• Grant: RESILIENTD Grant
• Budget round: 2025
• Research priorities: Diagnostic tests
• Country: Ethiopia
• Project no.: NTD FP25\105
• Budget: €190,080
• Duration: March 2025 - February 2029
• Status: Ongoing

Project coordination
The Leprosy Mission Ethiopia

Partners
AHRI
Addis Ababa University
University College London

Aim: To investigate the social determinants of health and economic status in relation to health outcomes in people diagnosed with leprosy and leprosy reactions at ALERT hospital, Addis Ababa, Ethiopia

Full project title: The social determinants of health in people affected by leprosy in Ethiopia – a mixed methods study

Project summary

Health as defined by people is not just the absence of illness or pain, it is the presence of wellbeing, it’s belonging, and it’s a sense of purpose. Health disparities and inequities are not inevitable, they are the result of faulty systems. Moving away from acceptance of disparities as inevitable and towards an understanding that we created the conditions that produce inequities and can, therefore, dismantle them. Many inequities result from people being failed across the social determinants of health (SDH).

In this research project,  the researchers aim to explore how non- medical factors, known as SDH, i.e. the conditions in which people are born, grow, live, work and age, may worsen health outcomes for people affected by leprosy in Ethiopia.

Ethiopia had the second highest number of new leprosy cases reported in the African Region in 2022 of whom 39% were women, and the highest number of children (364) with 11.5% having advanced disability at diagnosis. These figures are suggestive of inequality and inequities experienced by people affected by leprosy, visible only at the time of diagnosis.

The World Health Organization (WHO) theoretical framework will help the research team to understand the complex interplay between environmental, biological, and social factors. Gendered roles, social and economic status, education, food security, the physical environment, employment, social networks, access to healthcare - are factors that affect an individual’s risk of acquisition of Mycobacterium leprae infection, development of clinical disease, associated morbidity, consequent disability, care seeking behaviour, adherence to treatment, treatment outcomes, financial hardship and psychological wellbeing.

Seeing the world through the eyes of people who live the complexities associated with leprosy recognises that they are the experts in their own lives. Taking in these perspectives helps us to better understand where to start and to know what actions will produce the most significant change for them. The researchets aim to involve people affected by leprosy from the early stages of this study through an initial survey that will help in describing the landscape of the lives of people affected by leprosy in the Ethiopian context. Findings will guide the co-creation of interview guides as well adapting economic questionnaires which will explore changes in household socioeconomic status of people affected by leprosy, cost of illness and coping strategies over a period of 3 years.

The researchers will also look at available data in published literature and reports, interview people and organisations working with people affected by leprosy and map participants’ “patient journey” as a way of visualising the issues encountered from noticing the first symptoms to getting the right treatment and beyond. This study will be conducted at ALERT hospital in Addis Ababa, the main leprosy hospital in Ethiopia. People with leprosy attending for treatment will be approached and informed about the research. If they are willing to participate, they will be invited to take part in one or two parts of the study and their clinical data will be recorded.

• Grant: RESILIENTD Grant
• Budget round: 2025
• Research priorities: Diagnostic tests
• Country: Côte d’Ivoire, Nigeria
• Project no.: NTD FP25\102
• Budget: €154,051
• Duration: April 2025 - March 2028
• Status: Ongoing

Project coordination
Effect Hope

Partners
Liverpool School of Tropical Medicine
Ahmadu Bello University, Zaria
Hope Commission International

Aim: The study aims to understand Peer support groups (PSG) sustainability from the perspective of group members, and to identify barriers and drivers for sustainability of PSGs established in Nigeria and Côte d’Ivoire,

Full project title:

Project summary

Peer support groups (PSGs) are instrumental in empowering individuals affected by Neglected Tropical Diseases (NTDs) and addressing social determinants of health (SDoH), focusing on social inclusion, livelihoods and advocacy. However, sustainability is often compromised, with activities diminishing over time without continual financial and technical support. To address this critical gap, the researchers aim to understand: What are the key factors influencing the sustainability of Peer support groups (PSGs) for individuals affected by skin-NTDs?

The  research team seeks to assess and enhance sustainability and ownership of existing PSGs in Nigeria and Côte d'Ivoire to operationalise best practices and harmonise long-term impact measures. PSGs were established in Nigeria through COUNTDOWN, an  implementation research project in collaboration with the Federal Ministry of Health in 2020-2021. Groups have continued to operate despite the end of the project. Therefore PSGs will be revisited to identify contributing factors to their sustainability  three years post-establishment. Additionally, the RESTORE project is currently piloting PSGs in Côte d'Ivoire.

Working in partnership with persons affected as co-researchers, the researchers will conduct interviews with stakeholders and facilitate a series of creative participatory workshops to map the steps towards sustainability and empowerment. Through the course of the research study, the research team will: Examine the current status of existing PSGs to identify barriers and drivers of sustainability and empowerment; Evaluate the impact of PSGs on the SDoH of members; and implement co-developed indicators for sustainability and empowerment and best practices for existing groups for a harmonised PSG model, ultimately accelerating WHO 2030 targets for enhanced person-centred NTD care. Learnings will be applied to further adapt PSGs through their different developmental stages, promoting cross-country knowledge exchange.

• Grant: LRI Regular Grant
• Budget round: 2025
• Research priorities: Disability
• Country: Brazil
• Project no.: FP25\25
• Budget: €173,238
• Duration: 48 months
• Status: Not yet started
• Co-funding partners: Turing Foundation

Project coordination
Oswaldo Cruz Foundation

Aim: The primary objective of this project is to obtain the inverse genomic signature of ENL based on the proposition that this drug signature should have a therapeutic benefit if it generates a gene expression profile that is the inverse of the signature associated with the ENL.

Full project title: Decoding Therapeutic Landscapes: Unravelling the Inverse Genomic Signature of Erythema Nodosum Leprosum
(ENL) for Neutrophil-Targeted Interventions

Project summary

In recent studies, researchers have been meticulously analysing how our genes respond to infections. They focused on a condition called erythema nodosum leprosum (ENL), which affects people with leprosy. They compared the genes of leprosy patients with ENL to those without it, as well as to patients who started taking thalidomide, a medicine used to treat ENL in Brazil. Thalidomide typically helps reduce ENL symptoms within few days. Previously, they studied the genes in skin lesions of ENL patients and found certain genes linked to a type of white blood cell called neutrophils. Now, the research team wants to find the opposite pattern of genes, hoping it will lead to new treatments for ENL. The researchers plan to use computer analysis to find drugs that could target these genes and then test them in the lab using neutrophils from healthy people and leprosy patients with or without ENL. This meticulous research process ensures the validity of the findings and the potential to improve the lives of people affected by ENL.

• Grant: LRI Regular Grant
• Budget round: 2025
• Research priorities: Transmission
• Country: Brazil
• Project no.: FP25\19
• Budget: €247,235
• Duration: 36 months
• Status: Not yet started

Project coordination
University of Salford

Partners
University College London
Manchester Metropolitan University
Universidade Estadual da Paraíba
Universidade Federal do Piauí
Universidade Estadual do Ceará
Centro Universitário Aparício Carvalho
Universidade Federal do Mato Grosso
ICAS, Brazil
Instituto de Desenvolvimento Sustentável Mamirauá
Virginia Tech 
Universidad de Málaga
Hospital Giselda Trigueiro - Natal/RN
Universidade Federal do Pernambuco
Instituto Lauro de Souza Lima

Aim: As a primary objective, this research seeks to address significant knowledge gaps by exploring the geographic distribution and prevalence of both M. leprae and M. lepromatosis in armadillos collected from 10 states in Brazil. 

Full project title: Unveiling the zoonotic dynamics of Leprosy in Brazil: a molecular exploration and surveillance approach

Project summary

This project aims to investigate the transmission dynamics of M. leprae between humans and armadillos in Brazil. Armadillos are regularly hunted in Brazil, and there is evidence suggesting that contact between humans and armadillos increases the risk of contracting leprosy. In contrast, in the United States, where interactions between humans and armadillos are less frequent, leprosy is acknowledged as a disease that can spread from these animals to humans. Brazil reports a significant number of leprosy cases each year (around 28,000), and it is known that two groups of armadillos, Dasypus and Euphractus, can naturally carry the leprosy bacteria, M. leprae. However, the mechanisms behind M. leprae transmission from armadillos to humans in Brazil are still poorly understood.

In this context, this project will attempt to find answers to three main questions: 'How common is leprosy among armadillos in Brazil?', 'Are there different types of the leprosy bacteria in armadillos?' and 'Does the same bacterial strain occur in armadillos and humans?'.
To tackle these questions, we have assembled a diverse team of researchers and conservationists from 10 states in Brazil.  The research team will work closely together with local communities to collect and analyse samples from hunted armadillos to better understand leprosy prevalence in these wild animals.  Samples of humans affected by leprosy will also be analysed to compare with the strains found in armadillos.

Conventional and new DNA sequencing techniques will be used to analyse the genome of the bacteria responsible for leprosy in both human and armadillo populations. The research will focus not only on detecting the bacteria causing leprosy but also on investigating their genetic similarity and potential resistance to treatment. By elucidating the M. leprae transmission routes between humans and armadillos, the project aims to enhance public health interventions for disease prevention and control.