Mpox can cause severe complications in vulnerable groups such as pregnant women and children, necessitating targeted public health interventions and vaccine trials in these populations. Limited data suggest the MVA-BN vaccine is safe for pregnant women and likely poses no risk to breastfed infants, but comprehensive human data are lacking. Trials in endemic areas are crucial for evaluating the vaccine's safety and efficacy in real-world settings. Vaccine hesitancy, exacerbated by misinformation and distrust in healthcare systems, poses a significant challenge, especially in the Democratic Republic of the Congo. Pregnant women are particularly affected by concerns about vaccine safety, which influences their willingness to vaccinate. Addressing these concerns through targeted communication and community engagement is vital. A proposed phase 3, randomized trial will assess the safety and immunogenicity of the MVA-BN vaccine in healthy pregnant and postpartum women and in infants/children (6-24 months old). Additionally, a qualitative study on vaccine hesitancy will inform the trial design and implementation, aiming to enhance vaccination uptake in these high-risk groups.

Variants of concern (VoC) of SARS-CoV-2 raise the possibility of increases in transmissibility, severity and immune evasion. Children and pregnant women who have not been prioritised in the pandemic, are likely to be the last population for whom vaccines are approved and may have low uptake, increasing the risk of VoC arising in this population. Monitoring this group across regions is crucial given rapid changes in epidemiology due to interventions, vaccine rollout and viral evolution. VERDI (SARS-CoV-2 variants Evaluation in pRegnancy and paeDIatrics cohorts) will build on a long-standing infectious disease research and trial network (Penta) to address research questions on the impact of VoC in these vulnerable groups. VERDI’s objectives are: i) track and characterise VoC in paediatric and pregnant populations across the globe; ii) understand effects of VoC on clinical outcomes (short/longer term), vaccine effectiveness and transmission characteristics; iii) model outcomes and impacts of VoC; iv) develop evidence-based recommendations for control of COVID-19. VERDI will achieve these objectives by bringing together a diverse range of cohort studies including large scale national and regional level population-based cohort studies from the EU and beyond, providing a unique opportunity for harmonised analysis of data on VoC from a range of sources (e.g. electronic health records, bespoke cohort studies, household transmission studies, screening programmes). We will facilitate expansion of existing studies, e.g. replicating ongoing European household studies elsewhere. Through this approach, VERDI will expand and enhance existing cohort networks, including promoting flexibility to adapt to future emerging infections. The project will improve understanding of the epidemiology and impact of VoC, leading to robust recommendations for control in a range of global settings as well as developing preparedness for future health emergencies.

The world is facing the silent “pandemic” of antimicrobial resistance (AMR). Central Africa has the highest mortality rate (23.5 deaths/ 100,000) attributable to AMR in the world. Research is desperately needed to better understand the burden of AMR in this region, and it is vital that this work is done by local researchers who will be the future leaders of scientific and clinical research in central Africa. The overall aim of the Central Africa Training Platform for Clinical Research on infectious diseases (CATCR) project is to produce essential, world-class research in central Africa, for central Africa, by central African people. To achieve this, it is crucial that the critical mass of PhD and PostDocs in central Africa is increased. Therefore, the consortium will (1) develop a multifaceted training programme on infectious diseases focusing on AMR for MSc, PhD and healthcare professionals; (2) develop a clinical fellowship programme of recruitment, training, evaluation and retention; (3) research the lack of knowledge on antimicrobial usage trends in patients with parasitic infections; (4) research the causal link between prevalence rates and influencing factors of carbapenemase-producing Enterobacterales (CPE) and occurrence of AMR in humans and livestock; and (5) research to understand the prevalence of tuberculosis (TB) and drug-resistant TB characteristics in Central Africa. Finally, (6) the project will focus on communicating, and disseminating research results. Through CATCR, talented researchers, clinicians and health care professionals working on AMR in central Africa will benefit from access to fully-funded fellowships to complete ground-breaking research. Public and regulatory authorities in Africa will use the research and newly established fellowships to develop vital AMR action plans and to increase the critical mass of researchers in the region will ultimately lead to benefits for patients and citizens of central Africa.