Ebola virus disease has been declared a Public Health Emergency of International Concern in Democratic Republic of the Congo. In the short term, our consortium plans to optimise, manufacture, and validate a novel Ebola rapid diagnostic test (RDT) for deployment at the point of need — that is low cost and high performance. A simple, 5 minute, high performance test, that complements complex laboratory tools, is urgently needed to ensure earliest possible detection of Ebola in the heart of communities experiencing an outbreak. Successful deployment will lead to an optimised and evaluated device for manufacture to support the current outbreak in DRC, surveillance in neighbouring regions, and in time post-DRC outbreak surveillance. In the long term, we envision substantial impact generated by establishing a new model for sustainable delivery of high performance outbreak diagnostics, deployed at the point of need. Accordingly, diaTropix - a new manufacturing facility dedicated to epidemics and neglected diseases in Dakar, Senegal - will be set up with the capability, expertise, and reagents to produce rapid diagnostics responsively to evolving outbreaks — with Ebola demonstrating proof of concept and feasibility, and a portfolio of rapid diagnostics in the pipeline for dengue, yellow fever, measles, and malaria.

Preventable and treatable diseases cause a huge amount of illness and a huge number of deaths in Africa. Infectious diseases, like malaria, are some of the biggest killers. Not only do these diseases cause major health problems for those infected, they are also a major financial burden to individuals and communities, and they hinder economic and societal development for whole countries. The poorest and most marginalized communities are usually the worst affected, and so these diseases exacerbate inequalities associated with geography, gender and ethnicity. Current strategies to tackle infectious diseases in the poorest settings rely on rudimentary approaches to diagnosis and treatment, such as reliance on a few clinical features (like fever, difficulty breathing or pallor) and very few simple tests to decide the treatment someone should receive. This approach is necessary because there are rarely diagnostic laboratories nearby to provide comprehensive testing, and even if there are, their services are often too expensive. Unfortunately, the simple methods of diagnosis often result in incorrect diagnosis, and provide little data from which to learn how to improve. A wrong diagnosis can mean the wrong treatment is given, resulting in prolonged illness or death, whilst at the same time encouraging overuse of some treatments like antibiotics or anti-malaria drugs, which can drive resistance to these drugs. A revolutionary solution to this problem is to develop a new generation of digital diagnostic tests which can be used at the point-of-care in even the hardest-to-reach communities. These diagnostic tests are not only more accurate and faster than current alternatives but potentially cost saving. Digital diagnostics have the potential to transform the situation by linking the precision typical of an advanced laboratory with the portability, connectivity, analysis and support that can be provided through a modern smart phone. This means tests can be administered anywhere and anytime by a wide range of healthcare workers with minimal training. For example, a drop of blood collected from the tip of the finger of child by a health worker in their community, could be applied to a tiny microchip powered by a mobile phone battery, and within 15-20 minutes a result could be available to make a diagnosis. The results are transmitted from the microchip to a smartphone via Bluetooth so no internet connection is required. If "Malaria" is detected, the device can notify the healthcare worker of the type of malaria and the correct treatment. The smartphone could also send the result and location data via the mobile network to a remote computer system, which could determine whether there is an unusually high level of malaria in that area and, if so, notify the national Malaria control program that extra resources are required to tackle an outbreak before it gets worse. Thus the child benefits from the right treatment, the community benefits from the intervention, and the health authorities benefit from being able to allocate the resources available to where they are most needed or will work best. The real-time data also allows international organizations to make more effective policies to tackle malaria and allocate funding. In our proposal we are developing a network of scientists with diverse skills and expertise, joining them together with commercial companies that manufacture diagnostics, and organizations who work directly in African countries putting new disease control tools and strategies into practice. This network will plan how best to develop new digital diagnostic devices to tackle health problems in Africa. The network will test its strategies by specifically planning the development of a new digital diagnostic test device for malaria and drawing out a roadmap to its implementation.

ZIKAlliance is a multidisciplinary project with a global "One Health" approach, built: on a multi-centric network of clinical cohorts in the Caribbean, Central & South America; research sites in countries where the virus has been or is currently circulating (Africa, Asia, Polynesia) or at risk for emergence (Reunion Island); a strong network of European and Brazilian clinical & basic research institutions; and multiple interfaces with other scientific and public health programmes. ZIKAlliance will addrees three key objectives relating to (i) impact of Zika virus (ZIKV) infection during pregnancy and short & medium term effects on newborns, (ii) associated natural history of ZIKV infection in humans and their environment in the context of other circulating arboviruses and (iii) building the overall capacity for preparedness research for future epidemic threats in Latin America & the Caribbean. The project will take advantage of large standardised clinical cohorts of pregnant women and febrile patients in regions of Latin America and the Caribbean were the virus is circulating, expanding a preexisting network established by the IDAMS EU project. I will also benefit of a very strong expertise in basic and environmental sciences, with access to both field work and sophisticated technological infrastructures to characterise virus replication and physiopathology mechanisms. To meet its 3 key objectives, the scientific project has been organised in 9 work packages, with WP2/3 dedicated to clinical research (cohorts, clinical biology, epidemiology & modeling), WP3/4 to basic research (virology & antivirals, pathophysiology & animal models), WP5/6 to environmental research (animal reservoirs, vectors & vector control) , WP7/8 to social sciences & communication, and WP9 to management. The broad consortium set-up allow gathering the necessary expertise for an actual interdisciplinary approach, and operating in a range of countries with contrasting ZIKV epidemiological status.