To understand and mitigate economic inequalities, both locally and globally, we need to acknowledge inequalities within households. Yet, in most empirical studies, such intra-household inequalities are disregarded mainly because we lack appropriate measurement tools and data. Not only is this problematic for inequality measurement, this lack of understanding hampers the design of cost-effective poverty reduction and child development policies. This project has five general objectives. First, I will update the facts about inequalities through direct measurement of intra-household consumption allocations, and relate these to spousal income contributions. Second, I will develop and validate novel measures of parental resource-allocation preferences and use these to study whether children are likely to benefit more if mothers, rather than fathers, receive cash transfers. Third, I will develop and validate novel measures of household decision-making and use these to investigate how targeted transfers shape women’s empowerment. Fourth, I will study whether cash transfers or an educational parenting program is most cost-efficient for child development. Fifth, I will use an integrated framework and the new tools and data, to refine our understanding of the mechanisms behind inequalities among adults and child development. Concretely, the project will contribute to our knowledge in the following specific ways. I will carry out an extensive data collection on intra-household allocations, parental-allocation preferences and women’s empowerment, in ten very diverse countries, one from each decile of the world income distribution. I will engage in a local RCT in Tanzania on cash transfers and parenting, which also involves extensive data collection on household consumption, time use, preferences and decision-making. Finally, I will conduct lab experiments in Chile, India and Tanzania so as to validate the parental-allocation preference and decision- making measures.

The fight against mosquito-borne diseases in sub-Saharan Africa is significantly hindered by the absence of comprehensive, long-term, and high-quality datasets. This limitation hinders our understanding of disease transmission dynamics, the effects of climate change, the consequences of anthropogenic factors such as deforestation and urbanization, and the impacts of vector control interventions. Although the WHO advocates for surveillance as a core intervention against vector-borne diseases, most low-income countries lack the financial and technical capacity to implement this on a large scale. Furthermore, there are no systematic efforts to collect such critical data in Africa, even as risks from climate and land use changes increase. We therefore propose to establish a networked observatory for systematic and long-term collection, analysis and dissemination of high-quality data on mosquitoes and mosquito-borne diseases in Africa, starting with five countries in the east & southern Africa region. The observatory will comprise geographically dispersed data collection nodes, reflecting spatial variations in climate, disease epidemiology, and socio-economic conditions, and will be owned and managed locally by African partners to enhance sustainability. To maximize value, the observatory will cover multiple mosquito-borne diseases, collecting standardized data on entomological metrics such as vector densities, species diversity, seasonal phenology, host preferences, transmitted pathogens, and genomic variations, alongside critical climatic, anthropogenic, and other environmental factors. We will build in-country capacity to perform all the entomological and genomic assays locally without having to ship samples abroad; including capacity to analyze, interpret and use the data. We will also gather summaries of health metrics from local facilities and collaborate with partners to include One Health indicators, aligning with global health security priorities.

This proposal responds to the HORIZON 2024 call “EDCTP3 Joint Undertaking: Research on existing Malaria vaccines and development of new promising candidates.”The malaria epidemic will not stop without a safe, efficacious, and affordable vaccine that can interrupt transmission. The first licensed malaria vaccines, RTS,S and R21, will substantially reduce childhood deaths in Africa. We propose to pursue accelerated approval of Pfs230D1+R21, the first multi-stage malaria vaccine to reduce transmission, which will reduce clinical malaria rates and support control and elimination. While R21 kills sporozoites in skin/liver, Pfs230D1 lyses gametes in mosquitoes. In field trials with adults and children, Pfs230D1 reduced mosquito infection rates >75%. Pfs230D1+R21 development relies on in-vivo direct-skin-feeding (DSF) bioassay, that feeds mosquitoes on skin to recapitulate natural parasite transmission, to measure reasonably likely surrogate efficacy endpoints for accelerated licensure. Modelling R21 and Pfs230D1 field efficacy data suggests Pfs230D1+R21 will substantially reduce malaria burden in high-transmission zones, while other simulations predict accelerated elimination in low-transmission zones. Through innovative trial designs and capacity-building, we will pursue EDCTP3 aims: 1) establish safety and efficacy of a multi-stage vaccine to reduce transmission; 2) pursue accelerated approval of Pfs230D1+R21; 3) expand population-wide long-term safety and efficacy data on R21; and 4) generate expertise and data to inform recommendations that expand cGMP and supply chain for vaccines in Africa. The program will expand clinical trial capacity for transmission-blocking interventions, build expertise and evidence to support future vaccine manufacture in Africa, and improve understanding of malaria immunity including correlates of protection. At project end, an approved multi-stage malaria vaccine to reduce transmission will be poised for Phase 4 cluster-randomized trials.