<< Objectives >>Preparing the future generation of scientific ambassadors of the sustainable transition to conduct research whose evidence-based results can inform the policy-making process in Europe and in partner regions, is the general objective of AMBITION. The 3 specific objectives are:1. To co-design a Joint Honours Programme for PhD candidates 2. To enrich their capacity and the enabling environment to boost the transition3. To consolidate PhD education as a strategic asset of EU-AU science diplomacy<< Implementation >>The above specific objective are associated to activities leading to the results- Developing the Cooperation Model, the MOU and the final Regulation- Defining Curricula and syllabuses for the Winter/Summer Schools- Selecting and design the Complementary Skill modules- Designing and animating the MOODLE platform- Co-Create the Game-based Learning with PhD Students- Producing the Policy Briefs by the Ph.Ds- Preparing and disseminating the White Paper- Organizing Stakeholder’s Meeting<< Results >>The 3 specific objectives are associated to ad-hoc results:1.1 Regulation & Study Plan for the Joint Honours Programme are prepared within the consortium1.2 3 Winter/Summers Schools are delivered2.1 On-line Web series on Complementary Skills is activated2.2 PhD AMBITION Gateway is available to the Ph.Ds3.1 Game-Based Learning Process is implemented by PhD for Undergrad or High School Students3.2 Policy briefs are prepared by PhD candidates3.3 White Paper is produced for further upscaling

African hospitals are increasingly providing microbiological diagnostics, hygiene and antimicrobial stewardship (AMS) procedures in response to multidrug-resistant (MDR) bacterial diseases. However implementation within integrated, multidisciplinary hospital services is often poorly established. We first aim to assess the impact of an enhanced hospital hygiene intervention on the incidence of healthcare-associated infections (HAI) in hospitalized patients, using a stepped-wedge cluster randomised trial (SW-CRT) design. Clusters (surgical, medical wards, ICUs) in four tertiary level hospitals in Ethiopia and Ghana will be transitioned to interventions focusing on hand and instrument hygiene procedures, hygiene procedures for visitors and standardized room surface cleaning. Microbiological assessments and AMR of patients and hospital environments will be conducted, with an expected 10-15% reduction in HAI incidence. Nested within the SW-CRT, we further focus on therapeutic drug monitoring (TDM) and predicted pharmacodynamic target attainment (PTA) to optimize beta-lactam antibiotic regimens as part of AMS procedures. Patients (N=400) with severe bacterial infections (e.g. sepsis) will receive standard versus standard plus TDM/PTA based AMS assessment, with dose optimization expected in up to 50% of cases. By integrating TDM/PTA into an AMS eHealth system, we aim to generate generalizable population-based PTA support, linked with cost-effectiveness analysis to promote sustainability within routine care procedures. By shifting antibiotic treatment from an empirical to a more individualized patient management strategy, we aim to introduce optimized and affordable AMS interventions, expecting an impact on improved clinical response and reduction of AMR within hospitals. Our study consortium is built on multidisciplinary expertise. Partners have been linked for years through African-European hospital partnerships implementing high quality microbiological diagnostics.

Ivermectin is a critical drug for the control and elimination of multiple neglected tropical diseases. Currently, children weighing under 15kg do not receive treatment with ivermectin due to an absence of safety data and the lack of a suitable paediatric formulation. Consequently, these children are left untreated. This results in considerable morbidity at the individual level and a reservoir of infection at the population level. These issues create a critical barrier to achieving the goals of the 2030 NTD roadmap. In 2023, the World Health Organization (WHO) conducted a Paediatric Drug Optimisation (PADO) review to identify critical needs for therapeutics in children affected by NTDs. Recognising the central role of ivermectin in the control of NTDs, along with the opportunity to accelerate progress by expanding treatment to paediatric populations, this report highlighted a paediatric-friendly ivermectin formulation as as a critical priority for NTD programmes worldwide. A novel orodispersible formulation of ivermectin provides the opportunity to address this critical gap. Our consortium brings together leading academic and drug development partners across Europe and sub-Saharan Africa to address this global priority need, with crucial experience in novel therapeutics and navigating the European and African regulatory landscapes. Our consortium will deliver studies to demonstrate the safety, pharmacokinetics and efficacy of the novel, orodispersible formulation of ivermectin suitable for use in young children. This will include conducting a large safety study across West, Central, East and Southern Africa to demonstrate the efficacy of this agent for the treatment of soil transmitted helminthiasis. We will work closely with European and African regulators to ensure that our project delivers both the scientific and regulatory data required to bring this agent to market and transform access to effective NTD treatment for for millions of children worldwide.

Susceptibility to Artemisinin-based combination therapies (ACTs) currently remains high among the African Plasmodium falciparum population, but resistant mutant has been detected recently. To mitigate the risk of resistance leading to a dramatic increase in malaria related mortality, more efficient ACTs need to be urgently explored for quick deployment in Africa. Artemether-lumefantrine (AL) is widely used and shows high efficacy and favourable safety in Africa but needs to be protected to increase its useful lifespan. Atovaquone-proguanil (AP) is highly efficacious, safe and resistant parasites are not circulating in any endemic area. AP targets multiple parasite stages -liver and blood in human host, and mosquito- through an independent mode of action, limiting the risk of cross-resistance with current ACTs. The aim of the project is to assess the efficacy of a triple-therapy associating artemether-lumefantrine (AL) and atovaquone-proguanil (AP) for the treatment of uncomplicated P. falciparum malaria in African children in a non-inferiority comparator-controlled trial. A phase III clinical trial will be conducted to compare safety and cure rate of a 3-day treatment course with AL+AP versus AL in 1,664 consenting 6 to 70 months children with uncomplicated malaria from Benin, Gabon, Ghana and Mali. The main outcome will be cure rate at day-42, excluding reinfections. Antimalarial pharmacokinetic parameters and post-treatment prophylactic efficacy will be estimated for the two treatments and compared. Sub-studies will look at transmission-blocking efficacy through membrane-feeding assays and gametocyte dynamics, drug resistance selection. By proofing that AL+AP has safety and cure rate similar to AL, this project will lead to important public health-level benefits by provision of a first candidate regimen to be deployed when ACT resistance spreads throughout Africa and by decreasing human to mosquito transmission.