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      "title_narrative":["GCRF Urban Violence & Climate Change Network"],
      "description_narrative":["Violence and climate change risks in the global South are increasingly urbanised, convergent and growing development challenges, negatively affecting the livelihoods, mobility and well-being of the most marginalised urban communities. Both urban violence and climate change impacts in cities also have economic costs, which affect overall development outcomes. Non-conflict violence in particular - spanning several forms of violence including gang violence, sectarian conflict, landlord-tenant conflicts and gender-based / intersectional violence - accounts for the largest share of the global burden of armed violence and is in large part urban. However, its implications have not been fully understood in the context of the climate change impacts and responses affecting urban areas. Urbanisation in developing countries is driving up climate-related risks and vulnerabilities across a spectrum of hazards, while climate adaptation and mitigation responses are now taking place in ways that alter urban socio-ecological systems. Without explicit consideration of violence-related risks, climate change programmes may exacerbate urban violence, or simply not reach vulnerable areas. Conversely, greater synergy of response in urban planning practices to address public security and climate change vulnerability - through the design of public spaces or public health interventions - can support human development gains. All the countries included in the network face the development challenge of ensuring safe, sustainable and inclusive urban development occurs now and into the future, and without which they will not be able to achieve their Sustainable Development Goals.   Researchers and practitioners working on urban climate change and those working on urban violence have had little opportunity to connect agendas. As a result, we lack understanding of how the two phenomena relate in peoples' livelihoods and influence respective initiatives for risk reduction. The aim of the network is to address this gap through research and practice change, in order to reduce the vulnerabilities of marginalised urban groups. Working across cities in Brazil, Honduras, Kenya, Jordan, Sudan, Pakistan, India, and Sri Lanka, the network will support inter-disciplinary workshops with researchers, local and international civil society organisations, municipal governments and networks and international agencies. These will define a future research agenda. The network will also support related practitioner learning through stronger exchange about initiatives to address climate risks and peace building in urban contexts. This will involve webinars, the development of website resources and a practitioner exchange forum. Finally, the network will support participation of network members in major global policy debates about urban security, climate change and development, to raise the policy profile of the importance of considering urban violence-climate linkages, and the practical and ethical implications of the issues for policy and governance. The network will be led by the Institute of Business Administration, Pakistan, supported by the University of Nottingham, working in strong collaboration with university and non-academic partners in focal cities of the global South. The envisaged outcomes of the network are the clear articulation of a new research agenda (reflected in new collaborations, grant bids, publications and contributions to the global evidence base) alongside a new forum for practitioner learning and the enhanced debate of relevant issues amongst municipal governments and international agencies.","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 Collaborative Multi-agency Platform for Building Resilient Communities"],
      "description_narrative":["There is significant evidence of the growth of natural disasters on a global level. The Asia-Pacific region continues to be the world's most disaster prone region; it has many low-/middle-income countries and accounted for 47% of the world's 344 disasters in 2015 with 16,046 fatalities and reported economic damage in the region of US$ 5.1 Billion. In this context, the most disaster-prone sub-region is South Asia, recording 52 disasters and 14,647 deaths, representing 64% of the global fatalities, in 2015.   Scientific research has shown that disaster risks do not only exist because of the presence of a physical hazard; they are compounded by the presence of vulnerability. Therefore, there is an urgent need to shift our focus from pure emergency response and recovery towards a sustainable disaster mitigation framework that focuses on building resilience within a disaster prone area, involving government agencies and the local community to reduce the impact of a hazard. However, at present there is a lack of tools and methods available to agencies to enable them to come together to understand the underlying vulnerabilities of a disaster prone area and build resilience to reduce disaster impact on a community.   Digital technology has the potential for creating a collaboration environment for various agencies and communities to act collectively to reduce the impact of disasters. The goal of this project is to develop a Collaborative Multi-agency Platform that can be used for building resilient communities in disaster prone areas in low-/middle-income countries. The project will focus on the challenges faced by three countries: Malaysia, Pakistan and Sri Lanka. These countries are frequently affected by a multitude of natural hazards including floods, landslides, cyclones, droughts, and earthquakes and have therefore been chosen as the focus for this research to capture broader set of disaster conditions and requirements common to low-/middle-income countries.   The project aims to address the following research questions: What is the nature of a resilience framework that will allow low-/middle-income countries to assess their vulnerabilities and resilience capabilities and take measures to build resilient communities? How can we enhance multi-agency collaboration within low-/middle-income countries? What changes are required in terms of technology, organizational structures and collaboration processes to enhance multi-agency collaboration? What are the characteristics of a collaboration platform that can support collective vulnerability assessment and reduction by multi-agencies? How can we establish a system dynamic model that can support the simulation of cascading effect on critical infrastructure systems due to a hazard? How can we construct a collaborative 3D environment based on near real-time 3D satellite data and analysis for supporting early response and damage assessment after a major disaster? In addressing itself to these questions, the project will lead to development of an advanced digital platform that can be used in low-/middle-income countries to strengthen their resilience capacities for disaster.   The project team is comprised of University of Salford (THINKlab & Centre for Disaster Resilience), the Universities of Moratuwa & Colombo (Sri Lanka), Tun Hussein Onn University (Malaysia) and the University of Peshawar (Pakistan). This team will be supported by a broad set of project partners, including industry and government agencies who are playing a key role in disaster resilience city agenda in UK, including: the Cabinet Office Civil Contingencies Secretariat, the Greater Manchester Resilience Forum, Rockefeller Foundation, Environment Agency, the Satellite Applications Catapult, Telespazio Vega Ltd and Secure Information Assurance Ltd. Similarly, in each partner country we have established industry and government agency stakeholder groups to engage and steer the project to achieve a greater impact.","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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      "default_lang":"en",
      "iati_identifier":"GB-GOV-13-GCRF-MR-C-MRFA-NCD2016MR-P025188-1",
      "reporting_org_ref":"GB-GOV-13",
      "reporting_org_type_code":"10",
      "reporting_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY"],
      "title_narrative":["Analysing the policy and governance environment for NCD control, and identifying potential policy options."],
      "description_narrative":["The Non-Communicable Diseases (NCDs) have emerged as the most important global threat to human health and wellbeing. Four major NCDs - heart disease, cancers, diabetes, respiratory diseases - cause the deaths of 38 million people every year, of whom 16 million die prematurely (under the age of 70 years). These diseases cause chronic illness and disability and are a source of suffering and financial hardship for individuals, families, communities and health systems struggling to provide continuous care for people with long-term health problems. The NCDs affect populations across the globe - and they are now the leading cause of death in many low and middle income countries.   Many of these diseases are driven by exposure to commercial products - tobacco, alcohol, highly processed foods (including the so-called 'junk foods') which have high levels of salt, sugar and/or trans-fats. Evidence shows that limiting exposure to these products is likely to bring health benefits, but it is often very difficult for individuals to sustain 'healthy behaviours' over their lifetime. Evidence-informed prevention strategies most likely to bring benefit to the largest numbers of people include: regulating exposure, e.g. taxation on products known to be health-reducing, such as sugary drinks; restricting access, e.g. no sales of tobacco to children, non-smoking zones in public spaces; or reformulating products to make them less likely to cause harm, e.g. lowering the salt content of processed foods. Such strategies, when implemented well, can have a significant impact on improving population health.   However, Governments face many challenges in implementing these policies - for example, there may be resistance from strong and powerful commercial companies that have a vested interest in selling their products. Moreover, in many countries, there is little policy experience in tackling the NCDs.   In this project we propose to undertake detailed policy analyses to identify acceptable and feasible options for Governments in both low- and middle-income countries to tackle the growing burden of NCDs in their countries. Our work will focus on three policy areas - control of sugar, salt and trans-fats in processed foods. We will work with researchers in Afghanistan, Bangladesh, Iran, Nepal, Pakistan, Tunisia and Vietnam to identify how the Government in each country is currently tackling NCDs. We will then map out the influences on policy options operating in each country. Such influences are likely to include the role of powerful stakeholders such as the food producing and selling industries, the media, the medical establishment, the Ministry of trade, etc. We will also identify whether any civil society groups (in some countries this might mean, for example, groups of parents concerned about junk-food marketing to children; in other countries it will include groups of patients suffering from diet-related NCDs such as diabetes) are working on policy issues. We will conduct interviews with key stakeholders to better understand the opportunities for seeing effective policy implemented for controlling sugar, salt and/or trans-fats, as well as identifying the challenges and barriers to putting effective policy options into operation.   This kind of health analysis requires a specific skill set which is not common in many countries. As part of our project we will therefore establish and strengthen the capacity of a network of researchers from all 8 countries (including the UK), who will support each other to carry out the analyses and interpret the findings. We will foster cross-learning of policy successes between different countries. In addition, we will promote engagement and dialogue with a wide variety of stakeholders in each country throughout the lifetime of the project in order to ensure that the findings of the research carry meaning and weight in policy decisions to improve population health both in the 7 research countries and beyond.","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."],
      "participating_org_ref":["GB-GOV-13","GB-COH-RC000346","GB-COH-RC000346"],
      "participating_org_role":["1","2","3"],
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      "participating_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY","MEDICAL RESEARCH COUNCIL","MEDICAL RESEARCH COUNCIL"],
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      "activity_date_iso_date":["2017-03-01T00:00:00Z","2017-07-01T00:00:00Z","2019-02-28T00:00:00Z","2019-12-31T00:00:00Z"],
      "activity_date_type":["1","2","3","4"],
      "contact_info_organisation_narrative":["Department of Business Energy and Industrial Strategy"],
      "contact_info_department_narrative":["General enquiries"],
      "contact_info_email":["enquiries@odamanagement.org"],
      "contact_info_website":["https://www.gov.uk/government/publications/beis-official-development-assistance-research-and-innovation"],
      "contact_info_mailing_address_narrative":["Department of Business, Energy and Industrial Strategy, 4th Floor, 1 Victoria Street, SW1H 0ET"],
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      "budget_type":["1","1","1"],
      "budget_period_start_iso_date":["2017-04-01T00:00:00Z","2018-04-01T00:00:00Z","2020-04-01T00:00:00Z"],
      "budget_period_end_iso_date":["2018-03-31T00:00:00Z","2019-03-31T00:00:00Z","2021-03-31T00:00:00Z"],
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      "default_currency":"GBP",
      "default_lang":"en",
      "iati_identifier":"GB-GOV-13-FUND--GCRF-MR_R019436_1",
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      "reporting_org_type_code":"10",
      "reporting_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY"],
      "title_narrative":["Interdisciplinary interventions for stunting and wasting in Zimbabwe, Zambia and Pakistan"],
      "description_narrative":["Undernutrition underlies almost half of all child deaths and has far-reaching educational, economic and health impacts. We focus on stunting and wasting, the major forms of undernutrition, which are not explained simply by shortage of food. Stunting, or reduced height, impairs long-term educational attainment and earning potential in adulthood and has multiple underlying causes, but few effective preventive strategies. Wasting in its most serious form presents as severe acute malnutrition (SAM) and children have a high risk of dying in hospital or after discharge home. For children to survive, thrive and lead prosperous lives, we need new ways to tackle undernutrition. We aim to strengthen partnerships, draw on expertise beyond traditional nutrition disciplines, and conduct a long-term programme of research in three countries with a high burden of child undernutrition - Zimbabwe, Zambia and Pakistan. Our ambition is to improve child survival, health and potential by finding new ways of preventing stunting and treating wasting, to help reach the Sustainable Development Goals.  Our long-term research programme has three aims. Our first aim is to understand the network of environmental, social and biological factors that interact to cause undernutrition so we can find the most promising targets for intervention. Our second aim is to use this learning to evaluate new strategies for undernutrition. We will design packages of interventions that are often not used together, and test their effectiveness, first in small pilot studies and then in large clinical trials aimed at preventing stunting and treating wasting. Our third aim is to use the findings we generate to influence policy and development programmes so that new interventions are scaled up effectively to reduce undernutrition.  We plan to use this current grant opportunity  to strengthen links with each country, build more south-south cooperation through collaborative meetings and a shared programme of work, and engage new investigators from outside the nutrition field. We will conduct four pilot projects to identify new approaches to undernutrition, which will start to inform our long-term programme. First, we will bring together experts in human, animal and environmental health to discuss the risks and benefits of livestock ownership for stunting and start to design a future intervention that increases the positive effects of livestock ownership whilst mitigating the negative effects. Second, we will work with social scientists to evaluate the attitudes and behaviours of mothers whose children are recovering from SAM. Strengthening the capacity of mothers to look after their children might help to deliver a package of care after discharge from hospital to improve the long-term outcomes of children with SAM. Third, we will explore whether giving high-dose vitamin D is a promising strategy to improve recovery of children with SAM in Zambia and Zimbabwe, as we recently found in Pakistan. We will measure vitamin D in our laboratory using blood samples collected from children with SAM during hospital admission and at discharge, to see whether vitamin D deficiency partly explains their poor outcomes. If so, high-dose vitamin D should be evaluated in a future trial. Finally, we will conduct a pilot study to treat maternal depression as a way of improving child growth. Poor maternal mental health can compromise caregiving and feeding practices and increases the risk of child stunting. Treatment of common mental disorders using a community-based intervention based on problem solving therapy, delivered by trained lay workers, is highly effective but is mostly used in urban areas currently. We will conduct pilot work to see if this intervention works for mothers in rural Zimbabwe, and whether it is a promising approach to improve child growth and development.","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."],
      "participating_org_ref":["GB-GOV-13","GB-COH-RC000346","GB-COH-RC000346"],
      "participating_org_role":["1","2","3","4"],
      "participating_org_type":["10","15","15","80"],
      "participating_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY","MEDICAL RESEARCH COUNCIL","MEDICAL RESEARCH COUNCIL","QUEEN MARY UNIVERSITY OF LONDON"],
      "activity_status_code":"4",
      "activity_date_iso_date":["2018-03-01T00:00:00Z","2019-02-28T00:00:00Z","2019-02-28T00:00:00Z"],
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      "contact_info_organisation_narrative":["Department of Business Energy and Industrial Strategy"],
      "contact_info_department_narrative":["General enquiries"],
      "contact_info_email":["enquiries@odamanagement.org"],
      "contact_info_website":["https://www.gov.uk/government/publications/beis-official-development-assistance-research-and-innovation"],
      "contact_info_mailing_address_narrative":["Department of Business, Energy and Industrial Strategy, 4th Floor, 1 Victoria Street, SW1H 0ET"],
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      "budget_status":["1"],
      "budget_type":["1"],
      "budget_period_start_iso_date":["2018-04-01T00:00:00Z"],
      "budget_period_end_iso_date":["2019-03-31T00:00:00Z"],
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      "default_lang":"en",
      "iati_identifier":"GB-GOV-13-FUND--GCRF-MR_R019576_1",
      "reporting_org_ref":"GB-GOV-13",
      "reporting_org_type_code":"10",
      "reporting_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY"],
      "title_narrative":["Capacity building in dietary monitoring and public health nutrition in the Eastern Mediterranean Region Countries"],
      "description_narrative":["In common with many Western countries, the Eastern Mediterranean Region (EMR) has a major problem with obesity and the associated public health issues. The World Health Organization (WHO) has been developing new health policies to lower intakes of sugar, saturated fats, trans fats and salt with the aim of reducing the risk of non-communicable diseases (diabetes, cardiovascular disease and obesity) in children and adults. To implement these policies successfully it is essential to have high quality food composition and food intake data to underpin research into the links between diet and health and to enable effective dietary monitoring and policy development. Most EMR countries use international food composition tables that include foods consumed in western diets with different nutrient composition, especially for mixed and traditional dishes. Some of these data from other countries are outdated and do not reflect the composition of foods currently consumed in EMR countries, meaning that calculated nutrient intakes are inaccurate. Methods of measuring dietary intake also need to be up-to-date and use appropriate food information. This project intends to provide technical and scientific support for researchers (mainly food and nutrition experts) in LMIC countries in the EMR, and will also provide training in the use of improved standardized methods for production and management of food composition and food intake data and also identify appropriate biological markers of food nutritional value and measurements of health outcomes. A review will be undertaken of food and nutrient intakes in the LMICs to develop strategies for reducing sugary and fatty foods in these diets based on new WHO guidelines. The Quadram Bioscience Institute, that aims to develop solutions to worldwide challenges in human health, food and infectious disease and non communicable disease, will lead the project in partnership with the WHO EMR office. The latter will help to coordinate and co-align regional activities to ensure public health priorities are targeted effectively. Three main activities will underpin capacity building in the EMR with a focus on 10 target LMICs (Morocco, Tunisia, Egypt, Jordan, Palestine, Sudan, Lebanon, Pakistan, Iran & Afghanistan). The project will build on existing links with the WHO EMR and will develop and extend activities with LMIC in the EMR. Four main activities are planned: (1) Training and knowledge exchange workshops; (2) Short-term exchanges of researchers; (3) Development and application of harmonised protocols for pilot sample collection, food analysis, data generation and creation of online regional food composition datasets; (4) Development of possible dietary and other strategies to support reduction in intake of sugary and fatty foods. The main outcomes will be to build capacity and practical skills in the LMIC to improve production, management and use of food composition and dietary intake data, and biomarkers. Knowledge of European and International standards will be disseminated, with support from WHO, to experts across the region. Networks of expertise within the region will also be an important outcome leading to increased collaboration and effective data sharing. The project will enable more efficient use of better quality, region specific, food composition and intake data that can be used for research, monitoring and policy development. This will benefit LMICs in the region by providing data and tools that can encourage reduction of sugar, saturated fat, trans fats and salt and thereby reduce the incidence of diet related disease.","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."],
      "participating_org_ref":["GB-GOV-13","GB-COH-RC000346","GB-COH-RC000346"],
      "participating_org_role":["1","2","3"],
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      "participating_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY","MEDICAL RESEARCH COUNCIL","MEDICAL RESEARCH COUNCIL"],
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      "activity_date_iso_date":["2018-03-01T00:00:00Z","2019-02-28T00:00:00Z","2019-02-28T00:00:00Z"],
      "activity_date_type":["1","3","4"],
      "contact_info_organisation_narrative":["Department of Business Energy and Industrial Strategy"],
      "contact_info_department_narrative":["General enquiries"],
      "contact_info_email":["enquiries@odamanagement.org"],
      "contact_info_website":["https://www.gov.uk/government/publications/beis-official-development-assistance-research-and-innovation"],
      "contact_info_mailing_address_narrative":["Department of Business, Energy and Industrial Strategy, 4th Floor, 1 Victoria Street, SW1H 0ET"],
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      "recipient_country_code":["AF","EG","IR","JO","LB","MA","PK","SD","TN","PS"],
      "recipient_country_percentage":[10.0,10.0,10.0,10.0,10.0,10.0,10.0,10.0,10.0,10.0],
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      "policy_marker_vocabulary":["1","1","1","1","1","1","1","1"],
      "collaboration_type_code":"1",
      "default_flow_type_code":"10",
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      "budget_status":["1"],
      "budget_type":["1"],
      "budget_period_start_iso_date":["2018-04-01T00:00:00Z"],
      "budget_period_end_iso_date":["2019-03-31T00:00:00Z"],
      "budget_value":[177395.0],
      "budget_value_currency":["GBP"],
      "capital_spend_percentage":0.0,
      "transaction_type":["3","2"],
      "transaction_date_iso_date":["2018-12-31T00:00:00Z","2018-03-01T00:00:00Z"],
      "transaction_value":[177395.0,177394.8],
      "transaction_value_currency":["GBP"],
      "transaction_value_date":["2018-12-31T00:00:00Z","2018-03-01T00:00:00Z"],
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      "default_lang":"en",
      "iati_identifier":"GB-GOV-13-FUND--GCRF-MR_N006062_1",
      "reporting_org_ref":"GB-GOV-13",
      "reporting_org_type_code":"10",
      "reporting_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY"],
      "title_narrative":["Multicenter RCT to evaluate the clinical and cost-effectiveness of a culturally adapted therapy (C-MAP) in patients with a history of self-harm"],
      "description_narrative":["Suicide is a serious global public health issue ranked amongst the leading causes of death in many countries. The worldwide rates of suicide have increased by 60% in the last 45 years, and the 1.8% total global burden of disease attributed to suicide in 1998 is expected to increase to 2.4% by 2020.   The WHO Mental Health Action Plan 2013-2020 and all the member states have committed to work towards the global target of a 10% reduction in the suicide rate by 2020. WHO's Mental Health Gap Action Programme includes suicide as one of the priority conditions and the recent WHO report \"Preventing suicide: a global imperative\" calls for suicide prevention to be a high priority on the global public health agenda. More than 800 000 people across the world die due to suicide each year and for each suicide there are more than 20 people attempting suicide. Each suicide takes the life of the individual and has a tremendous effect on friends, family and the wider community. Up to 75% of all suicides occur in in low- and middle-income countries where resources and services are limited for treatment and support for people who need. There is a clear gap in the robust evaluation of culturally appropriate suicide prevention strategies in low and middle income countries. Individuals who have a history of self-harm are at much higher risk of dying by suicide than individuals who do not have such a history. The WHO recommends that offering them appropriate treatment should be a key component of all suicide prevention strategies.   There are in excess of 100,000 acts of self-harm carried out in Pakistan annually. The aim of the proposed trial is to evaluate the clinical and cost-effectiveness of a culturally adapted psychological therapy (C-MAP) in patients with a history of self-harm. We carried out a study in Karachi to determine the effectiveness of a 6-8 session CBT-based intervention (C-MAP) in people who had recently self-harmed. The assessments were carried out at baseline, 3 & 6 months. There was a significant reduction from baseline in suicidal ideation, severity of depression and hopelessness in the intervention group compared to the Treatment as Usual (TAU) group at each follow up assessment. The findings from this work have highlighted the applicability of such an intervention to health services in Pakistan for patients who present after a self-harm episode. The proposed research will be conducted in Karachi, Lahore, Rawalpindi, Quetta and Peshawar. Participants will be randomized either to the Intervention (C-MAP) or TAU. The existing culturally adapted intervention (C-MAP) includes an evaluation of the self-harm episode, crisis skills, problem solving and basic cognitive techniques to manage emotions, negative thinking and relapse prevention strategies. The intervention will be delivered in six sessions over 12 weeks. Assessments will be conducted at baseline and at 3 months (end of intervention) 6 months and 12 months after randomisation. The outcome measures will include questionnaires to measure the repetition of self-harm, severity of suicidal ideation; depression; hopelessness; quality of life and coping resources. In addition, qualitative interviews and focus groups will provide rich information regarding the experiences of participants and therapists, which will inform the development of more effective and sensitive services for self-harm management. TAU will be standard routine care delivered by local medical, psychiatric and primary care services according to their clinical judgement. A record will be kept of any treatment received by each participant.   This trial will provide detailed clinical and cost-effectiveness analyses for the management of self-harm which will inform future research and national clinical practice guidelines. We have established contacts with the ministry of health and once the trial is completed we will enter discussions to present the results to them and attempt to influence policy change.","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."],
      "participating_org_ref":["GB-GOV-13","GB-COH-RC000346","GB-COH-RC000346","GB-COH-RC000797"],
      "participating_org_role":["1","2","3","4"],
      "participating_org_type":["10","15","15","80"],
      "participating_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY","MEDICAL RESEARCH COUNCIL","MEDICAL RESEARCH COUNCIL","THE UNIVERSITY OF MANCHESTER"],
      "activity_status_code":"4",
      "activity_date_iso_date":["2015-08-01T00:00:00Z","2015-11-01T00:00:00Z","2018-07-31T00:00:00Z","2019-10-31T00:00:00Z"],
      "activity_date_type":["1","2","3","4"],
      "contact_info_organisation_narrative":["Department of Business Energy and Industrial Strategy"],
      "contact_info_department_narrative":["General enquiries"],
      "contact_info_email":["enquiries@odamanagement.org"],
      "contact_info_website":["https://www.gov.uk/government/publications/beis-official-development-assistance-research-and-innovation"],
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      "reporting_org_narrative":["DEPARTMENT FOR BUSINESS, ENERGY & INDUSTRIAL STRATEGY"],
      "title_narrative":["Novel inter-disciplinary approaches for identifying and tackling the spread of AntiMicrobial Resistance through Environmental pathways in PAKistan"],
      "description_narrative":["Medicine has been transformed by the development of antibiotics, medicines that kill bacteria. These have made deadly bacterial diseases that once killed millions such as tetanus, syphilis, and leprosy, easily treatable. They are given as a preventative measure prior to surgery to prevent infection and they relieve suffering from less dangerous diseases such as strep throat. There is, however, a problem. Bacteria are becoming resistant to antibiotics. This is a result of evolution. The use of antibiotics inevitably selects for bacteria that carry genes that can protect them against these compounds. We call these antibiotic or antibacterial resistance genes (ARGs). Genes are pieces of DNA that make up part of the bacteria's genome or smaller DNA molecules such as plasmids. ARGs provide bacteria with the ability to degrade or excrete antibiotics. They can be exchanged between different species of bacteria allowing these abilities to spread through communities.  The use and misuse of antibiotics is accelerating the rate at which ARGs evolve and spread. Using antibiotics to treat non-bacterial infections or to improve the growth rate of livestock results in large amounts of antibiotics entering the environment, this creates a strong selective pressure leading to many resistant bacteria. This resistance can develop in free-living bacteria that perform important functions in ecosystems, e.g. soils or rivers, but then spread to bacteria that cause disease within humans, pathogens. There are pathogens beginning to appear that are resistant to multiple antibiotics, e.g. multidrug-resistant tuberculosis. If this multi-drug resistance spreads further then diseases that are now treatable will become increasingly deadly. This is a potential global public health disaster.   The problems caused by antibiotic resistance (ABR) will particularly badly impact Low and Middle Income Countries (LMICs), such as Pakistan, that depend upon cheap antibiotics to treat many infectious diseases. Tragically, it is just these countries, which are likely to have the most problems. This is because antibiotics are easily available without prescription over the counter. People take antibiotics to treat non-bacterial diseases or do not take them for long enough, this allows the resistant bacteria to spread and proliferate. This is compounded by manufacturers of antibiotics releasing wastewater contaminated with antibiotics into the environment, farmers using large quantities of antibiotics in intensive livestock rearing, and the fact that human and animal waste is dumped untreated into water sources. All this pollution results in more resistant bacteria evolving. It is unclear, however, which of these factors are most important to address, in order to prevent the spread of ABR.  We have assembled a team of biologists, engineers, social scientists and mathematicians, to better understand ABR in Pakistan and how to combat it. We will conduct a survey of resistance genes across multiple areas within Pakistan, chosen in order to determine what causes them to proliferate and spread, ultimately leading to drug-resistant infections in humans. We will do this by sequencing DNA direct from environmental samples to resolve the genes that are present in the bacteria. We will sample from the environment and from a range of health facilities to reveal how genes are being transmitted from environmental bacteria into pathogens. We will also study the behaviour of people and institutions in Pakistan and determine how that contributes to the scale of the problem. This will allow us to propose ways in which they can reduce the spread of antibiotic resistant genes. These might be changes to how antibiotics are used in health facilities or improved approaches to waste disposal. This will be of great benefit to Pakistan but also - because these genes are capable of spreading between individuals across the world - to other LMICs and us in the UK too.","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":["Supervised Treatment in Out-Patients for Schizophrenia (STOPS+)"],
      "description_narrative":["Schizophrenia is a severe long-term mental health condition. It causes a range of different psychological symptoms including hallucinations (hearing or seeing things that don't exist), delusions (unusual beliefs not based on reality), muddled thoughts based on hallucinations or delusions and changes in behaviour. Schizophrenia is a common cause of long-term disability in the 15-49-year-old group and whilst effective treatments are available, in developing countries around two thirds of patients receive no treatment.  This lack of treatment, commonly known as the 'treatment gap' arises due to factors including poor treatment adherence, a lack of primary care involvement and poor access treatments. We have previously reported a new approach (Supervised Treatment in Out-Patients for Schizophrenia (STOPS)) that resulted in improved treatment adherence and functioning in a resource poor setting in Khyber Pakhtunkhwa (KP), Pakistan. In this study we trained and supported relatives and family members to monitor medication taking, building on the success of a similar approach used for patients with tuberculosis.  We now aim to implement and evaluate a 'scaled-up' version of STOPS (STOPS+) which is based on the World Health Organisation mental health guidelines and maintain treatment adherence with the help of family members and text message reminders. We will work with primary care physicians and multipurpose primary are technicians to task shift care, under the supervision of mental health experts.  The study has 3 phases: PHASE 1: PRE-IMPLEMENTATION PHASE involving community engagement, modification of STOP to STOPS+ (involving patient, healthcare and wider community partners) and the identification of potential study participants.  PHASE 2: IMPLEMENTATION OF STOPS+ IN PRIMARY CARE SETTINGS USING A CLUSTER TRIAL DESIGN to determine the clinical and cost-effectiveness. 24 primary care centres in district Peshawar, KP will be randomised to deliver either STOPS+ or Enhanced Treatment As Usual (ETAU). We will recruit 526 patients (263 in each arm) suffering from Schizophrenia or schizoaffective disorder based on the International Classification of Diseases (ICD)-10 criteria. The outcomes of interest will include Global Assessment of Functioning and adherence to treatment regimen.  PHASE 3: EVALUATION OF THE IMPLEMENTATION IN REAL WORLD SETTING will be measured using the standardised World Health Organization's Assessment Instrument for Mental Health Systems (WHO-AIMS), economic evaluation, secondary data from the trial and utilisation of primary health care, and in depth interview study involving all participants.  If successful this trial will improve schizophrenia care, improving lives for patients and their families. This work will provide important information for policy makers and set the foundations for reducing disability and improving long term patient outcomes.","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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