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

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

Recent incidents in Europe and worldwide have threatened civil society by the attempted use of different biological toxins and have thereby shown that increased vigilance and adequate preparation is of increasing importance in a world facing growing risks of man-made disasters. Previous studies which the consortium is well acquainted with showed that there is a lack of robustness in European preparedness for biotoxin incidents. There is a need for standard analytical tools and procedures, reference materials, state-of-the-art training and establishment of a European proficiency testing scheme. Using current best practice, the EuroBioTox core members will develop and validate improved analytical tools, reagents and standard operating procedures based on realistic incident scenarios. Certified Reference Materials for the threat biotoxins will be developed and, by establishing a European repository, will be made available to the EuroBioTox network including more than 50 European organisations, expert laboratories, industrial partners and end-users. Training courses at basic and advanced levels will be developed and attended by the EuroBioTox network partners, followed by a series of proficiency tests which, through these “outer circle” associates, will disseminate best practice methods across Europe. The current animal test for botulinum neurotoxin is ethically unacceptable and alternative in vitro tests will be evaluated. After this project there will be a pan-European network of competence, certified reference materials, standard operating procedures and a common way of handling biotoxin incidents.

The general objective of PRO-METROFOOD is to bring the emerging METROFOOD-RI ESFRI project to the level of maturity required for entering in the active project list, strengthening the Consortium and planning the future phases. The specific objectives have been set up in close relationship with the “ESFRI SWG & IG Recommendation”. 4 specific objectives have been identified: OBJ1 – design strategies on the medium and long terms; OBJ2 – provide the organizational framework of METROFOOD-RI; OBJ3 – demonstrate the capability of METROFOOD-RI to supply scientific services and prepare the chart of services; OBJ4 – establish plans to coherently integrate METROFOOD-RI into the European landscape, realising coordination with EU and National initiatives and positioning at a global level. The strategic Plan will be tailored to the Pan European Infrastructure current and envisaged capabilities, market opportunities and business needs. It will be developed by involving funding agencies, relevant authorities supporting METROFOOD-RI and other stakeholders. A management conceptual model will be developed and the framework will be designed under operational, strategic and institutional aspects. Management procedures suitable for the different phases will set up, so to cover short and long-term goals. A Quality Documentation System (QDS) will be developed and a data management plan (DMP) will be defined. In order to demonstrate the capability of PRO-METROFOOD to supply services and to test its inter-operability, pilot services will be performed. In strict accordance with the METROFOOD-RI strategies, plans to coherently integrate METROFOOD-RI into the European landscape will be developed. A Communication plan and education and training programmes will be developed for the different phases of METROFOOD-RI realization (earl, preparatory, implementation and operational phases). For each phase the main coordinator, the target group and the main training subject areas will be specified.

Cervical cancer is the third most prevalent gynaecological cancer, after uterine body and ovarian cancers. Occurring in young women, with a peak of incidence around age 40 and death at 55 years, this cancer is one of the most marked by social inequalities. The women of the most disadvantaged social categories are those who combine both the most risk factors and poorer adherence to preventive measures that rely on vaccination against human papilloma viruses (HPV) and screening for early stage cervical lesions, starting at the age of 25 years. As almost every case of cervical cancer could be prevented by cervical screening and HPV vaccination. The different European countries have implemented cervical cancer screening practices, more or less systematic, and more or less effective, with rates of regular screening widely varying. Even in countries where this rate is high, such as Finland or Sweden, some women who are truly refractory to screening. This is a major health issue because these women are often at high-risk with a 5-year survival closely correlated with the stage of disease when discovered. The costs also increase exponentially depending on the cancer stage. Numerous randomized trials conducted around the world have attempted to improve the response rate in underscreened women. But unfortunately the response rate barely reaches 20% of these women. Many factors can explain the difficulties in obtaining a satisfactory screening rate, whether geographic distance, economic constraints, disengagement of general practitioners, education level or socioeconomic status. It is therefore a European public health problem for which we assembled a network of experts from 10 European countries (Belgium, Bulgaria, France, Germany, Ireland, Italy, Portugal, Romania, Spain, and Sweden), three research groups, the International Agency for Research on Cancer (IARC), the European Cervical Cancer Association (ECCA) and the Poverty Action Laboratory (J-PAL), and a representative association of patients, The European Institute of Women's Health (EIWH). These experts, clinicians and researchers, have expertise in screening for cancer, especially cervical cancers, in conducting large randomized clinical trials, in qualitative and quantitative analysis of social and cultural determinants, in analysis of social disparities and discrimination for access to care, or in modelling health policies. If all group members do not all have worked together in the past, numerous collaborations already took place within the group. The goal of our network is to file a research project for the H2020 SC1-PM-10-2017 call for proposal entitled “Comparing the effectiveness of existing healthcare interventions in the adult population.” This project aims to test, in partner countries, interventions to increase adherence to screening in underscreened women, with special attention, but not exclusively, to women of low socio-economic status; to evaluate the quality, and assess its drivers, of downstream management of abnormal screening findings; model interventions in different countries; to analyse the cost-effectiveness of the intervention; and finally to develop an implementation research to define the best strategy through European countries of different socioeconomic structures and disease prevalence levels. The project will be managed by a French coordinator and a steering committee of clinical researchers, and will be promoted and coordinated by the INSERM. The MRSEI funding will be used to strengthen interactions within the group, validate pillars of the program (work packages) and within these pillars refine more specifically questions deserving to be assessed.