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      "title_narrative":["Containing antimicrobial resistance in rural Cambodia: a one-health multi-disciplinary intervention to improve village healthcare and farming practice"],
      "description_narrative":["Antibiotic resistance has been termed the greatest menace of the current century by the World Health Organization. If appropriate measures to mitigate antibiotic resistance are not taken immediately, it is estimated that millions of people will die, in the near future due to complications arising out of inability to treat resistant infections and most of this burden will fall on the poor, underdeveloped part of the world.   The main drivers of antibiotic resistance are antibiotic use and antibiotic residues in the environment. Both generate resistant bacteria. Appropriate monitoring and mitigation of both is neglected in poorer countries due to inadequacy of awareness, infrastructure, economics, political will, socio-cultural dimensions and a myriad of other factors. Resistance knows no geographical or political boundaries; it spreads quickly all over the world. So, not only the poorer human beings from underdeveloped countries suffer, these countries also become 'hot spots' of resistance generation and spread.   Cambodia is the poorest country in the Greater Mekong Sub-Region and continues to recover from a prolonged civil war which saw its institutions and infrastructure destroyed, which resulted in the loss of most of its educated personnel. With support of international partners, Cambodia is rapidly developing;  Cambodia was one of the countries, which achieved the millennium development goals in reducing infant and child mortality. The proposed provinces for the antibiotic resistance study and intervention are among the most remote and underserved both within the formal health and agricultural systems and rely for care on personnel who have minimal training for both care of patients and animals. When a person or animal becomes ill, medicines including antibiotics, often of dubious quality are bought from local pharmacies or market stalls and administered by the persons themselves. Human antibiotics are often given to animals and vice versa. Due to the deficit of trained health personnel, Cambodia has developed a cadre of village level healthcare workers, who have minimal training and little supervision to treat villagers or their sick animals. Little care is taken in disposing of antibiotics, which must be resulting in huge amount of residues in Cambodian environment.   The proposed project will investigate and map the current status of antibiotic use, antibiotic resistance and antibiotic residues in the target area and would examine the drivers for these in these remote areas, involving various stakeholders including human and animal healthcare providers and policy makers. We would involve the newly instituted laboratory and personnel in the Royal University of Agriculture and Veterinary Medicine as well as our partners, the Ministry of Health and the Ministry of Fisheries and Agriculture. We would also seek to evaluate the efficacy of a community dialogue intervention in improving the knowledge and understanding of use, handling and disposal of antibiotics to achieve appropriate antibiotic resistance management.","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":["Roll out the radical cure with primaquine for vivax elimination: development grant"],
      "description_narrative":["What does it take to roll-out radical cure with primaquine regimens of vivax malaria in Cambodia, Laos, Vietnam, and Bangladesh? Without radical cure more than half of all patients with vivax malaria suffer one or often many repeated relapses. Not only does relapse cause suffering, loss of income and misery, people with relapsing malaria are also infectious and contribute to the continued transmission of vivax malaria. Vivax malaria relapse can be prevented by the administration of drug regimens which include primaquine. These drug regimens are underused because they can potentially trigger hemolysis (rupturing of red blood cells) in people with an inborn error in an enzyme (G6PD), which can be severe enough to require blood transfusions. Two important developments make it now easier to administer radical cure for vivax malaria. First, several companies have developed point-of-care sophisticated devices (biosensors) to measure G6PD enzyme activity. Using biosensors health care providers can detect patients with an enzyme deficiency and exclude them from treatment with primaquine. Second, a recent study has shown that a 7-day primaquine regimen is as safe and as good at clearing vivax malaria as the traditional 14-day drug regimen. We think that patients are more likely to complete a 7-day course than a 14-day course.   These two developments, biosensors and 7-day primaquine regimens, should lead to the widespread uptake of radical cure with primaquine. However, many health care providers and the policymakers (who make the guidelines health care providers follow) are not aware of these recent developments. Furthermore, the currently available evidence may not convince them. One way to convince them may be to start discussions on the preparation and eventual results from large demonstration trials. We are planning a large trial in which all vivax patients in selected villages receive a primaquine regimen. We will compare the incidence of vivax malaria in villages where primaquine radical cure is routinely used with the incidence of vivax malaria in villages where primaquine is not used, according to current national guidelines.  We expect that people with G6PD deficiency can be reliably detected at the point of care and excluded, that the primaquine regimens are well tolerated in G6PD-normal patients and that continuous treatment of vivax cases with radical cure will reduce and eventually stop the transmission of vivax malaria.   The demonstration trial is a major undertaking and critically depends on the choice of an appropriate G6PD test, the right primaquine regimen, the agreement of the proposed study community and the policy makers. To make sure the conditions are promising we are proposing here the funding of a development grant. We are planning to use the grant for a multidisciplinary preparatory study. The three main component of the proposed study are:   1) To interview relevant policymakers and stakeholders on what they think of the roll-out of the radical cure and what evidence would convince them to support the roll-out.  2) We will compare the performance of the available G6PD biosensors with the traditional standard tests in the diagnosis of the enzyme deficiency and select the best-performing biosensors that can be reliably and feasibly used by village health workers.  The village health workers already diagnose patients with vivax malaria using rapid diagnostic test. In addition, they will diagnose G6PD deficiency using the biosensors to make sure that biosensors are helpful in field conditions. 3. We will explore which is the acceptability by health workers and patient adherence to the primaquine regimen at the village level. 4) We will find out the most appropriate sites for the trial.  At the end of the study we expect to have accumulated enough knowledge to undertake a large demonstration trial in our target countries.","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 Clear Road Ahead- Developing a Combined Technological and Socio-Economic Approach to Freeing Affected Communities from Anti-Vehicle Landmines"],
      "description_narrative":["Clearing landmines both saves and improves lives in numerous different ways. Demining can help a community access agricultural land, markets and food supply, schools, hospitals and other essential services, through the clearing of transportation links and routes. By clearing anti-personnel (AP) and anti-vehicle mines (AVMs) from roads and fields, people and communities are reconnected, and this can bring huge socio-economic benefits to developing countries where these are most needed. Clearing AVMs from roads can also be a prerequisite for other aid agencies and government services to access remote communities. It restores freedom of movement and fosters freedom from fear. However, efforts to clear roads and fields from the threat of landmines are complicated by two issues: 1) the slow speed of current demining approaches particularly for certain classes of landmine; and 2) the need to prioritise the order in which different areas and land types are cleared for maximum benefit in the shortest possible timeframe.   We propose a project to tackle both of these issues, creating a new technological tool for detecting landmines alongside a methodology for examining cultural, political, and socio-economic factors at the national, district, and even community levels. This approach can guarantee the deployment of the technology for the greatest possible benefit in the shortest possible time.  To the best of our knowledge this is the first time that a combined strategy of this kind has been attempted. The particular target of the project is minimum-metal AVMs laid in roads and fields, which is a class of landmines that is very difficult to detect by other methods, and thus very slow and costly to clear. Beyond this synergistic approach, the project will benefit from the unique advantages of our proposed technology for the clearance of AVMs. This is because our sensor relies on a frequency-sensitive detection of the explosive material, which is contained in large quantities in anti-vehicle mines.  The sensor's underlying technology is based on a quadrupole resonance (QR) approach, which relies on a simple detection mechanism: a pulse or series of radiofrequency (RF) pulses is applied at a particular frequency for the explosives of interest, and the presence (or absence) of a return signal is sought. As with metal detectors, a specially-designed planar RF antenna is placed close to ground level and fed with a sequence of RF pulses at or close to the QR frequency of the explosive to be detected. The same antenna is then used to detect the weak signals emitted by the explosive following the excitation. The important difference from metal detection is that it is the actual explosive contained within the mine that is detected and not any feature of the mine (such as the casing or the trigger), so the false alarm rate is low. This is particularly important for humanitarian demining, which aims to clear most, if not all, of the landmines in the interrogated terrain.","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 Step Change in LMIC Prosthetics Provision through Computer Aided Design, Actimetry and Database Technologies"],
      "description_narrative":["Approximately 100M people worldwide need prosthetic and orthotic (P&O) devices [1]. Low-cost, robust devices are only half the story; an estimated 80-90% do not have access to P&O services \"due to a shortage of personnel, service units and health rehabilitation infrastructures\" [2]. All three barriers could be addressed by data, so we propose research into novel tools to enhance P&O data.  Access is particularly poor for people in Lower and Middle Income Countries (LMICs) such as Cambodia with its landmine legacy, who are typically young and live longer lives of more physical work than in the developed world, for whom most prosthetics technology has been developed. LMICs have higher levels traumatic amputation from accidents, conflict and landmine injuries, and humanitarian crises present particular access challenges [3]. Services are set up primarily for trauma injuries but by 2035 it is estimate diabetes may affect over 500M people, and is growing fastest in LMICs [4].  Through the International Society for Prosthetics and Orthotics (ISPO), substantial improvements have been made in P&O design and training for LMICs [2,5]. An overwhelming patient:clinician ratio remains and \"the development of the sector is too slow ... to meet existing needs or keep pace with the growing populations of people with disabilities\" [2]. Even with ISPO accredited training, in South East Asian LMICs it is estimated that three times the current number of clinician is required for the current amputee population [6].  We will conduct two data-technology research studies, to develop tools to improve P&O service access, train clinicians and improve efficiency of service funding use. With a team of expert clinicians, academics and policy makers in Cambodia, we will investigate: 1) digital measurement tools to assess a user's residual limb anatomy, biomechanics of gait, typical daily prosthetic limb use, and health status; and 2) the architecture for a portable digital patient casenote system: a robust and secure IT network for travelling prosthetists to visit provincial areas to provide evidence-based treatment for those in remote communities who cannot afford to travel.  Beside these scientific challenges, the context makes this work highly ambitious. Experience shows that care must be taken in applying P&O from Western countries directly in LMICs. As well as users' different needs, their relationship with clinicians and prosthetics are different for complex cultural, social and environmental reasons. We frame our scientific research using a first-of-kind ethnographic study of P&O service providers and users to ensure the developed technologies are practical. We will also conduct business modelling research, producing tools to ensure the technologies are cost effective and can be implemented sustainably.  These technologies have the potential to transform the quality of life of prosthetic limb users worldwide and are required today. A more portable P&O service would enable people to access provision, fitting, adjustment and repair of their prosthetics with reduced time off work - essential where an agricultural worker spends their day's earnings on the same day's food. Prosthetists would access and update casenotes for their patients, provide a repository for clinician training, and enable users to access information regarding their progress and report problems to obtain critical treatment.  Longer term the project results will enable a valuable database to become established. The data will enable selection of technology that delivers greatest quality of life benefit, making best use of limited budgets [7]. It will support academics and trainee healthcare providers in research and education. We have a network of Asia's most influential clinicians, educators and policymakers to help achieve these ambitious benefits. Finally, the research will return benefits to the UK - we do not yet have a unified P&O digital record system and database.","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":["Low cost through knee prostheses. TaKeuP"],
      "description_narrative":["Cambodia is one of the world's most landmine affected countries with over 64,000 casualties recorded since 1979 and over 25,000 amputees. Added to this there is also a rise in the number of amputations resulting from road traffic accidents. Currently around 10 million people in South East Asia, India and Sri Lanka need but do not have access to prosthetic and orthotic services and there is a deficit of circa 40,000 professionals. This project directly targets end-users (Prosthetists and amputees) in Cambodia with a view to future expansion into the Philippines, Myanmar, Indonesia and Sri Lanka through strategic partnership with Prosthetics and Orthotics NGO Exceed Worldwide and the Exceed Research Network. We have active collaborations with UK (and European) prosthetics manufacturers (Blatchfords, Otto Bock, Össur), NHS prosthetics and rehabilitation services, and the Defence National Rehabilitation Centre Headley Court.   Recent developments in medical care have resulted in a surgical preference for through-knee amputation where previously above knee amputation was considered preferable. Through-knee amputations allow the socket for the prosthesis to fit on the stump so that the load through the artificial foot and knee is transmitted directly to the end of the stump; this maintains healthy, normal load through the thigh bone. An above knee amputation does not permit this normal loading; the socket has to transmit the loads all the way to the pelvic bone, partially bypassing the thigh, causing pressure sores, inhibiting the range of motion of the amputated limb, and producing bone fragility in the thigh. Therefore, through-knee amputations result in a reduction in pain, fewer incidences of bone formation within muscle (a highly debilitating complication), the ability to bear significantly higher loads, and maintain bone health.  The cost (>£50,000 per device) and maintenance required make modern sockets and powered knee mechanisms designed for through-knee amputees inappropriate for use in low and middle income countries. Current low cost solutions for this provided by the adaptation of Red Cross knee joint prostheses suffer from major limitations such as an inability to be locked in extension, severe compromises on cosmetic appearance resulting in social exclusion, and a very low prosthetic knee joint (due to the long thigh component) producing other functional deficits.  In this project we will develop a low-cost through-knee prosthesis the initial concept for which has been developed by the applicants through prior work with partners in Cambodia. This will be developed further to create a pathway to support the translation of future frugal technology projects (projects that are low cost in terms of manufacture and maintenance) and we will populate this frugal technology pathway with a series of follow on prosthetics and orthotics projects for amputees. Finally, we will ensure that there is a route to harness the frugal technology development for low and middle income countries for the benefit of healthcare in the UK. This project will create a community of researchers, engineers and clinicians developing and translating affordable prostheses.","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":["Improving Community Resilience and Sustainability Through Operational Research Capacity Building in Southeast Asia (CREST-OR)"],
      "description_narrative":["Operational Research (OR) has significant potential to contribute to meeting Sustainable Development Goals (SDGs) and disaster risk management (DRM) objectives of developing countries. However, most ODA countries lack the research capacity to develop and apply relevant OR methodologies. The CREST-OR project is a collaboration between three of the UK's leading universities in the field of OR - Kent, Lancaster, and Southampton - and prominent universities in four Southeast Asian (SEA) countries - Vietnam, Indonesia, Laos, and Cambodia. CREST-OR will establish a long-term UK-SEA partnership to build research capacity in OR methodologies, improve community resilience to natural disasters, and achieve national SDGs and DRM objectives. SEA partners will benefit from advancing their OR research capabilities, and the formation of new institutional links among project partners. UK partners will benefit from increasing knowledge in the application of OR to international development and disaster management challenges. The project will support longstanding initiatives in SEA countries through engagement of policy-makers and practitioners at national and local levels (e.g. emergency response agencies, local authorities, and development NGOs).  CREST-OR will build capacity in the use of OR for solving challenges in four focal areas: disaster management, food security, resilient transport infrastructure and smart cities. These areas were identified with the SEA partners based on existing collaborations within the UK researchers and, most importantly, on development priorities of their respective countries. In SEA countries, rapid economic growth and infrastructural development has not been supported by sufficiently robust planning. Social and environmental priorities have been regularly forfeited, while population growth has intensified development challenges. Climate change is now raising disaster risks and threatening to derail development achievements, with the greatest effect felt by the poorest and most vulnerable segments of society. OR offers a powerful set of tools to support more informed, evidence-based decision-making by government agencies and NGOs to address challenges related to disaster risk and its impact on food supplies, infrastructure and cities development. By building OR research capacity in these areas, CREST-OR will contribute to address several UN SDGs: SDG2 (Zero Hunger), SDG9 (Industry, Innovation and Infrastructure), SDG11 (Sustainable Cities and Communities), SDG13 (Climate Action) and Priority-2 (Strengthening Disaster Risk Governance) of the Sendai Framework.  The project will undertake the following capacity building activities: - Capacity assessments to identify educational and research gaps in the knowledge and use of OR methodologies, especially in relation to the SDGs, and understand the policy landscape in which CREST-OR will operate. - Three workshops, including: a Scoping Workshop to develop a prioritised list of relevant research projects, which will form the basis of CREST-OR research agenda; an Academic Workshop with specialised research training sessions for SEA researchers at different career stages; a Final Workshop to share developed research project proposals, receive end-user feedback and plan future research strategy. - Secondment of SEA Early Career Researcher in UK partner universities to develop research proposals, take part in research activites, and receive training in advanced and contextualised OR methods (e.g. simulation, optimisation). - Short visits of UK academics to SEA institutions to consolidate understanding of local context, run short training workshops, and support the development of OR curricula and research units. - Attendance of SEA researchers to the UK OR Society annual conference to facilitate their engagement in international debates and integrate them into a wider research community. - Development of a website for research networking and knowledge exchange.","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":["Self-recovery housing for development: scaling up crisis preparedness and humanitarian shelter response"],
      "description_narrative":["Earthquakes, storms, floods, and conflict cause untold damage to infrastructure, services, agriculture and livelihoods. The destruction of housing is often most visible, and the most devastating to the families, with often hundreds of thousands of homes destroyed. Householders themselves are invariably the first to respond; they are never passive, and signs of shelter recovery are very apparent from the first days after a disaster. The majority - as many as 80 or 90% - receive little or no assistance from the international community and are the main drivers of their own recovery process. This process has been termed 'self-recovery'. Previous GCRF awards supported interdisciplinary teams led by ODI in collaboration with CARE International UK, BGS, UCL and Loughborough University. They developed the understanding of the self-recovery process and advanced the theoretical basis for humanitarian assistance to the process of supporting self-recovery in practice. In large part as a result of this work, self-recovery is now a strategic element of the humanitarian shelter sector discourse with many disaster responses purporting to support this inevitable process. In recognition of the value of a people-centred approach that moves away from the convention product-based modalities, the CARE Philippines post-cyclone self-recovery project won the 2018 World Habitat Award in acknowledgment of its self-recovery focus. Sixteen thousand houses were built, each one unique and reflecting the priorities and means of each family. https://www.world-habitat.org/world-habitat-awards/winners-and-finalists/post-haiyan-self-recovery-housing-programme/ The self-recovery approach that respects the primacy of agency and choice aligns well with current humanitarian and development concerns such as the 'humanitarian development nexus', the Grand Bargain's emphasis on localisation, participation and cash-based responses, the Sendai Framework on Disaster Risk Reduction, the Sustainable Development Goals and the Global Shelter Cluster strategy. This is further explained in the Business Case. However, very little has been done to develop guidance for practice. With the exception of the protocol 'Informing Choice for Better Shelter' that delivers a guide for the development of technical educational material, there are no published tools nor guidelines that provide an implementation framework for self-recovery in shelter projects. This project addresses this gap. CARE International has over 70 country offices across the world, all of them in ODA eligible  countries. All of the proposed activities will take place two hazard prone countries where there is a CARE presence and/or an activated coordination system in the form of a country level shelter cluster. The potential regions to be selected include South Pacific islands, East Africa, Central America, Philippines and SE Asia the precise locations to be dependent on ongoing and new disaster responses. In all instances the research team will be working with the Global Shelter Cluster, country level clusters and/or CARE International country teams. These will all be ODA eligible countries. The protocol developed will be adapted to become a preparedness tool for the specific ODA eligible country context. All outputs will be thoroughly scrutinised by the humanitarian sector and incorporated directly into practice.","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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