European Union Members States (EU-MS) share similar levels of development and access to care. Yet, key population health indicators vary widely across countries. The societal burden of these inequalities is high, and leveraging evidence to achieve better health outcomes is a priority. Within countries, Health Information Systems (HIS) are the cornerstone of public health interventions. In Europe however, health surveillance data are fragmented: EU-MS report different items to different international data collection exercises; there is variation between countries with regard to the amount of data collected, how it is generated, and its quality; and there are gaps in information. Whereas we have good mortality data, we are weak on morbidity data, on the quality of care for chronic conditions, and on evaluating patients’ experiences of disease. Overall, there is heterogeneity in the level of evidence that can be used by key stakeholders and in specific health-domains; and we do not know the extent to which differences in health information (HI) capacity might influence on the population burden of disease. This post-doctoral project aims to provide a “HI Impact Index” that could be used by EU public health agencies and policy planners to measure the uptake of evidence into policies and care, and ultimately their impact on population health overall and in priority areas for Europe: maternal and child health, chronic diseases, antimicrobial resistance, injury prevention, and patient reported outcomes and experiences. The research will be hosted at the Belgian Federal Research Institute for Public Health under the supervision of Professor Herman Van Oyen, coordinator of the upcoming European Joint Action on Health Information. This MSCA project is a unique opportunity for me to consolidate my credentials as a European public health researcher and expand my career possibilities beyond the perinatal health field.

Rabies is the deadliest disease on earth (99.9% fatality rate). Annually, ~58.000 people die from rabies, more than half of them are children. Many remain unvaccinated because of the high costs and the need for a cold-chain. Likewise, despite the existence of an excellent yellow fever (YF) vaccine, yearly ~30.000 people die of YF. The 80-year old low-tech production process does not allow to produce sufficient doses. There is now a real danger that major YF-outbreaks become uncontrollable. We aim at developing an efficient, safe, cheap, thermostable and easy-to-produce vaccine that can be needle-free administered, that protects against both rabies and YF, and that can be implemented in routine prophylactic paediatric vaccination. For this, we will employ our (P01a) proprietary infectious DNA (iDNA) vaccine technology. Simple, even needle-free injection of a low dose (1-10µg) of this easy-to-produce naked plasmid in mice and hamsters launches the YF vaccine virus and protects hamsters as efficiently as the commercial vaccine against lethal YF challenge. The iDNA YF vaccine will be used as vector to express relevant protective rabies antigens. Dual protection of such chimeric iDNA rabies/YF vaccine will be demonstrated against lethal rabies and YFV challenge in small animal models. Likewise, chimeric rabies/Japanese encephalitis and rabies/Zika virus iDNA vaccine candidates will be generated using this versatile platform. Next, induction of protective immunity will be demonstrated in rhesus macaques. The iDNA vaccines combine the benefits of both the YF live-attenuated vaccine (highly efficient life-long induction of immunity) and the thermo-stability, ease-of-production and the potential to customize (in response to emerging medical needs) of “classical” DNA vaccines. A path towards advanced pre-clinical and clinical development of such novel vaccines will be developed in compliance with European regulatory and WHO prequalification requirements.

The fragile health systems in urban sub-Saharan Africa (SSA) are already overwhelmed with NCDs. Despite this, the implementation of the evidence-based WHO Best Buys policies for NCDs prevention in the African region has been found to be off-track. Additionally, less attention has been given to adolescents and yet this is a period in life where behavioural patterns of NCDs risk factors are established and track into adulthood. There is also a gap in our understanding on how to implement and scale up effective diet and physical activity interventions in real world settings in SSA. Our project therefore aims to reduce two important modifiable risk factors for NCDs: unhealthy diets and physical inactivity and their underlying social determinants among adolescents (aged 10-19 years) living in mixed socio-economic urban communities in two SSA countries (Ghana & Kenya) by designing, deploying, and evaluating strategies for implementation of evidenced and theory based interventions mapped on to the WHO Best Buys. We selected the two countries because they represent different cultural contexts of nutrition transition (East and West Africa), and both countries are undergoing rapid economic development, urbanisation and increases in NCD prevalence. The intervention delivery will take a multi-sectoral approach to increasing the capability, opportunity and motivation of adolescents to eat healthier and be more physically active. We will focus on three settings to enhance the reach: secondary schools and, family/community/faith-based settings and the digital environment using social media. Together, this project will increase opportunities, awareness, knowledge and health literacy, motivate adolescents to increase self-efficacy, guide self-regulatory actions and adopt positive health behaviour (such as dissuasion from physical inactivity and sedentary behaviours, or unhealthy food choices) to prevent NCDs.

African swine fever (ASF) has recently transformed from an exotic disease to a panzootic threat to domestic and wild suids world-wide. Europe is currently facing different scenarios with front and point introductions, affected wild boar and domestic pig populations, epidemic and endemic situations. While our traditional prevention and control strategies work well with industrial pig farms, we quickly reach our limits when we have to control the disease in the abundant wild boar population or in regions with a majority of backyard farms. To turn the tide and to safeguard animal health, vaccines, especially oral vaccines for wild boar, could be the missing tool. There has been considerable progress in vaccine development and while we should continue to look for alternative approaches, we must now also dare to test the promising candidates beyond simple proof-of-concept studies. Only in this way can we generate the data base for benefit-risk analysis of whether and how current generation vaccines could be employed. Along these lines, this project sets out to test the vaccine candidate "ASFV-G-ΔI177L" in safety and efficacy tests after oral and intramuscular application as prescribed by international guidelines. This vaccine candidate has shown safety and very good protection under laboratory conditions and has been applied in the field in Vietnam. As a backup option, other promising candidates, “ASFV-G-ΔMGF” and “ASFV-G-Δ9GL/UK, will be tested in initial comparative trials. Accompanying the prescribed tests, our interdisciplinary consortium will characterize the protective immune responses, target the optimization of oral immunization and model tailored vaccination strategies. The data body generated in this project is crucial for benefit-risk-assessments at the level of all authorities entrusted with licensure and deployment of ASF vaccines and for this reason, relevant stakeholders will be involved from the start to guarantee full exploitation of our data.

There is a clear gap in the adoption of paediatric healthcare innovations which continues to hinder the access to such innovations. Demand-driven policy instruments offer the possibility to overcome market failures and allow risk sharing between co-owners and investors. These include Public Procurement of Innovation (PPI) and Pre-Commercial Procurement (PCP), Value-Based Procurement (VBP), and Social Impact Bonds (SIBs). Such demand-driven funding instruments have the potential to reduce the adoption gap in paediatric healthcare. However, these innovative funding tools are rarely used to support paediatric innovation adoption. This limited adoption of demand-driven funding tools can be attributed to several barriers which are specific to paediatric healthcare, such as the perceived high-risk and complex nature of bringing paediatric innovations to market, fragmented regulatory pathways and market access, limited market demand (low numbers of patients) and perceived small impact. Additionally, there is poor awareness, knowledge and understanding of demand-driven tools, which results in their underutilisation. The i4KIDS-LEGACY project will create a holistic innovation action plan in paediatrics to ensure optimal implementation and utilisation of demand-driven innovation financing instruments to support the adoption of paediatric innovation in a coordinated manner across Europe. The project will: 1) Identify demand-driven financing instruments and mechanisms for paediatric health. 2) Collect data on the needs and challenges in the adoption of paediatric innovation. 3) Develop working groups to ideate solutions that address the needs and challenges identified. 4) Collaboratively build a European action plan to catalyse the use of demand-driven tools for the adoption of paediatric innovation solutions. 5)Promote cross-border adoption of paediatric innovations using financial instruments.