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Northwestern University Feinberg School of Medicine
Robert J. Havey, MD Institute for Global Health

Awarded Global Innovation Challenge Grants

The Havey Institute for Global Health is pleased to offer support to affiliated Northwestern faculty for research in global health. The Global Innovation Challenge mechanism is intended to encourage exploratory and cutting edge research by providing support for early and conceptual stages of project development geared towards addressing healthcare needs worldwide.

 Building the African Network for HPV-associated Cancer Prevention and Control
October 2023

Human Papillomavirus (HPV) is the most common sexually transmitted infection (STI) worldwide. In Sub-Saharan Africa (SSA), it is particularly serious due to the lack of HPV vaccination, and to change in sexual behaviors (increasing unprotected oral and anal intercourse) in the population. HPV-associated cancers (HAC) are due to high-risk HPV (hr-HPV), mainly HPV 16 and 18 strains which are responsible for 5% of all human cancers, a third of all virus-associated cancers, and a third of all cancers in low- and middle-income countries (LMICs), particularly in SSA. HPV DNA testing is simple and easy to perform as it only requires a small amount of DNA, which remains stable at room temperature and can easily be transported to a laboratory. However, it has not been widely used in LMICs due to financial, social, and logistical barriers. The self-sampling (SS)-based HPV test overcomes many of these barriers including the inadequate number of clinicians, time and cost of healthcare visits for sampling, and stigma associated with STI-related diseases. This consortium is designed to build capacity in order to promote SS-based HPV testing for HAC (cervical cancer, anal cancer and oral/oropharyngeal cancer). The aims of this project are to (1) Establish the Africa HAC Prevention and Control Network for equitable, feasible, culturally acceptable, cost-appropriate, and sustainable early detection and screening for HACs; (2) Apply and disseminate the new knowledge and skills through pilot implementation testing of (a) developing processes for population-level SS-based HPV screening and referral of hr-HPV+ cases
for advanced testing and treatment at clinical sites with an American Society of Clinical Pathologists-supported network; and (b) establishing a cartography of circulating HPV strains. This new proposed consortium under the leadership of Northwestern's Center for Global Oncology, will allow building a strong network of HPV researchers and sites in Africa for the rapid development of preventive strategies that are contextually adapted to the LMIC environment.

Quick Facts

Principal Investigator: Lifang Hou and Mamoudou Maiga

Co-Investigator(s): Supriya Mehta, co-I, Rush Univ. Charles Wood, co-I, LSU Jane Holl, co-I, UoC Robert Murphy, co-I, NU Chad Achenbach, co-I, NU Jian-Jun Wei, co-I, NU Imran Morhason-Bello, UI/Nigeria Jonah Musa, co-I, Univ. of Jos/Nigeria Brehima Diakite, co-I, USTTB/Mali Moussa Seydi, UCAD/Senegal Mamadou S Sow, Univ. of Conakry/Guinea Julius Mwaiselage, UDSM/Tanzania Fredrick Otieno, NRHS/Kenya

Partnered Institutions: USA: Rush Unv, LSU, UoC; Nigeria: UI & JOS; Mali: USTTB; Guinea: UC; Tanzania: UDSM; Kenya: NRHS

 Understanding solutions to promote healthy Ageing and reduce multimorbidity in Rwanda
June 2023

Ageing is often accompanied by chronic diseases, multimorbidity, and frailty, increasing need for clinical and social care. This is challenging even in high income countries. In low- or middle-income countries these challenges conspire with background poverty, infectious diseases, changing societies, and under-resourced health and social care systems. There is little knowledge on health ageing and needs and priorities of older people or the people who care for them from in sub-Saharan Africa to maintain health ageing. Studies that have been done are limited in scope. While Rwanda has extended Universal Health Coverage (UHC) through the innovative Community-Based Health Insurance (CBHI) programme, they are not necessarily responsive to the needs of older people; for example, there is limited medical personnel trained in geriatrics and gerontology at different levels. The work will blend mixed methods health systems research, implementation research as well as survey design and epidemiological data analysis. The results of this cross-disciplinary study will therefore provide evidence to design novel interventions to maintain health ageing and inform policy and planning.

Quick Facts

Principal Investigator: Lisa Hirschhorn

Co-Investigator(s): Alemayehu Amberbir

Partnered Institutions: Rwanda: University of Global Health Equity, Rwanda

 African Hepatitis B/HIV-HBV Co-infection Clinical Research Network (AHBCRN)
February 2023

Chronic Hepatitis B (CHB) infects over 60 million people in sub-Saharan Africa (SSA) and is responsible for abou t200,000 deaths per year mostly from liver cirrhosis, liver failure and cancer. HIV is also very common in SSA, present in over 25 million. Because of similar routes of transmission, around 10% of persons with HIV in SSA are living with CHB. HIV has been shown to significantly accelerate the risk of liver complications in persons with CHB, even among those well controlled on HBV-active antiretroviral therapies. In 2016, the WHO Global Health Sector Strategy (GHSS) on Viral Hepatitis called for a reduction of HBV incidence by 90% and mortality by 65% by 2030 through a number of program interventions such as hepatitis B infant and birth dose vaccination, blood and injection safety and harm reduction, as well as HBV testing and treatment. To date, the hepatitis response in SSA has significantly lagged behind other all other regions reaching these targets. Crucially, there is a dearth of local data on CHB that can help inform best practices in the diagnosis, care and treatment of persons with HBV and HIV-HBV which is significantly hindering progress towards HBV elimination. In addition, persons with CHB with and without HIV in this region remain incompletely characterized which is a significant barrier to participation in clinical trials, particularly those investigating novel curative agents where persons in SSA stand to gain the most benefit. To address some of these critical gaps in CHB research in SSA and be well poised to contribute to future CHB therapeutic trials, we propose to establish a multisite African HBV and HIV-HBV Clinical Research Network that will enable cutting edge research to be conducted to help improve health outcomes and optimize hepatitis care and treatment in these and other high prevalence settings. This innovation award will support the development of this network and three key deliverables including: i.) implementation of two longitudinal research cohorts of adult HBV and HBV-HIV co-infected participants at each network site; ii) development of a biobank of biospecimens collected on research participants at regularly defined intervals; and iii) creation of a comprehensive dataset of well characterized HBV and HIV-HBV populations providing high-quality preliminary data for future CHB studies and clinical trials. Pooling our expertise and resources to undertake collaborative studies will address some of the critical gaps in HBV prevention and care in low and middle income countries that are preventing progress towards HBV elimination, providing locally and globally relevant and policy changing data on many aspects of HBV patient management.

Quick Facts

Principal Investigator: Claudia Hawkins

Co-Investigator(s):

Edith Okeke MPI, Dawvar Pantong Co-I (JUTH)
Emoubor Odeghe, Ganiet Oyeleke Co-I (LUTH)
Seyi Akanade, Adegboyega Akere Co-Is (U of I)
Djeneba Fofana, Yacouba Cissoko Co-Is (Mali)
John Rwegasha (MUHAS/MNH)

Partnered Institutions: 

Jos University Teaching Hospital, Nigeria
Lagos University Teaching Hospital, Nigeria
University of Ibadan, Nigeria
University Of Science Technical And Technologies De Bamako, Mali
Muhimbili University of Health and Allied Sciences, Tanzania

 SARS-CoV-2 Transmission & Policy: Using active surveillance with bench science to inform what works, what doesn't, and what's promising?
South America (Peru, Argentina, Brazil, Bolivia), Sub-Saharan Africa (Tanzania, Mali, Nigeria), and South Asia (India), Fall 2022

The SARS-CoV-2 virus continues to mutate into new variants, which pose a global threat to public health. Because new variants can quickly shift the course of the pandemic, public health leaders often rely on incomplete, delayed data when tasked with critical policy decisions. This project will create an enhanced active surveillance system for researchers around the world to consult. Our interdisciplinary team of experts across surveillance systems, epidemiology, informatics, evaluation methods, engineering, infectious disease, genomics, molecular biology, and econometrics will use the enhanced system to provide immediate answers to key policy questions as new developments in the SARS-CoV-2 virus alter the trajectory of the pandemic. Our long-term goal is to inform effective public health policy on the resolution of this and future public health crises.

Our objective in this proposal is to create and disseminate interdisciplinary research on effective policy at the population level through global partnerships. We will accomplish this objective in two specific aims: (1) To identify shifts and the evolution of the pandemic, at any geographical level and timeframe, using disease modeling, transmission, and expansion metrics of SARS-CoV-2 and its VOI/VOCs. (2) To conduct policy relevant research on SARS-CoV-2 in response to new developments in the pandemic, by using difference-in-differences and dynamic panel estimators. These advanced statistical methods allow us to test policy and effectiveness of vaccinations, quarantines, and various mitigation strategies such as masking, remote work, and learning. We will also conduct a simulation study to quantify the potential benefits of our systematic, ongoing disease models as compared to traditional surveillance metrics. Our system of surveillance, modeling, and projections will have a high impact at the global level. To disseminate our work, we have secured partnerships with the media, Northwestern Alumnae, the United Nations, USAID, USAID missions and countries globally, WHO, CDC, and our global network of universities.

Quick Facts

Principal Investigator: Alexander Lundberg, MS, PhD

Co-Investigator: Lori Ann Post, PhD

Partnered Institutions: All India Institute of Medical Sciences, New Delhi, India; Center for Pathogen Genomics and Microbial Evolution (CPGME)

 SARS-CoV-2 surveillance and capacity building in Peru and Bolivia
Peru and Bolivia, Fall 2022

Since its emergence in 2019, Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, has infected hundreds of millions of people in a global pandemic. To define and monitor the effects of variants of concerns (VOCs), researchers and public health experts around the globe rely on genomic surveillance. A lack of timely genomic surveillance information has resulted in an unclear picture of the origin, severity, and transmissibility of VOCs among different global populations. The need for improved genomic surveillance is most acute in low- and middle-income countries (LMICs), which often lack the resources and expertise to track the emergence and spread of clinically relevant SARSCoV-2 variants. Most countries in South America are notably underrepresented in global genomic surveillance efforts, with just 2.3% of all SARS-CoV-2 genome sequences in the GISAID global database originating from the continent. Improving genomic surveillance capacity in LMICs is critical to the early detection of and response to emerging variants.

Here, we propose to establish and enrich strategic foundational partnerships in three cities in South America (Lima and Iquitos in Peru and Santa Cruz in Bolivia) to fill critical gaps in global SARS-CoV-2 genomic surveillance infrastructure and build local capacity for pathogen genomics. This will be accomplished in 4 stages: (i) establishment of collaborative ties and an administrative framework across partner institutions; (ii) remote provision of SARS-CoV-2 surveillance capacity through whole-genome sequencing at Northwestern University as well as in Lima, Peru for immediate dissemination and reporting; (iii) local establishment of SOPs for clinical data collection and specimen biobanking; and (iv) provision of consultation and training towards capacity building with the goal of joint funding. The proposed project will establish a network of collaborations in undersurveillanced countries and regions in South America to contribute to local and global COVID-19 research and build capacity for local genomic surveillance.

Quick Facts

Principal Investigator: Egon Ozer, MD, PhD

Co-Investigators: Judd F. Hultquist, PhD & Ramon Lorenzo-Redondo, PhD

Partnered Institutions: Centro de Investigaciones Tecnológicas Biomédicas y Medioambientales (CITBM) at the National University of San Marcos in Peru, Iquitos that is dedicated to clinical scientific research, La Asociación Civil Selva Amazónica (ACSA, the Amazon Forest Civil Association), and Human Health Sciences as the Universidad Autónoma Gabriel René Moreno (UAGRM)

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