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UK-China Agritech Challenge - Utilizing Earth Observation and UAV Technologies to Deliver Pest and Disease Products and Services to End Users in China

UK - Department for Business, Energy and Industrial Strategy (BEIS)

(KCL) This project aims to develop time-series tools for pest and disease monitoring, forecasting and management in China, providing service products at national and local levels to enhance pest and disease control of wheat rust and locusts in particular. It will also develop advanced UAV-based tools that provide more efficient spraying of control measures (biopesticides) to provide alleviation of these problems without causing chemical pollution. In this context, the King's team will be developing ways to downscale satellite-based maps of land surface temperature to scales more akin to those of the fields within which the crops grow, in order to aid the development of mathematical models that can be used to forecast and monitor the efficacy of the bio-control measures and the spread of wheat rust. They will develop UAV-based methods to deliver maps of crop parameters from aerial imagery, which will be used to help both development of the downscaled satellite datasets and to provide an understanding of the crop structures that can be used to help in the development of the spraying technologies and planning tools that will be developed for the aerial platforms. Finally they will also develop methods to remotely sense locust surface temperatures from thermal imaging, in order to contribute to the development of better models of locust internal body temperature upon which the final mathematical models of bio-pesticide development rate depends. (Loughborough) Our proposal aims to develop a long term sustainable innovative partnership in agriculture technology between the UK and China through a comprehensive approach to deal with these two major agricultural pests/diseases. It will do so from a monitoring,forecasting and management perspective, combining cutting edge technology, modelling and biological information.The project is structured under six work packages that follow the cycle of a dynamic Agri-Tech service: observe to understand the nature of the problem and locate the pest/crop problem (WP1), orientate through development of forecast models to provide strategic risk awareness (WP2), decide providing useful information where to control pests at national and local levels (WP3), and act locally using precise application of bio pesticides via UAV deployments (WP4). The scopeof the project primarily falls into Agri-Tech Challenge 1 ""Precision agriculture, agriculture digitisation and decision management tools"" but also makes significant contributions to Challenge 2 ""Improving the efficiency of sustainable agriculture"". A key theme is to develop technologies for integrating data collected by UAVs, earth observation satellites,and bioscience applications related to disease/pest modelling. The project will develop autonomous and smart planning tools for agricultural remote sensing and plant protection, ultimately for the benefit of end users to reduce the cost and improve the effectiveness of their operations. One of the key outcomes is the development and application of novel technical systems for the monitoring and prediction of crop disease/pest outbreaks, As a novel technology, biopesticides treatment of orthoptera will be investigated and demonstrated, along with the modelling and prediction of yellow rust and orthoptera, real-time remote sensing methods will facilitate time specific and site specific treatment along with improved general farming management. Combining this with the work on biopesticides will significantly reduce the use of chemical pesticides and the risk of the development of crop's resistance to them, and will increase biodiversity due to lack of chemical pesticides. In addition to these benefits, the project will open up new business opportunities for both the UK, and Chinese industrial partners outside of China.

Programme identifier:

GB-GOV-13-FUND--Newton-BB_S020977_1

Start Date:

2019-02-14

Activity Status:

Implementation

Total Budget:

£330,703.55


Development of antimicrobial peptides against Gram-negative antibiotic resistant pathogens

UK - Department for Business, Energy and Industrial Strategy (BEIS)

The underuse and overuse of antibiotics has resulted in Gram-negative bacteria becoming resistant to known antibiotics. Although this is a global problem, the lack of new antibiotics and alternative therapy is of concern especially in SA, where patients with a weakened immune system, such as those with HIV, are highly susceptible to infection. The diagnosis of Gram-negative infections is often difficult, especially when these occur deep in the body. The resistance to antibiotics used to treat these infections makes the situation worse as the infection progresses undetected and so both new antibiotics and new ways of monitoring the success of treatment are urgently needed. This is a global crisis and only through an international collaborative scientific effort, will new antibiotics be discovered. An important aspect of this process is to build capacity in peptide based antibiotic drug discovery. A focus of such an endeavour is to provide scientists from historically disadvantaged backgrounds and institutions in SA the opportunity to be leaders in this field of research. Through this process, the training of the next generation of scientists is essential to ensure a continued success to find novel approaches to combat the perpetual threat of evolving bacterial infections, especially in the context of unique health care challenges in South Africa. One such approach is based on using antimicrobial peptides (AMPs), nature's own antibiotics which have remained effective throughout evolutionary history, but which have yet to make a breakthrough into clinical use. AMPs are key components of the innate immune system of a huge variety of living organisms, including humans, and have the ability to eradicate infection. Now, to show that AMPs can be developed as antibiotics for therapeutic application in patients we will learn how to modify them to increase their safety and stability. We will also ensure that they are more likely to work in patient by testing them in conditions that match more closely the patient infection setting. Existing methods of laboratory antibiotic testing are deficient as they often under- or over-estimate the potency of different types of antibiotic, most notably AMPs . As well as treating patients, we want to use AMPs to monitor their recovery or tell us when other antibiotics should be given. We will adapt imaging techniques, recently developed to study brain activity or find tumours and reveal the success of radio- and/or chemo-therapy. AMPs can be modified to carry a radioactive tracer and will circulate around the body before homing in on the bacteria causing infection. The tracer that is attached is used for either positron-emission tomography (PET) or single-photon emission computed tomography (SPECT) where a relatively low, and hence safe, dose of gamma rays is emitted. The intensity and location of the PET or SPECT signal can be mapped in the body in three dimensions to give the location and extent of any infection and to signal when, e.g. a localised infection starts to spread around the body. Since AMPs selectively target bacteria radiolabeling can provide a rapid, noninvasive method for infection imaging and with the correct antibiotic treatment, rapid patient recovery with reduced risk of antibiotic resistance development. Through Newton funding a UK and SA collaboration will be established to accelerate the innovative discovery of new AMP-based antibiotics. Through increased mobility and exchange of UK and SA researchers from UP, NWU and SMU, links between researchers in both countries will be strengthened and new partnerships will be developed with the possible establishment of a global pre-competitive drug discovery consortium. This process has a further benefit and that is the strengthening of the strategic relationship between the UK and South Africa.

Programme identifier:

GB-GOV-13-FUND--Newton-MR_T029552_1

Start Date:

2020-04-01

Activity Status:

Implementation

Total Budget:

£0


The Malaysian GestatiOnal Diabetes and prevention of DiabtES Study (MY GODDESS)

UK - Department for Business, Energy and Industrial Strategy (BEIS)

Gestational diabetes is a condition that occurs during pregnancy when the blood sugar is higher than it should be. After the baby is born, the blood sugar returns to normal. The number of women in Malaysia that develop gestational diabetes is about 50,000 each year and these numbers are increasing with the worldwide epidemic of obesity. Around half od the women with gestational diabetes are likely to develop either type 2 diabetes or pre diabetes within 10 years. In other words, these women who are child-rearing and who may also be working outside the home, are developing diabetes in their 30s and 40s, almost 20 years before the average person. Gestational diabetes leads to further health problems and the baby can be born big-for-dates which increases his/her chances of developing type 2 diabetes later in life. Malays, Indian and Chinese Malaysians are all at high risk for getting diabetes. The chances of getting type 2 diabetes could be significantly reduced if women made lifestyle changes to lose weight and increase their physical activity. This can be very difficult with modern lifesyles and demands. Also getting gestational diabetes is usually a very upsetting experience because the mother feels guilty and also worrying about the health of her baby. There have been trials, mainly in North America, testing different types of lifestlyes but the findings from these trials are not clear cut. There have been no trials reported in Malaysia. We still do not know what kind of support women would find the most helpful. King's Health Partners has one of the largest clinical and research units for diabetes. We have been developing new approaches to supporting women with gestational diabetes (led by Prof Angus Forbes and Pro Helen Murphy). Our interviews with women with gestational diabetes showed that women in the UK have a poor understanding of their risk of developing diabetes and we think this might be the same for women in Malaysia. They also did not know how best to lower their risk and worried that exercise and different diet might harm their baby. We also found that women became very upset, guilty and burdened after they were told they had gestational diabetes. This project is called MY GODDESS and we aim to share the ideas and experiences of women in the UK and Malaysia. In the first set of studies, we will review the research already published and find out what works and what doesn't. We will focus on studies that uses digital technology such as apps, websites from the smartphone or computer. We will then interview women with a history of gestational diabetes and ask what was difficult about making lifestyle changes and what helped. We will then use use our shared knowledge as researchers and as patients to design a new treatment to support lifestyle change. We will consider ideas such as group sessions, lifestyle coaches text messages, and wearing devices that measure our step counts and heart rate. We will develop the MY GODDESS app which can be downloaded onto a smartphone. We believe that if we understand better how to harness the 'health power' in digital technology, we will produce stronger support systems to help women with GDM lead healthier lifestyles. The second project is to test our new treatment, MY GODDESS, in a small study to see if we could test our new could be conducted at a largerthat it does help women to make lifestyle changes. We will recruit about 50 patients. We will study how many women we could identify, who will be interested in participating and who will stay in the treatment to the end. We will ask women for feedback about their experience, what worked and what did not and any suggestions about improvement. By the end of the project if our findings are in the right direction, we will submit a proposal to conduct a full scale trial to test whether MY GODDESS works in a much larger sample of women across Malaysia.

Programme identifier:

GB-GOV-13-FUND--Newton-MR_T018240_1

Start Date:

2019-12-31

Activity Status:

Implementation

Total Budget:

£339,117.65


NIHR Global Health Research Groups: research call 3

UK - Department of Health (DH)

The NIHR's third Global Health Research call for Groups. UK universities and research institutes were invited to submit applications, working in equitable partnerships with researchers in low- and middle-income countries (LMIC), to develop their ambitions to deliver world-class applied global health research to address under-funded or under-researched global health areas specific to those countries. Global Health Research Groups are defined as a partnership of specialist researchers within universities and research institutes in LMICs and the UK: 1. Either new to delivering applied health research globally, or expanding to new global partnerships to deliver applied global health research addressing unmet needs in new health areas or geographies in ODA-eligible countries; 2. Who, through a planned start-up phase, will develop or expand equitable research partnerships and networks, to undertake LMIC-led needs analysis designed to refine relevant research questions and priorities through engagement with policy makers, evidence users and local communities, as appropriate; 3. Who will establish a new programme of applied health research delivered through ambitious, structured plans for e.g. scoping studies, needs analysis, economic analysis, pilot studies and potentially trials; 4. Who are able to develop the strength of the partnership to improve practice and inform policy based on scientific evidence; 5. Who will set up and deliver a focussed programme of capacity and capability strengthening at individual and institutional level appropriate to the respective goals.

Programme identifier:

GB-GOV-10-NIHR_GHRG3

Start Date:

2021-09-01

Activity Status:

Implementation

Total Budget:

£21,304,290.29


MAP-care: Multimorbid Ageing Primary Palliative Care in Ghana, Malawi and Zimbabwe.

UK - Department for Business, Energy and Industrial Strategy (BEIS)

What is the problem? People around the world are ageing, especially low and middle income countries. This presents a new challenge- how can we provide care that is focused on the person rather than the multiple illnesses that they are likely to live with? Long term illnesses are becoming more common as people age, and living with these multiple illnesses can present many symptoms, psychosocial and spiritual concerns. Survival can be unpredictable, and cure cannot be achieved for many conditions associated with ageing. What might be a solution? We are a group of researchers, doctors and nurses working in palliative care. Palliative care helps to reduce the burden of symptoms and concerns faced by people whose disease cannot be cured, and which will worsen leading to death. Palliative care focuses on the patient, their family rather than their disease. Because of this, palliative care has been recommended for people who are living within multiple illnesses. Most contact with health staff, especially in rural areas, is with primary care. Primary care offers a strong potential to improve the care of older patients and families who are facing serious multiple illnesses by delivering palliative care. What do we plan to do? We will work with patients, families, health staff and Ministry of Health to design a new way to deliver palliative care from within primary care for older patients with multiple serious illnesses. We will then try delivering this now way to deliver care within primary care, and find out if it is delivered in the way we expected and what patients, families and staff think of the new way of working. This will happen in Ghana, Malawi and Zimbabwe. We will do this in a number of steps. First, we will work with patients and families to find the best way for them to be able to give their thoughts and views on this study. Then we will talk to a range of patients, families and staff to get their views on how the new way of delivering care night look and how it could work. We then hold a meeting for all those people who are relevant to this goal (patients, families, clinical staff, clinical managers, Ministry of Health) to work together to build the new way of caring for patients> The research team will also use the information from patients, families and staff to work on a measure of care costs to ensure it is relevant for older people with multiples serious illness. Once these steps are complete we can then try delivering this model of care at a rural district hospital primary care service. Using questionnaires we will ask patients about their health and wellbeing and the quality of care they receive both before delivery. We will also have in-depth discussions with patients, families and staff to ask their views and experiences of the care, and to try and discover whether it worked in the way we planned. What do we hope will be achieved? We know that palliative care improves patient and family wellbeing and can also be cheaper than care usually received. In Africa, palliative care has not focused on the common diseases of older people. In our three partners countries we will move forward our understanding of how to expand the benefits of palliative care into primary care for older people with multiple serious illnesses. We will deliver a series of new advances: how to work with patients and families to inform work in this field; report the palliative care needs of older patients with multiple serious illnesses and staff views on how to meet them within existing settings; clear understanding and detailed description of how to achieve the care delivery from the views of all needed to engage for success; adapted questionnaire that will allow us to measure the costs of care for patients, families and the health system; views from those delivering and receive the care on what helps it to improve wellbeing and what makes it difficult; a revised ""manual"" on how to deliver for wider testing and rollout.

Programme identifier:

GB-GOV-13-FUND--GCRF-MR_T037660_1

Start Date:

2020-06-01

Activity Status:

Implementation

Total Budget:

£0


Cross Border Conflict Research Programme Lot 2

Chemonics International Inc

The objective of the programme is to improve effectiveness of HMG investments in fragile and conflict affected situations (FCAS), by providing real-time data, expertise and public good research to inform DFID and Whitehall policy and operations including through the Whitehall Conflict Security and Stability Fund (CSSF) and DFID programmes. The programme is broken into two separate contracts: Lot 1 (X-border conflict dynamics/response), and Lot 2 (Violent and peaceful behaviour). This contract is Lot 2 which is examines the drivers of peaceful and violent behaviour, and the conditions under which individuals, groups and societies can be encouraged to move away from violence and towards peace.

Programme identifier:

US-EIN-52-2145827-GB-GOV-1-300100-102

Start Date:

2020-04-07

Activity Status:

Implementation

Total Budget:

£3,168,049


SPHEIR Prepared for Practice

MedicineAfrica Ltd

PfP is addressing Somaliland’s health workforce crisis by transforming health education, putting practice-orientated learning, teaching and assessment at its centre. By the end of the project, there will be a new generation of prepared-for-practice graduates better able to meet the needs of the Somaliland health sector. MedicineAfrica acts as the technology partner on this project. MedicineAfrica runs and administer an online platform to facilitate distance learning. We also advice and consult on enhancing the e/learning experience for tutors and students along with supporting in various other project area.

Programme identifier:

GB-COH-07840888-MA001_PFP_Somaliland

Start Date:

2017-02-01

Activity Status:

Implementation

Total Budget:

£727,622.50


Understanding phenotype and mechanisms of spontaneous preterm birth in sub-Saharan Africa (PRECISE-SPTB)

UK - Department for Business, Energy and Industrial Strategy (BEIS)

Preterm birth, birth before 37 weeks of pregnancy, is a major cause of infant death and illness in sub-Saharan Africa. Over 80% of preterm births globally have been estimated to occur in sub-Saharan African (sSA) and Asian countries, the majority being due to women going into preterm labour spontaneously or their membranes (waters) rupture early (classified together as spontaneous preterm birth, SPTB). Despite knowledge of the global impact of SPTB, most of the research into this often devastating pregnancy outcome has focussed on pregnant women in high income countries such as the UK and USA. Much less in known about SPTB in women from low income countries. However, the underlying biological causes of SPTB are complex and heavily influenced by environment, nutrition, infection and other risk factors that pregnant women are exposed to. Region specific research is essential if we are to improve maternal and newborn healthcare in countries where the burden of preterm birth is highest. Addressing this need, we plan to study to clinical and social risk factors (from 5000 women recruited to the PRECISE Network pregnancy cohort, https://precisenetwork.org/) combined with biological markers of SPTB in the female reproductive tract, blood and placental tissue in women from Kenya, The Gambia and Mozambique. We will integrate these data to enhance our biological understanding of SPTB as well as identifying novel biomarkers relevant to sub-Saharan African populations to predict risk of SPTB. We will also create sustainable teams of SPTB researchers by training five new African scientists and supporting their supervisor as research leaders. We will, with colleagues in The Gambia, establish a bioinformatics training programme and a laboratory science network for our researchers in Sub Saharan Africa and the UK. We anticipate that this work will impact future strategies for clinical risk management, prevention and treatment that specifically addresses the needs of women in sub-Saharan Africa, as well as having potential relevance to SPTB globally.

Programme identifier:

GB-GOV-13-FUND--GCRF-MR_T03890X_1

Start Date:

2021-02-28

Activity Status:

Implementation

Total Budget:

£1,067,100.73


Improving mental health and human capital: developing a mental health intervention for 'Youth in Action' programme in post-conflict areas in Colombia

UK - Department for Business, Energy and Industrial Strategy (BEIS)

Colombia endured more than five decades of armed internal conflict leaving behind high rates of mental health problems among the Colombian youth. Conflict and associated mental health issues also cause great cost to human capital. These disorders are usually long-lasting and commonly co-exist with other physical/mental conditions. Despite these harmful consequences, there is little evidence of effective mental health interventions for helping young people affected by the conflict. Most services are fragmented, inadequate, and difficult to access for the majority of those victims of the conflict with mental health problems. This is a 36-month project to address the need for better designed mental health interventions for younger people affected by the conflict that can help not only to provide relief with their mental health problems but also allow these young people to make better use of the assistance available to improve their future economic prospects. The project aims to develop a feasible and acceptable mental health intervention that addresses comorbid mental health problems through a co-design process with extensive involvement of the community. The intervention will be embedded within one the largest social programmes (Youth in Action' or Jóvenes en Acción JeA) in Colombia to assist young vulnerable populations living in poverty. The intervention developed will be subsequently implemented and evaluated in three municipalities with high proportion of young people affected by the conflict and where JeA is available. The evaluation will consider the impact on the mental health as well as on the training and educational outcomes of the young participants with mental health problems receiving the intervention. To project will use a three-phase approach: 1. We will update a review of the literature in the subject and explore in depth the mental health needs, resources available, and local contexts through interviews with participants, especially those affected by the conflict, and JeA staff. 2. We will undertake the development of the intervention identifying potentially useful components and strategies based on the existing evidence. A potentially feasible intervention will be put through a co-designed, participatory process (involving JeA beneficiaries, JeA staff, and other relevant stakeholders) to gather ideas as to whether this intervention can be potentially feasible and acceptable to the target population. Once a preliminary agreement is reached this will go through another more intensive process of adaptation using similar co-designed processes. Once an agreement is reached in terms of the content and strategies to deliver the intervention, this will be assembled and tested with a small sample of potential users to ensure there are no major technical problems to deliver the intervention. 3. Finally the co-developed, approved and usable intervention will be tested in a pilot study using appropriate scientific methods to evaluate the feasibility, acceptability and usefulness in 'real-settings'. Results will inform if the intervention improves clinical and educational and employment prospects among those who use it. We will share findings with stakeholders and policymakers to argue for more and better mental health services to serve our populations. All participants will provide informed consent and projects will receive ethical approval. Our multidisciplinary team of experienced professionals from some of the best research centres in Colombia and the UK has been working together for almost a decade, showing an excellent track record of equitable and successful collaboration. We also have well-established partnerships with representatives from government and civil society. We have a deep knowledge of the settings and have developed excellent connections with policymakers to ensure implementation in a larger and sustainable way.

Programme identifier:

GB-GOV-13-FUND--Newton-ES_V013173_1

Start Date:

2021-02-14

Activity Status:

Implementation

Total Budget:

£338,044.86


Leave no one behind: Mental Health & Disability - Ghana Somubi Dwumadi Programme

Options Consultancy Services

The objective of the programme is to support people with disabilities and mental health, neurological and substance use conditions to improve their health and wellbeing and ensure they are engaged, empowered and able to enjoy improved social and economic outcomes and rights. The four outcome areas which will be achieved include stronger leadership and governance for disability and mental health; Scaled-up quality, integrated, community based and recovery orientated services; Inclusion via empowerment, capacity building, and reducing stigma and discrimination; and Increased evidence based research to scale up comprehensive, integrated quality, recovery-orientated mental health services and to achieve disability inclusion.

Programme identifier:

GB-COH-2695347-10980

Start Date:

2020-01-20

Activity Status:

Implementation

Total Budget:

£11,966,598


Cross Border Conflict Research Programme Lot 1

Chemonics International Inc

The objective of the programme is to improve effectiveness of HMG investments in fragile and conflict affected situations (FCAS), by providing real-time data, expertise and public good research to inform DFID and Whitehall policy and operations including through the Whitehall Conflict Security and Stability Fund (CSSF) and DFID programmes. The programme is broken into two separate contracts: Lot 1 (X-border conflict dynamics/response), and Lot 2 (Violent and peaceful behaviour). This contract is Lot 1 which is broken into the following two parts: Part A: X-border conflict ""hubs"" and x-border ""spokes."" Research will examine networks operating between major conflicts including Afghanistan, through Iran to the Middle East, through the Levant, North Africa and the Gulf to East Africa. Research will include techology based methods (e.g. satellite and aeiral imager, financial data, geo-tracking, communications and/or social media) complemented by quantitative and qualitative field work. Part B: Innovating conflict responses in an era of x-border conflict. Research will collect and collate empirical evidence on international conflict response systems, including multi-lateral and bilateral efforts focussed on peace support or stability and how they can innovate to meet the challenges of x-border conflict.

Programme identifier:

US-EIN-52-2145827-UK-8497

Start Date:

2020-05-04

Activity Status:

Implementation

Total Budget:

£3,168,049


Ghana Somubi Dwumadi

Sightsavers

The Ghana Somubi Dwumadie programme is a consortium led by Options Consultancy Services. The programme will work to: strengthen leadership and governance for disability and mental health through providing Technical Assistance to support effective policies, strategic reforms and institutional structures; scale-up quality integrated community-based and recovery oriented mental health and social services; disbursing grants to Civil Society Organisations, Self Help Groups and Disabled People’s Organisations to empower communities to have a voice in tackling discrimination and advocating for their rights; increase the evidence base on what works to scale up comprehensive, integrated, quality mental health services and disability inclusion. The programme is working in close partnership with the Government of Ghana and through granting to CSOs and is expected to engage with a broad group of stakeholders to ensure maximum value is delivered to the programme beneficiaries.  

Programme identifier:

GB-CHC-207544-13500

Start Date:

2020-01-20

Activity Status:

Implementation

Total Budget:

£643,149


GCRF_NF151 COVID19:Determining trustworthiness and safety of REmote Consulting in primary healthcare (REaCH) for chronic disease populations in Africa

UK - Department for Business, Energy and Industrial Strategy (BEIS)

During the COVID-19 pandemic, face-to-face healthcare appointments puts Africa's health workers and their patients at risk. Patients are afraid to attend clinics, e.g to collect medicines, and this may harm their health. Remote healthcare, by phone or internet, is advised by the World Health Organisation. Because this is difficult in Africa due to limited digital infrastructure, we have developed a training programme for health workers called REaCH. REaCH enables health workers to deliver trusted and safe care using the phone and limited internet availability. REaCH training aims to increase the number of appointments held by phone for patients with long-term conditions. We want to test whether these remote appointments are as acceptable, safe and trustworthy as face-to-face appointments. We will undertake trials in Nigeria and Tanzania. In each country we involve 20 health clinics and train 8-10 health workers in two clinics every month for 12 months. We collect monthly information on appointment type and the number of prescriptions and investigations given out. Twenty patients in each clinic per month will complete questionnaires on 1) how trustworthy they found their health worker to be and 2) how confident they are in managing their own health. Patients, clinic health workers and managers will be interviewed. We will produce a) Strengthened health care across Africa following REaCH training b) health workers and patients protected from coronavirus/COVID-19 c) stronger scientific research teams in Nigeria and Tanzania.

Programme identifier:

GB-GOV-13-FUND--GCRF-EP_V028936_1

Start Date:

2020-08-21

Activity Status:

Implementation

Total Budget:

£0


Identification of novel mechanisms of fetal-haemoglobin induction by common genetic variation in patients with sickle cell disease

UK - Department for Business, Energy and Industrial Strategy (BEIS)

We aim to discover the molecular mechanisms by which benign common DNA variants at two genetic sites, BCL11A and HBS1L-MYB, influence fetal haemoglobin levels in adults. Fetal haemoglobin (HbF) is the oxygen-carrying molecule dominating red blood cells in the unborn. It is switched off around the time of birth and replaced with the adult form of haemoglobin. Since in patients with sickle cell disease (SCD) adult haemoglobin is defective, the ability of some adult patients to produce the fetal form will make the disease significantly milder. Much knowledge has been accumulated regarding the structure and function of the BCL11A and HBS1L-MYB sites. The HbF-affecting genetic variants reside in gene-regulating elements called 'super-enhancers' that control the activity of neighbouring genes in red blood cell precursors and thus affect their development and haemoglobin content. Little is known about how the naturally-occurring DNA changes affect the function of these 'super-enhancers'. Here, we aim to uncover novel regulatory pathways and identify transcription factors binding to genetically-variable enhancer elements. This will add to the arsenal of targets for new therapeutic approaches aiming at reactivating HbF in patients. In addition to guiding new gene therapy strategies, our results will help laying the groundwork for the development of new affordable drugs to benefit the patients suffering from SCD mainly in low-and-middle income countries, especially Africa, where more than 200,000 affected children are born annually. In the UK, the disease is present mostly through the African diaspora and shows significant clinical diversity, partially driven by the variable, genetically-determined presence of HbF. Our experimental strategy will build on three major resources generated through collaboration: (1) four ethnically-diverse groups of well-characterised patients (n > 3,000) from the UK, Tanzania and Nigeria, where we will assemble extensive genetic data; (2) access to 2,000 genetically and haematologically characterised subjects from the TwinsUK cohort, where we will be able to obtain progenitor cells from 16 individuals with specific genetic profiles at BCL11A and HBS1L-MYB and (3) red blood cell producing cell lines carrying individual critical DNA variants generated through genome editing of the red blood cell-producing cell line BEL-A in collaboration with its creator, Prof Jan Frayne. Our principal goals are: (1) to genetically and functionally dissect common genetic variability at the two major quantitative trait loci for fetal-haemoglobin levels, BCL11A and HBS1L-MYB in order to unravel potentially novel molecular mechanisms through which genetic variation controls gene expression, determines HbF levels and influences the generation of red blood cells. A post-doctoral researcher recruited from our collaborators in Tanzania or Nigeria will investigate transcription factor binding (the techniques used will be EMSA - 'electrophoretic mobility shift assays', ChIP - 'chromatin immunoprecipitation') and chromatin looping (a folding of the DNA that occurs in active cells to position regulatory elements next to their target genes, the technique we will use is called '4C-seq') and gene activity in relationship with the genotype of the cells studied. (2) to identify the causal DNA changes at three independent subloci (HMIP-1, HMIP-2B, BCL11A-2) of the above through a combination of genetic mapping and functional studies. From these we will create a genetic score that can be calculated for each patient, aimed at predicting HbF levels and clinical severity in sickle cell disease. This score will become a parameter ascertained in genetic and clinical studies, including drug trials, helping to make such studies more informative; (3) to help build capacity and expertise for sickle cell research in Tanzania and Nigeria through training of researchers and building of extensive genetic datasets for their patient cohorts.

Programme identifier:

GB-GOV-13-FUND--GCRF-MR_T013389_1

Start Date:

2020-03-01

Activity Status:

Implementation

Total Budget:

£0


Health systems strengthening through person-centred care: development of a feasible and acceptable theory-based workforce approach to improve quality.

UK - Department for Business, Energy and Industrial Strategy (BEIS)

What is the problem we want to address? Serious illness has major effects on both the patient and family. In low and middle income countries these can be physical (such as pain and their symptoms) psychological, social (with additional stressors on income, children's school fees, stigma) and spiritual. This can affect both the wellbeing of the patient and family and their ability to access and stay in care. Health systems must address more than just the disease- they must become more ""person centred"". Person-centred care means that the health system is organised to meet the needs of the individual in ways that respond to their preferences, values and beliefs, offering dignity and respect. Being person-centred is seen to be a way to ensure that care services are high quality. By improving the health system through the workforce (the health care staff) the information it holds (on the individual's needs and preferences) and the way things are delivered, we can make care more person-centred. What will we do? In this study, we want to do some of the important initial work to inform a larger study to improve person-centredness. We will use our partnership across the UK, Zimbabwe and Uganda to find out what best person-centred care looks like from the view of patients and families facing serious illness, and very importantly from those who would be responsible for delivering (health care professionals). We will use this new information to work with health care teams to develop a strategy that is acceptable to patients and staff that can be put into practice in these countries as examples of health systems strengthening. We will also look at the best way to measure person centredness, so that when we conduct a larger study we have an accurate way to knowing if we have achieved our goals. What will be the outputs? The World Health Organisation has a strategy to improve person-centredness of care for all- this study will provide a practical way to deliver this from an African perspective. We will also deliver an adapted way to measure the experience of care from the patient & family perspective. Our proposed strategy will be led by the views of patients, families and health professionals- making it more likely to achieve success. We are working with health organisations in the community and with Governments to make sure that we can achieve better care through stronger health systems.

Programme identifier:

GB-GOV-13-FUND--GCRF-MR_T020091_1

Start Date:

2020-09-01

Activity Status:

Implementation

Total Budget:

£0


NIHR Research and Innovation for Global Health Transformation: Call 3

UK - Department of Health (DH)

National Institute for Health Research (NIHR)'s second Research and Innovation for Global Health Transformation (RIGHT) call. RIGHT funds cutting-edge interdisciplinary applied health research in key areas in low- and middle-income countries (LMICs) where a strategic and targeted investment can result in a transformative impact. RIGHT Call 3 supports equitable partnerships between LMIC and UK researchers to generate new research knowledge and evidence on interventions to improve outcomes for those affected by multimorbidity in ODA-eligible countries. UK universities and research institutes were invited to submit applications including a co-applicant or joint lead applicant from an LMIC relevant to the research proposal. Research must be focused on improving the health and welfare of people in LMICs.

Programme identifier:

GB-GOV-10-RIGHT_3

Start Date:

2021-09-01

Activity Status:

Implementation

Total Budget:

£17,253,751.81


NIHR Research and Innovation for Global Health Transformation: Call 2

UK - Department of Health (DH)

National Institute for Health Research (NIHR)'s second Research and Innovation for Global Health Transformation (RIGHT) call. RIGHT funds cutting-edge interdisciplinary applied health research in key areas in low- and middle-income countries (LMICs) where a strategic and targeted investment can result in a transformative impact. RIGHT Call 2 is funding mental health research in LMICs through supporting applied research on the development and evaluation of interventions to improve outcomes for people affected by mental health issues. UK universities and research institutes were invited to submit applications including a co-applicant or joint lead applicant from an LMIC relevant to the research proposal. Research must be focused on improving the health and welfare of people in LMICs.

Programme identifier:

GB-GOV-10-RIGHT_2

Start Date:

2020-01-01

Activity Status:

Implementation

Total Budget:

£20,583,874.30


NIHR Global Health Research Groups: research call 2

UK - Department of Health (DH)

The NIHR's second Global Health Research call for Groups. UK universities and research institutes were invited to submit applications, working in equitable partnerships with researchers in low- and middle-income countries (LMIC), to develop their ambitions to deliver world-class applied global health research to address under-funded or under-researched global health areas specific to those countries.

Programme identifier:

GB-GOV-10-NIHR_GHRG2

Start Date:

2018-04-01

Activity Status:

Implementation

Total Budget:

£45,255,360.85


NIHR Global Health Research Units and Groups: research call 1

UK - Department of Health (DH)

The NIHR's first Global Health Research call for Units and Groups. UK universities and research institutes were invited to submit applications, working in equitable partnerships with researchers in low- and middle-income countries (LMICs), to either expand (Units) or develop (Groups) their ambitions to deliver world-class applied global health research to address under-funded or under-researched global health areas specific to those countries.

Programme identifier:

GB-GOV-10-NIHR_GHRUG1

Start Date:

2017-04-01

Activity Status:

Implementation

Total Budget:

£128,940,425.80




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