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The Bill & Melinda Gates Foundation will fund groundbreaking research in global health and development, including a project to lessen infant antibiotic use in Africa led by UNC Project-Malawi’s Tisungane Mvalo.


The Bill & Melinda Gates Foundation will fund groundbreaking research in global health and development, including a project to lessen infant antibiotic use in Africa led by UNC Project-Malawi’s Tisungane Mvalo.

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Tisungane Mvalo, MMED

June 28, 2019

CHAPEL HILL, N.C. – The Lilongwe Medical Relief Fund Trust announced that it has won a Grand Challenges Explorations grant – an initiative funded by the Bill & Melinda Gates Foundation. Principal investigator Tisungane Mvalo, MMED, will pursue an innovative global health and development research project, titled “Improving Diagnosis of Sepsis in Young Infants in Africa: Are We Using Antibiotics Appropriately?” The Lilongwe Medical Relief Fund Trust is an independently incorporated non-profit that serves as the service and programs arm of UNC Project-Malawi.

Grand Challenges Explorations (GCE) supports innovative thinkers worldwide to explore ideas that can break the mold in how we solve persistent global health and development challenges. Mvalo’s award is one of approximately 50 Grand Challenges Explorations Round 22 grants announced by the Bill & Melinda Gates Foundation. To receive funding, Mvalo and other Grand Challenges Explorations winners demonstrated in a two-page online application a bold idea in one of seven critical global heath and development topic areas. The foundation will be accepting applications for the next GCE round in September, 2019.

Mvalo, research assistant professor of pediatrics at the UNC School of Medicine, and Gerald Tegha, MTech – both of UNC Project-Malawi and the Lilongwe Medical Relief Fund Trust – will lead a project to establish metagenomic next generation sequencing at a research laboratory in Malawi to identify pathogens causing infections in young infants to ensure rapid treatment with appropriate therapy and limit unnecessary antibiotic use. Their collaborators include Msandeni Chiume, MBBS, MSc, at Kamuzu Central Hospital in Malawi; Pascal Lavoie, MDCM, PhD, of the University of British Columbia in Canada; Emily Ciccone, MD, an infectious diseases fellow in the UNC Department of Medicine; and Jonathan Juliano, MD, MSPH, associate professor in the UNC Department of Medicine and member of the UNC Institute for Global Health & Infectious Diseases.

Newborns are particularly vulnerable to infections due to their naïve immune systems that can also be quite immature in babies born prematurely. It is estimated that more than a quarter of the 2.9 million neonatal deaths each year are caused by infections. Given these high numbers, antibiotic treatment has become the default, standard practice for all young infants that have a suspected serious bacterial infection. However, a recent study using clinical microbiology approaches only identified an infectious agent in half of suspected cases in Southeast Asia, suggesting that antibiotics are often being used unnecessarily.

Whether these findings can be generalized to other parts of the world is currently unknown, but answering this question may have major implications for how clinicians approach treatment of neonates with suspected sepsis, a serious life-threatening response to infection.

The research team will use next-generation sequencing to identify pathogens suspected to cause sepsis in infants under three months of age, in an urban hospital in Malawi. They will also look for the presence of antimicrobial resistance genes, and assess whether the detected pathogens and genes can be linked to microorganisms naturally found in infants’ gastrointestinal systems or whether they may have been acquired from their mothers’ vaginal flora at birth. Overall, this research aims to understand what pathogens are involved in sepsis in this age group and where in the environment these pathogens may come from.

About Grand Challenges Explorations

Grand Challenges Explorations is a $100 million initiative funded by the Bill & Melinda Gates Foundation. Launched in 2008, over 1420 projects in more than 65 countries have received Grand Challenges Explorations grants. The grant program is open to anyone from any discipline and from any organization. The initiative uses an agile, accelerated grant-making process with short two-page online applications and no preliminary data required. Initial grants of $100,000 are awarded two times per year. Successful projects have the opportunity to receive a follow-on grant of up to $1 million.