International Collaborative Research Grant Scheme

The International Collaborative Research Grants (ICRG) scheme was a partnership between the Wellcome Trust, the National Health and Medical Research Council (NHMRC) of Australia and the Health Research Council (HRC) of New Zealand. The scheme was designed to foster collaborative research between the low- and middle-income countries of the region as well as Australia and New Zealand. Countries of the region include countries in South and South-east Asia and the islands of the Pacific.

Objectives

The ICRG scheme aimed to improve health in low- and middle-income countries of the region by:

funding research into major health issues of low- and middle-income countries of the region
developing research capacity in both low- and middle-income countries of the region and in Australia and New Zealand.

The grants scheme aimed to provide support for teams of researchers drawn from different countries to pursue collaborative research projects focused on the major health problems of the low- and middle-income countries of the region. The focus of the New Zealand part of the scheme is research that contributes to health outcomes for Pacific peoples.

Statement from the Director of the Wellcome Trust, Dr Mark Walport

The Governors and I are delighted by the successful outcome of the joint initiative between the Wellcome Trust, the National Health and Medical Research Council of Australia and the Health Research Council of New Zealand.

This important programme supports collaborations between researchers in Australia or New Zealand and those in low- and middle-income countries of South and South-east Asia and the islands of the Pacific. It fits the Trust's mission to foster and promote research with the aim of improving human and animal health.

The Trust has a long-standing commitment to tropical medicine and other health issues that affect the poorer nations of the world. The subject was one very close to the heart of Sir Henry Wellcome, under whose will the Trust was founded.

It is particularly gratifying to see the diversity among the 11 research programmes that will be supported and the range of low- and middle-income countries involved. These include studies of infectious and parasitic diseases in Papua New Guinea, China and Malaysia. Trauma is a major health issue in low- and middle-income countries. We are pleased, therefore, to have the opportunity to support programmes of research into accidental and deliberate pesticide poisoning in Sri Lanka, and into road traffic accidents in Pacific Island communities. Mother and child health and nutrition are key health issues in the region. A project in Thailand will increase the evidence base for interventions in pregnancy, childbirth and infancy. Obesity, a major problem among Pacific Island communities will be studied in a programme located in Fiji. Two projects in Thailand focus on important issues of public health in communities where resources for health care are limited.

The Governors of the Trust have been pleased to support biomedical science in Australia and New Zealand for a number of years and this new programme builds on the traditions of research excellence in both countries.

Finally it is important to point out that this is the first time the Trust has joined with governments outside the UK, to fund a specific programme. The success of this endeavour gives us confidence that such partnerships will in the future be one way by which to maximise the impact of funding for research to improve health.

Grants awarded

Total grants awarded: £11 860 000
Total Wellcome Trust component: £6 000 000
Total NHMRC component: £4 530 000
Total HRC NZ component: £1 330 000

1. Research and training to reduce morbidity and mortality from malaria in Papua (Indonesia) and Papua New Guinea (PNG)

Total grant: £1 270 000
Wellcome Trust component: £600 000
NHMRC component: £670 000
HRC component: Nil

Principal applicants: Professor Nicholas Anstey, Dr Emiliana Tjitra
Coapplicants: Ric Norman Price, Isi Kevau, Peter Sly, Paul Harijanto
Institutions of principal applicants: Menzies School of Health Research, Australia; Ministry of Health, Indonesia
Institutions of coapplicants (if different): University of Papua New Guinea, Papua New Guinea; University of Western Australia, Australia; Bethesda Hospital, Indonesia

Malaria kills many thousands of people each year in Indonesia and PNG. This project will look at better ways to treat and prevent malaria. The team will examine whether using new combinations of drugs in clinics can reduce the amount of severe malaria seen in Papua. The team will examine whether giving people with severe malaria arginine, a naturally occurring amino acid, can increase molecules that may protect against severe malaria. Finally it will examine how lung damage occurs in people with severe malaria and whether this can be predicted.

2. Reducing deaths from pesticide poisoning: Establishing a regional toxicology research centre

Total grant: £1 250 000
Wellcome Trust component: £950 000
NHMRC component: £300 000
HRC NZ component: Nil

Principal applicants: Professor Nicholas Buckley, Professor Nimal Senanayeka
Coapplicants: Andrew Dawson, Rezvi Sheriff, David Henry, Ravindra Fernando
Institutions of principal applicants: Australian National University; Peradeniya University, Sri Lanka
Institutions of coapplicants (if different): University of Newcastle; University of Columbo, Sri Lanka; University of Newcastle, Australia

The World Health Organization estimates suggest nearly half a million people die from acute pesticide poisoning in the Asia-Pacific region each year. The Sri Lankan project will be the first attempt to systematically test whether a range of strategies can reduce long-term neurological damage and deaths from pesticides. Over the next five years, the Australian-Sri Lankan Collaboration will aim to:

improve assessment of sub-acute and long-term morbidity
promote 'evidence-based' treatment
develop new antidotes (and assess their cost effectiveness)
see if pesticide regulation can reduce the rate of severe or fatal poisoning.

If successful, this programme may become a model for the region as to how to substantially reduce this largely hidden tragedy.

3. Study of HPV-6 L1 virus like particles as a therapeutic vaccine for genital warts and recurrent respiratory papillomatosis

Total grant: £560 000
Wellcome Trust component: £310 000
NHMRC component: £250 000
HRC NZ component: Nil

Principal applicants: Professor Ian Frazer and Dr Jieqiang Lu
Coapplicants: BoBei Chen
Institutions of principal applicants: University of Queensland, Australia; Wenzhou Medical College, China

This project will examine the effectiveness of a vaccine designed to prevent tumours and cancers associated with papillomarvirus infection as treatment for existing infections, and will look for predictors of a favourable outcome from treatment.

4. Building evidence-based research and practice in South-east Asia: Impact on pregnancy and childbirth care and outcomes

Total grant: £1 030 000
Wellcome Trust component: £480 000
NHMRC component: £550 000
HRC NZ component: Nil

Principal applicants: Professor David Henderson-Smart, Professor Pisake Lumbiganon
Coapplicants: Caroline Crowther, Mario Festin, Sally Green, Jacqueline Ho
Institutions of principal applicants: Queen Elizabeth II Research Institute, Australia; Khon Kaen University, Thailand
Institutions of coapplicants (if different): University of Adelaide, Australia; University of Philippines, Philippines; Monash Medical Centre, Australia; Perak College of Medicine, Malaysia

Disorders related to pregnancy and childbirth are a major health issue in SE Asia. They represent one of the biggest health risk differences between the high-income countries and low- and middle-income countries. By establishing a network of researchers and teachers of evidence-based health care across four SE Asian countries supported from Australia, this collaborative project aims to improve the clinical practice of treating pregnancy and childbirth related disorders and the health outcomes of mothers and infants in SE Asia.

5. Traffic related injury in the Pacific (TRIP) project

Total grant: £620 000
Wellcome Trust component: £300 000
NHMRC component: Nil
HRC NZ component: £320 000

Principal applicants: Professor Rodney Jackson and Professor Sitaleki Finau
Coapplicants: David Thomas, Lepani Waqatakirewa, Shanthi Neranjana Ameratunga, Gregory Dever
Institutions of principal applicants: Faculty of Medicine and Health Sciences, University of Auckland, New Zealand; Fiji School of Medicine, Fiji
Institutions of coapplicants (if different): Ministry of Health, Fiji; Ministry of Health, Republic of Palau; Department of Health, Samoa

Injuries among road users are a major cause of death and disability globally and place a disproportionately high burden on low-resourced environments. Reliable information about the causes and consequences of road user injuries in Pacific countries is described as a 'black hole' denying the opportunity to prevent injuries or their serious consequences for those involved, their families and communities.

The Traffic Related Injury in the Pacific (TRIP) project is a comprehensive step-wise collaborative research project developed through the partnership of the University of Auckland, Fiji School of Medicine and Health Departments of Fiji, Samoa and Palau. The project aims to gain critical scientific knowledge that will help:

prioritise effective strategies to prevent traffic-related injury in these Pacific communities
develop a trained and competent workforce to address other and future threats to the health and safety of Pacific people more generally.

6. Neonatal immunisation with pneumococcal conjugate vaccine in Papua New Guinea

Total grant: £940 000
Wellcome Trust component: £460 000
NHMRC component: £480 000
HRC NZ component: Nil

Principal applicants: Professor Deborah Lehmann and Professor John Reeder
Coapplicants: Patrick Holt, William Pomat; Peter Richmond, Inoni Betuela
Institutions of principal applicants: Telethon Institute for Child Health Research, Australia; PNG Institute of Medical Research, Papua New Guinea
Institutions of coapplicants (if different): University of Western Australia, Australia

One million children die every year of pneumococcal (Pnc) disease, the majority in the third world. Many die in early infancy and babies may benefit from immunisation with a Pnc conjugate vaccine (PrevenarTM) at birth. The Papua New Guinea (PNG) Insatiate of Medical Research, Telethon Institute for Child Health Research and the Department of Paediatrics, University of Western Australia, will collaborate to closely examine the safety of this approach, particularly with regard to impact on the development of immunity and response to other vaccines given to infants. This study will also provide a unique opportunity for training of PNG and Australian scientists in both countries, transfer state-of-the-art immunological technology and stimulate further collaborations on respiratory infections in the region.

7. Burden of disease and cost-effectiveness of intervention options: Informing policy choices and health system reform in Thailand

Total grant: £1 300 000
Wellcome Trust component: £980 000
NHMRC component: £320 000
HRC NZ component: Nil

Principal applicants: Dr Alan Lopez and Dr Wiput Phoolcharoen
Coapplicants: Theo Vos, Yarawat Porapakkham, Jeff Richardson, Porapan Punyaratabandhu
Institutions of principal applicants: School of Population Health, University of Queensland, Australia; Ministry of Public Health, Thailand
Institutions of coapplicants (if different): Monash University; Mahidol University, Thailand

This research project aims to improve the scientific basis for health services provision in Thailand by filling important gaps in knowledge about the causes of disease and the possibility of effectively intervening to reduce them. Since the accuracy of the routine death registration system in Thailand is unknown, it cannot be confidently used to guide policy. The team will evaluate how accurately causes of death are being recorded, both in urban and rural areas. It will also calculate how much disease and injury in Thailand is being caused by major risk factors, such as tobacco and unsafe sex. Using this information the team will evaluate the effectiveness of the major interventions to reduce diseases and injuries from risk factors that are affordable and applicable in the Thai context.

8. Pathways to improved, sustainable morbidity control and prevention of schistosomiasis in the People's Republic of China

Total grant: £1 000 000
Wellcome Trust component: £460 000
NHMRC component: £540 000
HRC NZ component: Nil

Principal applicants: Professor Donald McManus and Professor Zheng Feng
Coapplicants: Gail Williams, Jiagang Guo, Alex Loukas, Yuesheng Li
Institutions of principal applicants: Qld Institute of Medical Research, Australia; Chinese Centre for Disease Control and Prevention, China
Institutions of coapplicants (if different): University of Queensland, Queensland Institute of Medical Research, Australia

Six hundred million Chinese people are infected with parasites. One of the most important of these is the Asia or Oriental human bloodfluke, Schistosoma japonicum. It causes schistosomiasis (Bilharzia), a very serious and debilitating disease and a major health problem for more than 40 million Chinese people living in Southern China. Infection occurs when people make contact with water contaminated by microscopically small cerciriae larvae that are released from freshwater snails. As well as humans, Schistosoma japonicum infects a number of other mammals, such as water buffaloes, which complicates control efforts.

Current control is based on treatment with the drug parziquantel. Vaccines in combination with other control methods, including the use of new drugs, are needed to make elimination of the disease possible. This new programme of research has a very strong emphasis on mutual research training and scientific interaction that will:

determine whether another drug, artemether, can be used as an aid in control
increase our understanding of the immunological and genetic processes involved in the development of the disease of schistosomiasis
determine the importance of buffalo infections in maintaining human schistosomiasis transmission
undertake genomics and postgenomics research on existing and new discovered S. japonicum molecules that are candidates as new vaccines and diagnostics
develop a mathematical model that can predict the optimum methods for the sustained control of schistosomiasis in China.

9. Enterovirus 71 in the Asia-Pacific region: Reverse genetic approaches to virus surveillance and vaccine development

Total grant: £430 000
Wellcome Trust component: £160 000
NHMRC component: £270 000
HRC NZ component: Nil

Principal applicants: Professor Peter McMinn and Professor Mary Cardosa
Coapplicants: Andrew Kiyu
Institutions of principal applicants: Institute for Child Health Research, Australia; University Malaysia Sarawak, Malaysia
Institutions of coapplicants (if different): Ministry of Health, Malaysia

In this research the team will use advanced biotechnological techniques to study the distribution and virulence markers of an important emerging infectious disease, enterovirus 71 encephalitis, in the Asia-Pacific region. The knowledge and technical advances derived from this study will be shared with neighbouring countries in order to conduct sensitive surveillance for this infection throughout the region. The study's other major aim is to use cutting-edge biotechnological techniques to develop a genetically defined, live attenuated vaccine strain. Candidate vaccine strains will be tested for their effectiveness in both cell culture-based and animal models.

10. Thai health-risk transition: A national cohort study

Total grant: £1 110 000
Wellcome Trust component: £610 000
NHMRC component: £500 000
HRC NZ component: Nil

Principal applicants: Dr Adrian Sleigh and Dr Sam-ang Seubsmanr
Coapplicants: Anthony McMichael, Tippawan Prapamontol, Tord Kjellstrom, Boonchai Somboonsook, Bruce Caldwell, Suwanee Khamman, Jane Dixon, Duangkae Vilainerun, Lynette Lim, Nuchjaree Kamolsukudom, Christopher Bain
Institutions of principal applicants: Australian National University, Australia; Sukothai Thammathirat Open University, Thailand
Institutions of coapplicants (if different): Chiang Mai University, Thailand; Ministry of Public Health, Thailand; Office of National Economic and Social Development Board, Thailand; University of Queensland, Australia

Thailand's disease patterns are changing. Some changes are good but others, like emerging diabetes, heart disease and injuries, are of concern. Development-related 'health transition' can be optimised if there is information on new causes of disease - immediate risk factors, and 'upstream' economic, cultural and environmental influences. The team will study this health-risk transition in the whole Thai population - looking back 50 years, then forwards in 100 000 Sukothai Thammathirat Open University students living all over Thailand and followed for four years. The team will:

map changing risks and upstream influences
produce information for Thai preventive programmes
boost regional research capacity
create a regional partnership
support PhD and postdoctoral training.

11. The Pacific OPIC study: A four country study of obesity prevention in communities

Total grant: £2 350 000
Wellcome Trust component: £670 000
NHMRC component: £650 000
HRC NZ component: £1 030 000

Principal applicants: Professor Boyd Swinburn, Associate Professor Robert Scragg, Dr Sam-ang Seubsman
Coapplicants: Sitaleki Finau, Robert Charles Carter, Marita McCabe, David Robert Thomas, Colin Fonotau Tukuitonga
Institutions of principal applicants: Deakin University, Australia; University of Auckland, New Zealand; Fiji School of Medicine, Fiji
Institutions of coapplicants (if different): University of Melbourne, Australia; Ministry of Health, New Zealand

Obesity is a rapidly escalating, worldwide epidemic. Many countries recognise the need to prevent obesity but there is insufficient evidence about what interventions work. The Pacific Obesity Prevention in Communities (OPIC) Project will provide data on the effectiveness of a range of interventions to prevent obesity among young people in Fiji, Tonga, New Zealand and Australia.

Prevention research is particularly required in countries such as Fiji and Tonga because their prevalence of obesity is extremely high. The interventions used in this project will be culturally appropriate and include at least 1000 young people in each intervention group. The outcomes of this project will be applicable to both low- and high-income countries. This project will lead to a greater understanding of the socio-cultural, policy, and economic contexts and provide crucial evidence for public health action to prevent obesity.