WT/POST Fellowship

London School of Hygiene & Tropical Medicine

Estimating the health co-benefits from climate action  There is evidence that the global value of health co-benefits that result from climate action, are greater than the financial costs of mitigation measures around climate change. However, policy decisions at national and sub-national levels seldom reflect a connection with these global assessments. The World Health Organisation (WHO) has recognised this as an area of priority, and over the course of 2020-21 are committed to work with Health Economists to provide economic evidence that can be integrated into national level considerations, and specific policy measures for climate change.

As a Health Economist, I will work with the Department of Environment, Climate Change and Health at WHO headquarters, to support the generation of reliable country-level estimates of potential health gains and savings from national climate mitigation commitments of member countries. I will use mixed methods in my research, including cost-benefit analysis for feasible interventions and policy analysis to appreciate successful policies in neighbouring countries. The outputs of my work, which will highlight the health implications of climate change for policy-makers within and outside the health sector, will include a policy report highlighting country level health benefits due to reduced emissions, as well as a paper for submission to an academic journal.


Learned Society Curation Awards

Wellcome – HHMI Learned Society Curation Awards

Learned Society Curation Awards Expert Review Group

Beyond the journal: a Microbiology Society open research platform This project aims to convert one of our journals, Access Microbiology, into an Open Research Platform (ORP), offering greater peer review transparency and fast-tracking the communication of valuable research, maximising potential for impact and influence.

At submission, articles will be made available on microbiologyresearch.org with a DOI, with clear links to open data, methods, and code, and accompanied by the reports from the machine learning review tools (e.g. Statcheck). Peer review will be transparent, and a version history maintained from preprint to Version of Record.

Many societies are seeking new ways to serve their communities but are reluctant to adopt the pre-existing F1000 ORP software. This may be because they wish to maintain a single portal for access to all the work they publish; they are reluctant to enter into a publishing agreement with a commercial player; or they are concerned that the concept may not be embraced by their communities. Through this project, we hope to prove that an ORP can be provided using software in common use by publishers of all types, and that self-publishing societies can set up such a platform independently. We also hope to provide a financial model that proves ORPs can be financially self-sustaining.

Grants awarded from 1 October 2005 to 30 June 2021

Creative Commons Attribution 4.0 International (CC BY 4.0)


Learned Society Curation Awards

Tools to Highlight Impact and Aid Curation of Scholarly Outputs The proliferation of scholarly content and implementation of transparent peer review are creating challenges for readers and evaluators to assess research significance and review outcomes, and for journals to curate field-specific content. We propose controlled experiments in which we test the utility of badges and impact statements to signal the significance of articles published by the American Society for Cell Biology (ASCB) in its research journal, Molecular Biology of the Cell (MBoC). We will devise badges that alert readers to article attributes such as new concept, broadly relevant, technical advance, teaching resource, etc. We will also experiment with new peer review processes, including a streamlined process designed to concisely identify points of significance and key issues, and one in which authors, reviewers, and editors work together to craft concise impact statements for display on articles. The effects of these innovations will be assessed relative to traditional practices by comparing article-level metrics including article views, downloads, and Altmetrics attention scores and by surveys. We will then use these innovations and the expertise of ASCB members, including early career scientists, to curate preprints and articles in other venues with the goal of providing standard, portable tools for use by other publishers.


Discretionary award – DRI

AMR Newsletter and matching AMR.Solutions website Starting February 2017, the insight from a significant amount of the Wellcome Trust-supported Expert-in-Residence work done by the applicant in support of the R & D efforts of the AMR community has been translated into a newsletter and a mirroring blogpost website. This content has come from attending key meetings (Dr. Rex is often asked to present, chair, and/or serve on program committees), authoring papers, and engagement (ad hoc email, TCs, and/or face-to-face meetings with key members of the developer community.

Wellcome Trust supported this work 2017-2019 through hourly billing and expense reimbursement. It is now proposed this support be converted to a fixed-term grant with consideration of the possibility of extensions of the grant if / as the DRI program progresses

The grant funds would be used to transformation and grow the project in 3 ways:

 Website upgrade for improved analytics and visual quality.
 Audience growth beyond R & D to the disciplines as finance, corporate leadership, and media relations, all of whom are key to success in this area.
 Social media outreach by maintaining the core USP while making use of Twitter, Facebook, Instagram, and LinkedIn to reach more deeply into the audience of those working in antibiotic R & D.


The AIDS Quilt and health activism

WT/POST Fellowship

Secondment Fellowship Interview Committee

The AIDS Quilt and health activism The proposed project will support the Science Museum with idea development for a future exhibition on health activism through research in three interrelated areas. Firstly, knowledge will be built around the recently acquired quilt block #3 of the Dutch AIDS Quilt by gathering information about the NAMES Project Netherlands Foundation (donor of the quilt) and the 8 individuals commemorated in quilt block #3. Suitable parties will also be identified for interviews regarding the history of the quilt. The relationship between Amsterdam and London with regards to health activism and quilting will also be investigated. Secondly, by exploring the symbolism and materials used in the quilt block, the project seeks to understand the myriad of different purposes the quilt serves. Given that the quilt and its functions are tied up with an array of different emotions, the project also aims to study how quilt, affect and health activism are entangled. Relatedly, if the planned exhibition is conceived also as a form of activism, what role then might emotions play in the organisation of the exhibition? Lastly, the project will also examine contemporary forms of health activism so as to identify potential artefacts for collection and display by the museum.


Strategic Support: Science

Emerging research cultures: A study of the Wellcome Trust 2019 funding of PhD Networks  The Wellcome Trust 2019 PhD Programmes Call had two central criteria: scientific excellence and positive research culture. The call was unusual in the relative weight given to each of these criteria, and the open-ness to different understandings of research culture. It is important to understand the impacts of this intervention on the part of a major funder into research training. The aim of this study is to gain insights into the impact of this intervention, and into the development and implementation of measures to improve research culture. The study embraces the emergent nature of understandings of positive research that has distinguished this call from the outset. It adopts a dual approach: firstly it will support the formation of a community of practice, consisting of the funded programmes and the Wellcome Trust, as equal members; and secondly it will use the methods of participant action research to support iterative and reflective processes for understanding what positive research culture consists in, and what constitutes best practice. This dual approach serves as a framework for active observation, in which the lessons learned by the community of practice can be articulated and shared with other stakeholders, in the form of reports and publications.


Covid-19: How it is changing us

Discretionary Award - Public Engagement

Covid-19: How it is changing us This landmark research aims to understand in real time, and longitudinally, how Covid-19 is changing people’s experience of community and levels of social protection in society.

It will specifically focus on the ways in which:

 Covid-19 is affecting and shaping the interactions between individuals in society and the effect on health, wellbeing, resilience, quality of life, and community

 digital is playing a role in community responses to the virus

 different measures to mitigate the virus changes the experience of community in a time of crisis

 individuals and communities relate to science, research and its role with respect to Covid-19

The aim of this project is to collect real-time information to inform policy makers and practitioners about how communities are responding to the pandemic, public health measures and other mitigation measures. It will also generate early insight into the potential longer-term impacts on both individuals’ mental health and community wellbeing.

To understand how communities are experiencing Covid-19 across the UK, we will conduct a quantitative study with a nationally representative sample across the four nations. This will be supplemented by innovative digital ethnographic research which generates in-depth real time insight into the experiences of a diverse group of 100 adults.


Discretionary award – DRI

Wellcome Trust support for CIDRAP – Antimicrobial Stewardship Project The CIDRAP Antimicrobial Stewardship Project (CIDRAP-ASP) was launched in July 2016 with the
goal of building an online international community focused on antimicrobial stewardship through
various platforms and with content and ASP tools applicable to high, middle and low income
countries. CIDRAP-ASP has offered freely available, high-quality information and educational
resources on antimicrobial stewardship practice, research, and policy. It features a dynamic,
content-rich website designed to engage a diverse, international audience. This project capitalizes
on CIDRAP’s existing internationally recognized expertise, infectious disease news and information
system, website infrastructure, and strong national and international audiences.
Through our partnerships with subject matter experts, we provide a wealth of diverse resources for
practitioners across the spectrum of human, animal, and environmental health to support their
ability to provide optimal care. CIDRAP-ASP generates deep, rich original content and aggregates
the most useful information from diverse perspectives and expertise.
CIDRAP-ASP occupies a unique niche in the ecosystem of projects addressing antimicrobial
resistance and stewardship because of the diversity of resources to which it provides access, and
the research and integrity with which it approaches nuanced and sometimes controversial topics.


International Masters Fellowship

Evolution of Burkholderia pseudomallei antibiotic synthesis and resistance genes Burkholderia pseudomallei (Bp) is a Gram-negative environmental bacterial pathogen. It causes melioidosis, a deadly infectious disease endemic in tropical and subtropical countries. Despite an increase in prevention efforts, the mortality rate of human melioidosis is still high. Bp is intrinsically resistant to several classes of antibiotics, which limits treatment options. The bacterium also synthesises antibiotics primarily to compete against other organisms in its soil habitats. I am testing the hypothesis that antibiotic resistance in Bp is either evolved as a self-protection mechanism against the antibiotics produced by itself, or interspecific competition or both. Using a dataset of 2,500 whole-genome sequences of Bp, I propose to mine the genes involved in the antibiotic synthesis, antibiotic resistance and their associated mobile genetic elements, thereby creating the first comprehensive antibiotic resistance and synthesis database for Bp. Long read sequencing will be employed to aid further identification of mobile genetic elements which will help determine the route of acquisition of these genes. I will use several bioinformatics methods to test the co-inherited patterns of antibiotic synthesis and resistance genes, their evolutionary stability and their mobility. Together, this will provide new ecological insights into antibiotic synthesis and resistance mechanisms in Bp and other bacteria.


Discretionary Award - Policy

Enabling research uptake through integrating networks and communities of practice Findings from health research should be translated into recommendations that can be implemented within policy and practice if research is to deliver its maximum impact and ability to change health outcomes. Currently research ‘success’ typically concludes with the publishing of papers in high impact journals with less attention to how, and indeed whether, those findings are made visible and accessible to those tasked with decision making that should be changing their practice on the basis of these new findings. Compounding this is the current difficulty for these practice and policy decision-makers to easily be made aware, find, access and synthesise new research recommendations. The Global Health Network seeks to address this by bringing researchers and decision makers together to find new tools and mechanisms for researchers to present their outcomes as recommendations that can be readily discoverable and put into practice. This proposal will firstly, establish a community of practice for researchers and decision-makers to share knowledge and develop resources, processes and mechanisms that can support turning results into discoverable, practical and usable recommendations. Secondly, to deliver an advanced digital database which enables rapid synthesis of the available research recommendations to drive improvements in uptake.


WT/POST Fellowship

Collecting and curating the material culture of contemporary women's bodies This project investigates the function and value of material culture associated with contemporary women’s experiences of health, such as menstruation, fertility and contraception. Drawing on recent work in LGBTQ+ and health activism, I will systematically research related objects in the Science Museum’s collection, share my findings through the museum’s online public engagement networks, identify further areas for collecting, and create a collecting proposal for consumer products designed to control, restore or facilitate bodily functions. This project asks four questions: What is the material culture of contemporary women’s experiences with health, and how does it fit into museum collections? What types of objects should be collected to represent the contemporary material culture of this theme? How can these objects be used in public engagement work in the present and the future? How can they be used to support ongoing efforts to break cultural taboos about women’s health and bodies in the context of museums? An analysis of these objects and their collection will shed light on their historical significance and reveal new ways that they might be used to highlight experiences of women’s health and medicine in the past, present and future.


Discretionary Award – Innovations

Western Kenya integrated COVID19 response leveraging community health strategy, youth and technology to flatten the curve and improve COVID19 case detection, isolation and management in Western Kenya To respond to the COVID19 pandemic, we will be deploying community health workers, equipped with mobile technology, and accompanied by youth to visit households door to door to screen for symptoms of COVID19, isolate, test, and manage suspected cases of COVID19. The community health workers and youth will educate households about preventive measures including frequent handwashing and home management of mild cases. Simultaneously, we will work with nurses, doctors, and clinical officers, to test and treat more severe cases of COVID19 in health facilities. Our goals are to visit every household in Siaya county covering a population of close to 1 million, and to train and support health workers working in the 32 health facilities in Siaya."


Discretionary Award - Public Engagement

Highlight It: A Public Information Campaign around the Coronavirus This project will ensure as many people as possible have access to straightforward, clear information, that quickly responds to the questions and confusion people have about the coronavirus and the ways in which it is impacting their own lives and those they love. In order to reach millions of people around the world, the project will create high quality, embeddable content that newsrooms, platforms, health authorities, government bodies can all share with their audiences. It will also galvanise engaged citizens, who want to help, by creating an 'army' of 'Information Volunteers' who can take the same content and push it out to their own networks, whether that's via WhatsApp groups, Facebook communities, or family email chains. This crisis has demonstrated that there is no time or resource for duplication. By sharing efforts to monitor trending misinformation, collect real-time questions and areas of confusion from the public, and centralizing the output of shareable 'cards' that respond to these rumours and questions, it will help over-stretched newsrooms and communication departments, and provide concerned citizens with a role to play during a time where they want to help their communities.


Single Cell Expression Atlas

Biomedical Resources Grant

Single Cell Expression Atlas Single Cell Expression Atlas (https://www.ebi.ac.uk/gxa/sc) is an open science resource that offers powerful searches for a gene expression data in different cell types, across tissues, species and conditions. Since its launch in May 2018, the Single Cell Expression Atlas has annotated and reanalysed 132 single cell RNA-Seq (scRNA-Seq) experiments across 12 different species that can be searched and visualised through its web interfaces. The SCEA is unique in that it reprocesses raw scRNA-Seq data in a standardised way. This proposal aims to keep up with the rapid technology development, expand the resource with new data modalities, continue expanding the species coverage and cross-species mapping  and expand the functionality of the resource. In particular, we will integrate single cell data sets from spatial and in-situ transcriptomics technologies, as well as emerging single cell omics protocols. Additionally, we will expand the types of analyses performed to facilitate study integration, cell type discovery and annotation. Finally, we will develop anatomograms at the organ, tissue and cell type level to enable intuitive interpretation of the experimental results and easily integrate the different types of data on the user interface.


Discretionary Award - Mental Health

COVID-Mind: Mental Health during Covid-19 This proposal is for the establishment of an international mental health research network for Covid-19 and the running of a UK mixed-methods mental health study.

The proposed network will have three core aims:

    To support the establishment of high-quality longitudinal studies in countries internationally exploring the effects of Covid-19 on mental health
    To enable international collaboration in longitudinal data analysis to understand cross-cultural differences in the mental health effects of Covid-19
    To catalogue and disseminate other quantitative and qualitative mental health research on Covid-19

We will also lead a large-scale UK concurrent mixed methods study comprising a longitudinal study and a qualitative interview study to provide high quality, rigorous scientific data on the mental health impact of Covid-19 in the UK. This study is already underway and has 5 core aims:

 To understand the psychological and social impact of Covid-19
 To map how the psychosocial impact evolves over time as social isolation measures get stricter and once measures are relaxed
 To ascertain which groups are at greatest risk of adverse effects on their mental health
 To explore the interaction between psychosocial impact and adherence to healthy and protective behaviours
 To identify activities during isolation that could buffer against adverse effects


Research Resources Award

Undaunted: minority mental health activism and archives The project has three central activities.

One: Access. Cataloguing the papers of Melba Wilson OBE (fl. 1965-2010). Wilson’s career included leading national and regional mental health programmes, policy units and services, specifically with a focus on minority ethnicity people.

Two: New descriptive practice. The cataloguing of Wilson’s papers will be used as a springboard into new approaches around cataloguing and dissemination of archival sources.

Three: Collections development. Scoping hidden histories of activism in the intersection of race and mental health, including the histories/ archives of organisations such as Ipamo (1995-1998) a Lambeth based Black mental health initiative, and the Afiya Trust (founded 1997) a national charity that works to reduce inequalities in health and social care provision.

Supporting these three strands is our collaborative studentship with the University of Roehampton, and a programme of public engagement to disseminate the outputs of the project and to ensure a wider impact of the project outcomes.

The key outcomes of the project are:

 Enhancing the resources available in this field of research.
 Creating new opportunities for discursive research.
 Making a lasting change to the availability and range of minority mental health archive collections.
 Innovating in the field of archival practice.


Mining the Past

Research Resources Award

Mining the Past This is a project to conserve, catalogue and exploit the archives of the National Union of Mineworkers (NUM). It presents the opportunity to develop a nationally significant archive for occupational and industrial health at the MRC and a Midlands network for coal related archive collections. The NUM records are currently held in poor conditions at the union’s headquarters in Barnsley. The project involves the removal of the archives to professional conservation facilities for drying and cleaning prior to storage at the MRC. It includes the sorting and cataloguing of the collection for research use as well as a public engagement programme. The project will:

 Remove the collection to Harwells for conservation treatment
 Re-box, sort and summarise the collection for immediate access and use in promotional activities
 File/item list the collection for full online catalogue access
 Select and digitise items for research, teaching and exhibitions.
 Develop a project website
 Co-host seminars with the Centre for the History of Medicine (Warwick) on coal, industry and health
 Develop a Midlands network of coal related archive collections for future collaboration, education and outreach activities
 Use the NUM archive as a focus for the development of a national industrial health and welfare archive


AMS Partnership Scheme

Academy of Medical Sciences: Breaking Boundaries The Academy of Medical Sciences’ mission is to advance biomedical and health research and its translation into benefits for society. The vision set out in this proposal is central to our strategy to create a diverse workforce of researchers to advance scientific discovery and to generate and optimise improvements in health.

Drawing on our strengths of breadth, connectivity and unparalleled career support activities, over the next five years we will:

 Support researchers’ transition to independence by enhancing our Starter Grants for Clinical Lecturers and Springboard for Biomedical Researchers schemes
 Promote health innovation with new programmes that support greater cross-disciplinary and pan-sector connectivity and collaboration by researchers

This proposal will enable us deliver a platform of cohesive, innovative activities that enhance research career pathways and achieve wider positive impacts on diversity and research culture. Our proven track record in galvanising action across the sector and leveraging further funding will drive greater coordination and effort across the UK’s university, healthcare and industry sectors.

In five years’ time we will have created mechanisms and a regional infrastructure that will equip and support cohorts of excellent researchers and future leaders to work collaboratively and proactively in addressing societal health challenges.


WT/POST Fellowship

Empowering Technology? Issues of Access in Digital Primary Care  In 2019, the NHS Long Term Plan and GP Contract committed doctors to making online their default patient access point by 2023. The widely used NHS app and web-based appointment and repeat prescription systems will be updated to facilitate, e.g. video consultation and remote monitoring. England's provider, NHS Digital, claims these changes will increase capacity and cut costs by reducing physical attendance. Many consumer champions and academic experts have questioned the lack of independent evaluations of the technology, and stress the likelihood that privileging digital access will exacerbate existing healthcare inequalities. The expedited roll-out of these technologies required by the current COVID-19 crisis may heighten such concerns by evidencing a 'digital divide'.

A rapid review will bring together current research from academia, the public sector, industry, and third sector. This will demonstrate the current state of digitisation and each group's specific concerns and interests in implementation. Interviews will then concentrate on areas of consensus surrounding best practice, establishing several case studies of leadership.

For policymakers, it will set out possible solutions for avoiding the exclusion of patients from specific age, income, or ethnic backgrounds; and draw attention to the possibilities for partnership by highlighting shared interests across stakeholding groups.


Research Resources Award

Rediscovering Harold Bridger: his life, work and legacy.  Since 1989 the Planned Environment Therapy Archives have been unique in their remit to capture and preserve the records of therapeutic communities and care.

In 2002 the Archives acquired the papers of the psychoanalyst Harold Bridger. The collection spans the whole of Bridger’s career, from his pioneering work as the Commanding Officer at the Second Northfield Experiment, through his role as a founding member of the Tavistock Institute of Human Relations, and on to his groundbreaking work concerning team dynamics in the workplace.

Bridger’s papers have enormous research potential in the fields of psychiatry, psychology and sociology as well as the history of medicine, economics and social reform.

The project will look to address the under-use of Bridger’s Archive by cataloguing the collection to international standards, identifying and carrying out preservation work, and promoting the collection.

To achieve this, a Project Archivist will be appointed to appraise, arrange and describe the materials. During the project, the post holder will carry out basic preservation to support long term use of the collection, and will oversee the digitisation of obsolete media. The Project Archivist will promote the collection by creating a network of stakeholders and attending relevant conferences and events.


Coronavirus

AFRICA CDC RESPONSE TO COVID-19 PANDEMIC The African Union, Africa CDC, in collaboration with WHO on Febraury 22nd, 2020 convened an emergency meeting of all 55 ministers of health to discuss the COVID-19 pandemic. At the end of the meeting, they agreed on a continent-wide strategy for COVID-19 that will allow for greater coordination, collaboration, cooperation and communication. The strategy focuses on six major technical areas and is implemented through and endorsed Africa Coronavirus Task Force (AFCOR). As of 15 March 2020, over 26 countries have reported greater than 250 cases. In Africa, the primary strategy for COVID-19, therefore, is based on limiting transmission and minimizing harm. Delaying and diminishing the peak of outbreaks can help health systems better manage the surge of patients and communities better adapt to the disruption of social, cultural, and economic activities. In order to compliment WHO’s efforts to respond to COVID-19, Africa CDC is uniquely positioned to support Member States through its presence within the African Union, the highest political body in Africa, and its five Regional Collaborating Centers. The primary challenge now is executing these tactics in a continent that is large, diverse, and at high risk of social and economic disruption from a pandemic.

Centers for Disease Control and Prevention, U.S.


Research Resources Award

Womens Aid Federation England Archive 1974-2020 Women’s Aid Federation England (WAFE) is the national coordinating body for all local and domestic violence services, including refuges in England. It provides information, training and resources to these services as well as to other agencies. It monitors the experiences of and the provision for women and children suffering abuse. It lobbies, advocates and campaigns throughout England.

The archive encapsulates the broad spectrum of its work. Growing out of the Women’s Liberation Movement in 1974 the organisation moved in twenty years from being one which met with aggression from the police to one which was highly regarded for its knowledge and research. The organisation marks its 50th year in 2024. WAFE is working in collaboration with the University of Leeds Special Collections and the Feminist Archive North (FAN) to safeguard the historical record and make it accessible for research.  Collection, appraisal, documentation and preservation will ensure the collection is publicly available before this milestone year. New research collaborations will become active, learning resources will be created, and knowledge of WAFE's activity and significance will be shared and exchanged. The collection has interdisciplinary research significance and is a major resource for WAFEs own understanding of its contribution to health and society.

Grants awarded from 1 October 2005 to 30 June 2021


Discretionary Award - REiAA

Enhancing Research Uptake and Policy Engagement in the DELTAS Programme  Enhance DELTAS  is a programme led by the African Institute for Development Policy (AFIDEP) to provide research uptake and policy engagement support to awardees of the Developing Excellence in Leadership, Training and Science (DELTAS) Africa initiative, led by the African Academy of Sciences. Enhance DELTAS  will work with the first and second DELTAS Africa programmes to develop the capacity of individuals, support DELTAS institutions in creating enabling environments for policy engagement and research uptake, facilitate interaction between researchers and policymakers, and contribute to the field of Evidence Informed Decision-Making through peer reviewed publications. The programme will use face-to-face workshops, online self-learning materials including videos, interactive webinars, toolkits, and talks by policymakers. The programme will be underpinned by a robust monitoring, evaluation, and learning framework so that the programme can be continually improved, the changes as a result of the programme can be assessed, and the knowledge from implementing the programme can be shared with the EIDM community.


Research Resources Award

Positive history: preserving the archives of HIV/AIDS: care and testimony The aim of this project is to make accessible for research three recently acquired archive collections held by London Metropolitan Archives which together illuminate two important threads of the AIDS crisis of the 1980s and its aftermath: pioneering medical treatment, care and support; and lived experience of not only those diagnosed with HIV/AIDS, but their carers, partners, relatives and friends. They comprise: Mildmay Hospital archive including 4000 patient case files; 103 interviews of people with AIDS, their families, partners and carers, filmed by the  AIDS Since the 80s project; and the archive of peer-led support charity Positively UK (formerly Positively Women). The key outcomes will be: freely available online catalogues to item level of all three archives; a research database of key information extracted from the Mildmay Hospital case files, and full digital access to the 150 hours of filmed interviews supported by time-coded summaries, transcriptions and captioning. The archives, and the areas they inform such as the history of sexuality, science and medicine, as well as social and cultural change, and the methodologies used to make them discoverable, will be promoted through a conference, two professional skill-sharing events and two film-screenings, building on existing demonstrable interest in these archives.


AAS Africa Platform (AESA)

Funding of Covid-19 R&D Priorities in Africa Success against the Covid-19 pandemic requires a transdisciplinary approach incorporating social sciences and humanities, economic research and health systems research. It also requires access to funding. The African Academy of Sciences (AAS), through its hosted AESA Platform, acts as Secretariat for this Fund for Covid-19 R & D priorities in Africa. This Fund is seeking proposals against identified priorities; coordinating a network of researchers working on Covid-19 R & D to build a clinical research and trials platform for Africa; and taking a longer-term view to address pandemic preparedness in research actions.

The Fund is open to multiple priority areas for research and development, including:

 Epidemiological studies

Studies to define disease severity and susceptibility of particularly groups at high risk of severe infection; the role of different age groups in transmission; the impact of control and mitigation measures; and to predict the most effective interventions.

 Clinical management

Studies to define the natural history of Covid-19 infection including the identification of prognostic factors for severe disease and the identification of vulnerable groups; and studies to improve the clinical outcome of Covid-19, including strategies to improve the processes of care.

 Infection prevention and control

Studies to assess the effectiveness, in both healthcare and community settings, of movement control strategies in preventing secondary transmission and of personal protective equipment in reducing the risk of transmission.

 Candidate vaccines, diagnostics and therapeutics

Clinical trials of potential treatments and preventative strategies, facilitated by the recent AESA programme launched as the Clinical Trials Community online platform.

 Ethical considerations for research

Studies on culturally appropriate approaches to the ethical, social and legal issues prevalent in emergency situations, such as presented by Covid-19.

 Social sciences in a pandemic response

Engagement to bring community voices to decision-making processes, to understand non-intended consequences of pandemic-control decisions and to understand contextual vulnerability; and studies to mitigate impacts of the socio-economic and political externalities of Covid-19.


Innovations Priority Project

Preparing to Scale Oxitec’s 2nd Generation Aedes aegypti Technology in Resource-limited, Dengue-prone Urban Settings Human diseases that are transmitted by the Aedes genus of mosquitoes are
increasing rapidly, diseases such as Zika, dengue, chikungunya and yellow fever.
Recent estimates suggest that today around half the world’s population are at daily
risk of infection, the vast majority by a single mosquito species, Aedes aegypti.
Oxitec’s have developed a ground-breaking biological approach to control this vector
using safe, non-biting male mosquitoes ("OX5034-E"). Our male-only mosquitoes
carry a self-limiting gene, which means that when they mate with wild females,
offspring inherit a copy of this gene that prevents females from surviving to
adulthood. The genetic mechanism that prevents females from surviving also enables
deployment of our safe, non-toxic, non-biting male Aedes aegypti via egg packets in
small recyclable boxes filled with water.
This project will fund the final stages of tailoring Oxitec’s "just-add-water" vectorcontrol
device into a sustainable and scalable Aedes aegypti control solution. We
will be optimising the OX5034-E device and developing customised digital tools to
support the wide-spread deployment of this technology, particularly in low-income
communities that so often require it most.
The project’s three primary goals to accomplish this are:
- Developing new methods for scalable and rapid deployment of OX5034-E
devices in dengue-prone settings.
- Demonstrating OX5034-E’s ability to integrate with traditional Aedes aegypti
control programs used by resource-limited governments and communities.
- Completing the supporting online and mobile platform to help future end-users
manage the planning and deployment of OX5034-E.
We will provide immediate benefits by delivering a two-year Aedes control program
in a dengue-impacted city in Brazil, but importantly our project is destined to deliver
impact at a global scale. In the years to come we anticipate saving thousands of lives,
and positively impacting the livelihoods of many millions of people who currently live
under the near constant threat of this invasive and dangerous vector.


Biomedical Resources Grant

Dr Liz Goddard, Prof Francesca Little, Prof Landon Myer, Prof Mark Nicol

A Biorepository for Research in Child Health We propose to create an African biorepository and linked comprehensive database to support cross-disciplinary research that advances child health. The biorepository will consolidate  > 527,000 samples and data from three ongoing large population-based studies: (i) Drakenstein Child Health Study, a birth cohort with samples from parents, children and the environment collected antenatally through childhood; (ii) paediatric tuberculosis studies with samples longitudinally collected over 15 years; and (iii) Cape Town Adolescent Antiretroviral Cohort, a study of HIV-infected adolescents on antiretroviral-therapy and uninfected controls investigating development and determinants of chronic disease. Ongoing prospective data and sample collection for the next 5 years, in these and other child health studies, will substantially grow this facility ( > 732,000 samples). The facility will support several Wellcome Trust grantees and serve as a platform for cross-disciplinary research, linking metadata and samples to different databases (demographic, clinical, radiological, microbiological, genetic, transcriptomic, environmental, immunological, psychosocial). A key focus is on infectious exposures and development of non-communicable diseases, key priorities in African health. A web interface will be created for investigators to access samples or datasets. This resource will be invaluable for current and future collaborative research to advance child health and to provide African-specific data and samples.


Biomedical Resources Grant

A2O - Transforming EMPIAR into an Essential Resource for EM Data Spanning Scales from Atoms to Organisms The Electron Microscopy Public Image Archive (EMPIAR) was developed following consultations with the cryo-EM community highlighting the pressing need for public dissemination of image data underpinning cryo-EM structures. Since 2014, EMPIAR has quickly grown in volume (286 entries; 284 terabytes as of 01/04/2020) and established its role and value for the community ( > 180 EMPIAR citations). Its remit now includes micro-crystal electron diffraction (microED), soft-X-ray tomography (SXT), and volume-EM (including Focused Ion Beam and Serial Block-Face SEM) data. The main goals of this grant are to streamline and facilitate the deposition process (encouraging deposition and improving quality and quantity of deposited information) and to enhance and facilitate data reuse. All hardware and IT infrastructure will be provided by EMBL-EBI.

Specific aims:

 Fully support deposition of volume-EM data;

 Support handling large (tissue- and organism-level) 3D-volumes by pump-priming EMPIAR with flagship connectomics and non-connectomics datasets;

 Enable efficient and interactive reuse of large 3D-volumes by supporting multiscale imaging formats;

 Facilitate potential mandatory deposition by simplifying the deposition workflow and enhancing data reuse;

 Improve support for correlative imaging data, working with stakeholder communities and the EMBL-EBI BioImage Archive;

 Prepare for rapid growth of data volumes by evaluating and implementing data-compression methods.


Biomedical Resources Grant

Schistosome and Snail Resource (SSR); supporting global schistosomiasis research  Schistosomes, transmitted by freshwater snails, infect  > 200 million people in low/middle-income countries, particularly sub-Saharan Africa. While substantial advances have been made in the control of human schistosomiasis, the diversity and complexity of schistosomes and their specific fresh-water snail hosts warrants fundamental research requiring lifecycles and live material. Without the availability of Schistosoma lifecycles, future research faces substantial obstacles; currently very few labs are able to maintain the parasites and/or the snail hosts and current long-term cultures lack the genetic heterogeneity observed in natural populations. Our proposal is for the creation of a Schistosome and Snail Resource (SSR), maintaining live material and lifecycles that are currently limited or that do not exist elsewhere. The SSR will provide access to 1) the "standard/model" Schistosoma and snail species; 2) key African Schistosoma species/strains; 3) cultures of diverse snail vectors, enhancing current research and capacity while enabling new research avenues. Our historical expertise in establishing and maintaining unique schistosome and snail isolates from different endemic settings, together with our state-of-the-art snail facility (NHM) and LSHTM rodent facility will facilitate the development of the resource. The SSR will add considerable value by facilitating priority research needed to support schistosomiasis control and elimination.


Technology Development Grant

Dr Charlotte Hagen, Prof Mark Lythgoe, Prof Rachel Chambers, Dr Anna Franz, Dr Joseph Jacob, Prof Alessandro Olivo, Prof Mariya Moosajee, Prof Paolo De Coppi, Prof Peter Lee

A multi-contrast X-ray nanoscope for multidisciplinary research We are seeking to acquire the resources to develop a unique X-ray 3D nanoscope. We will need: custom-source, isolation, manipulators, custom-detector, radiation-safe enclosure, two PDRAs (hardware- and software-focussed) and 1year system engineer for the transition to the long-term maintenance/management of the instrument.

We plan to build a nano-resolution multi-contrast 3D scanner with transformative potential across diverse disciplines, including cellular structural biology, pathology, musculoskeletal and respiratory medicine, tissue engineering and child health.

This will create a multi-user tool, benefitting researchers across multiple specialties. The simultaneous attainment of nano-scale resolution, unprecedented scale range (six orders of magnitude,5cm/50nm), multi-contrasts and a wide energy range will make the X-ray nanoscope proposed here a unique non-destructive 3D imaging tool.

Its key advancements will be ultra-high-resolution zoom-ins on intact samples, whose entire structure is measured at a lower resolution, combined with multi-contrast modes arising from phase effects. A simple analogy of this new X-ray tomography paradigm is the way we navigate digital maps. We use coarse resolution at large scales, blowing-up in precise locations of interest. Both capabilities must be concurrently present: it would not be useful to navigate large areas at highest resolution (lost in space) and having only coarse resolution would lack invaluable insights.


Biomedical Resources Grant

Dr Johannes Dessens, Prof David Baker, Dr Colin Sutherland, Dr Paul Bowyer, Prof James Logan

Transmission facility for human malaria parasites
We will establish a facility for the transmission of human malaria parasites to the mosquito vector and onwards to humanized mice that is open to all members of the research community. Owing to the difficulty in transmission of human malaria parasites in laboratory settings, only few facilities exist where this can be achieved consistently. The three UK facilities capable of this are not open facilities, and none have established the humanized mouse model for investigating the liver stage of the parasite. Notably, this facility will enable the investigation of transmission-blocking compounds, malaria vaccine development, basic research into the interaction of the parasite with the mosquito host and the mammalian liver using a humanized mouse model, the effect of insecticides on the transmission of parasites by insecticide-resistant mosquitoes, the trial of specific genetic modifications of mosquitoes, genetic crosses of malaria parasites and many other investigations. This will make available avenues of research that are currently out of reach for most members of the research community and support the acceleration of new and innovative interventions to halt the spread of malaria.


EAT Foundation Wellcome Support

Discretionary Award - OPOH

EAT Foundation Wellcome Support Summary

EAT is pleased to submit this request for a continuation of Wellcome’s support for EAT knowledge engagement and communications activities. A critical assessment of the economics of food and land used systems was identified as a critical knowledge gap to further progress on transitions to healthy and sustainable food and land use system. In collaboration with SISTEMIQ, FOLU, and PIK, we are pleased to share our comprehensive proposal for the Food System Economics Commission building on the foundational work of the EAT-Lancet Commission, and FOLU’s Growing Better report.

Second, while EAT has had to cancel the 2020 version of the EAT Stockholm Food Forum, the Communications team has very rapidly pivoted and begun to develop an online version of the Forum, EAT at Home. This virtual forum is a multi-month digital food festival experience, designed to spotlight leading science, planetary health chefs, business solutions, dynamic dialogs and debates, cooking demos and more in an interactive and accessible format that will build and continue momentum on food transition, while greatly increasing the diversity of voices that EAT is able to feature and engage.

Third, EAT thanks Wellcome for its continued support, including to core institutional functions.


Technology Development Grant

Next Generation Data Formats for BioImaging Bioimaging measures the structure, constitution and dynamics of molecules, cells, tissues and organisms in biological systems. Data are often GBytes or Tbytes in size, cover space, time and other dimensions, include complex metadata that describe experimental setups, acquisition parameters and analytic outputs and are stored in 100s of different proprietary file formats. The scale and complexity of these data are a consistent, unsolved block to researchers making their bioimaging data public and FAIR, despite the fact that open data sharing and publication are mandated by the Wellcome and many other funding agencies.

OME is a globally recognised, open source bioimage data specification and software project (https://www.openmicroscopy.org). Since 2002, OME's OME-TIFF file format and Bio-Formats file translation library have served as the global de facto standard for accessing bioimage data, but the capabilities of these tools will soon be surpassed by the growing volume and complexity of bioimaging datasets. We propose to build next generation bioimage file formats, flexible data models, data linkages and transfer tools to serve the needs of the rapidly evolving bioimaging community and feed new public data repositories and databases. The software will be liberally licensed to allow adoption across the research and industrial bioimaging communities.


Technology Development Grant

Next generation atomic force microscopy for solving problems in biomedicine AFM has unique capabilities for understanding life, and is able to image living systems in their native state under physiological conditions with molecular resolution. However, technologically, it is where EM was in the 1990s – far from delivering its theoretical potential when imaging biology. By understanding the physical principles of the technique and systematically optimising the instrumentation, the potential of EM has been unleashed in recent years. We aim to drive a similar "resolution revolution" in AFM, developing an instrument that can:

 Image functioning biological molecules in intact systems, including living cells, without perturbing their function or structure.
 Obtain these images with sufficient resolution to identify biomolecules by their topography.
 Accurately measure the organisation of biological molecules in complex, native samples.

We will do this by targeting fundamental weaknesses in AFM technology:

 Reducing the thermal noise of the cantilever by producing smaller and softer cantilevers, and a microscope that can use them, reducing the imaging force 10-100x compared to the current state-of-the-art.
 Reducing positioning noise and drift by developing a hierarchical, interferometric closed-loop scanner that reduces noise by  > 10x and drift by 100-1000x compared to the current state-of-the-art, providing traceably accurate measurements of size and position.


Coronavirus

Prof Azra Ghani, Prof Neil Ferguson, Prof Nicholas Grassly

Epidemiological modelling to support the global COVID-19 response: How to mitigate impact in low-income and crisis-affected settings The current COVID-19 pandemic is the greatest threat posed by a respiratory virus since 1918 H1N1 influenza pandemic. To date, the majority of epidemiological modelling analyses have focussed on High Income Countries (HICs). However, there is an equivalent need for models appropriate to Low- and Middle-Income Countries (LMICs) that comprise 85% of the world’s population and have differing demographics and behaviours that are not captured by existing models. To address this, we will use a model of SARS-CoV-2 transmission to forecast epidemics and healthcare needs in LMICs, explore the potential impact of proposed interventions and estimate their impact in real-time. It will be fit to individual country surveillance data to support estimation of the reproduction number and projections will be made of the potential impact of alternative mitigation and suppression strategies, including household quarantine and social distancing, both generally and in vulnerable populations. The fit of the model to COVID-19 case count and mortality data collected after the implementation of various interventions will be used in real-time to evaluate their effectiveness in individual LMIC countries and the criteria for lifting of social distancing measures explored using the best fit model.


Technology Development Grant

Dr David Kent, Prof Jennifer Southgate, Dr Peter O'Toole, Prof Ian Hitchcock, Prof Paul Kaye, Dr Steven Johnson

Photonic hyperspectral no-label spotter (PHENOSPOT) A comprehensive understanding of communication in both healthy and diseased cells requires new tools to quantify the spatial distribution, onset and rate of protein secretion. To address this challenge, we will develop an in vitro technology that maps the three-dimensional (x, y, time) distribution of multiple cell-secreted molecules, such as chemokines, hormones, and cytokines, with single cell resolution. This technology allows to better characterise the heterogeneity of cell populations in response to stimuli and to define mechanisms of inter-cellular communication. Our innovation exploits the sensitivity of optical resonances to map the secretion of specific proteins without the need for a labelled antibody. Critically, and in contrast to competing technologies, such label-free approaches enable protein detection in real time. The photonic sensor can be fabricated at low-cost and can be integrated into standard commercial microscopes rendering the technology widely applicable. We have already demonstrated the technology and will now optimise its performance, develop its capability to detect at least 3 different types of proteins in parallel and work with a commercial partner to develop a system compatible with a laboratory-standard inverted microscope. We will engage with the community through exemplar projects that span infection and immunity, cancer, haematology and vaccinology.


TyVOID

Innovations AIGH Enterics Flagship

Science, Innovation and Translation Programme Advisory Group

Dr Firdausi Qadri, Prof John Clemens, Dr Kathy Neuzil, Dr Virginia Pitzer, Dr Xinxue Liu, Prof Shrijana Shrestha, Dr Buddha Basnyat, Dr Katherine Theiss-Nyland, Dr Merryn Voysey

TyVOID This study will: assess the change of medium-term efficacy of the new Typhoid Conju-gate Vaccine (TCV) in children, by comparing the relative risk of typhoid in those initially vaccinated in 2017/2018 with later cohorts vaccinated in 2020 and 2021; assess the de-cline in individual-level immunity 3-5 years after vaccination; measure ongoing popula-tion-level impact against typhoid fever in the community. The data collected will help identify correlates of medium-term protection; inform the need for, timing of and potential cost-effectiveness of adding booster doses to vaccine schedules; permit the develop-ment of a mathematical model to predict future impact of typhoid vaccination in two en-demic settings.


RSTMH small grants for snakebite

Discretionary Award - Snakebite

Royal Society of Tropical Medicine and Hygiene

RSTMH small grants for snakebite  For Wellcome Trust to contribute to the established RSTMH small grants programme to enable those early in their careers to conduct small research projects into the topic of snakebite. Our small grants are awards of up to £5,000 including VAT and available to those early in their careers who are working in a field relevant to tropical medicine or global health e.g. doctors, nurses, academic researchers, NGO workers, health economists, social scientists. These grants typically represent the very first time someone has received funding in their own name, the first application form they have written, and the first time they have managed their own project,including a budget and reporting. The grant process is designed to be as straightforward as possible, for many applicants English is not often their first language. The application is made through our online portal and 2 referees, including their supervisor, must be provided. Snakebite is a topic of great importance to RSTMH given its high levels of death and disability. Though funding has increased in the topic there is a need to encourage early career interest and we feel the small grants present a way to do this, which is easy for Wellcome to benefit from.


Biomedical Resources Grant

Dr Sameer Velankar, Prof Janet Thornton, Prof Andrew Martin

3D-FunSites - a virtual encyclopaedia of protein functional sites for assessing variant impacts and drug repurposing   We will significantly expand CATH, widely used by biomedical researchers, and enhance its value for disease analyses. Data on disease-associated genetic variations is vastly increasing but to fully exploit it we must understand how the resulting residue mutations impact protein functional sites and therefore functions. We will use CATH to predict the impact of variants on diseases and drug responses, enabling personalised medicine.

CATH-FunFams are functional sub-classifications of CATH evolutionary superfamilies and the only structural resource comprehensively linking variants, structure and vast sequence data for predicting functional sites accurately (FunSites). Close proximity of disease variants (residue mutations) to FunSites, in 3D, is a key indicator of pathogenicity.

Our expanded CATH-FunFams and FunSites will enhance machine learning methods to predict functional impacts and drug responses/side effects, including for different genders and ethnicities.

We will:-

1. Expand CATH-FunFams and FunSites  > 5-fold by adding sequence data from metagenomes.

2. Expand CATH-FunSites further by integrating comprehensive data from PDBe-KB, PDBsum and VarSite.

3. Develop machine-learning tools that exploit data from (1)  &  (2) to predict impacts of genetic variations in different populations.

4. Integrate drug data into FunFams and develop tools to predict drug repurposing/side effects.

5. Develop intuitive webpages reporting functional impacts/drug repurposing/toxicity.


Collaborative Award in H&SS

Humanities and Social Science Selection Panel

Connecting three worlds: socialism, medicine and global health after WWII The project pioneers a new history of global health that, for the first time, incorporates the socialist world - a constellation of countries in a fluctuating political, economic and military nexus distinct from the capitalist West. It identifies the particular health cultures produced by socialism (in all its variety) and explores the impact of socialist internationalism in co-producing global health in the 20th century. This project offers a radical new account that will not only transform our knowledge of historical processes, but will further our understanding of ideas, practices and processes that current global health structures have been built on.

Global health histories are framed mainly through American, colonial and liberal perspectives. The omission of socialist contexts, however, distorts our understanding of what global health is. Although there was not one socialist template, diverse framings of socialist medicine played major roles in shaping and contesting global practices.

A systematic analysis of socialist medicine and international health through global case studies integrates missing expert networks, political agendas, public health models and diplomatic agreements in global health history. This work, in turn, allows us to rethink concepts such as socialism, solidarity, development, socialist medical research and health provision.


Biomedical Resources Grant

InterPro and Pfam: Protein domains and families for biomedical research InterPro is a core protein data resource that amalgamates 13 protein family databases (including Pfam) to provide the definitive description and classification of protein domains and families. Various scientific communities rely on the range of annotations provided by InterPro and its member databases to acquire novel insights into the vast amounts of new DNA sequence data, enabling scientists to interpret experiments and design new ones based on annotations spanning complete genomes down to single residues. The past five years have witnessed a major increase in the scale of sequences, concomitant with the emergence of AI/ML approaches for unlocking the biological signals encoded within the data. This project will exploit these innovative approaches to enhance protein annotations and refine classifications through the incorporation of additional data types, along with the application of ML methods and organisation of the protein family data. We will integrate KOfams and AMRFinder into InterPro, while continuing to scale the InterPro/Pfam/HMMER resources to tackle billions of proteins. Cumulatively, these developments will accelerate biomedical research by facilitating scientists to decipher the effect of human mutations, understand drug interactions, combat antimicrobial resistance, and tackle emerging pathogens.

Grants awarded from 1 October 2005 to 30 June 2021


PhD Training Fellowship for Clinicians

Clinical ApplicatioN of DEep Learning and Intelligent Vision in Radiology: CAN DELIVeR The workload associated with medical imaging has greatly increased both in terms of volume and complexity in recent years. The amount of clinicians trained in expert interpretation of these data has however, failed to keep pace with demand. This project encompasses the application of Machine Learning to specific radiology use cases. Imaging with MRI is the cornerstone of surveillance of patients with MS and underpins decision making around initiation of and modifications to therapy Reporting these images is a significant proportion of the reporting time of our Neuroradiologists. Artificial Intelligence, and especially machine and deep learning have been proposed as a potential solution. Computer Science (CS) groups who aim to tackle these issues may fail  due to a lack of access to clinical insight and clinical data.  Furthermore clinical groups may lack the CS expertise. Presently in Ireland there is no framework for clinicians with medical imaging problems, which could potentially be solved with machine vision, to interact with computer scientists with the expertise to solve these problems. We intend to apply solutions using novel computer science techniques to clinical problems with a particular focus on the assessment of interval change between scan acquisitions.


Therapeutics Accelerator

Chloroquine/Hydroxychloroquine prevention of coronavirus disease (COVID-19) in the healthcare setting; a randomised, placebo-controlled prophylaxis study (COPCOV) There is no proven treatment, chemoprophylaxis or vaccine for COVID-19. This is the most serious pandemic emergency for 100 years. Healthcare workers are being affected disproportionately in the continuing epidemic threatening an imminent breakdown of health services. Chloroquine and hydroxychloroquine are safe and well-tolerated medications which can be taken for years without adverse effects.Both have significant antiviral activity against SARS-CoV-2 and there is emerging evidence from China and Europe of efficacy in treatment. Unfortunately there is also premature recommendation from countries such as India which now recommends low dose hydroxychloroquine for prophylaxis in health care workers.

We propose conducting a multi-centre, multi-country randomised, double blind, placebo controlled assessment of the prophylactic efficacy of chloroquine (Asia) or hydroxychloroquine (Europe) in preventing COVID-19 illness in at-risk healthcare workers and other frontline staff. At least 40,000 participants in Asia and Europe will be randomised 1:1 to receive chloroquine or hydroxychloroquine or a matched film coated placebo as daily prophylaxis for three months.  The study’s objectives are the prevention of symptomatic coronavirus disease (COVID-19) and the attenuation of the clinical severity.


Collaborative Award in H&SS

Dr Christopher Pearson, Associate Professor Daniel Ramp, Dr Tim Kurz

Remaking One Health: Decolonial approaches to street dogs and rabies prevention in India This study investigates the biosocial conditions that frame the persistence of rabies as a public health concern in India to rethink One Health approaches in post-anthropocentric directions. Dog-mediated rabies in Asia and Africa is a priority in transnational public health, and One Health approaches have scientific consensus as being key to its prevention (WHO 2019). India has the highest burden of human rabies globally despite long-standing initiatives, including One Health, on rabies elimination. Our project addresses this impasse.

Challenging the (post)colonial One Health conceptualisation of street dogs as out-of-place disease vectors, our analytical framework of multispecies cultures directs new inter-disciplinary attention to the lived experiences of human and nonhuman animal actors, and to multiple dimensions of people-street dog relations in urban and rural India. We will examine historical and contemporary transnational influences on dog-related public health agendas; public attitudes and knowledge; everyday interactions between people, dogs, and the biophysical environment; and institutional interventions to advance decolonial concepts and practices for healthy multispecies societies. Through this fresh approach to rabies, we will reframe how One Health is theorised and pursued, and reconfigure it to enable more equitable approaches to health in a world marked by multispecies risk and vulnerability.


Collaborative Award in H&SS


Discretionary Award - REiAA

An international dimension to the first Indian research management conference The DBT/Wellcome Trust India Alliance will shortly be organizing the first Conference for Indian Research Managers and Administrators (RMAs), as part of the ongoing India Research Management Initiative (IRMI). IRMI activities represent the foundational steps towards strengthening research ecosystems in India. The IRMI Annual Conference series is intended as a platform for Indian RMAs to share their work and perspectives with peers, for institutional and funder representatives to engage with the possibilities of Research Management in India, and for Indian RMAs to work together as a community of professionals. Work has begun on creating a structure for the 2020 Conference, which will include 60-80 RMAs, researchers and funder representatives from India. As the current pool of RMAs in India is small and relatively inexperienced, it will be beneficial to additionally include a small group of international RMAs, for presentations and interactions at the Conference. This is a request to the Wellcome Trust for funding the costs of attendance of international experts at the IRMI Annual Conference 2020.


Coronavirus

Managing COVID-19 epidemics in low- to middle-income and crisis-affected settings: Epidemiological and economic evaluation The COVID-19 pandemic is rapidly escalating and poses a potentially catastrophic threat to low and middle-income countries (LMICs) as well as crisis-affected populations. To support evidence-based, real-time decision-making by countries, donors, humanitarian actors and other stakeholders, the London School of Hygiene and Tropical Medicine (LSHTM) hereby proposes a six-month multi-disciplinary project.
The project is built around three Workstreams: (1) Evaluation of the health, fiscal and macro-economic impact of response options; (2) Global analysis; and (3) Technical support to decision-makers and local researchers. Specific activities (and associated deliverables) include the following:

 Improve global data collation and capacity for economic analysis around COVID-19
 Evaluate the health and economic implications of COVID-19 response options using micro-economic models
 Quantify the macro-economic consequences of COVID-19 response options
 Predict the transmission and mortality of alternative shielding options for high-risk populations
 Provide a regular series of global COVID-19 health impact, resource needs and cost estimates
 Advise LMIC governments, donors and humanitarian actors on COVID-19 strategy
 Support technical guidance and coordination for humanitarian actors
 Support LMIC economists to provide local evidence on COVID-19 responses

We propose to undertake the above largely through desk-based work from London over a period of 6 months (Apr-Sep 2020).


Academic DNA-Encoded Library Resource

Biomedical Resources Grant

Dr Andreas Brunschweiger, Dr Andrew Leach, Prof Martin Noble, Prof Michael Waring

Academic DNA-Encoded Library Resource Our goal is to enhance and accelerate the validation and translation of new drug targets identified by the UK academic biomedical research community. In order to achieve this we will establish a DNA-Encoded Library (DEL) screening resource that will provide cost-free and commitment-free access to high-throughput compound screening for academic research groups, by;

1) Designing and preparing DNA-encoded libraries containing 5-10 million diverse and drug-like compounds, representing a unique resource for academic researchers.

2) Utilising these libraries to undertake 40 target selections against novel protein targets for academic users, delivering validated hit compounds to  > 20 research groups by 2025.

3) Developing a sustainable and expandable resource which will continue to deliver beyond the current funding period.

DELs are an established screening approach that are utilised by the majority of large pharmaceutical companies. The technology allows for the rapid identification of ligands for a target protein with a very simple protocol compared to other screening approaches. Active compounds are identified by affinity selection of protein-binding compounds from libraries containing millions of different compounds that are each linked to a unique DNA sequence. The DNA tag allows for rapid and high-throughput deconvolution of the active compounds by next-generation sequencing.


Strategic Support: Science

Dr Gwyneth Card, Dr Matthias Landgraf, Prof Scott Waddell, Prof Gerald Rubin

A high-quality connectome of the complete female adult Drosophila central nervous system We previously proposed to generate a complete connectome for the adult male Drosophila central nervous system (CNS), comprising both brain and nerve cord. Capitalising on that investment, this discretionary award would allow us to deliver a second, high-quality, female connectome just one year later, at a fraction of the cost.

This would be the first full CNS connectome, bilaterally complete and with sensorimotor circuits intact, of an adult female animal with complex behaviours. It would immediately allow comparisons of neuronal number, morphology, and connectivity across 1) hemispheres (this animal), 2) sexes (with the male CNS), and 3) three same-sex individuals (with partial datasets FAFB and the hemibrain) and global estimates of intra-individual, inter-sex, and inter-individual variation.

The PIs will use this joint resource to investigate circuitry underlying sexually dimorphic  behaviours such as decision-making (e.g., mating receptivity and egg-laying), aggression, sensory integration and descending control of motor programmes, memory formation and recall, and sleep. We will make both datasets available with a range of analytic tools for use by the  > 200 labs studying Drosophila neurobiology worldwide. Moreover, we expect the technology and pipelines developed for obtaining and comparing these connectomes to facilitate future studies in other organisms, ultimately including humans.


Investigator Award in H&SS

‘The Last Taboo of Motherhood?: Postnatal Mental Disorders in Twentieth-Century Britain’ Around 1900 a new classificatory system appeared to eliminate puerperal insanity from the psychiatric canon. However, as this project will illuminate, far from disappearing from psychiatric practice, mental hospital admissions under this category actually increased, while maternal mental illness was frequently drawn on in constructing defence pleas in infanticide trials. Exploration of postnatal mental illness offers a superb opportunity to understand the relationship between psychiatric theory and practice across the twentieth century, how psychiatric categories were defined, understood and implemented, and how they both adapted to and helped create new service provisions and treatments. The project will also explore how broader social and cultural factors, including attitudes towards motherhood and women’s changing status, especially in relation to their alleged bodily and reproductive autonomy, was reflected in interpretations of postnatal mental illness. Existing at the ‘borderland’ of psychiatry and obstetrics, the project will investigate the energetic and on-going debates on causality, that became increasingly complex with the involvement of an expanding range of health professionals and campaign organisations in the second half of the century. Finally the project will explore how public and media responses and the experiences of sufferers can enhance our understanding of postnatal mental illness in the past.


Not available

Research on Research Institute Grant

Research on Research Institute - Sheffield Costs Not available


Technology Development Grant

Enabling advance imaging of synaptic function in living males and females over the course of the life-span with Positron Emission Tomography (PET)  Synapses are damaged in over 130 different brain diseases and yet thus far there are no reliable ways to measure synaptic structure or function in vivo in a preclinical or clinical setting. The recent discovery of promising Positron Emission Tomography (PET) radiotracers for imaging synapses, by targeting the synaptic vesicle glycoprotein 2A (SV2A), has the potential to transform clinical diagnosis, neuropathology, drug development and treatment of multiple brain diseases. Two major bottlenecks to deliver on this promise are: (1) the unavailability of high-yield and high-molar activity [18F]MNI1126, the lead SV2A PET radiotracer; and (2) the lack of a quantitatively accurate and validated SV2A brain PET atlas during normal aging in rodent models. This project will generate synthetic routes and radiochemistry methods for efficient production of [18F]MNI1126, it will develop detailed template resources for quantitative analysis of SV2A PET signal in different brain regions over the course of natural aging in the rat and mouse, and it will validate SV2A PET in vivo outcomes at unprecedented scale and resolution using synaptome mapping technology. The development of SV2A PET technology proposed in this award will catapult the use of quantitative SV2A PET in many brain diseases in humans and model organisms.


Discretionary Award - Open research

Negotiation of  WT compliant transformative agreements with society publishers The core aim of this proposal is to further increase the number of transformative open access agreements in place with Society and smaller publishers to ensure that Wellcome Trust funded authors have maximum opportunity and ability to publish in compliance with the 2021 Wellcome Trust Open Access policy.

The proposal seeks funding for a one year extension to the negotiation and licensing activity currently led by licensing manager, Kathryn Spiller. This role is dedicated to achieving agreements that meet the requirements of Wellcome Trust's policy and targets the society publishers that over the last 3 years have received the most revenue via Wellcome Trust funding grants.


Discretionary Award - OPOH

Pathfinder Commission for Planetary Health and Prosperity We propose a global Commission to quantify evidence for national, regional and global actions that will be positive for health, the environment and the economy. It will draw on knowledge generated by other initiatives where relevant but will fill a major gap that is not currently addressed, namely the focus on human health as well as decarbonising economies. This will require identifying and assessing policies, technologies and interventions across a range of sectors including transport, food systems, cities, energy, industry and health systems. The Commission will fill a number of knowledge gaps that are impeding progress towards a healthy zero-carbon economy – namely which actions will have the largest multiple benefits for health, the environment and prosperity in particular contexts, and which implementation strategies should be employed for effective scale-up.

In addition to synthesising and grading the evidence, the Commission will generate a framework for action in the form of practical guidelines targeted towards national and city governments, NGOs, civil society and the private sector. These guidelines will indicate how to assess which actions should be prioritised in particular contexts. It will also include a comprehensive influence strategy to be developed with partner organisations and a leading creative agency.


Investigator Award in H&SS

Equity & difference: Deconstructing gender in health research for women Despite policy changes and advocacy efforts to promote the inclusion of women as participants in research and to advance a global agenda of women’s sexual reproductive health over the past two decades, women remain significantly underrepresented in biomedical research and its translational outputs beyond reproductive health. In this empirical ethics project, we will investigate the reasons why structural barriers to women’s health improvements persist within the practices of research itself—in how research is designed, conducted, and translated. More deeply, we will interrogate the role that implicit and explicit moral attitudes, beliefs and arguments play in making the case for a focus on women’s and girl’s health needs, and in the reactions to these priority-setting appeals in academic, policy, and social media domains. Taken together this work aims to make a significant contribution to evidence-based advocacy within biomedical research practice, transforming how researchers think and do research with and for women and girls.


Investigator Award in H&SS

Addressing Infertility in Emergent Reproductive Markets: An Anthropology of Cross-Border Reproductive Care in Contemporary Central Asia In contemporary Kazakhstan, Kyrgyzstan and Tajikistan, involuntary childlessness is a source of immense social stigma, addressed through a heterogeneous therapeutic landscape including shrines and sacred sites, Soviet-era sanatoria, and newly-opened fertility clinics. Central Asian states are positioning themselves as international ‘reprohubs’ (Inhorn) offering fertility treatment within strict conjugal confines to growing Chinese, European and local markets for Assisted Reproductive Technologies (ARTs). This configuration has generated intense public debate about the ethics of medically assisted reproduction, specifically concerning the intensified movement of people, gametes and technologies across borders. Through a tripartite focus on sites of reproductive care, itineraries of reproductive assistance, and debates about the (bio)ethics of emergent reproductive technologies, this project will illuminate how different models and practices of reproductive care are debated and used by individuals and couples to address infertility in stratified and rapidly-marketizing medical landscapes. Immersive ethnographic fieldwork will reveal how biomedical interventions to address infertility are incorporated into wider repertoires of healing practices and will examine how ARTs appear as objects of policy intervention, legal regulation, and religious commentary in emerging reproductive markets. In so doing, it will advance our understanding of involuntary childlessness, therapeutic landscapes, and the social ramifications of both in the global South.


Investigator Award in H&SS

ERG10 Medical Humanities, Investigator and Collaborative Awards

Maps of Malignancy: Epidemiologists and Cancer in Sub-Saharan Africa Epidemiological efforts to map cancer in sub-Saharan Africa have a long history, playing an important role in how the disease has been imagined in the region. In the late colonial and early postcolonial period, British and French doctors produced small-scale epidemiological maps to advance understandings of cancer aetiology and improve treatment strategies at home. More recently, global surveillance initiatives seeking to rationalise health policy and planning in Africa have generated political atlases of the continent with national cancer burdens.

This project carries out an archival and ethnographic study of these epidemiological efforts to chart malignancy in sub-Saharan Africa over the past 70 years. It takes these cartographies of diseases as its object of study, examining their scientific, political and material conditions of possibility and analysing their influence on cancer imaginaries and healthcare policies in Africa. In doing so, the project aims to draw attention to the crucial role that epidemiological maps have played in the postcolonial history of biomedicine in Africa, while developing an innovative approach to epidemiological surveillance that highlights its socio-technical infrastructure and performative power. At the same time, the project also purports to move Africa out of the margins of the global history of cancer.


Jamal Edwards Delve

Discretionary Award - Public Engagement

Jamal Edwards Delve  Through workshops with mental health researchers, at our youth centres, young people will deconstruct hip-hop lyrics understanding how to link them to wider mental health issues and research.  The project will focus on empowering young people to investigate mental health experiences in the community and gather evidence on the mechanisms others have relied on to overcome their struggles with the aim of reinforcing young people’s resilience and discovering, through peer-led research, accessible prosocial tools to combat deterioration in mental health.


Human genome synthesis

Strategic Support: Science

Prof Tom Ellis, Prof Yizhi Cai, Dr Julian Sale

Human genome synthesis The ability to make any human genome would transform hypothesis driven investigations in diverse areas of biology, genetic-archaeology and biotechnologies.  However, there are currently no technologies for building human genomes. Moreover, there is a technological void between the state of the art in the creation of synthetic genomes and what will be required to enable the synthesis of human genomes.  The current challenge is therefore to bridge this void. The goal of this proposal is to bridge the technological void between the state of the art, which has enabled the synthesis of Mbp-scale microbial genomes, and the technologies that will be required to build a human genome, which is 3 orders of magnitude larger than any synthetic genome that has been created to date.  We will establish key technologies for human genome synthesis and exemplify these technologies through the synthesis of a recoded human chromosome.


Investigator Award in H&SS

North and South: Regional Health Inequalities in England North and South: Regional Health Inequalities in England

The ‘north-south health divide’ in England is longstanding and persistent, documented both before and after the epidemiological transition. In the mid-19th century, life expectancies in northern cities were four years lower than in southern cities, and today, there is still a two-year difference in average life expectancy between the northern and southern regions.

However, there has been no thorough academic study of regional health inequalities, so we know little about the temporality, aetiology, experience, representation or perception of the ‘north-south health divide’. This oversight is becoming even more pressing given emerging evidence that health inequalities are increasing and that the north is falling further behind.

Using a novel, mixed-method, intensive, multi-disciplinary approach, the North and South project will fill this gap by providing the definitive account of the ‘north-south health divide’ and regional inequalities in health in England – contextualised within the wider European experience.

By drawing on concepts, data and methods from geography, epidemiology, sociology, history, social policy and literary studies, the project will enhance our understanding of the ‘north-south health divide’; provide insights into how to close it; and advance the international health inequalities field empirically, methodologically, and conceptually.


University Award in H&SS

Prosthetic Embodiment: The lived experience of health, disability and medical technology from the 1970s the present. Prosthetic Embodiment investigates what it means to live – and live well – with prostheses. Adopting a historical approach, informed by critical medical humanities and disability studies, and focusing on artificial legs and their users, this globally sensitive project will be the first to consider how the experience of prosthetic embodiment has changed, from the 1970s through to the present. For people to use and live healthy lives with prosthetic legs, collaboration with those who make and fit them is vital. Through an innovative combination of historical approaches and visual anthropology, this study explores the agency and materiality of users, health professionals and technologies, following the relations between them in terms of prosthetic design, fitting, use, and recycling. A central question to be investigated is how practicalities of lives and bodily experiences are negotiated and renegotiated as users learn to live with new prostheses, and once again when devices are recycled through charitable organisations to new users in the global south. Exploring the diverse embodiment of people with limb difference will reveal important insights into how prostheses create both new possibilities and unexpected constraints on day-to-day living, and the experience of disability and medical technology more generally.

Grants awarded from 1 October 2005 to 30 June 2021


Research Fellowship in H&SS

Social Science and Bioethics Interview Committee

Alternative access schemes for pharmaceuticals: bypassing scrutiny? High prices of new medicines have led most European countries to set up health technology assessment (HTA): evidence-based processes that evaluate whether a drug’s benefits outweigh its costs, before it receives public funding. Yet, increasingly, expensive new medicines bypass this scrutiny. Instead, they enter health systems through alternative access schemes: diverse provisions that provide patients with access to treatment that are not routinely funded – for example the English Cancer Drugs Fund or individual patient funding requests. As a result, some drugs, including notably expensive cancer medicines, are prescribed even though they never demonstrated their "value for money" in HTA, reaching up to 5% of pharmaceutical budgets in some countries. Despite evidence of their growing significance, there is little systematic research on alternative access schemes.

This project seeks to understand why alternative access schemes emerged, how decisions in these schemes are made, and what the policy implications are for patients and public finances. It systematises knowledge of this emerging phenomenon by providing an overview of alternative access schemes in Europe and a detailed analysis of their political economy in selected health systems. It will contribute to debates on affordability of new medicines.


PhD Studentship in H&SS

ERG10 Medical Humanities, Early Career Awards

Culture as Medicine: Exploring future interventions for substance abuse treatment and prevention in South Africa The research questions are - How has indigenous medicine responded to the substance abuse crisis in SA?  What might future interventions look like?

 An auto-ethnographic reflection on addiction and recovery, that seeks to deepen local understandings and narratives to include notions of historical trauma, dispossession and ‘insecure attachment’ to ancestors, nature and land.
 Working with indigenous health practitioners (IHPs), the research will explore indigenous medicine’s response to the high levels of substance abuse in South Africa.  Drawing inspiration from indigenous-led treatment programmes in Canada, Peru and the United States, that fuse indigenous and biomedical approaches, future interventions will be explored with indigenous and allopathic health practitioners, researchers and people in recovery as co-researchers.
 The project will experiment with various research methods; introducing the notion of dreaming as a research method; story-telling; and indabas. We aim to collectively envision interventions that integrate ancient indigenous methods, biomedical/psychological approaches and technological tools. The research will be based in Cape Town but will include participants from all over South Africa.
 Public engagement methods will be decided collectively during indabas to tailor the dissemination of findings to the various communities needs, this could be through podcasts/community radio, web-based audio-visual material, community indabas, ceremonies and performances.


Research Fellowship in H&SS

Best interests and sufficient benefit: The ethics of hard decisions in healthcare Patients’ 'best interests' are important in healthcare, but their use faces challenges:

 Resource allocation: As well as aggregate measurements like population health, healthcare resource allocation should be sensitive to individual patients' claims. The idea of best interests provides limited guidance here, since resource constraints mean we cannot promote everyone's best interests.

 Value disagreement: Caring for patients who cannot communicate preferences – including infants – often generates fundamental value disagreement between carers and medical professionals over their best interests.

My proposal explores whether a principle of sufficiency - the idea that it is particularly important to prevent people from being very badly off - can help. Sufficiency has received renewed attention in political philosophy; my research will build on recent theoretical advances, developing a theory that is responsive and applicable to practical challenges.

Goals

 Systematically outline challenges to best interests and existing work on sufficiency;
 Generate a novel sufficiency-based approach that can be used in healthcare decisions;
 Consider challenges and develop recommendations for two related practical issues: resource allocation and the care of critically ill infants;
 Publish 12 peer-reviewed journal articles;
 Disseminate research findings via websites and public-engagement activity at Oxford;
 Host a workshop on the role of sufficiency in healthcare.


Research Fellowship in H&SS

Positively Belonging in Peru?: Venezuelan Migrants with HIV/AIDS at the intersections of Pharmaceutical Citizenship, Biosocialities, Race and Biomedicine. A recent, unprecedented influx of migrants to Peru means that roughly 3% of the country’s population are now of Venezuelan origin, with an estimated 1,700+ living with HIV. The focus of this research will be the social, medical, and legal aspects of ‘belonging’ for migrants in situations of medical precarity. This will be achieved by exploring the processes whereby these refugees access HIV-related medical-care and legal-migratory status, integrate into the wider Peruvian community, and interact with a biomedical system troubled with intersections of race, racisms, and xenophobia at a transformative moment in the history of Peru with never-before-seen mass- immigration from a Caribbean to an Andean nation.
In order to address this focus, the key research goals will be to:

 Investigate how HIV-positive Venezuelans negotiate ‘pharmaceutical citizenship’ (citizenship dependent on pharmaceutical compliance (Ecks,2005)) and receipt of Anti-retroviral therapy (ART).
 Interrogate actual and potential integration into biosocial communities (social-kinship based upon shared bio-factors (Young,2016)) based upon HIV-positivity.
 Query the intersections of racism and biomedicine when seeking HIV/AIDS-related health care for migrants.

Research for this project will involve 18-months ethnographic fieldwork in Lima, Peru with migrants and stakeholders, and will transform our understandings of migrant health, race, and ‘belonging’.


PhD Studentship in H&SS

ERG11 Social Science and Bioethics, Early Career Awards

Biovalue, hope, and translational science: The public impact of novel clinical trials for the treatment of Huntington’s disease  This research examines the relationship between the biotechnology industry and consumers, to determine what effect(s) this relationship may have on the outcome of clinical trials. Despite regularly being referred to as the ‘new genetics’, there has been little substantive change over the past two decades in the ways we have studied social aspects of genetic testing. Studies are largely embedded in the dichotomy of ‘consumption’/‘production’, treating 'patients'/'industry' as discrete categories in an unchangeable hierarchy. However, medical biotechnologies do not exist in a theoretical vacuum: they are continuously evolving products of social, political and economic endeavours, which have social, political and economic consequences. This research will follow the Phase 3 Study of RG6042 (previously IONIS-HTTRx), the first drug specifically targeting the mechanism responsible for HD, and a Phase 1 trial of a novel gene therapy. Methodology includes interviews, group interviews, and participant observation to determine how information moves and mutates, and how this effects medico-social pathways. Drawing on concepts of translational science, this research will examine how/when/why and to what effect 'scientific' knowledge is communicated among and between actors, and what effect this may have on the outcome of the trial for both participants and industry.


PhD Studentship in H&SS

What is internet addiction: Re-thinking the digital and addiction in relation to each other This proposal is for a year-long ethnography of an internet addiction rehabilitation centre in rural Washington State. It will develop an anthropological understanding of internet addiction, the study of which has so far been limited to neuroscience, psychology, and psychiatry. This will allow the cultural, social, and systemic background to the condition to be revealed.

The ethnography will be phenomenological, exploring the changes in the experience of space and time that rapid withdrawal from the digital causes – putting the living body at the centre of study. I will do this with the aim of establishing how use of the digital changes the experience of everyday life, explaining internet addiction through these changes. I will also ask whether the experience of extreme cases is shared by ordinary users.

I will investigate whether the condition can be used to denaturalise the broader category of addiction, unpacking and challenging suppositions established in the study of addiction and mental health.

As well as generating new knowledge and raising awareness, I will assist in the formation of patient groups, as well as supporting charities and healthcare facilities dealing with the condition. I will also aim to persuade healthcare services to fully recognise the condition.


PhD Studentship in H&SS

Læknir ok lægbók: Mediterranean remedies in Old Norse manuscripts, a comparative study and translation of medical practices My research focuses on XIII-XV Old Norse medical treaties featuring classics and continental models, to assess the extent to which Mediterranean medical practices were assimilated and re-elabotared within the Old Norse framework to understand the cultural dialogue between medieval Scandinavia and the continent. I will provide annotated translation of remedies, herbaria and antidotes contained in manuscripts preserved in Copenhagen and Reykjavík, comparing them with their continental counterparts at the British Library, Cambridge and Oxford. Consequently, the nature and the usage of these texts as sources of healing will be problematised and I will challenge the obsolete term "pseudoscientific" used in scholarship to refer to medieval medical practices and elaborate a new interpretive frame of understanding. I will demonstrate that Old Norse participated to the cultural syncretism in the Middle Ages by assimilating the occurrence of Classics and continental medical knowledge in manuscript context. This will lead to study a materiality of practices which allowed for a physical impact on the body. My research will address the cultural biases that have greatly affected certain topics within Old Norse scholarship which have not been considered in a comparative perspective and have led to the study of Old Norse culture in isolation.


PhD Studentship in H&SS

A Policy Evaluation of the Integration of Health and Social Care in Greater Manchester  This mixed-methods project will treat Greater Manchester’s integrated budget in 2016 and the delayed roll-out of Integrated Care Systems across the country as a quasi-natural experiment.

I will use a nested-analysis method with qualitative research and three ‘diverse' cases studies will be chosen non-randomly to understand how each Local Care Organisation are specifying their policy delivery according to different population needs.

The hypotheses from the small-n analysis will then be tested by further large-n analyses. My research will use advanced methods in order to isolate causal effects of the intervention of integrated care in Greater Manchester. I will use synthetic control methods to create a synthetic counterfactual trend of Greater Manchester if it had much less developed health and social care integration. My synthetic control will be developed from weighted trends from other city-region combined authorities in England. This method is an alternative to traditional methods such as difference-in-differences.

This research is interested in the consequences of integrating healthcare at a city-region geography on population health outcomes, this project hopes to understand whether this policy trend is likely to induce new inequalities into the health system, tackle those already in place, or both.


PhD Studentship in H&SS

Towards a History of the Female Body in British Colonial Punjab (1885-1947) I am invested in researching the history of the female body in British colonial Punjab from 1885 - 1947, as it lived and experienced British colonial medicine. I want to study the character of the relationship between British colonial medicine and the princely states of Punjab, and between biomedicine and religious nationalism, and the impact of these relationships on women’s bodies, and their motility, mobility, and embodied subjectivity. I have located hitherto unutilised primary sources – women’s magazines, journals, and quasi-medical magazines run by women written in Punjabi, and medical and administrative records of local women’s hospitals in the six princely states of Punjab – in order to investigate the lives of Punjabi women who experienced the biomedical regime through practicing medicine or becoming patients.

Through the position and practices of women under investigation, I wish to question the conceptualisation of ‘medicalisation’ that has often been applied to understand the impact of biomedicine on societies such as India. I wish to understand women’s decisions and choices during this period not only as representative of the medical-religious dichotomy or alliance, but also as representative of the impact biomedicine had on their experiences of their own bodies.