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      "description_narrative":["For the more than 200 million farmers in Africa who depend on rain-fed agriculture, drought is a matter of life and death. Their vulnerability is often aggravated by a lack of access to risk management tools such as insurance, which also limits their ability to take productive risks on their farms. Index insurance, where compensation is based on weather or area yield metrics, rather than on measured losses, is an affordable alternative to traditional insurance. However, index insurance will only increase resilience to climate shocks if the index insured fairly reflects the risk for both farmers and insurers.   Index design processes are becoming increasingly sophisticated, utilizing multiple data-sources and models. A certain degree of basis risk (where compensation doesn't match observed losses) is, however, inevitable as insurance is not designed to target every risk. Anticipating basis risk that ensues from the complexity in the relationship between meteorological drought (rainfall deficit) and agricultural drought (soil moisture deficit) is a key challenge for the agricultural insurance sector.   We propose a new system, SatWIN-ALERT, which can be deployed in real time to detect and predict basis risk events as they happen. As such, it could unlock in-season actions (such as increased monitoring), or allow timely post-season index assessment or action, enabling aid agencies and governments to anticipate basis risk events, and take action to support farmers who are facing uncompensated agricultural losses. In effect, the facility to predict pay outs and losses bridges the gap between post hoc index insurance and forecast-based finance. SatWIN-ALERT provides a means of combining the data issued by existing platforms into integrated assessments of droughts and subsequent compensation. As such, it can be integrated into well-established and trusted insurance design systems, such as the ARC risk viewer (ARV) or the IRI Social Network for Index Insurance Design (SNIID).   SatWIN-ALERT builds on existing state-of-the-art practices to take a sophisticated approach to basis risk management, allowing index insurance to play an improved role within climate risk management and development. We also bring together novel existing participatory and meteorological research to build systems that are suitable for operational use in ODA countries. To do this, we draw on fundamental research on monitoring of environmental conditions, and on recent improvements in forecasts - especially on sub-seasonal to seasonal time scales, working with established partners to bring results to hundreds of thousands of farmers. We will focus on countries identified as important to our partners, specifically Malawi for our participatory research, plus Nigeria, Senegal, Malawi, Zambia and Ethiopia (amongst others) for our basis risk case studies.  In summary, the proposed project will develop a novel operational system (SatWIN-ALERT), which empowers farmers to benefit from robust financial instruments, based on state-of-the-art models, observations and forecasts. Partnership with leading practitioners in Africa will enable SatWIN-ALERT to sit within existing insurance systems to revolutionise basis risk management and build the resilience of millions of farmers to weather-related hazard.","The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world."],
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      "title_narrative":["Building Resilience in Ethiopia's Awassa region to Drought (BREAD)"],
      "description_narrative":["Droughts in Sub-Saharan Africa have been exacerbated by the current El Niño event, resulting in well publicised risks of famine in the worst affected regions and food shortages elsewhere. This project will combine data collected in the Awassa region of Ethiopia before, during and after the current El Niño to quantify the impacts to locally produced food and farmer livelihoods. Our primary aim will be to assess biophysical interventions that promoted resilient food production during this El Niño event, with a strong social sciences input so that societal acceptance and impacts of beneficial interventions can be assessed.  We have assembled a UK-Ethiopia project team with long-standing expertise working in the region. It involves experts in all aspects of natural, economic and social sciences. We will test two over-arching hypotheses: (1) the short term extreme drought associated with the current El Niño will have a long term impact on communities, their farming systems and their soils; and (2) resilience to this drought can only be built through interventions that consider both biophysical and socio-economic factors. A major intervention that we will explore is sustainable soil management through organic residue incorporation, taking into account resource conflicts with animal feed and household fuel use that worsen during times of extreme drought. We explore the knock-on impacts of land management to the availability of green water (stored in soil) and blue water (abstracted from ground and surface water sources). Further data on soil fertility will be measured across a range of 36 case-study farms located within two districts that are different distances from water supplies. The project will allow for crop and soil data collected for two years before the current El Niño to be supplemented with continued measurements of post-drought resilience.  Previous data were collected in the ESPA funded project 'Alternative Carbon Investments in Ecosystems for Poverty Alleviation'. Modelling of crop and soil responses will allow us to upscale the impacts of land management interventions. Our outputs will be translated into outcomes through engagement with farmers, local and regional government and other stakeholders, both throughout the research and once the research is complete. As recently as December 2015, we met directly with these stakeholders, using well-established networks developed by our Ethiopian partners. Awassa is not the region in Sub-Saharan Africa that is worst affected by El Niño, but we argue that its relatively high population density, supported by food availability during good growing seasons, makes it particularly important. Moreover, land in the worst affected regions is so infertile that interventions may have limited impact, whereas in Awassa and similar more fertile regions of Ethiopia, interventions could promote greater agricultural productivity to supply national food demands during extreme events. We have already observed that Awassa houeholds spend more time collecting water and have been able to collect less due to pump breakdowns as groundwater levels get deeper during this drought. Yields have plummeted, affecting the earnings of subsistence farmer. Interviews conducted in December 2015 showed that farmers attempt to cope with the situation through short term strategies such as selling off livestock which will have long term consequences for the farming system in the area. The outcomes of this research will contribute towards increasing awareness of the impacts of drought in the region, and improving resilience of farming systems to drought. This will help farmers to employ better coping strategies for drought and to cope for longer, requiring less interventions and avoiding catastrophic harvest failures. In the long term, this will contribute towards better food security and nutrition, improved resilience and reduced risks associated with extreme droughts from future El Niño events.","The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world."],
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      "title_narrative":["Monitoring the impact of the 2015/16 El Nino on rural water insecurity in Ethiopia: learning lessons for climate resilience"],
      "description_narrative":["The developing drought in Ethiopia is linked to the ongoing strong 2015-2016 El Niño event and is leading to widespread food and water insecurity in the region, particularly for the large numbers of people living in remote rural areas. Whilst there is a well-developed national and international response to food insecurity, the failure of local springs and wells, the primary source of water in these areas, has caught many off guard, with growing evidence that migration is driven by water shortage. Research in east Africa during and since the last major El Niño drought in the late 1997/98, indicates that access to reliable groundwater sources is a major contributory factor to improving livelihood resilience, particularly of the poorest.  This current El Niño-related drought in Ethiopia, provides an important research opportunity to: (i) gather robust evidence of the behaviour under stress of shallow groundwater sources (mountain springs, valley springs, wells, boreholes); (ii) monitor the timing, magnitude and contamination issues associated with recovery; and (iii) assess the coping strategies developed by family groups and communities as water points fail. Methods developed since the last major El Niño event make this possible, for example: robust inexpensive sensors for continuously measuring groundwater levels, novel rapid methods for indicating pathogen contamination and a new suite of groundwater residence time indicators.    With this new evidence it will be possible to ensure vulnerable communities become more resilient to future droughts by: identifying resilient designs of water point; targeting mapping efforts to areas to identify vulnerable areas, and contributing to the design of early warning systems.  The research brings together an experienced team from BGS, ODI, and AAU, all of whom are currently working in Ethiopia, supported by partners in the meteorological department at the University of Reading and various implementation partners in Ethiopia.","The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world."],
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      "title_narrative":["Lung health in Africa across the life course"],
      "description_narrative":["Almost half of the world's population, including 700 million people in Africa, relies on biomass fuels (animal dung, crop residues, wood) for their everyday fuel-energy requirements. These fuels are typically burned in open fires, often indoors, that emit smoke into the household environment and lead to high levels of household air pollution. Women and children, especially young children, experience high exposures to air pollution in the home; this has been linked to a range of adverse health outcomes including non communicable lung diseases like chronic obstructive pulmonary disease (COPD) and lung cancer in adults and asthma in children. It is now recognised that household air pollution from biomass smoke is the third leading cause of global disability and death with 4 million deaths attributed to this exposure annually. This burden, much of which is represented by non-communicable respiratory disease, falls hardest on poor populations around the world and in countries in sub-Saharan Africa in particular.  To build the foundations for work to tackle this issue we have bought together a network of investigators from ten African countries (Cameroon, Ethiopia, Ghana, Kenya, Malawi, Nigeria, South Africa, Sudan, The Gambia and Uganda) underpinned by support from the Pan African Thoracic Society (PATS), American Thoracic Society (ATS) Methods in Epidemiologic, Clinical and Operations Research (MECOR) programme, MRC BREATHE-Africa partnership, Malawi Liverpool Wellcome Trust (MLW), Burden of Obstructive Lung Disease (BOLD) Centre, Spirometry Training Services Africa, Global Asthma Network (GAN), and Collaboration for Applied Health Research and Delivery (CAHRD). This proposal offers an unprecedented opportunity to create a multi-site multi-disciplinary pan-African platform for clinical, epidemiological and applied health research underpinned by regional and international collaborative research and delivery networks that will allow us to conduct research into the causes, prevention and treatment of non-communicable respiratory disease across the life course. By addressing a major cause of morbidity and mortality across the life course of children and adults living in low or middle-income countries in Africa the proposal is fully aligned with the overall principle of Official Development Assistance (ODA) to promote welfare of developing countries.   Within the two years of this foundations-building grant we will work hard to create a thriving partnership whilst delivering on two specific research aims: to 1) develop and share methodology for the measurement of non-communicable respiratory disease exposures and outcomes tailored to the challenges of conducting research in resource-constrained African environments and 2) use this methodology to generate and share high quality preliminary data from multiple African sites.","The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world."],
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      "title_narrative":["A mathematical modeling framework for tuberculosis burden estimation and economic evaluation of pharmaceutical interventions"],
      "description_narrative":["Tuberculosis (TB) is a major cause of disease and death globally. In 2015, WHO estimated there were 9.6 million TB cases and 1.5 TB deaths. Nearly 500,000 of these cases were resistant to two or more of the main drugs used to treat TB. New drugs, and combinations of drugs, are being developed to treat tuberculosis, as are new vaccines that may protect against disease in adults.  Quantifying the burden of TB is fundamental to understanding its global epidemiology and for making appropriate resource allocation decisions. Most estimates of new TB case numbers each year rely strongly on the number of cases reported by countries in that year to WHO. Unfortunately, one in three TB cases are thought to go either undetected or unreported, so the number of cases reported underestimates the number of new cases. While one can correct for this, it is hard to know exactly how much to adjust the reported numbers. Some countries have good systems for recording causes of deaths, which can be used to estimate the number of deaths caused by TB. Increasingly, large and expensive prevalence surveys are being used to estimate the number of people with active disease in a population. These estimates are less subject to bias, but measure a different quantity. Little work has explored the best way of combining these three data sources.  A major goal of this work is to use mathematical transmission models for burden estimation and provide a unified framework for all data. These models yield the number of new cases, deaths, and also the prevalence of disease. They explicitly represent disease transmission and so introduce a dependence between the number of new cases in different years. These models involve parameters evidenced from previous epidemiological work, but must be calibrated to learn from data on TB reports, deaths and prevalence. Calibration means adjusting imperfectly known model parameters in order to match observed model outputs to the data. This process provides a model that may be used to make predictions about burden, but may also teach us something about the underlying processes. Many of the parameters concerning the epidemiology and disease course of TB are quite uncertain, and this uncertainty is rarely represented fully in models needing calibration, but will be done in this project using statistical techniques that also allow comparison of different models' performance.   TB burden estimation and calibration of transmission models are almost always carried out on a country-by-country basis. Many parameters describing disease progression are likely to be similar in different countries, even if their exact values differ for unknown reasons. Hierarchical modelling techniques allow such parameters to be correlated between countries. This can improve precision, particularly for countries with little data, as estimates can be informed by data from neighbouring countries. I will explore these techniques for the transmission model, and also in statistical modelling aiming to account for the observed patterns of drug-resistance. The transmission model will ultimately be extended to include different types of drug resistance.  As new treatments and vaccines emerge, those with responsibility for public health will want to understand the potential impact these new technologies can have in terms of gains in health, and changes in spending. Producing cost-effectiveness and budget impact evidence requires a model that includes transmission, in order to account for indirect benefits accrued by avoiding secondary cases. We will use our model to provide guidance to decision-makers seeking to maximise health gain with limited resources. We will also analyse sources of uncertainty in the model to identify future research that would have most value in increasing the precision of burden estimates and in reducing decision uncertainty around the introduction of new interventions.","The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world."],
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      "title_narrative":["MICA: Development of new agents for the treatment of cryptosporidiosis"],
      "description_narrative":["A recent clinical study in Africa and South Asia has found that cryptosporidiosis is one of the most significant causes of death and illness from diarrheal diseases amongst children in the developing world. Cryptosporidiosis is caused by a single-celled protozoan parasite; the predominant species infecting humans are called Cryptosporidium hominis and Cryptosporidium parvum. This parasite mainly lives in the cells in the gut wall and has a complex life-cycle. Infection occurs due to consumption of water or food contaminated with the parasites. Parasites are spread from an infected individual through their faeces. In people who are healthy and well nourished, the disease clears naturally within a couple of weeks. However, in people who are malnourished (particularly in young children) and people with an immune system that is not functioning properly (for example HIV/AIDS victims), the disease can have a much more significant impact. It is the major contributor to life-threatening diarrhea in young children, with 2.9-4.7 million cases in children under 24 months in sub-Saharan Africa and the Indian sub-continent, leading to more than 200,000 deaths per year. Cryptosporidiosis is also associated with malnutrition and stunted growth in children and probably causes chronic infections, which last for weeks or months. The only drug registered for the treatment of this disease is nitazoxanide, which is not very effective, especially in those patients who are most severely affected due to a weak immune system and/ or malnutrition.   Therefore there is an urgent need for the development of new drugs to treat: (1) children <24 months, especially those that are malnourished and with chronic diarrhea; and (2) immunocompromised children and adults with advanced AIDS and chronic diarrhea. Cryptosporidium may be the cause of as much as 75% of chronic diarrhea in this patient cohort.   We have discovered some chemical starting points that can be used for a drug discovery programme. We have a series of compounds that kill the parasites and also are very effective in clearing the parasites from rodent models of cryptosporidiosis. The compounds are thought to work through preventing the parasite making proteins. The aim of this project is to take these starting points and optimise them to make a molecule which has the potential to be a drug. This will require us to optimise multiple features of the molecule: its ability to kill the parasite, its ability to reach the sites in the body where the parasite resides without being broken down, and its safety. At the end of this project we hope to have a \"preclinical candidate\". This is a compound that we think should be suitable to enter human clinical trials. The steps after this project, prior to human clinical trials will be to make the compound on a larger scale under properly defined conditions and to carry out formal safety testing.","The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world."],
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