Current measures in healthcare systems are insufficient to reach the EU Green Deal goals. The social, economic and clinical consequences are significant. Reasons that current initiatives fall short include lack of awareness as to the problem, or potential solutions. There is complexity as to what process to choose, the low cost, the low carbon, the one that provides better care or the one which has the better social impact. The current system has insufficient investment in sustainable education, policy or research. Solutions work well in limited areas but are inefficient as a model for true systemic change. There is no agreed system of environmental foot printing in the health system and few partnerships with industry and patients to develop a truly sustainable system. Kidney care is a suited test case with its large resource footprint and well-defined care pathways. KitNewCare’s consortium will solve the problem with leading experts in kidney care, life cycle assessment methodology, education, dissemination and communication, health economics, and data management. KitNewCare will perform an EU-wide mapping of the sustainability landscape to reveal the hotspots across different clinical centres in each impact area. To locate solutions Quality Improvement Cycles will be utilised to analyse clinical pathways and industry innovations. KitNewCare will co-develop and pilot sustainable tools (such as the purposefully developed actionable dashboard, based on the 4-factor LCA model, which will monitor and benchmark the 4 different outcomes) innovative solutions, training, guidelines and recommendations as a proof of concept which can then be applied to the healthcare system; Our work will be informed by a stakeholder interaction and a Patient and Public Involvement programme to ensure proper design, uptake, dissemination and exploitation. This will enable decision makers and healthcare providers to reduce pollution, carbon emissions, and waste.

There is an increasing prevalence of chronic diseases caused by undesired immune reactions (>10%) with high burden for the both patients (chronicity, organ failure, early death, decreased QoL) and society (EU:>100 bn €/a direct health costs) as current therapies are limited in efficacy and do not reshape sustainably the disturbed immune balance. Our ultimative goal is to develop a safe and efficient cell therapy based on genome-edited T cells with redirected specificity to sustainably combat IgA nephropathy (IgAN) - the most common glomerulonephritis and one of the most common causes of end-stage renal disease with unmet medical need. Our specific cell therapy approach is also suitable for other diseases with selective B-cell pathogenesis, such as IgA myeloma, IgA related celiac disease and rheumatoid arthritis, but as a blueprint also for diseases of other Ig classes (e.g. IgG4). Our novel concept offers a specific form of immunosuppression via Ig-(sub)class targeting & glycosylation targeting with redirected T cells in autoimmune diseases. Methodically, we benchmark three promising genome editing technologies, develop new standards for safety assessment and preclinical performance evaluation. At the end we will have a lead candidate of a new "living drug" product envisioned as a one-time treatment for IgAN and other IgA-associated that will be ready to enter clinical FIH trials (entry into TRL6). In addition, geneTIGA delivers enabling technology toolboxes with exploitation options beyond of the core project. They might de-risk and accelerate the development of next-generation gene and cell products in general. The project has thus, besides its scientific value, a high impact not only on the affected patients with IgAN and related immune diseases, but also for the European society by reducing the health economic burden caused by progressive chronic kidney disease, as well as by triggering innovation and business options in Europe's biotech and pharma field.