Despite available efficacy data on two malaria vaccines designed for broad use, there is little evidence about scalable delivery strategies in areas with seasonal malaria transmission. We propose a multi-site, multi-disciplinary Phase IV cluster-randomized trial in Burkina Faso and Mali to evaluate the effectiveness, real-life impact, acceptability, feasibility and cost-effectiveness of a novel integrated delivery strategy of R21/Matrix-M in areas with highly seasonal malaria transmission.We will compare campaign-style vaccination co-administered during Seasonal Malaria Chemoprevention to vaccination following an age-based strategy in routine Essential Programme on Immunisation activities using a non-inferiority design. We will engage with all stakeholders to co-design the integrated strategy, collect malaria incidence data via surveillance and prevalence via cross-sectional surveys, generate data on coverage, assess feasibility and acceptability among stakeholders and end-users using qualitative longitudinal study methods, and describe the cost-effectiveness of both approaches, with costs and outcomes measured from the societal perspective. We will also use the trial platform to perform post-licensure pharmacovigilance of R21/Matrix-M. The project will ensure translation of results into policy and practice throughout areas of highly seasonal malaria transmission. It responds to SDG3, and is aligned with the Immunization Agenda 2030, particularly by testing a community-based vaccine approach that should reduce the number of “zero-dose” children. By leveraging the SMC platform, we hope to mitigate vaccine hesitancy. Our multi-disciplinary approach aims to generate a comprehensive package of evidence that will allow policymakers to make informed guidelines for malaria vaccine schedules and delivery in the Sahel, at the same time reinforcing health systems and promoting synergies between malaria and vaccination programs in support of the Primary Health Care agenda.

The spread of Mpox virus (MPXV) in Sub-Saharan Africa, specifically Democratic Republic of Congo (DRC) and Republic of Congo (RoC) presents an urgent public health concern with global implications. MPXV cases have been reported across 114 countries with 89,752 confirmed reports and >150 deaths. It has the highest prevalence in DRC and has resulted in twice the number of deaths in the African region compared to Europe. RoC, a DRC bordering country, is also experiencing a surge in positive cases, highlighting an urgent need for data-driven efforts to identify transmission routes and implement public health initiatives. MPOX-PROBE is responding to this call for action with an international consortium and activities in three main pillars (1) improving epidemiological surveillance of Mpox with new diagnostics and sampling efforts including high-risk areas and vulnerable populations; (2) capacity building to improve diagnostic and research capacities of researchers and public health workers in DRC and RoC; (3) strengthening public health response by sharing surveillance data and newly developed spatiotemporal risk and transmission models for Mpox. Through MPOX-PROBE, this consortium will create actionable data to uncover MPXV transmission routes and natural reservoirs facilitating development of effective interventional packages. The transmission and risks models will allow prediction of future or emerging outbreaks and develop initiatives to prevent further spread. Together, these efforts will benefit vulnerable populations and general public in sub-Saharan Africa alike while also performing ground-breaking research to understand transmission mechanisms.

Neurocysticercosis (NCC) is a fatal zoonotic disease following ingestion of eggs of the pork tapeworm, Taenia solium. The eggs develop to larval forms (cysticerci) in various tissues, including those of the central nervous system, leading to NCC, mainly characterized by epileptic seizures. NCC management guidelines have been published by the WHO, however, their uptake in national policies is very limited. In NeuroSolve, we will demonstrate and promote a methodological approach for conducting health research that leads to improved adoption into policy and clinical practise. We will validate the approach by investigating evaluation- and implementation of an antiparasitic combination treatment and a serological test. Two health innovations that can make a major positive contribution to NCC management. The proposed approach includes (1) strengthening of clinical and research capacity through training and mentoring of early career researchers, clinicians and frontline healthcare workers as well as upgrading infrastructure for surveillance and control, (2) demonstrating the improved pragmatic effectiveness of the combined treatment on quality of life (3) evaluating the potential impact of serological testing on the patient outcomes and the wider health system through a simulation study, (4) demonstrating the cost-effectiveness and cost-benefit of the proposed health technologies, (5) developing and validating an implementation strategy that addresses identified barriers for uptake using the robust implementation frameworks and 6) enhance research results uptake into national and international guidelines and health policy through engagement of relevant policy makers throughout the project period and beyond. If the intended impacts are reached, NeuroSolve will improve health outcomes of NCC patients, provide a blueprint for meaningful implementation research and demonstrate to policy makers how research can strengthen healthcare systems.