to document the changing composition of the vaginal microbiota, beginning with South African and Kenyan women. They will use sequencing and build a biorepository to help identify health-promoting <em>Lactobacillus</em>-dominated microbiota in different geographic regions. These could be co-formulated into live biotherapeutic products to treat genital tract inflammation for women globally.
Richard Njouom from the Centre Pasteur du Cameroun in Cameroon will establish a genomic surveillance network across the country to routinely track circulating SARS CoV-2 strains and identify novel variants for informing health authorities. They will use an existing national network of six COVID-19 molecular testing laboratories for collecting samples. Around 1,200 samples will be screened using a commercial SARS-CoV-2 mutation panel over the course of 12 months to identify existing viral variants-of-concern and variants-of-interest. They will also set up a sequencing platform to sequence the spike protein of the virus to identify new variants, as well as for generating 240 whole SARS CoV-2 genome sequences to monitor viral evolution and identify markers of disease severity or increased transmissibility. Policy briefs will be used to inform the health authorities of circulating variants.
Nicki Tiffin, Professor at the University of the Western Cape, South Africa, will build an online platform – the African Data and Biospecimen Exchange – to facilitate equitable, ethical, and transparent data and biospecimen sharing on the continent, and promote research collaborations to improve health. Sharing biospecimens and data such as human genomics and pathogen sequencing data for use by other scientists is critical to sustain research in Africa. However current barriers that preclude sharing include high costs, the need for specialized formatting, and legal limitations for sensitive data. Dr. Tiffin has worked extensively across multiple health research domains, built research networks and collaborators across Africa, and is passionate about the effective use of health data in scientific research. She will build a platform for uploading standardized resource meta-data to reduce overhead costs, and provide practical guidance and online templates for sharing sensitive datasets. She will undertake a consultative process with domain experts to produce the design and functionality of the platform.
Pontiano Kaleebu of the Uganda Virus Research Institute in Uganda will expand their genome surveillance platform to monitor the circulation of SARS-CoV-2 variants in Uganda to help inform timely public health decisions and the development of diagnostics and vaccines. They will obtain geographically-representative COVID-19 patient samples for genomic sequencing, as well as samples from strategic sites including points of entry, where several variants have emerged. They are also collecting blood samples and nasopharyngeal swabs from patients, some of whom have been vaccinated, to determine their ability to neutralize viral variants and to produce monoclonal antibodies for potential use as diagnostics or for vaccine design. The methods and capacity established during this project will also be used for immunological surveillance of other infectious diseases.
Moses Obimbo Madadi, Clinician-Scientist and Associate Professor at the University of Nairobi, Kenya, will form a coalition of researchers and develop tools to study the vaginal microbiome and metabolites during pregnancy to help identify predictive biomarkers and intervention strategies for improving pregnancy outcomes in Kenya. Africa carries a high burden of severe pregnancy complications such as stillbirths and neonatal deaths. To address this, Dr. Madadi is leveraging his broad experience in clinical, basic, and epidemiological research to establish a unique niche of translational research to support the health of women in Kenya and around the world. He will perform a prospective cohort study at four hospitals in Nairobi by collecting clinical data and vaginal samples from over 1200 pregnant women. He will use next-generation sequencing to analyze microbial communities, and metabolomic profiling to identify predictive and diagnostic signatures of adverse pregnancy outcomes. These data will be used to develop artificial intelligence-assisted prediction models that could be used as valuable screening tools to identify at-risk pregnancies for early interventions.
Anita Ghansah, Senior Research Fellow at the Noguchi Memorial Institute for Medical Research at the University of Ghana, will build a cost-efficient malaria molecular surveillance system with high spatial and temporal resolution that covers the entire country. Dr. Ghansah is an internationally-trained genetic epidemiologist. Recognizing the power of genomics and bioinformatics approaches for bolstering malaria surveillance in Ghana, she has been a pioneer of bioinformatics training in the country. She introduced expertise for genotyping molecular markers of drug resistance, which led to a change in the national policy on first-line treatment of malaria. She will build the relevant personnel and infrastructure capacity for this project, and lead a research team and staff effort to rapidly monitor key molecular markers of drug and diagnostic resistance in blood samples from malaria patients using high-throughput sequencing and bioinformatics approaches. This will produce country-wide, near real-time surveillance data to better inform the control and elimination efforts of the National Malaria Control Program of Ghana.
Vincent Okungu, Researcher at the University of Nairobi in Kenya, will develop sustainable financing models to boost domestic funding for research and development (R&D) in East Africa. R&D is routinely underfunded in Africa, with the continent producing around 2% of the research output yet accounting for 15% of the global population. Dr. Okungu is a senior health economist whose passion is to see the development of resilient health systems in Africa. He has directed several health sector projects, including a national strategy for non-communicable diseases, together with the Ministry of Health, to guide resource mobilization and investments in Rwanda. He will investigate R&D financing by governments in two study countries, Kenya and Rwanda, and design creative approaches to motivate policymakers to increase budgets, as well as identifying high impact health programs such as vaccine development that could attract investments from public and private sources. He will also leverage knowledge from other sectors to learn how best to mobilize domestic finances for R&D and explore new sources of tax revenues. He aims to establish a mechanism for financing at least one priority R&D project agreed upon by public and private stakeholders in Kenya and Rwanda.
Ify Aniebo, Senior Research Scientist and Principal Investigator at the Health Strategy and Delivery Foundation in Nigeria, will integrate molecular and genomics data for tracking drug resistance and disease transmission to strengthen malaria elimination efforts in Nigeria, which has one of the highest global burdens. Dr. Aniebo is a molecular geneticist working on malaria drug resistance, and is acknowledged as one of her country’s top young health leaders. She is also devoted to empowering the next generation of African females into the sciences. To achieve her goal of eradicating malaria, she has created partnerships with scientists and policy makers within and outside Nigeria. Leveraging these partnerships, including Nigeria’s National Malaria Elimination Program, she will conduct a cross-sectional survey in households across the country and collect around 10,000 blood samples from children aged 6-59 months during the wet season when there is high malaria transmission. These samples will be subjected to next generation sequencing to investigate the prevalence and genetic diversity of the malaria pathogen across different regions, and the presence of drug resistance. She will also build a reporting tool and dashboard to present the data and directly support decision making.
Fitsum Girma Tadesse of the Armauer Hansen Research Institute in Ethiopia will establish the Ethiopian Malaria Genomic Epidemiology Network (EMAGEN) by bringing together key public health, biomedical, and biotechnology institutions in Ethiopia to build malaria molecular surveillance capacity and renew elimination efforts. Eliminating malaria requires an urgent shift to more quantitative methods that can more accurately and rapidly track disease transmission and drug resistance, and better target interventions. They will develop a framework for building capacity and integrating it into the national malaria control and elimination strategy, produce next generation sequencing and bioinformatics protocols that will be used to monitor anti-malaria drug resistance, and train personnel in genomics and bioinformatics. They will also develop a simple, interactive web interface to effectively communicate results to diverse stakeholders.
Christian Happi of Redeemer's University in Nigeria will assess the impact and risks of emerging SARS-CoV-2 virus variants in Africa, which are threatening vaccination efforts. They will produce viral pseudotypes using genomic sequences of around ten SARS-CoV-2 variants-of-concern that are dominant in Africa. These pseudotypes will be used in high-throughput neutralization assays with Vero cells in the presence of serum samples taken from over 400 vaccinated or previously-infected Nigerians, which contain many different types of antibodies, to evaluate their ability to neutralize the viral variants. This will reveal how well protected the population is against viral variants, and inform vaccine and immunization strategies. The serum samples that strongly protect against a range of SARS-CoV-2 variants will be subjected to single-cell immunoglobulin gene sequencing to identify neutralizing monoclonal antibodies for designing more effective vaccines.
Sikhulile Moyo of the Botswana Harvard AIDS Institute will expand the country’s genomic surveillance capacity to identify circulating SARS-CoV-2 variants and track their transmission routes and dynamics to inform the public pandemic response. Botswana has one of the highest global burdens of HIV and the associated immunosuppression may prolong SARS CoV-2 replication thereby increasing the probability of viral mutation and emergence of new variants. However, there is insufficient sequencing capacity to track these variants. They will increase national capacity by improving infrastructure, optimizing workflows, and providing training, as well as establishing a sampling framework and surveillance strategy. This will enable the temporal and spatial monitoring of circulating SARS-CoV-2 viral lineages across Botswana. They will also identify any associations between circulating viral variants and HIV infection, and study the risk of infection to specific SARS-CoV-2 variants among vaccinated people.
Atsbeha Gebreegziabxier Weldemariam of the Ethiopian Public Health Institute (EPHI) together with colleagues at the Armauer Hansen Research Institute, both in Ethiopia, will boost the country’s sequencing capacity to establish routine SARS-CoV-2 genomic surveillance and monitor the emergence and impact of new variants to better inform public policy. Over 1,000 SARS-CoV-2 positive samples will be collected across 14 hospitals and laboratories over a period of ten months and subjected to next generation sequencing and bioinformatics analyses to identify any new variants. They will then test the efficacy of existing diagnostic assays for detecting these different variants. New genomic data will be promptly uploaded to public repositories, and a web-based platform will be developed to rapidly communicate research findings to relevant stakeholders, including the Ethiopian Ministry of Health, so that results can be readily translated into public health policy.
Iruka Okeke of the University of Ibadan in Nigeria will use academic sequencing resources to expand the genomic surveillance framework of Nigeria’s Centre for Disease Control for the rapid detection of newly-evolved or imported viral variants to inform national vaccination strategies. Nigeria’s SARS-CoV-2 sequencing needs currently surpass its capacity. To address this, they will repurpose existing academic sequencing and bioinformatics resources and expertise for SARS-CoV-2 genomic surveillance, and share the data with the national and global communities in near real-time. They will also pilot an approach to more efficiently monitor the existence and spread of viral variants and viral breakthrough strains by sequencing SARS-CoV-2 positive samples from around 180 health workers, who have greater exposure and better access to vaccines.
Charles Sande of the African Research Collaboration for Health (ARCH) in Kenya will build on their existing SARS-CoV-2 genomic surveillance work covering the six counties of Coastal Kenya to identify new SARS-CoV-2 variants and evaluate their sensitivity to existing vaccines. Daily naso- and oropharyngeal samples from suspected COVID 19 cases will be processed for PCR testing and genome sequencing to identify any new SARS-CoV-2 variants. They will then evaluate the potential impact of these new variants on the Kenyan population by measuring the neutralizing activity of antibody-containing plasma obtained from a cohort of vaccinated adults. Using established channels, they will rapidly communicate their results to local and national health ministries, and across the African continent, to inform pandemic control strategies. Selected samples will be preserved for future monoclonal antibody development to target new variants.
Khurshid Talukder from the Centre for Woman and Child Health in Bangladesh will scale-up their proven approach using a package of 11 service interventions, including antenatal counselling and supportive care during labor, to reduce the cesarean section rate across Bangladesh. Bangladesh has an unnecessarily high cesarean section rate, which can have severe short and long-term health consequences for the mother and child. They developed a multi-service intervention to reduce the rate in their own hospital from 65% to 42% over two years. They will hold workshops at six other large maternity units for tailoring the intervention package to local needs, and train managers and maternity personnel to effectively deliver it in their clinics over an 18-month period. They will evaluate the effect of their approach on reducing cesarean section rates.
Mary Glover-Amengor of the Food Research Institute in Ghana will investigate whether drinking soymilk-burkina, a Ghanaian indigenous fermented milk and millet beverage (smoothie), improves the nutritional status and gut health of women of reproductive age living in the Volta and Oti regions of Ghana. They will produce the soymilk-burkina and test it for bacterial and fungal content and consumer acceptability. They will also recruit 30 pregnant and non-pregnant women and perform a randomized controlled trial to test the effect of daily consumption of 330ml soymilk-burkina over six months. Monthly blood and fecal samples will be collected during trial, and two months after, to analyze nutritional status, inflammation biomarkers and parasites. The gut microbiome will also be analyzed using culture-based assays and next generation sequencing.
Laeticia Celine Toe of Institut de Recherches en Sciences de la Santé in Burkina Faso will evaluate the nutritional content of traditionally-fermented millet porridge and its effects on gut health and inflammation in women of reproductive age in rural Burkina Faso. Maternal undernutrition affects child survival and is a major problem in sub-Saharan Africa and south Asia. This could be addressed by enhancing the nutritional content of common foods, which can be done by fermentation. They will provide a selection of households with locally-produced millet grain for fermenting, and collect samples every five days to evaluate the nutritional and microbial contents. They will also recruit a cohort of 30 women, including 15 pregnant women, to assess the effects of daily fermented millet porridge consumption on fecal microbiota composition, fatty acid levels, and inflammatory markers.
Peter Quashie of the University of Ghana, West African Centre for Cell Biology of Infectious Pathogens in Ghana will determine the impact of SARS-CoV-2 viral variants and their susceptibility to neutralization by vaccine-induced and naturally-acquired immunity to better manage pandemic control in Ghana. They will evaluate over 600 existing plasma samples taken at multiple timepoints from both vaccinated and unvaccinated COVID-19 patients with associated SARS-CoV-2 sequencing data to identify the viral variants, and additional samples as new variants emerge. They will use ELISA and Luminex assays to screen these samples for anti-viral antibodies. Positive samples will then be used in neutralization assays to measure their ability to protect against different viral variants. Plasma with strong broad or selective neutralization activity will be processed for single cell sequencing to identify monoclonal antibodies for potential therapeutic use. Their pipeline can also be applied to other viral outbreaks such as HIV or Ebola.
Manoja Kumar Das of the INCLEN Trust International in India will determine the optimal dose of traditional fermented rice-water (pakhala/torani) to improve the nutritional status and the gut and vaginal microbiomes in women of reproductive age in Odisha, India, to promote maternal health. They will provide different rice types and fermentation protocols for households to prepare torani and also prepare it in the laboratory and evaluate its stability and nutritional and microbial content. A prospective cohort study will be performed to determine the minimum daily dose needed to improve the diversity of the gut microbiota in eight to ten adult females. This will then be used in a pilot test with 200 adult reproductive-age women to evaluate the effects of a daily dose over six months on gut and vaginal microbiome diversity, nutritional profiles, and inflammatory markers.
Syed Asad Ali and colleagues of Aga Khan University in Pakistan will perform a clinical trial to test whether traditional fermented pickles (achars) reduce gut inflammation and promote healthy bacterial growth in women of reproductive age from the poor rural Matiari district in Pakistan, to help reduce rates of childhood stunting. Key drivers of childhood stunting are poor maternal health and nutrition, which could be improved by regular ingestion of fermented foods, although this has never been tested in a real-life setting. They will recruit 210 women of reproductive age and provide different types of locally-produced achar for consumption at home one-to-two times per day over a period of eight weeks. They will collect blood and fecal samples at four, eight, and 12 weeks, and test them for nutritional and inflammatory markers, and perform metagenomic analyses of a subgroup of samples to evaluate the composition of their microbiomes.
Heather Jaspan of the University of Cape Town in South Africa will conduct a randomized controlled trial of post-partum South African mothers to determine whether unpasteurized mageu is more nutritious and promotes a healthier gut microbiome than pasteurized mageu, which is more commonly consumed. Mageu is a common grain-based fermented porridge used as a weaning food in infants and as an energy drink in adults. It is generally produced in pasteurized form, which may inactive the live bacteria that can boost health. They will locally manufacture a live-culture grain-based fermented mageu and use it to conduct a pilot trial with 30 women. The women will receive either store-bought mageu or live-culture mageu for daily consumption over six weeks. They will collect fecal samples to measure microbial diversity, which is a marker of gut health, and host and inflammatory biomarkers between women consuming pasteurized versus unpasteurized mageu.
Yilan Ye from Tsinghua University in China will develop a small, self-adhesive menstrual product based on the suction cups of octopuses that can be fixed securely but reversibly inside the vaginal opening to block the flow of blood and enable its convenient disposal. They will design it specifically for women and girls in low- and middle-income countries by ensuring it is low-cost, re-usable, safe to apply, and does not require sanitation facilities. They will experiment with different commercialized, biocompatible thermoplastic polyurethanes (TPUs) as the raw materials to produce the adhesive polymers. They will first test these polymers for their ability to be strongly, reversibly and repeatedly stuck to the surface of porcine livers and hearts as surrogates that mimic the moist and irregular skin surface inside the vagina. Finally, they will develop an inject mold to manufacture a prototype for human testing that also contains a soft valve for convenient release.
Andrew Boulle and colleagues at the Western Cape Government Health Department and the University of Cape Town in South Africa will use a data science approach applied to anonymized COVID-19 health data from the government health department including over one million tests and 60,000 hospital admissions, to study the clinical epidemiology and evolution of a new variant of SARS-CoV-2 that emerged in South Africa and the impact on patients with existing health conditions. They will conduct a case-control study to determine the clinical severity of the variant and use a cross-sectional design to explore the evolution of viral load. They will also analyze the impact of COVID-19 on pregnancy by evaluating birth weight and other birth outcomes, such as still births, and use death registries to determine mortality rates in patients with HIV, TB, and diabetes.
Xiaofan Liu at the City University of Hong Kong in China and colleagues will reconstruct COVID-19 transmission chains between individuals in communities and households using statistical methods applied to existing datasets to more reliably estimate COVID-19 transmission characteristics, such as reproduction rates, that are critical for planning effective control measures. Currently, transmission characteristics are estimated using aggregated-level data, which leads to inaccuracies. Ideally, data on how COVID-19 is transmitted between individuals are needed. They will curate an existing collection of datasets containing over 40,000 COVID-19 cases in five Asian countries with person-to-person transmission evidence to reconstruct transmission chains. They will then apply statistical tests and an analytical methodology called regression analysis to identify the most important transmission risk factors, which may include virus strain, transmission media, population density, and climate conditions.
Luis Felipe Reyes at the Universidad de La Sabana in Colombia and colleagues will develop a standardized strategy for researchers to better utilize the ISARIC-COVID-19 dataset, which consists of over 520,000 hospitalized patients from more than 62 countries, and identify the causes and health impacts of severe complications. The dataset is particularly valuable because it covers varying standards-of-care around the world and could be used to study the geographic and time-based variability of the disease. The team will develop a standardized strategy to reformat and clean the ISARIC-COVID-19 dataset by producing data descriptors and reference codes and use this strategy to identify the risk factors and clinical characteristics of COVID-19 complications, such as cardiovascular complications, which are a major contributor to long-term morbidity and mortality, in order that vulnerable patients can be better treated.
Fernando Bozza at Fiocruz in Brazil and colleagues will quantify the real-world value of COVID-19 vaccines in Brazil for protecting individuals from severe disease and for protecting the entire population from being infected. Knowing how effective vaccination is, and how durable the response in the real world is, particularly in low- and middle-income countries, it is critical for ending the pandemic. They will determine the effectiveness of the vaccine for protecting individuals using an approach called test-negative design together with statistical and machine learning approaches to compare the severity of respiratory disease in COVID-19 patients from 43 hospitals. At the population level, they will perform an ecological study, and use regression analysis accounting for inequities to vaccine access, to measure the effect of vaccinations on COVID-19 cases, hospitalizations, and deaths.
Maria Yury Ichihara and colleagues at the Centre for Data and Knowledge Integration for Health (Cidacs) at Fiocruz in Brazil will create a social disparities index to measure inequalities relevant to the COVID-19 pandemic, such as unequal access to healthcare, to identify regions that are more vulnerable to infection and to better focus prevention efforts. In Brazil, markers of inequality are associated with COVID-19 morbidity and mortality. They will develop the index of available COVID-19 surveillance data, hosted on the Cidacs platform, and build a public data visualization dashboard to share the index and patterns of COVID-19 incidence and mortality with the broader community. This will enable health managers and policymakers to monitor the pandemic situation in the most vulnerable populations and target social and health interventions.
Kirsty Le Doare and colleagues at the MRC/UVRI & LSHTM Uganda Research Unit and Makarere University John's Hopkins University in Uganda will develop a model using data collected in real-time to identify the risk factors for adverse pregnancy and infant outcomes caused by the COVID-19 pandemic that can be used to rapidly inform interventions. Lockdowns can severely impact women giving birth and access to maternal, neonatal, and child healthcare. They will apply a Bayesian multivariate network meta-analysis, (a methodology that simultaneously analyses multiple outcomes and multiple treatments, allowing more studies to contribute towards each outcome and treatment comparison) to electronic medical records, leveraging existing data on the effect of the lockdown on antenatal and delivery services for over 30,000 pregnancies, vaccination data, and information on COVID-19 infection in pregnancy and infancy. They will also build a user-friendly data dashboard to support decision-making on infection prevention and control at the Ministry of Health.
Juliane Foseca de Oliveira and colleagues at Fiocruz in Brazil will develop mathematical and statistical methods to model COVID-19 infection transmission, prevention and control across populations in Brazil to better inform local intervention efforts. Social and economic inequalities are known to shape the spread of diseases, therefore the team will integrate existing health data together with social and economic determinants for 5,570 Brazilian cities, as well as assessing data on the effects of the mitigation strategies and social mobility patterns. These data will be used to develop and apply statistical analyses and nonlinear mathematical modelling to forecast disease evolution and outcomes that consider the specific socio-economic conditions, which influence transmission rates. The results will be presented on a user-friendly surveillance platform that can be used by local governments and communities to identify the most effective control methods for their region.
Dale Barnhart and colleagues at Harvard Medical School in the U.S. and Partners in Health of Haiti, Malawi, Mexico, and Rwanda will determine how the COVID-19 pandemic has impacted health care provision and utilization for patients with HIV, heart disease, and diabetes, and the health outcomes of these patients, in all four countries. They will pool existing electronic medical data on chronic care patients collected from up to 30 health facilities in each country and create a harmonized database to identify the impacts of COVID-19 and any successful strategies used to improve care. They will also develop a predictive model to identify which patient populations are most at risk from care disruption during the pandemic, which can help prioritize clinical and geographic areas that need interventions. Finally, they will develop data visualization tools to facilitate the communication and interpretation of the data by chronic care managers across the four different countries.
Carl Marincowitz and colleagues at the University of Sheffield in the United Kingdom and the University of Cape Town in South Africa will develop a risk assessment tool to help emergency clinicians quickly decide whether a patient with suspected COVID-19 needs emergency care or can be safely treated at home to avoid overburdening hospitals particularly in low- and middle- income countries (LMICs). They will use existing data to which they have access on 50,000 patients with suspected COVID-19 infection who sought emergency care in the United Kingdom, South Africa, and Sudan to develop prediction models for specific COVID-19 related outcomes in all income settings. These prediction models will be used to develop risk stratification tools, which enable providers to identify the right level of care and services for distinct subgroups of patients. These will be developed with input from patient and clinical stakeholders. The team will test the performance of their risk assessment tools for identifying high-risk patients with existing triage methods.
Janine Aucamp of North-West University in South Africa will produce a novel drug screening platform for malaria by building a physiologically-relevant in vitro tissue model of the sinusoidal space of the human liver, which supports the development of liver-stage malaria parasites (sporozoites). Artemisinin-based combination therapies are first-line treatments for malaria but their efficacy suffers from the development of resistance, thus alternative approaches are needed. One approach is to block parasite development in the liver, which can prevent the establishment and symptomatic onset of malaria. They will build three different three-dimensional micro-bioreactor liver models and evaluate how well they can be infected by Plasmodium falciparum sporozoites compared to two-dimensional cultures. They will then test the value of the most promising model for identifying anti-malarial drugs first using two approved drugs and subsequently by screening novel drugs.
Grace Mugumbate of Chinhoyi University of Technology in Zimbabwe will develop new anti-malarial drugs by using a chemogenomics approach for ligand-based and structure-based virtual screening to identify compounds that selectively bind to heat shock proteins of the malaria parasite, Plasmodium falciparum. P. falciparum heat shock proteins are essential for parasite growth and survival, and represent a valuable new target for developing safe and effective anti-malarials. They will use existing chemical and genomic data to produce three-dimensional structures of several heat shock proteins for performing the virtual screens. Machine learning approaches will be used to identify binding ligands and inhibitors that will be validated using enzymatic assays in vitro. Promising hits will then be subjected to structure-based optimization to identify active compounds as leads for further development.
Erick Strauss of Stellenbosch University in South Africa will develop a small molecule inhibitor of an enzyme that helps pathogenic bacteria evade the host immune system and potentially become resistant to antibiotics as a novel treatment for methicillin-resistant S. aureus (MRSA), which is a major public health concern. They discovered a bacterial enzyme, MerA, that neutralizes an anti-microbial compound secreted by immune cells. This prolongs the survival of the bacteria in the host, giving them time to develop mutations that could render them less susceptible to antibiotics. They have identified two different chemical scaffolds that occupy the active site of MerA and will employ a new inhibitor discovery strategy that combines parallel synthesis with an X-ray structure-based binding screen to identify promising MerA inhibitor leads. These leads will be evaluated by in vitro and ex vivo assays for further development.
Lyn-Marie Birkholtz of the University of Pretoria in South Africa will identify gametocytocidal
compounds that specifically prevent human-to-mosquito transmission of gametocytes and block gamete and oocyst formation in mosquitoes as a complementary strategy to help eliminate malaria. Traditionally, anti-malarial compounds have been developed to target asexual blood-stage parasites. However, also blocking parasite transmission is critical for eradication. They developed a platform that can screen multiple sexual stages of the parasite and recently used it to identify ten hit compounds from the Medicines for Malaria Venture (MMV) Pandemic Response Box (PRB), most of which have not previously been tested against malaria-causing parasites. They will validate those hits, optimize them, and analyze their structure-activity-relationship (SAR) and their potential mode of action to identify at least one chemotype as an early lead candidate for further development.
Laurent Dembele of the Université des Sciences, des Techniques et des Technologies de Bamako in Mali will use their cell-based ex vivo phenotypic drug assay to identify approved anti-malarial drugs that are effective also against the neglected malaria-causing pathogen Plasmodium malariae, which has become widespread in sub-Saharan Africa. To eliminate malaria, treatments should be effective for all circulating malaria pathogens. However, current artemisinin-based combination therapies (ACTs) are largely designed to target the historically more prevalent P. falciparum species. They will recruit around 400 patients with uncomplicated malaria in Faladje to determine the P. malariae malaria burden. They will also evaluate the ability of a panel of anti-malarial compounds to destroy cultured P. malariae together with P. falciparum to help guide treatment strategies.
Fortunate Mokoena of North West University in South Africa will couple molecular docking approaches with in vitro and in vivo validation to identify novel inhibitors of Trypanosoma brucei and Plasmodium falciparum, the causative agents of the lethal diseases, African trypanosomiasis and malaria, respectively. Current drugs targeting these pathogens have limited efficacy due to the development of resistance and can cause severe side effects. They will identify a new group of drugs that specifically target parasitic molecular chaperone proteins, specifically heat shock protein 90 (Hsp90), which is an ATPase that helps correctly fold newly synthesized proteins. They will computationally model the structures of Hsp90 from both T. brucei and P. falciparum and prepare a three-dimensional database of inhibitors for virtual screening. The top 30 candidate inhibitors that selectively bind parasitic Hsp90 will be subjected to geometry optimization and induced fit molecular docking, followed by evaluation of their parasite killing activity in vivo.
Elizabeth Kigondu of the Kenya Medical Research Institute will identify natural products that block the resistance mechanism developed by tuberculosis-causing bacteria against existing anti-mycobacterial drugs to help more effectively treat tuberculosis. Tuberculosis (TB) is a highly prevalent and severe disease that has been exacerbated by the emergence of multi-drug resistant TB for which only limited treatments are available. Efflux pumps play a critical role in mycobacterial resistance to two drugs, spectinomycin and rifampicin. They will identify natural products and their derivatives that block these efflux pumps by first searching databases for analogs to published efflux pump inhibitors, and then performing virtual docking experiments to identify those that bind. These will then be tested in drug combinations with spectinomycin and rifampicin for synergistic cytotoxicity and anti-mycobacterial activity.
Gabriel Mashabela of the South African Medical Research Council will develop novel tuberculosis drugs derived from South African medicinal plants by utilizing CRISPR genome editing technology to produce Mycobacterium deficient in essential metabolic enzymes that can be used to screen natural products. Although the majority of approved drugs are of natural origin, most drug-screening approaches use synthetic libraries, which lack diversity. However, natural products contain very low concentrations of bioactive compounds making them difficult to use in traditional drug screens. To address this, they will use CRISPR to reduce the levels of a selection of essential metabolic enzymes, without removing them completely, so that lower levels of bioactive compounds are needed. They will prepare extracts from 100 plants with anti-mycobacterial activity, and perform whole cell screening to identify those with killing activity against the different Mycobacterium mutants. These can then be further optimized for drug development.
Maurício Barretto of Fiocruz in Brazil will integrate COVID-19 data from Brazil into existing harmonized datasets from over 500 million people across the world, to better inform public health strategies. International data on COVID-19 is needed to help lift the world out of the pandemic. However, there is little real-world data from South Asia or Brazil. They will map data from the COVID-19 surveillance database for the State of Bahia, which covers a population of 15 million people, to the common data model known as OMOP, which brings together disparate data into a common format. They will run analytical tools on these mapped data to characterize COVID-19 forms and disease outcomes, to quantify the use of COVID-19 treatments in routine practice and to identify risk factors that can be used to predict disease severity and help better manage patients.
Haroon Hafeez of Shaukat Khanum Memorial Cancer Hospital and Research Centre in Pakistan will integrate COVID-19 data from Pakistan into existing harmonized datasets from over 500 million people across the world, to better inform public health strategies. International data on COVID-19 is needed to help lift the world out of the pandemic. However, there is little real-world data from South Asia or Brazil. They will map the anonymized electronic medical records from over 7.8 million people, including over 20,000 COVID-19 positive patients, from a hospital in Lahore to the common data model known as OMOP, which brings together disparate data into a common format. They will run analytical tools on these mapped data to characterize COVID-19 forms and disease outcomes, to quantify the use of COVID-19 treatments in routine practice and to identify risk factors that can be used to predict disease severity and help better manage patients.
Lyle McKinnon of the University of Manitoba in Canada will test whether a specific type of immune cell known as tissue resident memory T cells, which are found in the nasal cavity during SARS-CoV-2 infection, help limit disease severity and viral replication. The nasal mucosa is the first place in the body that is exposed to the SARS-CoV-2 virus. However, little is known about the local immune response and how this may influence disease progression, which varies dramatically between people. They have developed a nasal sampling protocol and will use it to characterize nasal T cells from COVID-19 positive patients in three sites in Winnipeg, Canada, and Nairobi, Kenya, to see if it correlates with clinical outcomes. They will also compare the activation of these nasal tissue T cells in uninfected individuals before and after SARS-CoV-2 vaccination to determine their role in vaccination-mediated immunity.
Elly Munde of the Hospital and Health Administration Services in Kenya will integrate a multiplex PCR assay into an existing malaria molecular surveillance program to detect a specific variant in the causative malaria parasite Plasmodium falciparum, which is undetectable by most rapid diagnostic tests and is threatening successful disease control. The specific haplotype of concern has a deletion of the genes encoding for histidine-rich proteins 2 and 3 (hrp2/3). Individuals infected with this haplotype produce a false negative result on most diagnostic tests. They will integrate the PCR assay into an ongoing cohort study, and develop statistical analyses to genotype the samples and decision support tools for guiding future intervention strategies. They will also evaluate the emergence and spread of these new haplotypes by genotyping existing samples to determine the effect of previously deployed diagnostic policies on disease control. If successful, they will scale their approach up nationwide.
Hamed Alemohammad of Open Imagery Network Inc. in the U.S. will collect and curate high-quality agricultural mapping data from drone imagery in Kenya that has commercial value and can also be openly accessed for public good purposes. High quality and timely geospatial data is often only collected in the commercial sector, which makes it too expensive for the public and philanthropic sectors to access and use to address development challenges. To resolve this, they will develop a minimum viable product to demonstrate the potential for collecting high-quality, annotated agricultural data that has commercial value and can also be openly accessed. The imaging data will be obtained from an approximately 40 square kilometre area, annotated to identify field boundaries and building footprints, and made available through their partner, PLACE, who have digital infrastructure and a data trust for providing commercial licenses.
Fatma Guerfali of Institut Pasteur de Tunis in Tunisia will implement wastewater SARS-CoV-2 surveillance in diverse sanitation settings in Kenya and Tunisia to help determine the true number of people infected with SARS-CoV-2, which is currently underestimated. The detection of SARS-CoV-2 RNA in sewage can be used to monitor virus circulation in the population. However, this is more challenging in settings with diverse sanitation practices, such as in many parts of Africa. They will quantify SARS-CoV-2 RNA in untreated wastewater from diverse sanitation settings and correlate them with clinical testing to determine their accuracy. They will also develop epidemiological models using a web-based informatics platform, which integrates geo-spatial, temporal and SARS-CoV-2 RNA analysis, to test the performance of longitudinal SARS-CoV-2 RNA wastewater surveillance from hospitals and public sanitation systems.
Geoffrey Siwo of the University of Notre Dame in the U.S. will use a computational approach to identify broad-spectrum antiviral drugs that trigger an innate immune response and could be used against a range of viruses. Traditional drug discovery approaches target viral proteins, but this requires prior knowledge of the virus and can lead to the development of resistance. In contrast, compounds that trigger the host’s natural biological defense mechanism inside each cell are less likely to cause resistance, and can be used for treating novel viruses as well as for vaccine adjuvants. They will develop an artificial intelligence (AI) approach that uses predicted broad-spectrum antivirals to generate a large variety of related molecules. These will be compared with a library of approved drugs to identify compounds with similar chemistries. The top 100 compounds will be tested for broad anti-viral activity in multiple human cell lines.
Danielle Ehret of the Vermont Oxford Network in the U.S. will develop a web-based clinical training course to train staff in neonatal intensive care units in Ethiopia to better recognize respiratory distress syndrome in preterm infants, and to safely deliver continuous positive airway pressure (CPAP) to reduce mortality rates. Respiratory distress syndrome causes almost half of all preterm deaths in neonatal units in Ethiopia. These would be preventable if the staff had received adequate clinical training. However, the recent pandemic forced a halt to the national hands-on training program that was planned in 2020. As an alternative, they will host monthly training webinars focused on diagnosis and treatment, and develop an observation checklist to assess the quality of CPAP delivery. They will evaluate their approach by quantifying staff training rates, diagnoses of respiratory distress syndrome, and treatment and mortality rates.
Moses Laman of the Papua New Guinea Institute of Medical Research will extend the national malaria surveillance platform, which maps infections across Papua New Guinea, to incorporate valuable genomic data of the malaria-causing parasites that can be used to better guide control and elimination efforts. They will enable the molecular data from the parasites generated by a central laboratory to be overlaid onto the clinical case data, so that transmission dynamics and parasite population diversity can be displayed on a web-based dashboard for easy access by program managers and health authorities. They will also provide training to relevant staff so they can use the new genomics data to inform their decisions on intervention strategies and outbreak containment.
Richard Bbaale of BanaPads Inc. in Uganda will recycle the discarded pseudo stems of banana plants to produce a non-toxic biopolymer and develop biodegradable sanitary pads for women and girls in underserved communities. Uganda produces roughly 10% of the world's bananas, which results in over 30 million tons per year of pseudo stem waste that is currently left to rot. They will extract the cellulose from the pseudo stem, which is the trunk of the banana plant that is cut off once the bananas have been picked, and use it to synthesize the biopolymer, carboxymethyl cellulose (CMC). This will then be combined with non-toxic additives to produce the different layers of a sanitary pad, namely the water-soluble film, an adhesive, fibrous elastic, and absorbent foam, that can be safely flushed down the toilet and gets degraded by bacteria in the septic sewage. Once the materials have been developed, they will produce a prototype pad for testing.
Issiaka Soulama of Groupe de Recherche Action en Santé in Burkina Faso will build a molecular surveillance platform for monitoring the emergence and spread of different strains of the malaria-causing parasite, Plasmodium falciparum, including drug-resistant ones, to support the National Malaria Control Program and improve the control of malaria. They will develop a web-based platform so that when a person tests positive at one of the existing monitoring sites, they can quickly and easily record the location of the infection. If given consent, they will also take a blood sample for genotyping the parasite at a central laboratory, and analyze them for potential drug resistant mutations. These data will be used for modelling near real-time transmission dynamics to inform future control policies and practices. The data will be shared with program managers who will be trained on how to interpret them to identify effective intervention strategies.
Naba Dutta of RMIT University in Australia will develop disposable sanitary pads from natural, biodegradable polymers and agricultural byproducts such as cellulose to decrease cost and waste production and improve safety. Disposable pads are generally made from synthetic superabsorbent material that is expensive, has a high carbon footprint and is associated with an increased risk of diseases such as pelvic inflammatory disease. Using their photo-crosslinking method, they will synthesize and test different protein-based hydrogels to produce the absorptive core of the pads, and also synthesize natural esters and test their ability to form an impermeable but breathable barrier layer. They will also test modified soy protein-based gels for adhesive properties, and jute fiber treated with polyphenols extracted from plants for the antibacterial layer. Once the components have been optimized, they will assemble them into a sanitary pad and test its performance compared to commercial pads.
Silvia Maria Di Santi at the São Paulo State Department of Health in Brazil will integrate genomics techniques into their routine malaria surveillance program to genetically characterize the parasite populations and monitor transmission dynamics in gold mining regions. Gold mining is associated with deforestation, which expands breeding sites for malaria-transmitting mosquitoes, poor housing conditions, and illegal activities, which makes eliminating malaria in these regions more difficult. They propose to use advanced sequencing technologies to better monitor the emergence of drug-resistant malaria-causing parasites and insecticide-resistant malaria vectors in a gold mining area in Pará, Brazil. They will collect samples from existing treatment and diagnosis sites and by recruiting miners, and collect Anopheles mosquitoes in different seasons. These will be subjected to whole genome and targeted amplicon sequencing, which will be implemented in a reference laboratory. They will also develop an interactive web browsing tool to visualize the raw sequencing data and reveal patterns of drug and insecticide resistance for informing interventions targeted to this region.
Martha Cecilia Suárez-Mutis of Fiocruz in Brazil will develop a molecular surveillance tool with genome sequencing to monitor the entry and subsequent spread of drug-resistant Plasmodium falciparum, the malaria-causing parasite, from across the country’s borders. Elimination of malaria requires close monitoring of the parasite population to track the emergence and spread of new genetic variants, particularly those resistant to the commonly used anti-malarial drugs, which will severely restrict elimination efforts. They will train local teams in five health posts close to selected country borders to collect blood samples from malaria patients, which will be sequenced in an established research laboratory to identify any known resistance mutations. They will also develop an analysis pipeline, tools, and an interactive web platform to translate the sequencing data into a user-friendly interface to assist decision-making by local and national managers.
Jennifer Edwards of Cardiff University in the United Kingdom will develop a low-cost material impregnated with a photo-active biocidal compound for producing reusable sanitary products that can be self-cleaned in the sun without the need for water or detergent. Many women and girls in low- and middle-income countries are unable to afford single-use sanitary pads or to properly clean reusable pads, which leads to many of them suffering from chronic infections. To address this, they have developed a series of non-toxic, metal and metal-oxide photoactive catalysts that produce reactive oxygen species when exposed to sunlight, and will test their ability to kill a range of bacterial and fungal pathogens, and to degrade other organic products, such as blood and odor. They will also evaluate cost-effective methods for incorporating them into different fabrics.
Wei Lu of the University of Michigan in the U.S. will develop a reusable sanitary pad from a highly hydrophobic material containing carbon nanofibers, which clot blood, and microfolds that trap it in small pockets on the surface and can be cleaned without water. Disposable pads are expensive and generate substantial waste, making reusable products more attractive in low- and middle-income countries. However, these all require washing with lots of clean water, which is often problematic. They will develop a material that, rather than promoting absorption, instead quickly immobilizes the blood in a solid state on the surface of the pad, which can be removed by simply stretching it. They will develop a prototype with optimized loading of the carbon nanofibers and with three-dimensional origami patterns that effectively capture the blood, protect the skin, and avoid leakage. The prototype will be tested for comfort and performance by volunteers.
Jaishree Raman of the National Institute for Communicable Diseases in South Africa will integrate a genomic surveillance platform with the existing routine malaria surveillance program to better identify the source of infections and monitor parasite spread within South and southern Africa. Eliminating malaria requires knowing whether new infections are imported from other countries or are caused by local outbreaks, because they require different intervention strategies. Distinguishing between these sources is difficult, particularly in countries with a high proportion of migrants whose movements are largely undocumented. Leveraging the recent advances in sequencing technology they will genotype samples collected routinely from patients, and translate the data into a usable format for uploading to the existing malaria information system. The data can then be integrated with the relevant epidemiological data, and utilized by managers of the national control program to track the movement of specific strains and better guide interventions.
Agaba Bosco from the Infectious Diseases Research Collaboration in Uganda will integrate a molecular surveillance system into their National Malaria Control Program to diagnose a currently under-detected variant of the causative parasite Plasmodium falciparum and better track spread. Most rapid diagnostic tests for malaria detect a specific parasite protein, however a new variant has emerged that has a deletion of the corresponding pfhrp2/3 gene, leading to a false negative test result. As these infections fail to be diagnosed, people aren’t being properly treated, and the disease continues to spread. They will upgrade the testing capabilities at the malaria reference laboratory to detect this deletion variant, and select 10 facilities spread across the country from which they will periodically sample 37 malaria patients to track the spread. They will also incorporate information systems for data capture and visualization dashboards to inform program managers and guide their decision-making.
Catherine Arsenault at the Harvard T.H. Chan School of Public Health in the U.S. and colleagues will measure the effect of the COVID-19 pandemic and associated containment policies such as curfews on the quality of health care in seven countries and the rates of mortality from non-COVID conditions. They have extracted data from health management information systems spanning two years from Ethiopia, Ghana, Haiti, Laos, Mexico, Nepal, and South Africa. They will first clean the data and then apply an analytical tool called segmented regression analysis to assess the effect of the pandemic on health service delivery, such as the provision of certain preventive and curative services, and use a statistical technique called difference-in-differences estimations to assess the effect of containment policies on healthcare demand, such as patient appointments. This will help countries to address gaps in their health care systems and plan recovery strategies for missed health care.
German-Hungarian startup Mastory is developing an e-learning system to engage Black and Latino students and students experiencing poverty in interactive storyline games. While students are immersed in a real-time sci-fi adventure, they learn to deal with mathematical topics from the core curriculum and experience their importance in emotionally meaningful contexts. Current methods for teaching abstract concepts in mathematics often fail to explain why they are relevant to real life, and particularly to the lives of priority students, causing many of them to disengage. Using their proven method, Mastory will provide teachers with software, hardware, and content that translates algebra lessons into a unique social experience for the students to engage with, be motivated and succeed. Partners on this project include the European Social Fund and Freie Universität Berlin.
This project aims to understand and analyze the determinants of vaccination coverage in the Brazilian territory by assessing its association with socio-economic factors, public health spending, coverage of primary health care and the Bolsa Família Program and the influence of patterns of content dissemination on immunization on social media. The results will be disseminated through virtual games, podcasts, interactive panels, infographics, an e-book for municipal managers, a webinar for undergraduate students in the health field and a seminar on World Immunization Day.
Zearn, a nonprofit curriculum publisher and math platform, will develop an individually adaptive fluency product for middle school students that focuses on sharpening foundations from Grades 3–5, including fractions and operations, to promote a deeper understanding of complex concepts on the path to Algebra proficiency. The product will adapt a series of activities to individual students, particularly focused on supporting students who have been struggling in previous grades. The materials and activities will be developed together with students, especially priority students. They will be designed to motivate learning, foster growth mindsets, and promote inclusivity, and each student will receive a tailored series of activities to pursue.
The Partnership for Los Angeles Schools in the U.S. will work with teachers and students to develop and incorporate social justice and identity-affirming content into math curricula for students to improve their academic performance and further enhance their opportunity to attain their hopes and dreams as independent and confident lifelong problems solvers. The Partnership will develop prototypes that incorporate social justice into teacher supports to modify lessons, tasks, and assessments, and to build new classroom cultures that cultivate student genius. Their approach will transform mathematics into a problem-solving and identity-affirming journey, and will teach students the power of mathematics for both understanding and changing how the world works. They will pilot the project in seven secondary schools in their network.
BetterLesson Inc. in the U.S. will develop professional learning opportunities for teachers seeking to create positive and affirming mathematics classrooms; they will also design rigorous, culturally-connected Algebra I activities for Black and Latino students. The content of traditional Algebra I lessons tends to reflect the inequities experienced by Black and Latino students, thereby failing to engage their strengths and inhibiting learning. BetterLesson will collect input from students to develop and test new activities on the Desmos platform that provide multiple access points and engage through creativity, exploration, and collaboration, such as sketching and free-form writing. They will also provide direct support and training to teachers via workshops and individual coaching to help them employ effective teaching strategies using these new activities in their classrooms. BetterLesson will partner with Desmos on this project.
The Black Teacher Collaborative (BTC) in the U.S. will develop a teacher training program for Black teachers to help them produce more affirming Algebra I classes for Black students to facilitate their learning and development. Their teacher training program will adapt traditional teaching practices for mathematics and make them more relevant for Black students, such as creating racially-relevant examples to better teacher principles and operations of inequalities. BTC will pilot test their approach in classrooms. The success of their approach will be evaluated by using test scores and grades to measure the effect on student performance, and by using student surveys to measure the effects on student confidence and the development of a positive racial mathematics identity. Partners on this project include Transcend.
Howard University Middle School of Mathematics and Science, in partnership with Howard University, in the U.S. will develop a program that teaches mathematics by applying it to the everyday lives of their female Black students in Washington DC, in order to spark their interest and improve their achievement scores and attitudes towards the subject. The abstract nature of mathematics lessons makes it inaccessible for many Black students, and this leads to fewer pursuing higher degrees. They will develop new lessons that apply mathematics to issues directly relevant to their female black students, such as using algebra to explore poverty and wage gaps, and algorithms to understand the effects of social media.
The Rhode Island Department of Education (RIDE) in the U.S. will develop a pre-algebra "Readiness Course" to better prepare multilingual learners in Providence for Algebra I. In 2020, only 3% of multilingual learners (also called "English learners") in Rhode Island achieved the SAT college readiness benchmark in mathematics. RIDE has developed and piloted a summer course that uses student-centered pedagogy and real-world examples to strengthen students' math skills, while also promoting their social-emotional growth. RIDE will expand the course to a full academic semester, and layer on additional supports to help multilingual learners succeed. These supports will be designed using RIDE's recently-released Blueprint for Multilingual Learners, as well as the insights of multilingual learners themselves. Partners on this project include WestEd Carnegie Math Pathways, English Learners Success Forum (ESLF), and the Equity Institute.
Amplify Education in the U.S. will develop a solution that leverages a visual approach to mathematics to help students gain a deeper conceptual understanding of data and statistics, making advanced concepts more accessible to students, especially English Learners. Interpreting and working with data is becoming increasingly important in American society, and by building on both algebraic and geometric concepts from earlier grades, Amplify will also enable students to better apply statistics to their everyday lives. Partners on this project include English Learners Success Forum (ELSF).
The Young People's Project (YPP) in the U.S. will develop a formal certification program and online learning platform to support high school students experiencing poverty to create and use interactive math games to more effectively teach algebra to their younger peers. YPP developed a program for teaching algebra whereby middle and high school students are employed as Math Literacy Workers to develop interactive games to improve their own math literacy, and to use them to improve the literacy of their peers. In doing so they also learn to develop their voices as agents of change in education. The Math Literacy Workers will use a formative diagnostic assessment tool, Math Mapper, built on a foundation of validated learning trajectories, to strengthen topic areas that need further development, and to develop a deeper understanding of mathematics and how students learn it. This system will enable the provision of formal credentials, through the Territorium platform, that can facilitate access to funds for paying the workers. Partners on this project include: The Math Door, Broward County Public Schools, Boston Public Schools Teacher Cadets, Territorium, and the Center for School Climate and Learning.
ConnectED: The National Center for College and Career in the U.S. will develop a digital tool to improve the Algebra I performance of multilingual students learning English. New approaches to teaching mathematics support students to think, talk and write about their mathematical reasoning -- not merely to apply formulas and solve for right answers. While the language that students generate while they are making sense of mathematics is rich with information about student learning, that information tends to be hard for math teachers to capture and analyze. Our proposed intervention will build teachers’ confidence with simultaneous formative assessment of language and mathematics, which is especially important for English Learners. ConnectED will partner with Envision Learning Partners (ELP) on this project.
The University of Florida in the U.S. will develop an interactive mathematics learning platform with instructional videos incorporating high-quality, culturally responsive educational material and online resources to better engage students experiencing poverty and Black and Latino students. Together with students, they will create culturally-relevant interactive learning modules leveraging the Illustrative Math curriculum and the wide-reaching Algebra Nation platform; for example, a culturally responsive interactive learning module may embed bivariate statistics in different sociopolitical contexts such as salary trajectories of vocational jobs versus college degrees. These will be designed to enhance students’ understanding of algebraic concepts as they relate to their cultural and community context. Students will be able to contextualize their own learning experience in stories that are meaningful to them, developing their identities as mathematicians simultaneously with their understanding of how to leverage Algebra 1 knowledge to find success in education and career. Algebra Nation will be a partner on this project.
Plan of Action for Challenging Times in the U.S. will use a student-driven approach to develop a program that leverages storytelling to improve the conceptual understanding of Algebra 1 for Black and Latino students. They will offer small group tutoring using a peer-led model to strengthen understanding of core algebraic concepts. They will also organize student groups and support them to use their own life experiences to create new stories for explaining specific concepts, and to develop them as learning tools for teaching other priority students. This will also create leadership opportunities and build self-confidence, and together will foster positive mathematics identities.
Village Education Tutors Foundation in the U.S. will develop a culturally relevant and virtual one-on-one mathematics instruction and coaching program geared towards African American and Latina students educated in underserved communities by providing whole child learner models that foster academic and mental health wellness. They will recruit highly qualified teachers, including bilingual teachers, and equip them with high-quality teaching material and online tools to create an equitable and safe space for students to develop into critical thinkers and lifelong learners through instruction tailored to meet the needs of each student. Teachers will also be trained to provide social and emotional support to help students cope with everyday challenges found within our U.S. economy such as economic insecurity, health care inequity and other social determinants of health.
Broward County Public Schools in the U.S. and partners will enhance and pilot a set of tools and strategies that enable teachers and priority students to build classroom cultures and practices for the learning and teaching of mathematics that incorporate the needs of the entire class, with a particular focus on engaging priority students. This approach builds on the Algebra Project’s Five-Step Curricular Process, which is a student-centered teaching framework for diverse populations that begin with a mathematically rich, concrete experience to be mathematized and make meaning of embedded, abstract mathematics concepts. Summer Induction Academies will be held so that students and teachers explore together multiple ways of thinking about and doing mathematics, leveraged by instructional materials and activities such as games for teaching prime factorization of integers, to strengthen understanding of key mathematical concepts. Partners on this project include the Algebra Project, Broward College, ETS, Florida International University, Territorium and the Young People’s Project.
The University of California at Los Angeles (UCLA) Curtis Center for Mathematics and Teaching in the U.S. will create a mentorship program to motivate students at the Barack Obama Global Preparation Academy (BOGPA) to improve their performance in mathematics by positioning students on small research teams investigating a mathematics problem arising in the environmental science of their community, human biology or aerospace engineering, with mentorship by UCLA and SpaceX BlackX mathematicians of color. The mentorship program will be designed to rehumanize mathematics for BOGPA’s 98 percent Black and Latino students by engaging them as doers and creators of mathematics and by building “windows and mirrors” into their mathematics experiences to show mathematics is a socially useful endeavor for Black and Latino students. Students will present their solutions during a planned event attended by the BOGPA community and UCLA and SpaceX BlackX mentors.
This project aims to demonstrate the importance of adequate health care for pregnant women in health facilities and its effects on maternal and child mortality. The project will also measure the causal effect of the distances taken for pregnant women to access health facilities and the health care provided, which will be useful to identify the gaps in maternal health care and to drive decisions on resources allocation and prioritized actions. A new database will be created for monitoring of access to public health facilities, considering distances and real-world accessibility conditions.
This study intends to evaluate the use of long- lasting insecticide-impregnated nets (LLINs) and their implications in a municipality of five Brazilian Amazonian states. Brazil has been using LLINs as a supplementary control tool for over 10 years and during this period many questions regarding its effectiveness were raised. Therefore, the present project aims to verify if the distribution strategy was accompanied by specific information, such as individual or group orientations, calendar provision, explanation about using, washing and caring in order to assess if there is a need to adapt this strategy to the population’s habits, culture and education, to the local dynamics of malaria transmission and environmental factors.
Eric Reiter of the Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE) in France will engineer nanobody-based biologicals to block ovulation as a practical, non-hormonal contraceptive with fewer side effects. Blocking the molecular regulators of ovulation is an attractive contraceptive mechanism. However, it can also affect steroid hormone production, which causes undesirable side-effects. Nanobodies are antigen-binding domains of antibodies that can very selectively modulate signal transduction pathways. They will identify candidate nanobodies that may selectively block ovulation using a phage display approach and functional screens. Specifically, this work will focus on identifying nanobodies that are biased ligands, triggering receptors selectively to yield only the desired downstream responses. These candidates will be engineered to produce long-lasting biologicals that will then be administered to mice and ewes to evaluate their ability to block ovulation as a proof-of-principle.
EVaccination app to ensure each newborn’s vaccination through trained semi-literate local people as incentivized Community Health Workers (CHWs) to find, counsel and accompany new mothers to public hospitals for vaccination
This project will link the SINASC, SIM, SIGA and SIH databases to assess the role of interventions in childbirth and will also analyze the avoidability of neonatal and maternal outcomes. It will develop guidelines and training for the classification of “onset of childbirth”. The group will use the Robson classification, map the disruptions of the pandemic to perinatal care, and will explore the role of maternal nutritional status on intervention rates in childbirth and on maternal and neonatal results, making the databases available for research and for training purposes.
In Brazil, the only information system that provides data on maternal morbidity is the Hospital Information System (SIH), but there are difficulties in implementing the criteria recommended by WHO and doubts about the quality of information. The project will validate the SIH against the Maternal Near Miss criteria and will build and validate an algorithm to identify severe maternal morbidity. As a product, it will develop an online indicator panel for the surveillance of maternal health to be used by SUS managers.
The objective of this project is to map the implementation and evolution of breastfeeding initiatives in the scope of primary health care (PHC), assessing their spatial and temporal distribution patterns and their correlation with the evolution of the indicators. The team will map the successful cases of pro-breastfeeding programs and identify their impact. A single dataset containing information on PHC infrastructure and breastfeeding rates and programs will be generated, as well as the qualification and validation of SISVAN breastfeeding information.
The project will identify the poverty profiles of families with children under the age of five enrolled in the Single Registry considering data from the Family Development Index, the Brazilian Deprivation Index and the Municipal Human Development Index. It will assess the amount needed to overcome the families' poverty gap and also estimate the mortality rates in each of these profiles. The results will be disseminated through dashboards, forecasting scenarios for stakeholders and a workshop with stakeholders from the Ministry of Citizenship and stakeholders. The project will also provide forecast scenarios for COVID-19 associated crises with a high level of granularity.
This project will identify clinical, sociodemographic, psychosocial, neurocognitive and epigenomic factors to assist in the identification of the most effective response to the treatment offered by SUS to detoxify the use of crack and cocaine by women. The project will use the Random Forest algorithm in a database developed by the research group itself in order to predict the factors that impact adherence and maintenance of abstinence among users.
This project will produce a consolidated database, which aggregates available data on emerging diseases (Zika and COVID-19); external climatic conditions (droughts and floods) and environmental problems (disasters, fires, pollution) as risk factors for unfavorable obstetric and neonatal outcomes. The database will enable the production of information on maternal and early neonatal morbidity and mortality in an accessible way.
The objective of this project is to create an obstetric observatory through an interactive platform for monitoring, analyzing public data and disseminating information in the area of Obstetrics in Brazil. It will provide exploratory data analysis with the purpose of assessing the impacts of the H1N1 (2009) and COVID-19 (2020) pandemics on maternal, fetal and neonatal health. A book entitled on the subject will also be produced and made available free of charge.
This project will investigate the joint effects of exposure to particulate matter, carbon monoxide, ozone, nitrogen dioxide and sulfur dioxide on maternal and child health. The joint and non-linear effects of these pollutants on maternal and child health will be evaluated, followed by those from wild fires and fires in the northern region. As a product, it will develop a map of multiple air pollution exposure levels by municipality, and it intends to create a definition for critical air pollution exposure levels for child health to inform pollution guidelines in Brazil and thus improve the environmental conditions for the development of children in the country.