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1

Challenges

Eliminate Pain from Endometriosis

Endometriosis is the growth of tissue like the uterine lining (endometrium) outside the uterus, usually within the pelvic cavity as ‘endometriosis lesions’. The result is chronic pain, infertility and diminished quality of life - 190 million women world wide are affected.

Endometriosis is currently diagnosed by invasive surgery and is treated by surgical removal of lesions or with drugs that suppress sex hormones. Sadly, in many women symptoms recur after surgery and available medical treatments have undesirable side-effects and are contraceptive. New non-invasive diagnostic approaches and treatments for endometriosis are desperately needed

Erin recently shared her research on a Podcast with Warwick PhD student Eleanor Harrison who runs the Youterus podcast, Listen to the interview here on her latest endometriosis research.

Breakthroughs:

We have used a disease model of endometriosis to provide vital insight into the pathophysiology of the disorder, with a specific focus on role of the immune system. We now know enough about particular immune cells to begin to target them therapeutically, with our first phase 1 clinical trial funded and poised to begin recruiting patients.
We are also performing research into how peripheral blood immune cells can be exploited for diagnostic purposes. Our vision is to provide new, non-hormonal medical therapies for endometriosis and revolutionise non-invasive diagnosis of the disorder, collectively enhancing the lives of millions of women worldwide.
We are developing behaviour change interventions in the management of long-term pain including those with endometriosis. Together these breakthroughs will improve the quality of life of women with endometriosis.

Challenge Lead

Dr. Erin Greaves

10

Challenges

Improving Fertility Outcomes in IVF

Improve Assisted Reproduction

According to WHO estimates, one in six people experience infertility in their lifetime. The main strategy for fertility treatment is assisted reproduction, such as in vitro fertilisation (IVF). In this process, oocytes are collected from the ovaries and then mixed with sperm to form embryos. These are cultured outside the body and transferred to the patient around day 5 of development. Just in 2021, 55,000 patients had treatment in fertility centres in the UK, and the numbers are growing every year. While very successful in general, the IVF livebirth rate per embryo transfer is around 30%. Every cycle of treatment comes with a great financial and emotional cost for the couples: the NHS funding is limited, and the procedure is a physical and emotional burden, especially if it ends up with failure. Improving the outcomes of assisted reproduction procedures is key to improve patients’ experience, which can be approached by addressing the most common causes for treatment failure.

The abnormal number of chromosomes in a cell, known as aneuploidy, is a leading cause of IVF failure, as well as infertility, pregnancy loss or developmental syndromes such as Down’s (three copies of chromosome 21). Aneuploidy most often arises from the oocyte (the egg cell), and the risk of abnormal chromosome numbers increases as the women age. This is because oocytes are formed early in development and their chromosomes have to be maintained until the decision to start a family. With the average age of women at first birth increasing, this increases the need for assisted reproduction for older patients. Errors can also occur in an early embryo, causing a fraction of cells to have a different chromosome number from others. Such embryos are known as mosaics. The implications of mosaic aneuploidy for embryo development are yet to be fully understood.

Breakthroughs:

We have recently discovered that early human embryos are prone to errors that could lead to mosaic aneuploidy that has implications for embryo development - read about it here. This is particularly important for in vitro fertilisation (IVF) process, and we have identified a potential small molecule intervention to reduce embryo aneuploidy (preprint here).
By studying the process of egg maturation and fertilisation we are revealing crucial age-related changes. Understanding this is key to address infertility in older female patients, especially since the mean age of first-time IVF patients has recently increase to just over 35 years of age, as reported by Human Fertilisation and Embryology Authority (HFEA). This has led to development of an “failed fertilisation test”, that we hope will help to diagnose patients struggling with infertility due to poor egg quality.

Challenge Leads

Aleksandra Byrska

Dr. Geraldine Hartshorne

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Challenges

Combat Antimicrobial Resistance

Antimicrobial resistance (AMR) poses a significant threat to global health, as it makes infections more difficult to treat and increases the risk of disease spread, severe illness, and death. Drug resistant microbes have caused a significant increase in the number of infection-related deaths and have severely impacted healthcare systems worldwide.

AMR is a complex problem that spans across disciplines. Better surveillance and tracking of infections, discovering new effective drugs, developing sensitive diagnostics and efficacious vaccines, along with policy development and social education are all essential in combatting AMR. Interdisciplinary solutions are hence crucial in successfully addressing this threat.

We have a community of researchers across different disciplines at UoW active in the area of AMR research. The Warwick Antimicrobial Interdisciplinary Centre (WAMIC)brings expertise from across the University together to develop cross-disciplinary solutions to AMR. The Sir Howard Dalton Centre conducts interdisciplinary, cross-scale mechanistic enzymology with a focus upon translation and science policy to help tackle AMR. The Warwick Antimicrobial Screening Facility is primed to aid in the discovery of new antimicrobial and anti-fungal treatments.

Breakthroughs:

Drug discovery: Our research encompassing cutting edge enzymology in vitro, and in vivo, structural approaches in silico has led to several discoveries of new drug targets and novel drugs. We are also exploring innovative approaches like phage therapy and nanoparticles for effective delivery of available drugs to intracellular bacteria and biofilms.

Understanding pathogen biology and host interactions: Our current research utilises cutting-edge molecular and cellular technologies including advanced microscopy to study bacterial physiology and drug targets, and mechanisms of drug resistance. We employ novel in vitro and in vivo models of infection to study complex host-pathogen and microbiome interactions.

Challenge Lead(s)

Dr. Meera Unnikrishnan

Prof. David Roper

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Challenges

Address Global Health Inequalities in Infectious Disease Management

Infectious diseases disproportionately affect low- and middle-income countries, where healthcare resources are limited. The challenge is to reduce these health disparities by improving access to prevention, diagnosis, and treatment.

Challenge Lead

Philip Anyanwu

13

Challenges

Accelerate Vaccine Development and Immunotherapy

The development and implementation of vaccines is essential to prevent infectious diseases and control new outbreaks. Immunotherapeutics holds immense promise in the treatment of other intractable diseases such as cancer.

Currently vaccine and immunotherapy development can be costly and time consuming. Accelerating the development and implementation of broadly protective vaccines will allow for improved intervention to target variable and hard to treat pathogens and protect populations worldwide. The development of novel immunotherapeutics promises to provide treatments for current intractable diseases.

Breakthroughs:

We currently have research on going in the areas of (1) nucleic acid and drug delivery system development spanning polymer technology of molecular syringes, and (2) the next generation broadly protective vaccines RNA viruses.

For the last decade we have provided advice to the Department of Health and the Joint Committee on Vaccination and Immunisation (JCVI) on the cost-effectiveness of vaccination policies. Our work was instrumental in the introduction of gender-neutral vaccination against Human Papillomavirus, and in the targeting and deployment of COVID-19 vaccines.

Challenge Lead

Craig Thompson

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Challenges

Cardiac Arrest Survival Challenge 1

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Breakthroughs:

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Challenges

Cardiac Arrest Survival Challenge 2

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Breakthroughs:

Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Sociis natoque penatibus et magnis dis parturient. Odio ut sem nulla pharetra diam sit amet nisl. Sagittis eu volutpat odio facilisis. Amet consectetur adipiscing elit pellentesque habitant morbi. Risus ultricies tristique nulla aliquet enim. Turpis massa tincidunt dui ut ornare lectus sit amet est. Sed adipiscing diam donec adipiscing. Eu volutpat odio facilisis mauris sit amet massa vitae. Montes nascetur ridiculus mus mauris vitae ultricies leo integer malesuada. Vulputate sapien nec sagittis aliquam malesuada bibendum arcu vitae. Morbi leo urna molestie at. Arcu dui vivamus arcu felis bibendum. Viverra nibh cras pulvinar mattis nunc sed blandit libero. Quam adipiscing vitae proin sagittis nisl rhoncus. Eros donec ac odio tempor orci dapibus ultrices.

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Challenges

Cardiac Arrest Survival Challenge 3

Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Sociis natoque penatibus et magnis dis parturient. Odio ut sem nulla pharetra diam sit amet nisl. Sagittis eu volutpat odio facilisis. Amet consectetur adipiscing elit pellentesque habitant morbi. Risus ultricies tristique nulla aliquet enim. Turpis massa tincidunt dui ut ornare lectus sit amet est. Sed adipiscing diam donec adipiscing. Eu volutpat odio facilisis mauris sit amet massa vitae. Montes nascetur ridiculus mus mauris vitae ultricies leo integer malesuada. Vulputate sapien nec sagittis aliquam malesuada bibendum arcu vitae. Morbi leo urna molestie at. Arcu dui vivamus arcu felis bibendum. Viverra nibh cras pulvinar mattis nunc sed blandit libero. Quam adipiscing vitae proin sagittis nisl rhoncus. Eros donec ac odio tempor orci dapibus ultrices.

Breakthroughs:

Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Sociis natoque penatibus et magnis dis parturient. Odio ut sem nulla pharetra diam sit amet nisl. Sagittis eu volutpat odio facilisis. Amet consectetur adipiscing elit pellentesque habitant morbi. Risus ultricies tristique nulla aliquet enim. Turpis massa tincidunt dui ut ornare lectus sit amet est. Sed adipiscing diam donec adipiscing. Eu volutpat odio facilisis mauris sit amet massa vitae. Montes nascetur ridiculus mus mauris vitae ultricies leo integer malesuada. Vulputate sapien nec sagittis aliquam malesuada bibendum arcu vitae. Morbi leo urna molestie at. Arcu dui vivamus arcu felis bibendum. Viverra nibh cras pulvinar mattis nunc sed blandit libero. Quam adipiscing vitae proin sagittis nisl rhoncus. Eros donec ac odio tempor orci dapibus ultrices.

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Challenges

Cardiac Arrest Survival Challenge 4

Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Sociis natoque penatibus et magnis dis parturient. Odio ut sem nulla pharetra diam sit amet nisl. Sagittis eu volutpat odio facilisis. Amet consectetur adipiscing elit pellentesque habitant morbi. Risus ultricies tristique nulla aliquet enim. Turpis massa tincidunt dui ut ornare lectus sit amet est. Sed adipiscing diam donec adipiscing. Eu volutpat odio facilisis mauris sit amet massa vitae. Montes nascetur ridiculus mus mauris vitae ultricies leo integer malesuada. Vulputate sapien nec sagittis aliquam malesuada bibendum arcu vitae. Morbi leo urna molestie at. Arcu dui vivamus arcu felis bibendum. Viverra nibh cras pulvinar mattis nunc sed blandit libero. Quam adipiscing vitae proin sagittis nisl rhoncus. Eros donec ac odio tempor orci dapibus ultrices.

Breakthroughs:

Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Sociis natoque penatibus et magnis dis parturient. Odio ut sem nulla pharetra diam sit amet nisl. Sagittis eu volutpat odio facilisis. Amet consectetur adipiscing elit pellentesque habitant morbi. Risus ultricies tristique nulla aliquet enim. Turpis massa tincidunt dui ut ornare lectus sit amet est. Sed adipiscing diam donec adipiscing. Eu volutpat odio facilisis mauris sit amet massa vitae. Montes nascetur ridiculus mus mauris vitae ultricies leo integer malesuada. Vulputate sapien nec sagittis aliquam malesuada bibendum arcu vitae. Morbi leo urna molestie at. Arcu dui vivamus arcu felis bibendum. Viverra nibh cras pulvinar mattis nunc sed blandit libero. Quam adipiscing vitae proin sagittis nisl rhoncus. Eros donec ac odio tempor orci dapibus ultrices.

18

Challenges

Development of unique diagnostics for early detection, prevention and monitoring of infectious diseases

Appropriate patient care, disease surveillance and effective public health responses all hinge on accurate and timely diagnosis of infection or disease. As a major driver of health and economic outcomes, diagnostics therefore represent a core pillar of global health security and universal health coverage, as well as being a fundamental component of functioning health systems.

Breakthroughs:

At Warwick, in partnership with UCHW, we have a programme of work which aims to develop novel diagnostics tests to improve the early and accurate detection of pathogens and diseases. Examples include the use of bacteriophages, E-Nose technology, genomics, waste-water surveillance, as well as the development of new lateral flow and PCR-based tests.

Challenge Lead

Nicole Robb

19

Challenges

Develop practical solutions for prevention and control of infectious disease using one health approaches to improve global health

Infectious diseases disproportionately affect low- and middle-income countries, exacerbated by limited healthcare infrastructure and resources and infrastructure are limited. The challenge is to reduce these health disparities by using research to inform policy and improve access to prevention, diagnosis, and treatment.

Understanding the risk to global health posed by these infections requires a holistic approach that considers all the involved populations and the potential routes of transmission. A one health approach encourages working across human, animal and environmental health to improve global health. We have researchers involved in supporting disease elimination and eradication goals, combatting neglected tropical disease and conducting field studies across the world.

Breakthroughs:

Healthcare in low resource settings: We have developed REmote Consulting in Healthcare (REaCH) training to optimise healthcare delivery the limited digital/telecoms infrastructure in Africa to deliver a safe and trustworthy healthcare equivalent of face-to-face consultations in low resource settings, allowing for continued care during the COVID-19 pandemic. We have also worked with international partners to shorten multidrug resistant tuberculosis treatments providing cost-effective alternatives in low resource settings.

Neglected Tropical Diseases: We have supported disease elimination efforts through modelling methodologies and analysis of elimination programmes against Gambiense Human African Trypanosomiasis, and Yaws. We have also supported the WHOs goals for eradication of Lymphatic filariasis through modelling which has led to discovery for enhanced drug administration methods.

Animal Disease and Zoonosis: We have developed novel approaches to prevent disease which have been used in field studies internationally. Our tools are able to capture and model the spread of livestock diseases and has ultimately aided efforts to control of Avian influenza (Bangladesh and Thailand) and Foot and Mouth disease (Denmark and USA) in rural and farming communities. Field studies in collaboration with the Brazilian Ministry of Health have disrupted zoonotic transfer of the parasite Leishmania infantum through its vectors, which is expected to lower the infectious transfer to dogs and humans thus reducing the incidence of visceral leishmaniasis.

Challenge Lead

Mike Tildesley

2

Challenges

Preventing Pregnancy Loss and Pre-term Birth

Miscarriage and infertility are devastating conditions for many women and their partners. Both conditions are often caused by failure of an embryo to implant successfully in the womb lining. The precise causes of miscarriage and implantation failure remain incompletely understood. Aside from physical trauma, each miscarriage compounds the risk of significant psychological morbidity.

Breakthroughs:

Our teams have developed and continue to develop novel research tests and treatments to increase the likelihood of a successful pregnancy. They offer support, advice and specialised tests that investigate the womb lining (endometrium) in women affected by miscarriage or IVF implantation problems. The aim is to pinpoint defects in the womb lining and underpinning research has lead to the development of the digital endometrial function test - (d)EFT.

In collaboration with colleagues in mathematics we have also pioneered the Miscarriage Support Tool. Data from women who miscarry has been used to generate an algorithm that predicts the chance of having a baby after 1 or several miscarriages and gives personalised information, support and advice based on a women’s experiences as well as tests and interventions that she should explore in preparation for trying again to conceive.

Challlenge Leads

Professor Jan Brosens

Professor Siobhan Quenby

3

Challenges

Improving Care and Tackling Inequalities in Women's Reproductive Health

In England, women’s reproductive health services and funding are really fragmented, with care funded by different organisations and provided in different places including GP practices, hospital gynaecology services and sexual health clinics. For example, women might have to go to one place for a smear test, another for contraception and another for menopause support. Care often isn’t joined up, women can find it difficult to access, and there are inequalities in care for women who need it the most.

It is rare for mothers and babies to die in the UK, and rates have reduced over time. Recently this has changed: we are falling behind other similar countries, and our maternal death rates have increased, while infant death rates have flatlined. There are also stark inequalities between different groups. For example, compared to white women some groups are more likely to die during or shortly after pregnancy (three times more for black women, two times more for asian women or women living in deprived areas). Families in these groups also experience worse health and care in many other areas, such as premature birth and stillbirth. Careful planning is needed to improve care, reach women who have the greatest need and link effectively with other services.

Breakthroughs:

We have led a rapid national evaluation of Women’s Health Hubs identifying and exploring early models launched before the Women’s Health Strategy, which continues to inform policy and practice. We are leading research to look at how women’s reproductive health services are being commissioned across health systems in England in response to the Women’s Health Strategy. This will explore the different approaches local leaders are taking, how they are working, and how inequalities in women’s health and care are being addressed. We are also working to evaluate inequalities in preconception maternity and postnatal care while optimising the care of women following birth trauma and pregnancy loss.

Read more about the latest study into women's health hub's led by Dr. Beck Taylor here

Challenge Leads

Dr. Beck Taylor

4

Challenges

Tackle inequalities and fragmentation in women's reproductive healthcare

In England, women’s reproductive health services and funding are really fragmented, with care funded by different organisations and provided in different places including GP practices, hospital gynaecology services and sexual health clinics. For example, women might have to go to one place for a smear test, another for contraception and another for menopause support. Care often isn’t joined up, women can find it difficult to access, and there are inequalities in care for women who need it the most. The 2022 Women’s Health Strategy in England aims to improve the situation. Since the strategy launched, every area in England has appointed a Women’s Health Champion and is putting plans in place to set up ‘Women’s Health Hubs’ to provide more joined-up, accessible care. Careful planning is needed to improve care, reach women who have the greatest need and link effectively with other services.

Breakthroughs:

We have led a rapid national evaluation of Women’s Health Hubs identifying and exploring early models launched before the Women’s Health Strategy, which continues to inform policy and practice. A follow up study is now underway to look at how women’s reproductive health services are being commissioned across health systems in England in response to the Women’s Health Strategy. This will explore the different approaches local leaders are taking, how they are working, and how inequalities in women’s health and care are being addressed.

Challenge Leads

Dr. Beck Taylor

5

Challenges

Developing a wellbeing census infrastructure to assess and address drivers of poor wellbeing in children and young people

Youth mental health disorders, including anxiety, depression, and behavioural issues, are on the rise, with significant long-term impacts on educational achievement, employment, and overall quality of life. Research indicates that early intervention is crucial to mitigate these effects, yet access to effective assessment and psychosocial interventions remain limited.

Breakthroughs:

We have developed a wellbeing census in West Midlands schools, a website with psychoeducational interventions (https://breathe-edu.co.uk/) and a co-created a digital app to prevent loneliness by increasing social connections amongst university students. We also work with children with special needs and have a particular expertise in assessing and treating mental health disorders in children with learning disabilities, helping families and professionals to recognise and address their mental health needs.

Challenge Lead

Dr. Helena Tuomainen

6

Challenges

Reduce the ever-increasing mental health treatment gaps in low and middle-income countries

Mental health treatment gaps are particularly pronounced in low- and middle-income countries (LMICs), where resources are scarce, and stigma often prevents individuals from seeking help. The World Health Organization estimates that approximately 85% of people with mental health disorders in these regions do not receive treatment.

Breakthroughs:
We are improving access to mental health care and reducing the impact of serious mental disorder outcomes in slums. We are currently developing a screening and intervention programme in schools in different LMICs.

Challenge Leads

Professor Swaran Singh

7

Challenges

Implement the organisational-level interventions to reduce work stress and improve mental health and wellbeing of the workforce across multiple sectors

Workplace stress is a growing concern across various sectors, leading to increased risk of developing mental health disorders such as depression, decreased productivity, higher turnover rates, and increased healthcare costs.

Breakthroughs:

Our researchers have delivered and evaluated several psychological and digital interventions to improve mental health and productivity in workplaces across the Midlands. Learnings have led to the co-development of novel innovative interventions for hard-to-reach groups such as shift workers with sleep problems who are traditionally excluded from receiving the most evidence-based treatment for insomnia (CBTi). Another hard-to-reach and underserved group are workers within the construction industry where suicide rates are 3 times higher than other sectors. Forming the key research arm within a partnership with industry, government and voluntary sector bodies, we are identifying the unique stressors and relevant interventions to tackle the mental health crisis within construction. We are also co-developing a longitudinal wellbeing survey with NHS workers at a local NHS Trust which will add depth to the standard cross-sectional annual NHS Staff survey and help senior leaders identify what works and what additional provisions are needed to support staff wellbeing.

Challenge Leads

Dr. Carla Toro

8

Challenges

Improving the effectiveness and delivery of mental health care and developing an evidence base for safe and effective digitalisation

Mental health problems are widespread in the UK and internationally and affect people throughout the life-course. Service demand and pressures are increasing. Challenges such as inequalities in access to care across social groups and poor experience of care remain. We are tackling key challenges for mental health services and policies such as: mental health inequalities, social isolation, family burden, self-harm prevention and delivery of acute care under legal frameworks (i.e. Mental Health Act and Mental Capacity Act).

Breakthroughs:
We are pioneering the development of an evidence base for AI-assisted interventions within mental health services. Our research and innovations are developed and carried out through rigorous and inclusive co-development and evaluation processes involving multidisciplinary collaborations and people with lived experience.

Challenge Leads

Professor Domenico Giacco

9

Challenges

Enhance surveillance and epidemiological predictions for Infectious Disease control

Infectious diseases are evolving rapidly, making timely detection and critical responses essential for informed policy decisions for public health. It is vitally important that policy decisions for public health are based on robust projections using the latest epidemiological data. There is an essential requirement to utilise data science (including mathematical and statistical modelling), genomic tools, syndromic surveillance, and evidence synthesis to predict, monitor, and control outbreaks.

Breakthroughs:

Surveillance and Data Science: We are developing novel methods to provide unique insights on a range of key infectious diseases, to support surveillance systems such as near-real time syndromic surveillance to understand which infectious agents are causing changes in healthcare presentations. Our data and evidence synthesis aim to deliver the best available insights and evidence to decision makers on a range of infectious disease threats; ranging from antimicrobial resistance, surveillance of neglected tropical diseases or vaccination strategies to health protection parameters of infectious diseases. We investigate the use of new methodologies such as machine learning to identify changes in levels of infectious diseases from what is expected, enabling rapid public health interventions, or predict winter health care pressures.

Epidemiological Predictions for Policy: Throughout the COVID-19 pandemic, Warwick researchers provided a range of projections and analyses to the UK government including: short- and medium-term projections such as the Roadmap to reopening documents in 2021; the role of schools in the spread of infection; the risks associated with universities and other closed setting; and the spread of novel variants (from Alpha to Omicron). We are currently working closely with UKHSA and DEFRA on analysis zoonotic spillover potential of highly pathogenic avian influenza (HPAI). Our work has international reach as we have worked closely with researchers at the KEMRI-Wellcome Trust Centre to provide similar assistance to the Kenyan Ministry of Health, with the Department of Health in the Philippines on the development of integrated bite case management protocols to support the elimination of canine rabies and on strategies to minimise zoonotic transmission of HPAI in Bangladesh and Thailand. We also work on the control of Neglected Tropical Diseases. Of particular note is the HATMEPP (Human African Trypanosomiasis Modelling and Economic Predictions for Policy) project, funded by the Bill & Melinda Gates Foundation, which supports ongoing global interventions to eliminate gambiense human African trypanosomiasis (gHAT or sleeping sickness).

Genomics for outbreak investigation: We have been developing a toolbox made of several methods for the analysis of pathogen genomic data. This includes methods to reconstruct phylogenies, estimate ancestral dates, detect outbreaks, reconstruct transmission trees, identify imports, analyse antibiotic resistance dynamics.

Challenge Lead

Dan Todkill