The 2.5 million children and adolescents living with HIV (CALHIV), most residing in sub-Saharan Africa, have unacceptably high rates of late diagnosis, treatment failure and death, compared to their adult counterparts. CALHIV are a vulnerable group who have been left behind adults in testing new treatment options, different modes of ART delivery, novel diagnostics and adherence strategies. The CHAPAS-5 trial is a sustainable multi-country adaptive platform trial in Mozambique, Uganda and Zimbabwe, to assess novel treatment regimens in ART-naïve and treatment-experienced viraemic children aged 4 weeks to <20 years of age. CHAPAS-5 employs an innovative Personalised Randomised Controlled Trial (PRACTical) design, randomising participants between appropriate ART regimens based on their clinical status, ART history, genotypic resistance and drug availability by weight band. The trial's primary outcome is: alive with viral load <400 c/mL at 48 weeks. CHAPAS-5 will evaluate novel oral and first generation long-acting injectable (LAI) treatment regimens and, subsequently, through its adaptive design, second-generation promising long-acting therapeutics. Nested pharmacokinetics will evaluate dosing for children, as needed. Social science, health economics and capacity strengthening are fully integrated through the project. Workpackages will explore options for community-delivery of LAIs, and employment of diagnostics, including POC CD4, near-POC viral load and resistance tests. Community groups and young people will be involved in our dissemination and communication activities. We will exploit project outputs and facilitate technology transfer for treatments and diagnostics from innovators to African manufacturers. CHAPAS-5 aims to improve health and well-being of CALHIV, to inform clinical guidelines, and to strengthen health systems through capacity development. Our trial platform will provide a long-term resource for studies seeking to improve outcomes in CALHIV.

In many parts of Africa, changing patterns of cross-border migration are transforming the importance of borders for marginalised populations. Recent literature cautions that simplified narratives about illegality in border zones are complicating efforts at addressing social inequities. This research examines social and political dimensions of rural livelihoods along the Zimbabwe-Mozambique border in conjunction with current debates about transboundary resource management in the region, focusing on perspectives in artisanal gold mining communities in Manica, Mozambique, where Zimbabwean artisanal miners live and work side-by-side with Mozambicans. The study explores what displacement means to different rural actors and how challenges are negotiated in pursuing resource-dependent livelihoods, with the ultimate goal of enhancing policies for addressing livelihood insecurity on both sides of the border. The Zimbabwe-Mozambique border is a high priority for research, as large numbers of Zimbabweans have crossed into Mozambique as Zimbabwe's economic and political crisis deepened and are engaging in artisanal mining. Empirically, the study addresses three interlinked research questions: 1) How does mobility across the border represent new opportunities or, conversely, new challenges, for reconfigured livelihoods in artisanal mining communities near/along the border?; 2) To what extent are global and national institutions taking these challenges and opportunities into consideration in their approach to transboundary resource management policies?; 3) How are formal artisanal miners associations and informal groups of artisanal miners (on both sides of the border) socially engaged in processes of contesting land near/at the border? Through in-depth life history interviews, focus groups, field diaries, visual methods and participant observation with artisanal mining associations, the study will explore how women and men in mining communities negotiate livelihood struggles, analysing social and economic ties that transcend the border. Analysing perspectives on mining, displacement and migration in relation to transboundary resource governance, policy documents will be reviewed and interviews conducted with national and district government authorities, companies and civil society organizations. This study will generate original data and contribute new insights to engage conceptual and policy debates as well as associated methodological and ethical debates in borderlands research. The analysis aims to inform researchers in geography, development studies, African studies and the growing field of borderlands research, as well as policymakers. In 2011, the African Union signed a Memorandum of Understanding with the African Borderlands Research Network, based at the University of Edinburgh, highlighting the need for research to support policymaking that enhances livelihoods in border regions. This project is especially timely in light of a global environmental treaty signed by more than 120 countries recently, including Zimbabwe and Mozambique, requiring governments to take new steps to manage artisanal gold mining. Government officials have expressed the need for research to inform National Action Plans for implementing the treaty in the 2015-2020 period. The project's regional workshops will co-produce knowledge while building local capacity of artisanal mining associations, government agencies, civil society and universities in Zimbabwe, Mozambique and the UK. Theoretical, ethical and methodological insights will be disseminated through books, articles, briefs, lectures and courses, to inform crosscutting debates at the intersection of borderlands research and extractive sector research. Building on past experiences working with United Nations agencies, this project will be transformative in cultivating new skills to lead North-South-South collaborative research that informs policymakers at regional, national and global levels.

The SUPPORT project aims to strengthen health research systems in sub-Saharan African (SSA) countries affected by poverty-related pediatric infectious diseases. This goal will be achieved through a comprehensive fellowship program designed to train and mentor early and mid-career researchers. The consortium comprises clinical research institutions, academia, and stakeholders from both SSA and Europe. Makerere University in Uganda will act as the scientific leadership hub, with fellows stationed at leading SSA research institutions, fostering South-to-South collaboration. Additionally, short-term internships at European institutions will complement their training. The selection of target host countries, including Mozambique, Uganda, Zambia, Zimbabwe, and Senegal, was based on their research capacity needs and disease burden, encompassing Anglophone, Francophone, and Lusophone nations. The impact of SUPPORT will be the establishment of a competent and innovative community of scientists and healthcare professionals equipped to actively investigate and address pediatric infectious diseases, including epidemic management, in SSA. By strengthening research capacity and promoting collaboration, the project contributes to long-term improvements in morbidity and mortality associated with infectious diseases in children from low- and middle-income countries (LMICs). SUPPORT will train 8 early-career fellows and 5 mid-career fellows, developing a new collaborative clinical study based on two ongoing EDCTP projects, EMPIRICAL and UNIVERSAL. The fellows will undergo a rigorous training program that combines online and face-to-face components to develop essential research skills. This training will be integrated with their individual research projects, which address critical research questions related to pediatric infectious diseases in SSA. The fellows will take the lead on these projects with guidance and support from mentors affiliated with African and European institutions.

35% of Africa, 40% of the sub-Saharan Africa land surface and almost 37% of the member states of the Southern African Development Community (SADC) is underlain by weathered and fractured 'basement complex' bedrock which contains groundwater within its weathered mantle (most significant under the 'African erosion surface') and to a lesser extent within rock fractures (most significant under the 'post-African erosion surface'). Achievement of the Millennium Development Goals (MDGs) in Africa (MDG Target 7.C: to halve, by 2015, the proportion of the population without sustainable access to safe drinking water and basic sanitation) is therefore fundamentally reliant on the long-term sustainability of groundwater abstractions from these crystalline basement complex aquifers (BCAs). The incentive for our proposal is a recent reconnaissance analysis of the sustainability of groundwater resources of the BCAs in Malawi (the 'Malawi analysis' of Robins et al 2013). The reconnaissance method for estimating groundwater resource limitation compares estimates of groundwater throughflow and storage depletion with actual abstractions at a coarse scale (100s km2). The analysis raises concern that groundwater abstractions exceed long-term recharge in 4 of the 15 'water resource areas' (WRAs) of Malawi, in parts of both the 'weathered' and 'fractured' BCA environments. This controversial conclusion contrasts with the long and widely held view that resource development from BCAs is limited by low transmissivity, hence through low yield of wells, compounded by widespread technological failure of the well-points themselves. Also, it provides a cautionary perspective on a continent-wide assessment of groundwater 'volumes in place' in Africa by MacDonald et al (2012) who have estimated the BCA resource at 500,000 m3/km2 on the basis of published geological maps and estimates of hydrogeological parameters. Availability and sustainability of the groundwater resource, however, fundamentally require ground-truth measurements and process-based analyses (Edmunds 2012). Cumulative groundwater abstraction has greatly increased across much of SSA over the past 30+ years following numerous rural water development and drought relief programmes. Therefore the Malawi experience could be indicative of groundwater resources sustainability in BCAs more widely throughout SSA. If the Malawi analysis is correct, one important implication is that additional, un-recoverable well-point failure will be expected in the affected regions. This expectation forms the basis for the test we will apply to the Malawi analysis. This proposal therefore addresses the concern that the Malawi experience is indicative for groundwater in BCAs throughout SSA. The principal objective is to test the Malawi analysis, by examining the implications for well-point failure using independent data on well-point occurrence and status (available through WaterAid and the Malawi Ministry of Water Development and Irrigation). Concurrently, we will explore the links between well-point failure, health, poverty and gender issues where resource limitation to sustainability of groundwater well-points has been proposed, using census and aggregated heath data. We will carry out field investigations to refine the analysis of groundwater resource limitation over a smaller area and to develop a preliminary analysis for a selected region in southern Zimbabwe. We will develop a methodology for application to water-use policy and local resource/well-point monitoring. We will stimulate awareness and adoption of the methodologies at a regional Workshop. Hence we will support national mitigation measures, and local management of groundwater use. The project will lead to new estimates of resource limitation in Zimbabwe, new collaborations, and form the basis for wider investigation of resource-limitation across SSA basement complex regions.