Leprosy (Hansen disease) and Buruli ulcer are among the devastating skin neglected tropical diseases (Skin NTDs) prevalent in sub-Saharan Africa that cause progressive and permanent disabilities, exposing the patients and their families to discrimination, social stigma, and economic burden, adding complex challenges to communities already exposed to extreme inequality. Considering the needs of the most affected populations, children and people living in rural remote areas, current treatments are suboptimal in their complexity and length. Treating leprosy requires multiple drugs administered for 6 to 12 months. Buruli ulcer treatment requires 3 pills daily at different hours for two months, and lesion healing can take up to 12 months. Both treatments are associated with significant side effects (skin discoloration from clofazimine, exacerbating the stigma that leprosy patients face, and potentially fatal hypersensitivity to dapsone). This proposal aims to transform the treatment of Buruli ulcer and leprosy using the novel compound telacebec. Telacebec has demonstrated profound activity against Mycobacterium ulcerans and Mycobacterium leprae, the causative agents of Buruli ulcer and leprosy, respectively, whose evolutionary biology has rendered them hypersusceptible to killing by telacebec. We propose to conduct two clinical trials with telacebec-based treatment regimens that will cure Buruli ulcer and leprosy with fewer drugs, shorter duration, and fewer side effects than current therapy. We will perform this work through an integrated, multidisciplinary consortium of experts with broad experience in drug development, therapeutic delivery, community engagement, stakeholder participation, policy implementation, and capacity building to achieve equitable access to a new standard of care for these diseases.

Pregnant women in Africa are exposed to considerable health risks, with parasitic infections being a major threat. Schistosomes, soil-transmitted helminths, and malaria parasites are highly prevalent and polyparasite infections are common. In pregnancy, besides iron deficiency parasites are a key factor causing anaemia associated with an increased risk of maternal and infant morbidity and mortality. More than 50% of the pregnant women are affected by anaemia and an estimated 0.8 million pregnant women globally have severe anaemia. Antenatal care is a health program to regularly deliver health services including preventive measures with the aim of improving maternal and newborn health. In terms of fighting parasitic diseases, WHO recommends to preventively treat soil-transmitted helminths, schistosomes and malaria parasites. In many endemic sub-Saharan African countries, however, these recommendations are often only partially implemented and not consistently applied in daily antenatal care. Reasons are multifactorial but hesitation in administering multiple drugs this vulnerable population and the complexity of integrating the use of multiple drugs into the antenatal care schedule. On the other hand, data is accumulating that outweighs the potential risk of antiparasitic drug intake versus health benefits. The project aims to increase the uptake and integration of presumptive antiparasitic treatment during pregnancy to combat anaemia and improve health outcomes for pregnant women and their babies in sub-Saharan Africa. To this end, a multi-country trial will assess the safety, tolerability and efficacy of co-administered antiparasitic drugs. Pharmacokinetic data, cost-effectiveness analysis and public health stakeholder’s involvement will further strengthen the case for future implementation of co-administered antiparasitic drugs in antenatal care schedules. Training in African scientific leadership will contribute to a critical mass of highly trained professionals.

The focus on economic growth as an instrument to lead societies towards sustainable high well-being is increasingly problematic. While Gross Domestic Product (GDP) growth is slowing, its environmental and social costs are increasing, such that continued reliance on GDP growth entails a trade-off between the well-being of current versus future generations. In addition, research shows that higher GDP generally hardly improves people’s subjective well-being. To better support policy options, our project aims to develop a new economic development framework that provides evidence-based and theoretically-sound policy insights on how to raise well-being of present generations (leaving no one behind) without sacrificing future well-being. We will identify how GDP growth and productivity growth can be promoted and invested in well-being, focusing on relationships that reconcile economic growth and sustainable high well-being while leaving no person and place behind. We will analyze how these relationships work at different subgroup levels, by explicitly considering gender perspectives and disadvantaged groups. The project’s multi-disciplinary approach integrates knowledge from different disciplines, combining quantitative and qualitative techniques to generate solid evidence. Our case studies will permit deriving important lessons from different regions of the world, Africa in particular. Moreover, the relevance of our policy recommendations will be supported by insights from and interaction with stakeholders. Within the triadic goals of well-being, sustainability, and productivity, the project looks for possible win-win-win pathways, producing a new economic development framework that provides insight into how societies can use greater productivity to aim at greater human well-being. Policymakers will be helped by means of a dashboard and green book, which provide guidance how to achieve sustainable growth and maximize well-being.