Project INDIGO
Project INDIGO
Project INDIGO is a research and innovation project jointly funded by the European Commission, as part of the Horizon 2020 Research and Innovation Program and India’s Department of Biotechnology. Now in its third year, INDIGO has two major ongoing projects namely PandemicPLUS and TetraLITE.
For the PandemicPLUS track, our objective is to improve pandemic preparedness by creating influenza antigens with reduced immunomodulatory effects through the removal of regulatory T cell epitopes.
This year, antigens designed for the H7N9 influenza strain were selected for further development and the production process was set-up. Initial data in mice show that the removal of regulatory T cell epitopes increases both responses against influenza as well as against other antigens. The challenge for 2023 will be to produce the newly designed antigen with high reproducibility, yielding pure antigens that are stable over time.
TetraLITE is aimed at creating fast-tracked seasonal vaccines that are affordable and with high efficacy by combining current vaccines with new adjuvants.
For TetraLITE, 2022 was marked by the start of the Phase I clinical trial. Formal GLP toxicity studies were performed, kits containing the vaccine and the adjuvant as well as all necessary documents for the Clinical Trial Application were prepared, submitted and approved. In early October, the Phase One safety study started according to plan, and immunizations and 4 week follow-ups for all volunteers were finalized 16 December. Samples were sent for midterm analysis and preparation for the Phase Two trial began.
In addition, basic research on the immunopotentiating mechanism of the novel adjuvant resulted in an open access peer-reviewed manuscript that was accepted for publication in December 2022. You can find this on the official Project INDIGO website: www.indigo-vaccines.eu
The Long-COVID Study
The Long Covid project aims to systematically characterize long-term clinical outcomes of SARS-CoV-2, explore potential underlying immunological mechanisms, and estimate the economic burden of Long Covid in a prospective cohort study conducted in the Nairobi Metropolitan region between February 2022 and June 2023. This is a collaborative project between researchers from the Joep Lange Chair & Fellows Program at AIGHD and the African Population and Health Research Center (APHRC).
During the last year, the Long Covid project has been moving forward with data collection and knowledge exchange between both institutions. Fellow researchers from the Joep Lange Program and researchers from the APRHC worked together to develop the data collection tool and to provide training to interviewers at the Kenyatta Research Medical Institute in Nairobi in February 2022. Follow-up online meetings with the data collection team have happened throughout the year to discuss issues and strategies to better handle challenges as a way to ensure data quality.
The visit to Nairobi has also brought an opportunity for researchers to get to know each other's backgrounds and to look for opportunities to further develop research skills and exchange knowledge between institutions. One step towards this common aim was an internship in which a research colleague from the Kenyatta Research Medical Institute attended a course in the field of health economics between September and December 2022 at Vrije Universiteit Amsterdam, a partner university of AIGHD. The upcoming steps include finishing data collection in June 2023 and performing the data analysis in close collaboration to promote and strengthen the knowledge capacity of institutions involved in the project.
The DI-DIDA Project
‘One of our dreams is to create the first African real-time digital One Health Platform’, says AIGHD Senior Fellow Tobias Rinke de Wit.
The DIDIDA project (Digital Innovations & Diagnostics for Infectious Diseases in Africa) started October 1, 2022. This is a 5-year project in five African countries (Uganda, Kenya, Tanzania, Senegal, Reunion). The principal Investigator is Glasgow University Professor Prof. Jon Cooper. AIGHD is one of the 15 stakeholders in this project.
DIDIDA strives to develop a new generation of diagnostic rapid tests for multiple febrile diseases at the same time. These tests will be based on DNA of the pathogens (e.g. malaria, salmonella, schistosomiasis, leptospirosis, brucellosis) and uses so called ‘isothermal amplification’, in scientific jargon referred to as ‘LAMP’. These tests will be digitalized through telephone based RDT reader Apps, that are developed by the not-for-profit company Audere in Seattle, USA. Test results will be monitored through semi-real time dashboards on mobile phones of local stakeholders in Africa.
A proof-of-principle operational subproject in this field will be performed in the digital health ecosystem in Kisumu, Kenya, that is supported by PharmAccess Kenya. The DI-DIDA interventions will be evaluated by and linked to 16 PhD programs for African students, 6 of which are in Kenya. The PhD programs in Kenya are under Strathmore University (with 2 PhDs doing economic evaluations), African Population and Health Research Center (with 2 PhDs in the social sciences), and Kenyan Medical Research Institute Kisumu (with 2 PhDs doing biomedical research). AIGHD will provide technical assistance to these programs through Angela Jornada Ben (Strathmore), Chris Pell (APHRC) and Tobias Rinke de Wit (KEMRI). DI-DIDA was officially launched in Nairobi, Kenya on November 9, 2022. Preparations for the project were ongoing in 2022. Official permission to perform DI-DIDA in Kenya was obtained from the Kisumu Department of Health.
DIDIDA contains elements of OneHealth thinking: connecting febrile disease outbreak data in humans to those in (domestic) animals and pathogens detected in (sewage) water. You can learn more about the DI-DIDA Project on our website: DI-DIDA - AIGHD
Project IMPALA
Project IMPALA
Enrolled Study Participants
In 2022, the Project IMPALA moved into its second phase, building on the groundwork that was laid out in the previous year. This phase focused on two major components: the social science research and the clinical study.
The social science component aimed to gain a better understanding of the local context prior to and during the introduction of the monitor in the two hospitals involved in the clinical study. The data will inform the future design and implementation plan.
The clinical component is aimed at identifying predictors of critical illnesses using an automated algorithm and began last July 2022. Despite initially encountering a few challenges, the recruitment of participants gradually increased over time. In fact, by December, the study had achieved a participation rate of 300 individuals.
At the beginning of the year, the three PhD candidates who are part of the project started their research activities. Daniel Mwale is responsible for conducting the social science research, William Nkhono delves into the artifical intelligence aspect, and Jacqueline Msefula manages the laboratory hub which tries to identify new biomarkers to predict critical illness.
Later in the year, the consortium held its second meeting in Malawi. During this meeting, the progress made by each hub was discussed in-depth, giving the consortium members a better understanding of the work being conducted on the ground. This meeting was attended by the scientific advisory board and stakeholder committee, who provided valuable insights and recommendations. Overall, the meeting proved to be a significant milestone in the project's progress, as it enriched the value of the consortium's efforts.
You can learn more about the project on the official website: IMPALA project (projectimpala.org)
Financial Diaries Project
The Financial and Health Diaries study in Kenya was designed to evaluate the impact of a mobile technology-based health intervention, called i-PUSH (Innovative Partnership for Universal Sustainable Healthcare), implemented by PharmAccess and Amref Health Africa. The program aimed to enhance access to quality healthcare for low-income women of reproductive age and their family members in Kenya. To that end, it alleviated women’s financial constraints to healthcare utilization by offering subsidized, mobile phone-based health insurance, while upgrading healthcare providers, enhancing the training of community health workers (CHWs) and improving decision-making capacity of providers and policymakers through better data.
Our analysis was based on a cluster randomized controlled trial, conducted between October 2019 and June 2021 among 240 households in 24 villages in Kakamega County. After a baseline survey, all men and women in the study households were interviewed separately and in private on a weekly basis for one and a half year, collecting granular financial and health data while the program was rolled out in the treatment communities. Although not the original aim of the study, the high-frequency data collection during COVID-19 allowed us to examine in detail the impacts of the pandemic on socio-economic outcomes, indirect effects on other infectious diseases and the mental health of our respondents. This has resulted in three academic publications.
The impact study finds that i-PUSH was highly successful in enrolling households in the National Hospital Insurance Fund (NHIF). The subsidy, which combined with the introduction of the i-PUSH program by trusted local CHWs, the hands-on assistance with the digital registration procedures at women’s homes, and support in retrieving the necessary documentation such as children’s birth certificates, have likely all contributed to the high enrolment rates. We find weak positive impacts on healthcare utilization, and substantial increases in financial protection, particularly for households living close to i-PUSH-affiliated clinics. Impacts on maternal and child health (MNCH) were more limited, probably due to confounding effects of other MNCH programs in the study area.
Our results have been published in three reports, have been presented at multiple international conferences and are currently being prepared for submission to academic journals. Jointly with APHRC, we disseminated the findings at well-attended and lively policy workshops with implementing partners, healthcare providers and government officials in Nairobi, Kisumu, and Kakamega counties, where the government is currently working on further expanding access to insurance. An unexpected but important spin-off of the research was the uncovering of the missing birth certificates for many children, which are essential to enroll in national health insurance. The County Register and County Health officials in Kakamega have jointly taken up this barrier to expedite children’s registration, also for the future.
AMR-Global
Global Solutions to Curb Anti-Microbial Resistance
In 2019, an estimated
people died from infections attributable to drug-resistant bacteria and could grow to as much as 10M if left unchecked.
Two Dutch Top sector for Knowledge and Innovation (TKI) areas, where specific funding is set aside for research by public-private partnerships, joined forces to fight AMR. The TKI Life Sciences & Health and TKI Water & Maritime came together to fund SWIM. The fifth GLORIA research project “SWIM” aims to reduce inappropriate exposure to antibiotic resistance through drinking water and to assess the potential impact on human health, an aim which requires collaboration between health and water experts. The project will test new technologies to filter antibiotics and antimicrobial resistant genes from surface water, in a drinking water treatment facility in Bangladesh.
AMR is an ever-growing global health problem. In 2019, an estimated 1.27 million people died from infections attributable to drug-resistant bacteria, a figure that could rapidly increase to 10 million per year if no action is taken. This action must be taken from multiple sectors in society, as no discipline can fight AMR on its own.
The interdisciplinarity that is vital for solutions to combat AMR, is also core to the research of the Amsterdam Institute for Global Health and Development (AIGHD), program coordinator of GLORIA and participant in two of the five GLORIA research projects.
In addition to AIGHD, the following 13 partners are working toward finding solutions to AMR within AMR-Global’s GLORIA program: Amsterdam UMC, Level Diagnostics, Leiden University Medical Center, ShanX Medtech, Erasmus MC University Medical Center Rotterdam , KNCV Tuberculosis Foundation, UMC Utrecht, Mozand, Deltares, KWR Water Research Institute, VU Amsterdam, Saxion Research Group International Water Technology, and NX Filtration.
SoNAR-Global
Created in 2019 and funded by the European Commission, SoNAR-Global is comprised of 15 partner institutions including AIGHD, located in Europe (France, the Netherlands, Italy, Germany, Austria, Slovenia and Malta) and eastern Europe (Ukraine), as well as in Africa (Senegal and Uganda), South Asia (Bangladesh), Southeast Asia (Thailand), and the United Kingdom.
SoNAR-Global, a global consortium led by social scientists specializing in emerging infectious diseases (EID) and antimicrobial resistance (AMR), has actively contributed to the COVID-19 pandemic response in multiple countries.
For this project, AIGHD led two work packages. First, AIGHD Research Fellow Dr. Christopher Pell led the development of a dynamic global social sciences network for preparedness and response to epidemics and antimicrobial resistance (AMR) including two actively involved regional hubs, one on AMR in Thailand and one on training in Senegal. This resulted in a global network of 811 members, with 19 networks/projects and 792 individuals, including social scientists, biomedical researchers physicians, public health practitioners, veterinarians, and nutritionists. These individual members are faculty and students in research institutions and universities, specialists in global health institutions, national public health structures, nongovernmental organizations and associations. Access to this database remains open to all who have inscribed in the network.
Second, AIGHD Senior Fellow Dr. Danny de Vries co-led the capacity strengthening activities developed through a mapping and consultation process for four social sciences training curricula for young social scientists, as well as researchers and actors in public health. The SPECIAL-SOC curricula offer knowledge in the social and medical sciences on AMR or Epidemics to non-specialized social scientists. The OPERATE-SOC curricula offer operational knowledge on social aspects of AMR or Epidemics to non-social scientists working in relevant fields, to enable them to use social science intelligence, and collaborate with social scientists. The AMR curricula were developed in Amsterdam and complemented by a Massive Open Online Course (MOOC) on The Social Dimensions of Antimicrobial Resistance, available at Coursera platform and hosted by the UvA, which has reached about 400 learners so far. The epidemic curricula were developed in Dakar, Senegal, translated into French and published as a physical manual as a response to very high demand among French-speaking African researchers and trainers for a paper manual. Overall, AIGHD contributed to trainings in France, Senegal, the Netherlands, and Thailand with biomedical researchers, ministry officials, policymakers, and responders while the regional hub based in Bangkok has catalyzed new research collaborations among social scientists and biomedical researchers.
While the EU Horizon funding has ended for this project, the network has now continued its existence as part of the ISIDORe network. Here, Sonar-Global is offering European Commission-funded Social Science Services including vulnerability assessments, protocols and implementation for public engagement, ethics assessments, post-action reviews, cost-benefit analysis and community surveillance activities for human and animal health. The latter two are especially supported by AIGHD.
Learners in our MOOC on The Social Dimensions of Antimicrobial Resistance
Stool4TB
Tuberculosis (TB) continues to be a leading cause of morbidity and mortality among children and people living with HIV (PLHIV).
TB is caused by the bacillus Mycobacterium tuberculosis, which is spread when people who are sick with TB expel bacteria into the air; for example, by coughing. The disease typically affects the lungs (pulmonary TB) but can also affect other sites (extrapulmonary TB). About a quarter of the world’s population is infected with M. tuberculosis. Stool4TB is an EDCTP funded project that aims to evaluate an innovative stool-based qPCR diagnostic platform (with the capacity to become a POC diagnostic tool) in the high TB and HIV burden settings of Mozambique, Eswatini and Uganda, under the hypothesis that it will narrow the extremely large TB case detection gap by improving TB confirmation rates in children and PLHIV.
2022 was a significant year for Stool4TB
Number of paediatric enrollees in the Ugandan cohort
PhD students began their research in all three sites and the first annual consortium meeting was held in Johannesburg, South Africa. One of the largest impacts from the Stool4TB project in 2022 was the involvement in the Union World Conference on Lung Health. Sabine Hermans and Elisa Lopez-Varela co-chaired the symposium SP-04 Stool-based diagnostics: a game-changer for hard-to-diagnose populations? During this symposium, 437 participants enjoyed their session on the day of the broadcast and it has generated 539 additional views.
EGHRIN
EGHRIN is advancing towards creating a new advisory board on the decolonialisation of Global Health, which should see light in 2023.
Global Health Town Hall Meeting: Healthy People, Healthy Societies: An Integrated Approach
As final COVID-19 restrictions were lifted, 2022 saw the organisation of the first physical event by EGHRIN in partnership with the League of European Research Universities (LERU), the Global Health Town Hall Meeting: Healthy People, Healthy Societies: An Integrated Approach, hosted by the University of Barcelona in June. This event gathered 64 attendees from LERU and EGHRIN members across Europe, who could not only participate in the open sessions streamed live but also in the breakout sessions. The content of these discussions was compiled after the meeting and have been the basis of LERU and EGHRIN response to the EU Global Health Strategy and future joint initiatives.
Simultaneously, EGHRIN updated its visual identity and website as part of the implementation of its Communications Strategy. Currently, via its dedicated Equality, Diversity and Inclusion Working Group, EGHRIN is advancing towards creating a new advisory board on decolonialisation of Global Health, which should see the light in 2023.
1ST
Major In-person event
Attendees
From LERU and EGHRIN