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African Research Leader scheme

The African Research Leader (ARL) scheme is a prestigious award, jointly funded under the MRC/DFID concordat agreement. The scheme aims to strengthen research leadership across sub-Saharan Africa by attracting and retaining exceptionally talented individuals who will undertake high-quality programmes of research on key global health issues pertinent to the region. A further call for MRC/DFID African Research Leaders is now launched.

ARL Case Studies:

Health and wellbeing of female adolescents and young adults, and their infants: limiting the inter-generational risk of metabolic disease in South Africa

ARL – Professor Shane Norris, University of Witwatersrand, South Africa

UK principal investigator – Professor David Dunger, University of Cambridge

A growing challenge in sub-Saharan Africa is the complex relationship between poor maternal nutrition and postnatal stunting on the one hand; and poor diet and the increased risk of adolescent and adult obesity on the other, leading to an increased risk of type-2 diabetes and metabolic risk in future generations.

Since obtaining his ARL award Professor Norris has become Director of MRC/Wits Developmental Pathways for Health Research Unit (DPHRU), a new unit within the Department of Paediatrics aimed at researching health and wellbeing across generations. DPHRU addresses the South African national priorities of increasing life expectancy, decreasing maternal and child mortality, and strengthening health system effectiveness, all by drawing on unique longitudinal cohort data.

Professor Norris proposes to tackle this complex area of research in two key ways:

  1. A comparative study of urban-rural adolescents and young adults for obesity and metabolic disease risk. This study draws upon two well-established longitudinal research platforms, the urban Birth to Twenty cohort (Bt20) and the rural Agincourt Health and Socio-Demographic Surveillance System (HDSS). Studies of contemporary adolescent and young adults (generation 1) and their offspring (generation 2) provide a unique opportunity to evaluate outcomes relating to risk factors for type-2 diabetes and metabolic disease that are transmitted across generations.
  2. Exploring the intergenerational risk of metabolic disease, with a focus on how pre-pregnancy body composition impacts on weight gain and carbohydrate metabolism during pregnancy; and the association of these factors with delivery (birth) outcome and infant body composition at age one year.

Having Professor Dunger as his UK partner has brought Professor Norris in closer contact with multiple nutrition, epidemiology and metabolism groups in Cambridge and this has created a strong collaboration for preparing further targeted intervention studies.

Filariasis elimination in Africa: refining the strategies through research

ARL – Professor John Gyapong, University of Ghana

UK principal investigator – Professor Moses Bockarie, Liverpool School of Tropical Medicine

Lymphatic filariasis (elephantiasis) in Ghana is caused by the parasitic worm Wucheria bancrofti transmitted by mosquito vectors. As part of a WHO global programme, the Ghana Filariasis Elimination Programme has been in operation since 2000.

The programme has completed several rounds of mass drug administration with rollout in different districts to attain total national coverage. Reduction to less than 1% prevalence in some sites has been demonstrated, while in others prevalence is much higher and has remained incompatible with elimination of transmission.

Since obtaining his ARL award, Professor Gyapong has received a significant rise in seniority and responsibility with his promotion to Pro-Vice Chancellor for Research Innovation and Development at the university. He has therefore recruited four junior investigators who will complete PhDs with the University of Ghana while also taking forward the four key research questions:

  • How to improve treatment coverage and compliance, particularly in urban populations?
  • Can the use of mobile telephony platforms improve reporting and strengthen the health system?
  • When to stop mass drug administration and how to effectively monitor recrudescence?
  • How will integrated control with other neglected tropical diseases affect lymphatic filariasis elimination and the health system?

Building on his own School of Public Health position, combined with the essential partnering with the national elimination programme in Ghana and the nearby Noguchi Memorial Institute of Medical Research (with access to wet lab facilities) has provided a strong cross-institutional platform for his research.

Targeting male mosquito behaviour for vector control

ARL – Dr Abddoulaye Diabaté, Institut de Recherche en Sciences de la Santé (IRSS)/Centre Muraz, Burkina Faso

UK principal investigator – Dr Frederic Tripet, Keele University

Malaria remains a major cause of mortality in many parts of Africa. The control of mosquito populations remains one of the most efficient ways of decreasing the incidence of the disease. This is commonly done by using insecticide-treated bednets and Indoor Residual Spraying (IRS). In many areas of Africa, however, mosquito populations are becoming resistant to commonly used pesticides.

Dr Diabaté’s research is to develop alternative approaches and strategies to curtail malaria and focuses on the male reproductive behaviour of Anopheles gambiae, the main vector of malaria in Africa. A. gambaie mates in flying swarms, and hence swarms constitute an ideal target for mosquito population control.

Dr Diabaté is the Head of the medical entomology laboratory at the IRSS, which is situated in a malaria endemic region of Burkina Faso. As a result of his award Dr Diabaté has been promoted to a ’Maître de Recherche’, a major step in his career progression to ’Directeur de Recherche’.

There are two main objectives of Dr Diabaté’s research programme:

  1. To explore the feasibility of predicting and manipulating swarm locations for mass swarm killing. The impact of swarm control will be measured in combination with IRS on local mosquito densities.
  2. To improve the mating performance of sterile laboratory-produced male mosquitoes which are released in the wild and can induce their sterility on further populations.

As part of his research he is building a unique malaria sphere which will hopefully attract researchers from across Africa and beyond.

The strong onsite mentorship of the Institute Director is extremely valuable and there is a clear vision to integrate disciplines from basic science discoveries to clinical and health benefits. His UK partner, Dr Tripet at Keele University, and broader partnering with Liverpool provide collaborative opportunities to access cutting-edge technologies not available in Burkina Faso.

Pathogenesis and management of M. ulcerans disease, Buruli ulcer

ARL – Dr Richard Phillips, Kwame Nkrumah University of Science & Technology (KNUST), Ghana

UK principal investigator – Dr Mark Wansbrough-Jones, St George’s University, London

Buruli ulcer is a neglected tropical disease caused by infection with M. ulcerans, a bacteria common in rural parts of West Africa including Ghana. It causes large, disfiguring skin ulcers mainly in children aged 5 to 15 years old, although people of any age can be affected. How a person becomes infected remains unknown but there have been major advances in understanding the mechanisms of disease since the establishment of the WHO Global Buruli Ulcer Initiative (http://www.who.int/buruli/en/), together with improved diagnosis and management. Antibiotic treatment for eight weeks is now standard, although some people may need only four weeks of antibiotic treatment.

The ARL award has helped Dr Phillips with his academic career and he has recently progressed from being a Research Fellow to a post as Senior Lecturer in Medicine at KNUST and he is looking forward to further promotion.

The main aims of Dr Phillips research programme are:

  1. To investigate markers for patients with early infection to identify patients who may respond rapidly to antibiotic treatment and for which a shortened course of antibiotic treatment will be adequate.
  2. To investigate the immune response to M. ulcerans during antibiotic treatment and when patients develop a paradoxical reaction, seen in 10 per cent of cases.

Dr Phillips will spend one year (out of his five-year award) in his UK partner institution, St George’s University, to work on improving technical assays and analysis including microarrays and proteomics work. This will also enable him to develop broader European collaborations and to consolidate aspects of the proteomics work before returning to Ghana.

Mental health among HIV infected CHildren and Adolescents in KAmpala, Uganda (CHAKA)

ARL - Dr Eugene Kinyanda, MRC/UVRI Uganda Research Unit on AIDS

UK principal investigator – Professor Vikram Patel, London School of Hygiene and Tropical Medicine

Although sub-Saharan Africa shoulders the greatest burden of youth HIV, little research has been conducted to better understand psychiatric problems (e.g. depression, anxiety and behaviour disorders) among HIV-infected children and adolescents in the region. The aim of this study is to investigate the impact of psychiatric disorders on HIV-infected children in Uganda and the implications for service provision.

Dr Kinyanda plans to investigate the prevalence, incidence and risk factors of psychiatric disorder among HIV-infected children and adolescents in urban Kampala and more rural Masaka, Uganda. He will also examine the help-seeking behaviour of these adolescents to identify service delivery gaps in Ugandan HIV services. The results of this study will provide invaluable information to policymakers and service providers about how to strengthen the provision of appropriate and effective mental health care for this vulnerable group.

Since obtaining an ARL award Dr Kinyanda has been promoted to Senior Investigator Scientist at the MRC/UVRI Unit; appointed Associate Professor in the Department of Psychiatry at Makerere University; and made an honorary Professor in the Faculty of Epidemiology & Population Health at the London School of Hygiene and Tropical Medicine (LSHTM).  These appointments have increased Dr Kinyanda’s collaborative opportunities and his own scientific profile both in Africa and beyond.

Professor Patel, UK partner and mentor to Dr Kinyanda, has fostered greater contact between the ARL and scientists and health professionals at the LSHTM and other UK institutions through a three month visit to the UK including an attachment with the adolescent HIV clinic at Mortimer Market Centre.

Defining the merozoite targets of protective immunity against Plasmodium falciparum malaria through multi-centre cohort studies

ARL - Dr Faith Osier, Kenya Medical Research Institute-Centre for Geographic Medicine Research, Coast

UK principal investigator – Professor Kevin Marsh, University of Oxford

In malaria endemic regions, young children under the age of five are susceptible to severe and complicated forms of malaria, while older children and young adults experience only milder forms of the illness, and gradually appear to remain symptom-free despite being infected. How this immunity is acquired remains unknown, but it is thought to arise through the development of protective antibodies triggered against specific malaria antigens.  It is only as a result of advances in technology that it is becoming possible to identify which of the many thousands of proteins that make up a malaria parasite are the triggers/targets of the protective antibodies.

Before obtaining her ARL award Dr Osier held an intermediate level fellowship from the Wellcome Trust.  Since securing the ARL award she has been appointed to various prestigious positions significantly boosting her CV.  She is now Visiting Professor of Immunology at Oxford University, Chair of the Bioscience Department at KEMRI-CGMRC, Adjunct Associate Professor in the Biomedical Sciences Department of nearby Pwani University and Secretary General to the Federation of African Immunological Societies (FAIS). She has also been nominated to AcademiaNet, an Expert Database for Outstanding Female Academics.

Dr Osier aims to use immuno-epidemiological analyses of multi-centre African cohorts, combined with bioinformatics and proteomic approaches, to identify and prioritise the best immune targets on the merozoite stage of malaria-causing Plasmodium falciparum. It is her hope that building on this new knowledge it will in the longer term be possible to develop an effective malaria vaccine.  She is already in discussions with scientists at the Jenner Institute for optimising her research to be on the right trajectory towards vaccine development.

Dr Osier’s benefits from the long standing expertise of her UK mentor, Professor Marsh,  but increasingly her own profile and leadership is being recognised with the establishment of new independent collaborations with Southern partners.

Pathogenic lineages of enteric bacteria in Nigeria

ARL - Dr Iruka Okeke, University of Ibadan, Nigeria

UK principal investigator – Professor Gordon Dougan, The Wellcome Trust Sanger Institute, Cambridge

Childhood diarrhoea and bacterial bloodstream infections account for a very high number of illnesses and deaths among children under-five in Nigeria and other parts of Africa. Enteric pathogens, such as Escherichia coli and Salmonella enterica, are major causes of these infections, however very little is known about the epidemiology of these bacteria in Nigeria, including which lineages account for the burden of disease.

With her ARL award Dr Okeke has relocated from her faculty position at Haverford College in the United States to pursue her career as a Professor at the University of Ibadan.  

Dr Okeke will use a case-control study design to determine the contributions of specific E. coli and Salmonella lineages to childhood diarrhoea in Western Nigeria. She will use molecular methods to characterize the different strains of bacteria, their evolution and antimicrobial resistance.

Dr Okeke will build on collaborative links with other regional laboratories and extend some of the expertise built at Ibadan to those labs. The research will therefore build capacity in the area of molecular bacteriology and provide a collaborative link between West African scientists and the Wellcome Trust Sanger Institute, where the principal investigator is located.

Improving detection of depression in primary care in Sub-Saharan Africa (IDEAS Study)

ARL - Dr Abebaw Fekadu, Addis Ababa University, Ethiopia

UK principal investigator – Professor Martin Prince, King's College London

The detection of depression in primary care in Africa, including Ethiopia, is disappointingly low and poses a serious threat to the plans for scaling up mental healthcare in low income countries. Although detection does not guarantee good quality clinical care, accurate identification and engagement with a care pathway is the first critical step. There are interventions with promise in high income countries in improving detection however these cannot be transferred to other low income settings as they are.

Dr Fekadu holds the position of Associate Professor at his university and since receiving his ARL award he has applied for promotion to full professor. His career is progressing well and he is now elected as a fellow of the Ethiopian Academy of Sciences and is successfully leading a research consortium to establish a regional African Centre of Excellence supported by the World Bank.

Dr Fekadu aims to develop and pilot an intervention that improves detection of depression in primary care in Ethiopia and other low income settings. He aims to do this in three phases. Phase 1 (inception): Evidence will be collected about the nature of depression and its detection in primary care, specifically in the local context. Phase 2 (Development): An intervention package for improving detection will be put together. Phase 3: The intervention package will be tested to see if it is locally acceptable, feasible to deliver, that it improves detection affordably and can be replicated widely.

Dr Fekadu benefits from the expertise provided by his UK mentor, Professor Prince, which has allowed him to raise his own profile and take advantage of new collaborative opportunities. He has also benefitted personally from the mentorship in terms of improving his research and leadership skills and receiving pertinent career advice.

Adolescent Executive Functioning Association with Scholastic Outcomes, Risk Taking Behaviour and Medical Adherence in the Context of HIV

ARL - Dr Amina Ali Abubakar, Pwani University, Kenya

UK principal investigator – Professor Charles Newton, University of Oxford

Children born HIV positive are now living longer due to the availability of Antiretrovirals. However, to realize their full potential these children need to receive interventions that reduce the negative impact of HIV. In Africa, there is limited research evidence to guide the development of these much needed intervention programmes. This study will investigate the impact of HIV exposure on the functioning of adolescents aged 10-14 years at the Kenyan Coast.

Dr Abubakar is an Associate Professor of Psychology and Public Health at Pwani University, Kenya. She also holds the position of a research scientist at KEMRI/WTRP and an honorary fellow at the department of Psychiatry at University of Oxford.  Prior to her ARL award she was a research fellow at Lancaster University.

In Africa there is a growing concern about the outcomes of HIV positive adolescents, particularly in the following key areas: poor educational outcomes, lack adherence to prescribed medication and involvement in risky sexual and drug related behaviour. Little is known of the impact of HIV on neuropsychological function of infected and exposed but uninfected adolescents in Africa. This study focuses on executive functioning (EF) which influences social, emotional and behavioural outcomes. Using a longitudinal study design Dr Abubakar plans to investigate the impact of HIV on executive functioning of adolescents and its association to scholastic outcomes, medical adherence and risk taking behaviour, by comparing adolescents who are HIV infected or exposed uninfected with those unexposed to HIV.

The specific objectives of Dr Abubakar’s research programme are to:

a) Examine the magnitude and pattern of EF deficits among HIV infected and HIV exposed uninfected adolescents;

b) Describe changes in EF over a critical time period during adolescence in the context of HIV;

c) Identify protective factors for EF outcomes in the context of HIV;

d) Describe the relationship between EF and Scholastic Outcomes, Risk Taking Behaviour and Medical Adherence in the Context of HIV.

Professor Newton, UK partner and mentor to Dr Abubakar, has provided greater insight into the biomedical and neurological aspects of the study and fostered contact between the new ARL and colleagues in Oxford and other UK institutions.

The pathogenesis and treatment of nodding syndrome

ARL - Dr Richard Idro, Makerere University, Uganda

UK principal investigator – Professor Kevin Marsh, University of Oxford

Nodding syndrome (NS) is a devastating but poorly understood brain disorder that is affecting thousands of children in Africa. It is characterised by head nodding and complicated by seizures, psychiatric difficulties, malnutrition, cognitive and physical decline. Studies suggest that this is a distinct type of epilepsy. The cause and mechanisms of disease are unknown. There is no specific treatment with available treatments only reducing symptoms in some patients.

Prior to his ARL award, Dr Idro was a consultant paediatrician in Mulago National Referral hospital in Kampala, Uganda. Since receiving the award, he has transitioned to Makerere University School of Medicine as Senior Lecturer in Paediatrics and Child Health. Dr Idro is also a visiting Professor on the International Brain Research Organization Neuroscience Schools and the European Academy of Neurology Regional Neurology Courses across Africa as well as visiting Fellow in Tropical Medicine at University of Oxford.

Dr Idro has set up a research unit in Kitgum General Hospital in northern Uganda where he is testing the hypothesis that NS is a neuro-inflammatory disorder induced by antibodies against the parasitic worm Onchocerca volvulus or its symbiotic bacteria, Wolbachia, cross reacting with and damaging the hosts neuron surface proteins and to determine whether these organisms may be targeted in treatment. He plans to do this by i) determining the relationship between NS, antibodies to host neuron surface proteins and infection by O.volvulus and by ii) conducting a pilot study targeting Wolbachia to explore the role of O.volvulus  in the pathogenesis of NS. A definitive association between nodding syndrome and O.volvulus will allow escalation of treatments and prevention. If data from the pilot study is positive, doxycycline (a drug that attacks the adult worm by killing Wolbachia bacteria it contains) offers a cheap intervention that will be tested in a larger study.

Dr Idro has benefited from Professor Marsh’s expertise and direction and has established new collaborations allowing him access to different labs in the UK (neurosciences at Oxford, parasite genetics at Sanger and host genetics at UCL) as well as enormous facilities at the university Oxford. He has further taken advantage of training and skills building in genetics.

Characterisation of the breakdown in immune competence of the lung that favours development of tuberculosis in HIV-infected individuals

ARL - Dr Henry Mwandumba, College of Medicine, University of Malawi

UK principal investigator – Professor Stephen Squire, Liverpool School of Tropical Medicine

Co-infection with Mycobacterium tuberculosis (Mtb) and HIV constitutes a huge burden on national healthcare services in sub-Saharan Africa where up to 70% of tuberculosis (TB) patients are HIV-infected. This study aims to better understand the mechanisms underlying host resistance and susceptibility to TB, which is central to the development of new approaches to prevent and/or treat HIV-associated TB.

The ARL award has contributed significantly to Dr Mwandumba promotion to reader within his university; prior to this he was a clinical senior lecturer. In February 2018, Dr Mwandumba was appointed Deputy Director at the Malawi-Liverpool-Wellcome Trust Programme, the largest research affiliate of the University of Malawi College of Medicine. These are major steps in his career progression.

As part of his research Dr Mwandumba will also explore the impact of HIV co-infection and ART on immune competence of the lung in general. His study will improve current understanding of immune control of TB in the lung and by exploiting the HIV mediated breakdown in immune control of Mtb, it will charter new areas of investigation. It has the potential to contribute important knowledge to ongoing efforts to develop new drugs and vaccines for TB in both HIV-uninfected and HIV infected individuals.

Dr Mwandumba benefits from the expertise and mentorship of Professor Squire, the UK partner and has set up new collaborations at LSTM for TB work. The strong collaboration with LSTM will additionally strengthen research and grant management processes in Malawi and offer opportunities for training of Malawian and UK scientists at both institutions.

Immune responses in malaria-exposed children immunised with a new generation blood-stage malaria vaccine

ARL - Dr Ally Olotu, Ifakara Health Institute, Tanzania

UK principal investigator – Professor Simon Draper, University of Oxford

Malaria remains a disease of public health significance affecting millions across the globe. Scaling up of malaria interventions has reduced the malaria burden in several parts of Africa, but this has not been consistent everywhere, with some areas reporting

sustained or even an increase in the burden of malaria. Vaccination is one of the most cost-effective public health interventions and an effective malaria vaccine is essential to achieve a sustainable solution to malaria in endemic countries.

Dr Olotu is a senior research clinician at the Ifakara Health Institute and hopes the ARL award will help him to achieve his long-term career goal to become an established principal investigator in the field of malaria vaccinology.

Dr Olotu plans to use standard laboratory techniques to determine if a new candidate malaria vaccine is safe and well-tolerated in adults, young children and infants. He will determine if the vaccine can produce antibodies capable of killing parasites growing in red blood cells in laboratory tests. The study will recruit volunteers residing in a low malaria transmission area in Bagamoyo, Tanzania and will provide new knowledge and inform decisions to conduct larger field trials to evaluate efficacy. The results will also identify whether there is scope to further improve this vaccine before conducting bigger trials in the field.

His UK partner, Dr Draper at University of Oxford provided Dr Olotu opportunities to collaborate with other researchers within Oxford and to participate in a multi-stage malaria vaccine consortium. This has led to an EDCTP award for a multi-centre proposal to evaluate the public health utility of a multi-stage malaria vaccine in malaria endemic countries. Dr Olotu as a co-applicant is leading a work package in Tanzania.

Investigating the Human Malaria Reservoir of Transmission during Pregnancy

ARL – Dr Alfred Tiono, Centre National de Recherche et de Formation sur le Paludisme (CNRFP), Burkina Faso

UK principal investigator – Professor Chris Drakeley, London School of Hygiene and Tropical Medicine

In recent years there has been considerable success in controlling malaria, reducing the levels of both infections and deaths. This success has prompted many countries to think about eliminating malaria altogether. Eliminating malaria will require additional and different approaches in that it will be necessary to identify people who transmit the infection to mosquitoes, who may be different to those that are sick. One group of individuals that realistically might infect mosquitoes more are pregnant women because they are at increased risk of getting malaria.

Dr Tiono is the head of the public health department at CNRFP. The award has increased his local and international exposure providing him with a further platform to raise his profile. He is widely regarded locally in Burkina Faso and is considered as a potential future leader of CNRFP.

Dr Tiono plans to evaluate to what extent pregnant women contribute to malaria transmission. To do this he will describe the levels of stages of the malaria parasite that can infect mosquitoes in pregnant women compared with other members of the population. He will also check if pregnant women are bitten more by mosquitoes and infect mosquitoes more than they do other people. Finally, he will combine these data to simulate interventions that are targeted towards pregnant woman in order to identify new strategies for malaria control.

Dr Tiono benefits from the expertise provided by Professor Drakeley at the LSHTM and is taking advantage of new collaborative opportunities. These include collaboration with Imperial college scientists who will help with the mathematical simulations and with researchers at the University of Glasgow with whom he will investigate the issue possibility of the transmission stages of malaria.

Determining Cellular Correlates of Immunity to Malaria in an Experimental Human Challenge Model of Exposed Adults

ARL - Dr Francis Ndungu Pwani University, Kenya

UK principal investigator – Professor Philip Bejon, University of Oxford

Malaria, caused by Plasmodium falciparum parasites, remains a major public health problem in sub-Saharan Africa. The substantial investment in developing anti-malaria vaccines has not been matched with similar levels of investment in the understanding of either: 1) the mechanisms of immunity to malaria, or 2) the reasons for the limited success with test vaccines in Africa. Although, children living with endemic malaria acquire immunity that initially protects them from severe malaria and death, the mechanisms that control the severity of symptoms, production of protective antibody, and parasite growth in the immune individual remain unknown. Additionally, it is increasingly becoming clear that malaria vaccines that proved immunogenic and efficacious in pre-clinical trials perform dismally in malaria exposed individuals. It is likely that the same mechanisms that mediate natural immunity also impair vaccine immunogenicity. These mechanisms remain major knowledge gaps, and my study will utilise samples from experimental malaria infections in adults with different levels of prior exposure to dissect the mechanisms involved. These studies may lead to innovative ways of delivering more immunogenic and effective anti-malarial vaccines for use in malaria endemic areas.

Dr Ndungu is a Post-Doctoral fellow at KEMRI Wellcome Trust Research Programme (KWTRP) and holds the position of Adjunct Senior Lecturer at Pwani University. Since his award he has applied for promotion to a Professor at the university.

Dr Ndungu plans to test which cellular responses correlate with the ability of an individual to control infection (inflammation and parasite growth) following experimental malaria infections in Kenyan adults. He will do this by identifying patterns of immune responses that can be used as predictive markers of an individual’s ability to control inflammation, produce protective levels of antibodies and to control parasite growth.

He is currently building on his collaborations with colleagues in Pwani, UK and KWTRP to establish an internationally recognised MSc Immunology Course at Pwani University. He has designed a curriculum that is well adapted for the Kenyan situation and it is planned to initiate this in 2019.

An investigation of interventions to increase uptake of HIV self-testing and linkage to post-test services among higher education students in Zimbabwe

ARL – Dr Euphemia Sibanda, CeSHHAR, Zimbabwe

UK principal investigator – Professor Frances Cowan, Liverpool School of Tropical Medicine

Adolescents and young people in Africa have the worst health outcomes of adolescents and young people globally partly because of the high rate of new HIV infections, particularly among young women. Despite this, young people are less likely to know their HIV status than older adults and as such are less likely to benefit from prevention and treatment options. The population of young Africans is expected to double in the next 30 years meaning that if nothing is done to improve young people's access to HIV prevention and care, the number of new infections in young people will also double.

Dr Sibanda is a senior researcher at CeSHHAR and since her award has been appointed a Senior Lecturer in Global Health and Epidemiology at LSTM from an honorary research fellow position. The award has brought recognition and a growing confidence in her abilities with Dr Sibanda seeing an increase in the number of invitations to participate in research consortia as a senior member of the team.

This project targets young students attending higher education institutions with a novel intervention, HIV self-testing, aimed at improving their uptake of HIV testing and supporting them to take up prevention and care services. Dr Sibanda proposes to compare the effectiveness and cost effectiveness of two models of distributing HIV self-testing among students, in a trial where higher education institutions are allocated by chance to one of two distribution models. Outcomes include: i) uptake of self-testing, ii) linkage to HIV prevention and care services depending on HIV result and, iii) cost per person tested, diagnosed positive and started on treatment or preventive service. She will also develop an internet-based tool to measure distribution of self-test kits and support and measure subsequent engagement with services. Dr Sibanda will then finally explore how to adapt these self-testing models for young people to other settings (eg schools or workplaces) and to support prevention and care for other chronic diseases in young people (eg hypertension or poor mental health).

Dr Sibanda receives ongoing local mentoring and support from Professor Cowan, who is based in Zimbabwe. However, she also benefits from expertise provided by Professor Shabbar Jaffar, Head of International Public Health at LSTM, who has introduced her to key senior researchers, afforded her the opportunity to attend a leadership training course at LSTM and holds regular meetings/teleconferences with her to discuss her work and progress.

Development of Novel Therapeutics for Parasite Infections and Cancer by Multi-step Microbial Biodiscovery Processes and iChip

ARL – Dr Kwaku Kyeremeh, University of Ghana

UK principal investigator – Professor Marcel Jaspars, University of Aberdeen

This project plans to exploit the huge microbial biodiversity of sub-Saharan Africa to create a large library of biosynthetically talented microbes and a pipeline of novel chemical structures that can be used for the development of drugs for infections, cancer and parasitic diseases that are largely endemic to sub-Saharan Africa.

Dr Kyeremeh is a Senior Lecturer of Chemistry at the University of Ghana. This Award has greatly enhanced his status and impact in the University, fully established his research, provided public visibility and helped in fulfilling most of the requirements in the application to Professorship.

Dr Kyeremeh will take advantage of the different well-established bioassays in the laboratories of his team to screen the microbial chemical diversity of sub-Saharan microbes from soils, plants, fishes, crabs and carnivorous molluscs. He will assemble a total of 300 novel West African microbial strains, isolate, characterize and determine the antibiotic, antiparasitic and anticancer properties of the molecules they express. The requirement of selective and potent activity is very important in this research and hence low levels of novel microbial chemical structures must be able to kill parasites or bacteria without having an effect on normal human cells. The biological activity profiles of all the molecules obtained in the project will be evaluated in detail giving the possibility for the discovery of new antibiotic, antiparasitic and anticancer agents. Furthermore, Dr Kyeremeh will use several different methods including variation of culture conditions, the use of antibiotics, bacteria-bacteria, bacteria-amoeba and bacteria-microalgae co-culturing to maximise the chemical diversity obtainable from microbes.

His research on drug discovery from microbial natural products is an entirely new area of research for the University of Ghana and Dr Kyeremeh has benefited from the mentorship of Professor Jaspars. The partnership has enabled visits to a variety of UK labs to gain insights into the various antibiotic, antiparasitic and anticancer bioassays screening platforms and modern gene heterologous expression techniques as well as others.

Etiological, intervention and outcome studies in African children, adolescents and young adults with heart disease

ARL – Professor Liesl Zühlke, University of Cape Town, South Africa

UK principal investigator – Professor Bernard Keavney, University of Manchester

Professor Zühlke plans to work on three heart diseases which cause major health problems in children and young adults in Africa: i) Rheumatic heart disease: where she will focus on rapid detection of Group A Streptococcus ( GAS) infection, barriers and facilitators to treatment for GAS and explore the entity of rapidly accelerated RHD; ii) Congenital heart disease: she plans to expand and develop the recently established cohort of patients in Cape Town to several Africa countries and explore specific hypotheses relating to quality improvement in this cohort; and finally, iii) The effects of HIV and long-term highly active anti-retroviral therapy (HAART) on the cardiovascular system of children and young people in South Africa, with multi-modality imaging.

The overarching aim of this project is benefit to children with heart disease in Africa. This will be achieved by building on Professor Zühlke 's emerging profile in children's heart disease in South Africa and beyond, enabling her to establish a portfolio of research cohorts, resources, and expertise. This project will deliver translationally relevant outputs directly relevant to the African healthcare context.

Professor Zühlke is a senior Lecturer at University of Cape Town and has been awarded Associate Professorship. The ARL award has enabled her to establish herself as a researcher within the department and will help build her reputation as an African Research Leader in both congenital and acquired children's heart disease.

Professor Zühlke benefits from the expertise provided by her UK mentor, Professor Keavney and is in close collaboration with him regarding future funding opportunities.

Seroepidemiology for monitoring vaccination and informing vaccine policy in Africa

ARL – Dr Ifedayo Adetifa, KEMRI-Wellcome Trust Research Programme, Kenya

UK principal investigator – Professor J Anthony Scott, London School of Hygiene and Tropical Medicine

Vaccines are essential for preventing many severe and often fatal diseases; however, their impact is greatly dependent on achieving high vaccination coverage in the target population. In developing countries, vaccination coverage is currently assessed via administrative records or from household surveys of vaccine cards or recall of vaccination history. These conventional methods can over/underestimate coverage, and they provide only very limited insights into population immunity especially as vaccination does not always result in immunisation. In high income countries, national serological surveys are conducted to obtain blood samples which are tested for antibodies produced in response to vaccines. This provides a measure of the proportion of the population that is protected by vaccination.

Dr Adetifa is a Clinical Epidemiologist at the KEMRI-Wellcome Trust Research Programme (KWTRP) and holds the position of an Associate Professor of Epidemiology at the London School of Hygiene and Tropical Medicine. One of the key aims of the KWTRP is to conduct research that will generate an evidence base to improve health and Dr Adetifa’s research is in synergy with this aim as it seeks to demonstrate the utility of using seroepidemiology to inform vaccine policy in Kenya for the benefit of the population.

Dr Adetifa aims to investigate the possibility of using antibody testing to monitor vaccination and to compare this to vaccine records held in the Kilifi vaccine registry. He then proposes to apply statistical methods to antibody test results to identify a mathematical model that reliably predicts vaccination coverage when compared to vaccine records. On identifying this model, he will then carry out a nationwide serological survey, apply the methods validated in Kilifi to the antibody test results to estimate national vaccination coverage, identify at-risk populations with gaps in their immunity and make recommendations for interventions to protect these populations.

Dr Adetifa benefits from the expertise provided by his UK mentor, Professor Scott, which enabled him to attend and present at the LSHTM Vaccine Centre retreat in March 2019. He received useful feedback and is building new collaborations.

A further 4 ARLs were awarded in 2019:

Evidence synthesis for building a translation pipeline to eliminate infectious diseases

ARL – Dr Eleanor Ochodo, Stellenbosch University, South Africa

UK principal investigator – Professor Paul Garner, Liverpool School of Tropical Medicine

This project is a collaboration between Liverpool School of Tropical Medicine (LSTM), Stellenbosch University and the Kenya Medical Research Institute (KEMRI). Dr Ochodo proposes to formally develop an approach to translating research findings into policy through summarizing and integrating research findings and then recommend methods of improving translation of evidence into policy and practice, concentrating on infectious diseases.

Integrating intervention targetable behaviours of malaria vectors to optimize interventions selection and impact

ARL - Dr Nicodem Govella, Ifakara Health Institute, Tanzania

UK principal investigator – Professor Heather Ferguson, University of Glasgow

Dr Govella aims to address the important but poorly understood area of malaria vector ecology that has significant implications for sustaining control and achieving elimination. It is known that the success of existing malaria control interventions, Insecticide Treated Nets (ITNs), can be undermined by variation in mosquito biting behaviour. However, the causes of variation in mosquito behaviour are poorly understood, making it difficult to predict when and where ITN programmes may be undermined. The proposed work would produce several crucial insights.

Hotspots, hospitals and households: enhanced drug-resistant tuberculosis case finding in Namibia (H3TB)

ARL - Dr Mareli Claassens, University of Namibia

UK principal investigator – Dr James Seddon, Imperial College London

This project has the potential to dramatically impact on the drug-resistant TB epidemic in Namibia and globally. Dr Claasens aims to (i) identify transmission hotspots for drug-resistant TB in two regions of Namibia, (ii) test the feasibility of three case finding intervention strategies, and (iii) model the impact of such interventions on drug resistant TB incidence in Namibia, as well as determine cost-effectiveness.

Defining changes in nasal immunity that favour propensity for pneumococcal colonisation in HIV-infected adults

ARL - Dr Kondwani Jambo, Malawi College of Medicine

UK principal investigator – Professor Daniela Ferreira, Liverpool School of Tropical Medicine

Despite the introduction to routine childhood vaccination in Malawi the prevalence of the pneumococcus among HIV-infected adults on antiretroviral therapy (ART) has remained high. Dr Jambo plans to generate information on some of the factors that make HIV-infected adults on ART more susceptible to the pneumococcus and improve understanding. This work will allow choices in optimal therapy against HIV and optimal vaccination strategies against pneumococcus, that could significantly impact pneumococcal transmission and disease in high transmission settings.