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Scaling up insecticide treated net coverage: evidence to support strategic policy decisions and investment

Summary of the impact

A comprehensive body of research into the effectiveness, cost and distribution of long-lasting insecticidal nets (LLINs) by LSHTM has made a major contribution to the reduction of malaria-related mortality between 2008 and 2013, especially among children in Africa. The research formed the basis of a radically altered strategic approach to combating malaria by WHO and other agencies, and led to the roll-out of malaria campaigns based around LLINs in several African countries. LSHTM research into the technology of LLINs, which also contributed to these developments, is described in a separate case study.

Submitting Institution

London School of Hygiene & Tropical Medicine

Unit of Assessment

Public Health, Health Services and Primary Care

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

Supporting decision-making on the introduction of Haemophilus influenzae type b (Hib) vaccine in low- and middle-income countries

Summary of the impact

Research at LSHTM has been central to the introduction of the Hib vaccine in developing countries. School staff were involved in the 1990s Gambia Hib vaccine trial, which demonstrated the impact of Hib vaccine on pneumonia. Through their work on the subsequent Hib Initiative, their research was instrumental in speeding up evidence-based decision-making for Hib vaccine introduction in a number of countries, mainly in Asia and Africa. The project has been an outstanding success, with Hib vaccine now introduced into 71 of the 73 countries eligible for GAVI Alliance support.

Submitting Institution

London School of Hygiene & Tropical Medicine

Unit of Assessment

Public Health, Health Services and Primary Care

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

Improving the way policy makers and service providers engage the public in policy and practice decision making

Summary of the impact

Research at Lancaster has had significant, cumulative impacts on public sector thinking about, and approaches to, public involvement in health policy, practice and research locally, nationally and internationally. As a result the public in the UK and internationally is now significantly better engaged in influencing health policy and practice, in particular those from disadvantaged communities, leading to improved health and wellbeing, and enhanced employability. This research shaped the network of NHS Patient and Public Involvement Forums established in England 2003-2007, and reframed how social exclusion and vulnerability were addressed in the report of the Global Commission on The Social Determinants of Health (Marmot report) and the WHO EURO Health 2020 Strategy.

Submitting Institution

Lancaster University

Unit of Assessment

Allied Health Professions, Dentistry, Nursing and Pharmacy

Summary Impact Type

Societal

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services
Studies In Human Society: Policy and Administration

Reducing morbidity and mortality in Malawi through an integrated Environmental Health approach to improving water quality and health

Summary of the impact

Strathclyde research underpinned formation of the Scottish Chikhwawa Health Initiative (SCHI) in 2006, to deliver tangible health benefits by reducing major causes of disease and death in Chikhwawa, Malawi. Health impact occurred through training of government personnel and community volunteers, combined with increased infrastructure capacity, at health facilities and in the community, producing improvements in water quality, sanitation and communicable disease control. Within the first 2 years of implementation among a population of 5700 people, a 30% reduction in diarrhoeal disease was achieved, and access to safe water improved through increased water points and improved water storage [1]. Initial success saw expansion of the initiative to 150 communities covering a population of 110,000.

Submitting Institution

University of Strathclyde

Unit of Assessment

Civil and Construction Engineering

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Medical Microbiology, Public Health and Health Services

Expanding access to effective antimalarial treatment through the private sector

Summary of the impact

Research carried out by LSHTM made a fundamental contribution to the creation of the Affordable Medicines Facility — malaria (AMFm), a financing mechanism initiated to improve access to effective antimalarials through subsidies and price negotiations with drug manufacturers. Drawing on LSHTM research showing the importance of the private sector in supplying antimalarial medicines, the scheme was proposed by the US Institute of Medicine (IOM) and piloted in Kenya and Tanzania. After its 2009 launch, a subsequent evaluation by LSHTM and others using LSHTM methodological innovations led to AMFm's integration into ongoing funding streams.

Submitting Institution

London School of Hygiene & Tropical Medicine

Unit of Assessment

Public Health, Health Services and Primary Care

Summary Impact Type

Economic

Research Subject Area(s)

Medical and Health Sciences: Medical Microbiology, Public Health and Health Services

The technology of insecticide treated nets for malaria control

Summary of the impact

Twenty years of comprehensive research into long-lasting insecticidal nets (LLINs) by LSHTM have contributed substantially to the prevention of around 1m deaths from malaria between 2008 and 2013. The research made a direct impact on guidelines and strategies issued by WHO as well as driving new technologies for insecticide-treated nets (ITNs), with downstream commercial benefits. Without the evolution of LLIN technology driven by LSHTM research, the large-scale roll-out of the new generation of nets (described in more detail in the other LSHTM impact case study on this body of research) would not have been possible.

Submitting Institution

London School of Hygiene & Tropical Medicine

Unit of Assessment

Public Health, Health Services and Primary Care

Summary Impact Type

Health

Research Subject Area(s)

Biological Sciences: Genetics
Agricultural and Veterinary Sciences: Crop and Pasture Production
Medical and Health Sciences: Public Health and Health Services

Provexis plc: a food ingredient for healthy blood flow

Summary of the impact

A discovery that a tomato extract could help with healthy blood flow has been translated into a functional food ingredient now marketed globally via the spin-out company Provexis plc. Fruitflow® — Provexis' lead product — is the result of findings by researchers at the Rowett Institute of Nutrition and Health, now part of the University of Aberdeen, that biologically active constituents in tomatoes inhibit blood platelet aggregation: a known cause of heart attack, stroke and venous thrombosis. In 2009 Fruitflow® was the first food ingredient to meet the requirements of the European Food Safety Agency for products with a specific health claim. Provexis — the University of Aberdeen Rowett Institute spinout — is listed on the AIM market — the London Stock Exchange's international market for smaller growing companies — has seen values of £14 - £60 million and secured co-development agreements with major international partners, including DSM, Unilever and Coca-Cola. This case study demonstrates the direct translation of research to produce a functional food ingredient of interest to global market players.

The claimed impact therefore relates to development of new product, which has received the first ever novel health claim (Article 13.5) from the European Food Safety Authority, and is being marketed as novel food ingredient globally by a multinational company.

Submitting Institution

University of Aberdeen

Unit of Assessment

Clinical Medicine

Summary Impact Type

Technological

Research Subject Area(s)

Engineering: Food Sciences
Medical and Health Sciences: Cardiorespiratory Medicine and Haematology, Public Health and Health Services

CS-24Z-03 Infection final 2 Sep13

Summary of the impact

Research conducted by Professor Nick Mascie-Taylor on the causes and effects of parasitic infection in Bangladesh, and on the effectiveness of different interventions, led directly to changes in government policy, the roll-out of drug and health education campaigns by the World Health Organisation and the World Bank, and ultimately a reduction in the prevalence of infection and an improvement in the health of Bangladeshi poor. For example, based on recommendations from this research, a two-drug strategy for the control of Filariasis commenced in Bangladesh in 2008; by 2010 twelve districts with high prevalence had been treated, resulting in ~27 million individuals receiving treatment. With this approach microfilaremia prevalence had fallen from about 15% to under 1%.

Submitting Institution

University of Cambridge

Unit of Assessment

Anthropology and Development Studies

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Medical Microbiology, Public Health and Health Services

Encouraging adoption of new children’s vaccines through the development of methods for decision support modelling

Summary of the impact

LSHTM researchers have developed four computer models to help decision-makers make evidence-based choices about new vaccines and vaccine schedules. These models analyse the public health impact and cost-effectiveness of different options under different assumptions and scenarios on a country-by-country basis. They are used by national immunisation managers and key decision-makers, international committees and partner organisations (e.g. the Global Alliance for Vaccines and Immunisation and the Bill & Melinda Gates Foundation). LSHTM's researchers have built on this research for WHO, informing global recommendations on vaccine timing and schedules.

Submitting Institution

London School of Hygiene & Tropical Medicine

Unit of Assessment

Public Health, Health Services and Primary Care

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Medical Microbiology, Public Health and Health Services

Preventing newborn mortality due to syphilis

Summary of the impact

Research conducted by LSHTM has played a key role in supporting the global elimination of congenital syphilis. Two studies providing evidence of the health burden of congenital syphilis in Africa and the effectiveness of benzathine penicillin treatment form a pillar upon which WHO established its new syphilis elimination initiative. Further research has resulted in the adoption of new point-of-care tests for screening pregnant women for syphilis in 30 countries. As a result, more women are diagnosed and fewer babies die of syphilis.

Submitting Institution

London School of Hygiene & Tropical Medicine

Unit of Assessment

Clinical Medicine

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Paediatrics and Reproductive Medicine, Public Health and Health Services

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