The seven specific objectives of TOXI-triage address the operational; technological; ethical and societal dimensions of CBRN response and recovery, and importantly the economic base from which sustainable CBRN and multi-use systems are derived. 19 partners in 4 Task forces will deliver 9 Work Packages (WPs) that address: end user specifications; Design and delivery; Test and Validation; and, Impact. The approach defines a concept of operations that envisages accelerated delivery of situational awareness through an ensemble of embedded sensors, drones, standoff detectors (including cameras), artificial intelligence for processing sensor signals and web-traffic from social media, and centralised command and control. Wireless traceability of casualties provides dynamic mapping including medical care. 2 field exercises are intended to test and verify the operational attributes of the systems, and 3 WPs focus on impact to deliver: Exploitation; Security and Ethics; and Effective Innovation Management. Distinctive technological attributes of TOXI-triage include: rapid non-invasive assessment of exposure/ injury through monitoring metabolic markers of injury; managing and exploiting the semantic web; traceability by design; aptamer-based bio-sensing; casualty-to-discharge system integration; and integrated environmental and stand-off hazard designation. The approach is rigorous with clinical trials to test systems in poisoning clinics and live agent tests in laboratories designated by the UN’s OPCW. Distinctive societal attributes of TOXI-triage include: addressing the needs of all vulnerable groups; optimising inter-cultural/ethnic messages and needs in CBRN response; fostering economic impact by multiple-uses for all the project’s systems. TOXI-triage intends that its outcomes will be used routinely in medical/environmental/urban and search and rescue emergencies. The benefits are intended to extend significantly further then enhanced CBRN resilience

The world faces a growing epidemic of antimicrobial resistance (AMR); however, only two new classes of antibiotics have been brought to the market in the last 30 years. The discovery and development of new antibiotics is essential to maintain medical advances but poses significant scientific, clinical, and financial challenges, particularly for antibiotics active against Gram-negative bacteria (such as E. coli). Such bacteria have effective barriers against drugs, making treatment difficult, resistance likely and development costs and risks high. In addition, any new antibiotics brought to the market would likely be used cautiously to delay the development of resistance, adding an additional financial challenge in recouping the development costs. The O’Neill Report on AMR identifies diagnostics as critical to the battle against antibiotic resistance. This innovation action, BreathSpec, proposes a viable solution to the global problem of AMR through the final developmental stages of an existing diagnostic device, which will allow a rapid, binary decision to be made on the need for antibiotic treatment, and which with suitable optimisation will allow further differentiation and stratification to take place. The Innovation Action includes technical developments to optimise its function, data acquisition for the development of the decision making analytical function and clinical validation. It addresses these issues by producing reliable identification and quantification of key signature volatiles present in exhaled breath. It provides a non-invasive method for monitoring the volatile organic compounds present in an individual’s exhaled breath (and subsequently the blood) and has long been recognised as having significant utility as a clinical test that can be used for early disease detection and monitoring, and potentially to diagnose specific bacterial infections for better, more targeted use of existing antibiotics.

Expert opinion from across the world recommends, & calls for, modular laboratory systems to be made available for disease monitoring missions. The WHO calls these, “Rapid Response Mobile Laboratories” (RRML). ONELAB will develop modular RRML for rapid, flexible, scalable, multi-scenario deployments into the widest range of possible settings. These next-generation facilities will support next-generation measurement-technologies/methodologies and, through satellite communications, form wide-area GIS enabled laboratory information systems. Thus, simultaneously providing point-of-need disease detection, along with high-level situational awareness. ONELAB will also develop advanced measurement systems for a staged disease detection response. Exploiting a panel of acute viral infection biomarkers enables early detection of disease during its asymptomatic incubation. Using this at the outbreak of disease, when much is still undefined, supports effective immediate & targeted public health interventions. Additionally, using proven methodologies developed in response to COVID 19, ONELAB will develop & demonstrate a workflow for semi-autonomous disease specific biomarker discovery. This application & delivery of agile science enhances the capability & capacity of current disease testing-strategies substantially RRMLs are only as good as the skilled teams who operate them. So, ONELAB builds world-wide networks & partnerships of experienced experts to: define contextually-aligned best practice; develop a consensus-driven concepts of operation; and, disseminate this though a pandemic testing playbook. We will develop capability & capacity with training & networking-events that continue beyond the project. Finally, community mass-testing requires engagement & acceptance from all citizens, which is why we will engage with the public, & produce a citizen’s guide to mass community testing, supported by educational outreach resources.