Jacob McKnight and Mike Wilson of the University of Oxford in the United Kingdom will develop a simple application that contains information about the quality, location, and the nature and cost of services provided by the different pathology laboratories in Kenya so that doctors and patients can choose the one that best suits their needs. They will conduct surveys to collect key information on the pathology laboratories in the Nairobi area, and consult with doctors and medical associations to find out how they use those laboratory services and what needs to be improved. They will build the application using these data and in collaboration with users. Ultimately, the system should also help to improve the overall quality of services.

Daniel Pepper of Vayu in the U.S. will assess the value of using unmanned aerial vehicles integrated with existing healthcare supply chains to transport healthcare products and diagnostic samples in Senegal. Healthcare supply chains are critical for saving lives but are restricted by poor road infrastructure in developing countries. Unmanned aerial vehicles can overcome these restrictions and ensure rapid transport in temperature-controlled conditions. They will engage stakeholders from the Pharmacie National d'Approvisionnement (PNA) to National laboratories, the Expanded Program of Immunization, the National Blood Bank and the Ministry of Health to explore the feasibility of using unmanned aerial vehicles for delivering vaccines, essential medicines, contraceptive products and blood, and also to pick up tuberculosis samples for diagnosis. They will perform a test over a three- to four-month period to evaluate the impact of their approach on delivery and costs, and gather feedback from users.

Shahnoza Eshonkhojaeva of Sinostream AB in Sweden will use machine-learning algorithms to predict the amount of medicines and supplies needed at individual health clinics in low-resource settings, and to inform medical stores for delivery. Their approach involves obtaining daily consumption patterns that are recorded on smart paper stock cards at rural health clinics, which requires no training, internet access, or electricity. These cards will then be scanned at district health service centers, the data digitized, and algorithms used to calculate consumption patterns and waste, and automatically predict future demand. They will build a prototype system and field test it in Uganda to evaluate how well it avoids under- or overstocking products, and the cost-saving and time-saving benefits of having an automated stock management system.

Roice Fulton of the Denominator Group in Switzerland will test the value of blockchain, which is a decentralized secure database, for stakeholders such as distributors and health workers to record and monitor the movement of a vaccine along a supply chain, to ensure the availability of sufficient levels of working vaccines. Following the route of a vaccine from the producer to the patient would ensure its safety and allow for better monitoring of stock and supply chain performance, which would improve vaccine availability and help identify ways to increase efficiency and lower costs. Blockchain is an efficient and secure way to share information. They will test their approach in Tanzania, which has a fairly robust supply chain, by tailoring blockchain to integrate with existing platforms, and evaluate its ability to reliably monitor vaccines.

Jessica Vernon of Maisha Meds in the U.S. will develop a smartphone-based point-of-sale system and online ordering platform to better supply medications to the private healthcare markets across sub-Saharan Africa. Local private pharmacies supply important health care products to a large number of people, particularly those without employer-funded health care. However, they are often understocked, or stocked with poor quality or expensive medicines, and require cash payments. Because many pharmacy owners have smartphones, they are developing a point-of-sale system for Android devices that records information associated with each sale such as price, brand, and patient phone number. This will enable the shop owners to better manage their inventory and predict future demand, thereby improving their performance. They will also leverage partnerships with trusted suppliers and develop an e-Marketplace so that pharmacists can order stocks electronically based on these predictions. They will test their platform over nine months in selected pharmacies in Kenya.

Yuehwern Yih of Purdue University in the U.S. will develop a cloud-based digital tracking tool to record data from local health centers in Uganda on the health status of pregnant women and the turnover of their stock, as well as diagnostic laboratory data, to optimize ordering and improve the availability of medical supplies. They will develop applications mimicking the current time-consuming paper-based registry formats to digitally record the relevant data, and adapt a material requirement planning system, which is used in manufacturing to track parts and maintain stocks. They will test their approach in two Ugandan hospitals to evaluate its effect on the efficiency of ordering and maintaining supplies, and on patient health.

Lee Schroeder of the University of Michigan in the U.S. will develop a smartphone application that can be used by health centers in Ghana to request independent drivers to transport patient samples quickly and at low cost to laboratories for diagnostic testing. Current courier services in resource-poor settings, when available, can be unreliable or expensive. A 'sharing economy' approach to delivery, by hiring independent drivers online, could improve services and reduce costs. They will develop a simple application for different devices, and recruit and train health workers and drivers to use the application, and package and transport the samples. They will then pilot test their approach for timely delivery of excess samples to two district level hospitals.

T.J. Corcoran of Hemalytics LLC in the U.S. will create a platform incorporating a web portal and smartphone application to track patients and their samples during diagnostic testing in low-resource settings to ensure they receive the results, and in a timely manner. They will develop a suite of mobile health tools for storing encrypted patient and sample data, capturing test results in the laboratory, and notifying patients and health workers of the results. They will test their platform using patients, laboratories, and administrators located in different cities in the U.S. This approach will help interconnect patients, health workers, and diagnostic laboratories, and thereby improve disease management.

Jonas Oddur Jonasson of MIT Sloan School of Management in the U.S. and collaborators will develop a more cost-effective method for transporting clinical samples between health centers and diagnostic laboratories in low-resource settings. In most countries in Southern Africa, sample transport is uncoordinated and leads to regular unnecessary trips, resulting in higher costs and long delays in disease diagnosis. They will develop an algorithm that uses the numbers and locations of samples needing to be transported each day to design optimal courier routes, and test its effect on cost and turnaround times using historical data in Malawi. They will also evaluate hardware devices for health workers to communicate collection requests to sample transport operators. They will run a pilot test of their system in Malawi to evaluate usability and the value of optimizing transport routes.

Charles Mace of Tufts University in the U.S. will develop paper-based cards to improve the collection, storage, and transport of blood samples from remote areas to diagnostic laboratories in low-resource settings. Dried blood spot cards are a low-cost and simple method for collecting and storing blood samples for analysis. However, they have a very basic design, which makes it difficult to control sample volume and elute specific types of molecules, which are needed to properly perform many diagnostic tests. To address this, they will improve the design and fabrication of the spot cards by patterning them with a specialized network of channels to trap the samples, and incorporating complementary materials to separate specific components of the blood. They will evaluate the manufacturing, storage capacity, and performance of their device using clinical samples in the laboratory.

Bhushan Toley of the Indian Institute of Science in India will develop a device that protects DNA specimens from destruction during transport to laboratories for diagnosis of infectious diseases. Sputum, urine, and blood contain the DNA of infectious agents that can be used to diagnose diseases to aid treatment and help prevent spread. Diagnosis is generally performed in specialized laboratories, but the DNA can be damaged during transport from remote locations due to the length of time it takes or exposure to high temperature. Drying the samples would help protect the DNA but this requires a sterile method that can handle larger volumes of multiple types of specimen. They will develop a device incorporating microfluidics for spreading out large-volume samples onto a porous paper membrane for rapid drying. They will test various agents for coating the membrane to stabilize the DNA and keep it sterile. They will optimize the design and test its ability to detect tuberculosis in clinical sputum specimens from infected patients.

Jim Duggan of the National University of Ireland, Galway, in Ireland will develop a simulator for public health supply chains in low- to middle-income countries that incorporates the stakeholders and steps needed to provide health care products from the manufacturer to the individual under different conditions, to optimize their performance and ultimately improve health. A key challenge is to ensure that the right medicines are available when needed, particularly when demand is high, for example during epidemics. The supply chain model will be built using the systems dynamic tool and tested in collaboration with public health professionals for its ability to improve the supply of health care products, and to support information sharing and decision making.

Agnes Mindila of the Jomo Kenyatta University of Agriculture and Technology in Kenya will develop a software application along with blockchain technology to monitor the supply chains delivering vaccines from the producers to the health workers to ensure good quality vaccines are available when needed. They will use blockchain technology, which involves digitally storing information in blocks that are shared across a network of computers and can be continually updated. They will also develop and test a software application so that everyone in the supply chain can access and record information about a specific vaccine to improve transparency and ensure the vaccine is authentic.

Ephrance Nuwamanya of Bushenyi Integrated Rural Development (BIRD) in Uganda will improve routine immunization coverage in Uganda by developing a digital system for health centers to record births and vaccinations, send automated reminders and education messages to families via SMS, and monitor vaccine orders and supplies. Vaccinations can prevent many potentially deadly diseases. However, few children are properly vaccinated across many sub-Saharan African countries, and there is no effective way to monitor vaccinations and educate families. To address this, whey will optimize their digital system for data collection and management of newborns and vaccinations, and integrate it with existing databases and hospital management systems. They will pilot test their approach in three district health centers in rural Uganda by teaching the health workers and local communities about their vaccination and information management system (VIMS), and evaluating its impact on the timeliness and coverage of vaccinations.

Olorunsogo Adeoye of the African Field Epidemiology Network in Nigeria will set up an immunization tracking system based on SMS in Nigeria to register children's immunizations, send out reminders of vaccination schedules, and educate families on the importance of routine childhood immunizations. Late or missing vaccinations are a major cause of morbidity and mortality particularly in developing countries. Poor vaccination coverage is due in part to a lack of information given to families on the importance and time-sensitivity of vaccinations and on the recommended schedules. They will develop an SMS-based tracking tool to work with an existing health management system so that health facilities can record each child's data, and SMS reminders can be regularly sent to families and health facilities to inform them when vaccinations are due. Automated voice jingles and messages will also be designed to provide families with useful information. Their system will be tested using 20 health facilities in Sokoto State in Nigeria where 2014-15 records show that none of the children in 40 districts received the complete set of vaccinations.

Robert Steinglass of JSI Research & Training Institute, Inc in the U.S. will teach community members to use traditional methods such as a drum to signal the arrival of a vaccination team to villages in India to improve vaccination coverage. Children in remote villages are vaccinated by outreach services. Although visits are scheduled on specific days, they often change, and there is no simple way to inform all the relevant families. Sound can travel long distances and is used to call communities together in many cultures. They will pilot test their approach over 12 months in a remote and hilly district in India, and train health workers and a community member to use a culturally-acceptable sound to alert the villagers to the arrival of the vaccinations. They will evaluate its effect on timely vaccination coverage.

Diana Negoescu of the University of Minnesota in the U.S. will ensure routine vaccinations are given to infants during the first year of life in resource-limited settings by providing free, shared transportation to medical centers, and text message reminders. In low-resource countries, public transportation, if available, is often unreliable and infrequent. However, newborns require regular, on-time vaccinations to prevent a variety of potentially deadly diseases. Network transportation providers such as Uber for cars and Safeboda for motorbikes have recently been implemented in Kampala, Uganda, and provide a potential solution. To determine the feasibility and value of free transportation and timely reminders, they will conduct a survey in Kampala to collect information on the associated costs, practical issues, and potential impact on vaccination coverage and infant health.

Marc Mitchell of D-tree International in the U.S. will develop an application that enables community health workers in Zanzibar to register children for immunizations before they are born, to ensure all children are vaccinated on time. Children are currently registered when they are already around four weeks old and only at health facilities, which excludes a lot of children born at home. They will build on their existing program in Zanzibar to develop the mobile phone technology used by Community Health Volunteers, who engage with pregnant women in their homes, for registering infants in the third trimester, generating immunization plans, and providing a support tool to educate mothers on the importance of timely vaccinations. They will test their application in the field by recruiting 100 health volunteers and evaluating immunization levels and timing in around 500 infants.

Pratyusha Pareddy and Manoj Sanker of the Centre for Healthcare Entrepreneurship in collaboration with NemoCare Wellness in India will develop a small, battery-operated wearable device for newborns that continuously monitors vital signs in premature babies to alert health workers when a life-threating situation might occur, and provides vibration to stimulate breathing. Premature babies are susceptible to a variety of potentially fatal conditions such as apnea (suspension of breathing) and hypothermia. The lack of sophisticated monitors for these conditions in resource-poor settings means that nurses often have to continually check up to 40 babies, which makes timely detection very challenging. They will design and build a prototype made of soft fabric to fit snugly on the child's foot, and incorporate a photoplethysmography sensor, which measures rate of blood flow, and a thermistor to measure temperature, as well as an audio-visual alarm. A platform will also be developed for wirelessly connecting multiple devices to a hub installed at the nurses' station, which is also fitted with an alarm. They will compare their prototype with currently used monitoring devices in the laboratory, and perform a small-scale field trial to get feedback from health workers and mothers.

Prem Mony of St John's Research Institute in India along with the Indian Institute of Science, Bangalore, will develop a temperature sensor to be worn by caregivers during kangaroo mother care of infants up to four weeks old combined with a mobile device to transmit data for analysis and real-time feedback. Kangaroo mother care involves continuous skin-to-skin contact with the mother to keep the infant warm, and is particularly valuable for protecting preterm infants. However, how long and how often it is actually used in the home, and thus its value, has been difficult to quantify. They will build a mobile phone application and establish a data-monitoring platform that can be combined with their wearable, energy-independent temperature sensor, which has already been tested in India. They will also add visual or audio alerts to remind mothers to use kangaroo mother care, and alert them when the baby's temperature gets too high or too low. Their approach will be tested in a small-scale clinical trial of 30-40 mothers.

Craig Goergen, Kirk Foster and George Wodicka from Purdue University together with David Reuter from Seattle Children's Hospital in the U.S. will develop a wearable sensor that can automatically measure blood pressure and body position, and transmit the results to a medical unit to identify pregnant women at risk of developing preeclampsia in remote, low-resource settings. They will develop smartphone-based automation for the well-established supine pressor test, which predicts preeclampsia based on an increase in blood pressure when changing position from lying on the left side to lying on the back. They will build and test a prototype using a non-invasive blood pressure monitor that can transmit results to a smartphone that will then integrate with a wireless accelerometer to determine body position. The team will build, test, and refine their device using healthy and pregnant volunteers. The team’s ultimate goal is to optimize test specificity by ensuring meticulous execution, and to improve test sensitivity by performing the diagnostic assessment longitudinally during the second half of pregnancy.

Friso Postma of the Early Signal Foundation in the U.S. will develop algorithms to translate biological data from wearable sensors on pregnant women such as temperature and heart rate to identify patterns that predict the onset of labor, to help get women in remote settings to health clinics in time for birth. They will select an existing wearable sensor to semi-continuously collect information on multiple factors such as gait, sleep architecture, and blood pressure of 60 Belgian women in the third trimester in their home. They will build infrastructure for data storage and a clinical support network, and analyze the data to identify features that can accurately predict labor.

Debra E. Weese-Mayer, Roozbeh Ghaffari, John A. Rogers, Matt Glucksberg, Aaron Hamvas, Mark Fisher, Bill Grobman and Casey Rand of the Ann & Robert H. Lurie Children's Hospital of Chicago and the Center for Bio-Integrated Electronics at the Simpson & Querrey Institute, Northwestern University in the U.S. will develop a skin-like sensor for newborns that improves the value of kangaroo mother care (KMC), which is a method used to maintain skin contact with the mother to keep the baby warm. Kangaroo mother care is particularly useful for premature babies in low-resource settings, but it is difficult to monitor how often it is used once the mothers have gone home. They have developed a wearable, ultrathin sensor adapted to delicate newborn skin by fusing soft, stretchable bioelectronics that can measure multiple physiological parameters such as breathing rate and temperature non-invasively through the skin. The device also emits audio and visual alerts when potentially dangerous values are detected, and can store and transmit data wirelessly for clinical monitoring and analysis. They will adapt the sensor to also detect motion and develop it for use during kangaroo mother care. The device will be tested for usability on a panel of mothers and nurses in a clinic in South Africa, and for accuracy in a U.S. based medical center.

Ratul Narain of BEMPU Technologies in India will create a sleeve that can be simply attached to slings used for kangaroo mother care, which is a continuous skin-to-skin contact method of care for newborns suited to low-resource settings, to measure and encourage use. Kangaroo mother care is particularly beneficial for preterm and low-weight babies as it maintains their body temperature and thereby avoids hypothermia and promotes weight gain. However, in India, uptake in the home is low, which appears to be due in part to the lack of real-time feedback for mothers showing how it is helping their baby. They will make the attachable sleeve, known as Kangagrow, containing mechanical force gauges and an audio-visual interface displaying a colored flower that gradually blooms during the continual use of kangaroo mother care to demonstrate to the mother and family that their efforts are providing what is essentially 'nourishment' to the baby. It will also contain a safe power source that doesn't require charging over the 30-day neonatal period. They will verify its accuracy in a hospital setting, and perform a multicenter trial of 100 mothers to see whether it promotes newborn weight gain and growth.

Soumyadipta Acharya of Johns Hopkins University in the U.S. will develop a technology they call NeMo (neonatal monitoring), for families in low-resource settings to monitor their newborns at home to help them identify potentially severe illnesses. Infant mortality rates are highest during the first week of life, and in developing countries are largely caused by treatable diseases such as pneumonia or sepsis. To help families detect these conditions they are developing a device that comprises a low-cost, paper sensor that can be placed on the infant's abdomen to measure respiratory rate and temperature, and a smartphone application that uses audio and visual cues to enable a family member to clinically assess the infant. The measurements and assessments together are then used to alert the family to dangerous conditions and connect them with a health worker. They will develop training methods and perform a pilot test of their device in Uganda to analyze usability.

Gregory Goldgof and Elizabeth Winzler of the University of California, San Diego in the U.S. will use a genetically modified drug-sensitive yeast strain to quickly and inexpensively identify the cellular target of compounds that can kill the parasite Cryptosporidium, which is a major cause of diarrhea-associated deaths of young children in developing countries. Currently, there is only one treatment available and it is of limited use in some of the more severe cases. The yeast strain has been modified to lack transporter proteins that remove toxic compounds from the yeast cells. By treating the modified yeast with a selection of compounds that can kill Cryptosporidium, they hope to drive some of the yeast cells to develop resistance by mutating genes that are responsible for the drugs activity. By sequencing the resistant yeast using whole genome sequencing, they can then discover the likely target of the drug and how it kills the parasite. This would help to develop new drugs that may be more effective.

Hayley Dickinson of Monash University in Australia will evaluate the spiny mouse, which is the only rodent that naturally menstruates, as a new animal model for developing and testing contraceptives. Menstruation is an essential feature of human reproduction, and is regulated by hormonal contraceptives. However, current contraceptives like the contraceptive pill can cause side effects such as anxiety and low libido. A small animal model that mimics human menstruation would be valuable for testing new contraceptives that have fewer side effects. The menstrual cycle of the spiny mouse, like that in humans, involves progesterone production from a transient endocrine gland. These mice also display cycles of anxiety behavior similar to premenstrual tension. They will validate it as a model for contraceptive drug discovery by analyzing the effects of current human contraceptives on fertility, hormonal profiles, vaginal cytology, and behavior.

Francisco Diaz of Pennsylvania State University in the U.S. will develop a high-throughput screening method to identify compounds that can block two biological events essential for female fertility without affecting ovulation or hormone production in order to identify new contraceptives with fewer side effects. These two events, which occur at the same time, are cumulus expansion, whereby cumulus cells release from the oocyte to enable it to enter the oviduct, and oocyte maturation, whereby the oocyte divides to produce the egg and a smaller polar body. They will extract cumulus oocyte complexes from primed female mice and apply them to a microwell array prototype that will contain 1,024 wells coated with different test compounds and connected in groups by microfluidic channels. Oocytes in the wells will be stimulated to undergo first cumulus expansion, and, after removal of cumulus cells, oocyte maturation. The ability of each compound to inhibit each step will be assessed by automated inverted microscopy. They will first optimize their platform using known inhibitors and then test it using a library of 1,200 FDA approved molecules.

Randall Peterson of the University of Utah in the U.S. will develop a zebrafish model for high-throughput screens to identify compounds that inhibit the formation of gametes, i.e., sperm or eggs, (gametogenesis), which could lead to male and female contraceptives that last for weeks or months after only a single dose. They will generate transgenic zebrafish lines that express a selection of four fluorescently-labeled markers for different stages of gametogenesis that can be rapidly quantified to measure the effects of candidate compounds on blocking gamete production. The suitability of these zebrafish lines for high-throughput multi-well compound screens will be tested using known inhibitors of gametogenesis.

Maria Gallo of Ohio State University in the U.S. will adapt a validated computer-based psychological test known as the Implicit Association Test to measure the true opinions of women in Vietnam on hormonal contraceptives in order to encourage use. Vietnam has one of the highest rates of abortion worldwide. Although hormonal contraceptives are available, it is thought that many women are worried about using them and instead use alternative methods that are generally less effective. Finding out exactly what these women think about hormonal contraceptives in order to dispel any myths is challenging because many people either don’t say or don’t realize what they think for a variety of social and psychological reasons. The Implicit Association Test overcomes this challenge by measuring the strength of the associations an individual makes between two pairs of contrasting concepts based on speed. They will adapt the test to determine opinions about the intrauterine device and oral contraception by measuring the strength of their associations with good or bad, and natural or unnatural. This will be tested using a cross-sectional study of 500 non-pregnant females.

Fiona Gannon of GOAL in Ireland will use mobile technology to conduct surveys of young people aged between 18 and 20 years old in urban regions of Sierra Leone to find out their opinions on contraceptives in order to promote more widespread use. They will develop the survey and advertise and deliver it directly on Facebook to encourage participation. Mobile phone airtime will be offered via mobile money agents as incentive to complete the survey, which will also ensure participants are the right age and from the right area. Participants will also be invited to be part of a collaborative brainstorming event – a hackathon – involving fun and interactive activities to help develop new family planning solutions that work better for their age group.

Darryl Russell of the University of Adelaide in Australia will develop a scalable in vitro screening assay that can automatically evaluate adhesion in the cumulus-oocyte complex, which is required to release the oocyte from the ovary for fertilization, to help develop new contraceptives. These contraceptives would specifically block ovulation, and thus likely have fewer undesirable side effects than those that alter hormone levels such as the contraceptive pill. They will isolate cumulus-oocyte complexes from mice, culture them with collagen, and quantitate their adhesion in a 96-well plate format using an automated assay that measures electrical resistance. They will select libraries of compounds known to influence cell adhesion to test their screening platform and identify drugs that potentially block ovulation. These will then be tested in human cumulus cells. They will also use short hairpin RNAs in mice cumulus-oocyte complexes to inhibit the genes that are switched on when ovulation is stimulated, and analyze the effect on adhesion using their quantitative assay. This could uncover the biochemical pathways required for ovulation that may also be useful for contraceptive development.

Isabel Cruz of the University of Illinois at Chicago in the U.S. will build an ontology-based data integration framework that can predict where malaria incidence is likely to increase or decrease in Zimbabwe, to better target elimination efforts. Eliminating malaria requires being able to monitor the changing patterns of infection risk across an entire region, which is affected by multiple factors including the location of health centers, temperature, rainfall, type of landscape, and population distribution. Integrating these data is difficult because they come from different sources and are measured at different scales (resolution). Also, monitoring how a disease changes over space and time has been particularly challenging. They will develop methods using string matching to first translate the data into a common spatial data format, and then ontology matching to integrate the data. They will also introduce a novel resolution method that addresses uncertainty in spatial and temporal resolutions. These will be used for mapping a pilot region, and tools will be built to identify and visualize patterns of malaria progression in time and space.

Aurelien Forget of the University of South Australia in Australia will develop a three-dimensional bioprinted model of the fallopian tube (oviduct) as a screening platform to identify compounds that specifically block sperm activation for developing a female contraceptive that targets male sperm. This contraceptive could in principle be taken before or after intercourse, and would pose no risk to male fertility as it is taken by the female, or to female fertility as it targets a male-specific process. It should also avoid the side effects associated with classical hormonal contraceptives. Sperm first need to be activated (capacitated) in the oviduct before they have the ability to penetrate the cells and protein layer surrounding the egg in order to fertilize it. To reproduce this process in vitro, they will isolate oviduct cell populations from mice and use their synthetic, printable extracellular matrix to build a three-dimensional oviduct that reproduces the four-layered structure. They will assess cell viability and function in their assembled oviduct, as well as its ability to capacitate mouse and human sperm.

Takudzwa Sayi of the University of South Florida in the U.S. will use journey mapping to discover women’s experiences and responses to hormonal contraceptives, as well as their interaction with providers, in Zimbabwe to help design new contraceptives. They will also hold focus group discussions with family planning providers to find out their views on the uptake of specific methods. They will enroll women and providers in rural and urban areas across Zimbabwe. The journey mapping will involve a series of six sessions and will document from the time a woman chooses a contraceptive through her experience of side effects and how she interacts with the providers. They will validate their approach by comparing it to results from standard survey methods.

Christine Valente of the University of Bristol in the United Kingdom will collect data on quantitative beliefs of women in Mozambique on contraceptive use to measure the relative importance of factors such as fear of side effects that inhibit use in order to help implement more effective methods. Many women in Mozambique avoid contraceptives, but the reasons, and importantly how women value those different reasons, remain unclear. They will design and conduct a survey to quantify key beliefs on contraceptives among around 700 women who do not want to become pregnant within two years from three provinces in Mozambique. This will enable them to identify ways to correct any false beliefs, such as by providing specific information on the risk of pregnancy in the absence of contraception, to increase contraceptive use.

Hope Neighbor of Camber Collective in the U.S. will use applied behavioral research to better understand how and why young, sexually active women who are approaching marriage in West Africa make decisions on family planning products. Women appear to regulate their fertility differently based on their specific situation and needs. Young women who are not yet married tend to use unsafe or ineffective practices such as herbal remedies and abortion. They will recruit women in this group to fill out journals to generate evidence on the nature of their fertility planning needs and identify specific attributes of contraceptives that would fit better into their daily lives. They will also develop hypothetical prototype contraceptives by involving the participants in a card game to identify ways of modifying existing contraceptives, such as enabling over-the-counter availability, and key attributes for future contraceptives that better suit their needs.

Emmanuel Roux of the French National Research Institute for Sustainable Development in France will develop a method to standardize malaria datasets from different countries so that they can be used to monitor the disease across borders, which is crucial for elimination. They will co-design domain ontologies with relevant experts to bridge heterogeneities and standardize metadata across existing national surveillance databases, and use generic tools to extract data on individual disease incidence in cross-border areas to build a cross-border database. They will evaluate their method at the border region between French Guiana and Brazil by providing health agencies and researchers access to the harmonized cross-border database via a web application. They will also test its accuracy at the border between Columbia, Peru and Brazil.

Jonathan Jackson of Dimagi in the U.S., together with James Faghmous from the Arnhold Institute for Global Health, Icahn School of Medicine at Mount Sinai, will develop an open platform that combines real-time data on health, climate, and the environment at high resolution, and near real-time satellite data to inform on population density, in order to detect areas containing limited information (cold-spots) on malaria so that control programs can better allocate resources. Current efforts suffer from the absence of up-to-date information and the difficulty of predicting when and where interventions are needed. Platform development will be conducted in collaboration with academia and the private sector, and will be designed to use existing data recorded on mobile devices, which contain GPS data. The platform will be designed to use existing data recorded on mobile devices, which contain GPS data. These data will be supplemented by designing a machine-learning approach to extract population density from global satellite data. They will test the accuracy and usability of their software in Senegal.

William Witola of the University of Illinois in the U.S. will help develop new drugs for treating children infected with the protozoa Cryptosporidium by using a gene knockdown approach to evaluate candidate drug targets. Found in contaminated water, Cryptosporidium is the second most common cause of potentially lethal diarrhea in young children in developing countries. There are no safe and effective drugs available due largely to the lack of genetic tools for studying Cryptosporidium in the laboratory. Phosphorodiamidate morpholino oligomers (PPMOs) are small molecules that can be designed to bind and silence specific genes also in protozoa. If these genes encode for proteins critical for vital cellular functions, the PPMOs can cause death. To evaluate his approach, he will design PPMOs and test their ability to silence essential Cryptosporidium genes and thereby block chronic infection in mice.

Martin Matzuk, along with Nicholas Simmons of Baylor College of Medicine in the U.S. and Masahito Ikawa of Osaka University in Japan, will build a male contraceptive drug discovery platform comprising a library of two billion small compounds generated by DNA-Encoded Chemistry Technology (DEC-Tec) at relatively low cost, and a panel of male-specific fertility proteins. Contraception options for men are currently limited to condoms or vasectomy. A safe, low-cost small molecule contraceptive similar to the female ‘pill,’ could also help men to better control family planning. They are using the CRISPR/Cas9 mutagenesis strategy to identify new genes essential for male fertility in mice. For ten of these new genes, they will synthesize the corresponding fertility proteins and test them for binding to the compounds in their new, expanded DNA-tagged drug library.

Paul Crits-Christoph and Chelsea Morroni of the University of Pennsylvania in the U.S. will develop a mobile phone application that enables women to identify the method of contraception best suited to their needs to help reduce the number of unwanted pregnancies in Botswana, which is currently estimated at 44%. Although around 61% of women are reported to not want any more children, the most commonly used contraceptives are single use, such as condoms, despite the availability of longer-term measures like intrauterine devices. They will work together with individuals in Botswana to compile a list of 10-20 attributes valued by women in a contraceptive, such as duration of protection and ease of use, and program existing software to identify a woman’s preferred choice using a simple series of questions. The application will then be used to test their hypothesis that the method of contraception most suited to an individual is different to that being prescribed by health workers in Botswana.

Xun Suo of China Agricultural University in China will develop a rabbit model of cryptosporidiosis that mimics the human disease, which presents as severe diarrhea particularly in young children, to help identify new treatments. Current animal models of infection by the parasite Cryptosporidium are suboptimal: mice are not naturally infected, while pigs and calves can be infected but are expensive and more difficult to manage, and none show the same symptoms as humans. Rabbits are naturally infected by Cryptosporidium and display human-related symptoms. They are also practical to handle and breed, and are relatively inexpensive. They will isolate infective oocysts from diseased rabbits in the wild, and establish the infection in the laboratory. They will also devise protocols to evaluate the disease such as scoring the severity of symptoms, and sequencing the parasite strains. The value of their model as a screening platform for identifying new drugs will also be tested.

Marion Sumari-de Boer and Kennedy Ngowi from Kilimanjaro Clinical Research Institute in the United Republic of Tanzania and Rosalijn Both from Segel Research and Training Consulting in Ethiopia will use mobile phones to learn about the contraceptive needs and behaviors of young unmarried men in Ethiopia and Tanzania in order to promote the use of contraception. This group is mostly overlooked in studies aiming to improve contraceptive and family planning practices, even though their behavior is directly relevant. They will recruit a diverse group of men aged between 18 and 29 years old and collect data by sending them weekly SMS messages containing specific questions. They will also conduct regular interviews and group discussions to identify contraceptive practices and needs.

Edward Thomsen of the Liverpool School of Tropical Medicine in the United Kingdom will build an open-source software platform tailored to support efforts to eliminate malaria by amalgamating desirable features from two existing disease data management platforms. The Disease Data Management System (DDMS) is an existing platform that integrates multiple datasets and supports operational decision-making through unique functionality such as automated outbreak alerts. In contrast, the District Health Information Software 2 (DHIS2) is a well-established platform that is the preferred solution for managing aggregated and individual case data. It has a large user-base and powerful analytics interface. They will develop software to modify DHIS2 with the desired features of DDMS and evaluate the performance of their integrated platform over one year in a malaria control program in Zambia.

Samuel Arnold of the University of Washington in the U.S. will develop methods to evaluate drug candidates for treating Cryptosporidium infections, which cause severe diarrhea particularly in young children from developing countries. There are no effective drugs against the Cryptosporidium parasite. This is partly because when it infects humans it becomes isolated in specific cells lining the gastrointestinal tract, which is where a drug would also need to be located at sufficient concentrations to be effective. However, the standard in vitro models are unable to easily and rapidly predict the efficacy of multiple drug candidates at this specific location. To address this, they will build a cell model of the intestinal wall that can also be infected with Cryptosporidium, and measure the permeability of a panel of protein kinase inhibitors that they have developed to kill the parasites. They will also use the software platform Gastroplus that can simulate the behavior of a drug once it has been administered and predict concentrations at multiple sites in the gastrointestinal tract. They will evaluate their method for predicting drug activity in vivo by testing the drugs in a neonatal mouse model of Cryptosporidium infection.

Thomas Churcher of Imperial College London in the United Kingdom will develop an analytical method to more accurately determine the origin of new cases of malaria in regions with low levels of the disease, which is critical for elimination efforts. Current methods are unreliable as there are no standardized criteria and they often rely solely on interviews. They will use routinely collected travel history data and disease maps to develop rigorous methods for estimating whether a case of malaria is either acquired locally or imported from another region. The accuracy of their method will be tested by comparing it with available data from Swaziland.

Olga Tosas Auguet of the University of Oxford and collaborators at the Modernising Medical Microbiology Consortium, Guy's and St Thomas' NHS Foundation Trust, Oxford Genomics Centre and London School of Hygiene and Tropical Medicine in the United Kingdom, and Oxford Tropical Network Overseas Programs in southeast Asia and Africa, will develop a new approach for the large-scale surveillance of bacterial antibiotic resistance in low-income settings. Current methods mainly involve the collection and analysis of individual clinical samples, which requires diagnostic equipment often unavailable in developing countries. They will pool together ~300 samples of rectal swabs and stools taken from biobanks, and analyze each pool by shotgun sequencing to identify the abundance of bacterial species and antibiotic resistance genes. They will use these data to calculate resistance potential and to determine how accurately this metric approximates the numbers of infections in a population that are resistant to a specific antibiotic.

Jan Mead of Emory University in the U.S. will develop a mouse model of cryptosporidiosis using human fecal transplants to mimic changes in the bacterial populations (microbiome) in the gut that occur in the human disease, which causes substantial morbidity and mortality in young children from developing countries. Drugs used to eradicate the intestinal parasite Cryptosporidium are thought to be affected by the levels and types of bacteria that populate the human gut, which is of particular importance in malnourished children who most often become infected. They will colonize germ-free mice with human fecal material and infect them with Cryptosporidium. The effect of the infection and of selected drugs on the microbiome will then be evaluated by DNA sequencing.