INCOBRA - Increasing International Science, Technology and Innovation Cooperation between Brazil and the European Union

Today we present you the STI-Net Network, one of the 5 EU-Brazil STI cooperation networks selected by INCOBRA to receive a 19500€ grant and light mentoring support.

What are STI-Net objectives?

The overall aim is to form an alliance between existing networks and additional partner organisations in EU and Brazil that incorporates key personnel from public health, clinical, academic and laboratory disciplines involved in sexually transmitted infections (STI) and antimicrobial resistance (AMR) surveillance by the end of 2018. In the next five years, the network will exchange expertise and support delivery of national surveillance programmes, innovations in healthcare pathways and scientific research focused on STIs and AMR between Brazil and the EU. 

The key objectives of the network are to:

1. Strengthen and extend existing, national surveillance programmes for STIs and associated AMR in Brazil and the EU covering Neisseria gonorrhoeae (NG), Treponema pallidum (TP) and Mycoplasma genitalium (MG) to inform a cohesive, rapid and effective public health response. The programmes will introduce appropriate diagnostics and test clinical samples from key populations to provide insights into the epidemiology, spread and impact of STIs and AMR in the Brazilian and EU populations. 
2. Use whole genome sequencing (WGS) linked to individual-level surveillance records to investigate STI transmission and the emergence of AMR across and between Brazil and Europe and create a unique scientific information resource that will be made publicly available to the scientific community to allow further research. 
3. Co-develop appropriate and feasible systems for piloting digital connectivity between STI and AMR test results and public health surveillance based on timely, electronic reporting of diagnostic results, data-matching algorithms and automated surveillance outputs by exploring development of participative surveillance apps, real-time data integration and analytics platforms, and digital dashboards for healthcare providers.
4. Pilot innovative, digital service models to enhance patient healthcare pathways through rapid turnaround times for appointment booking, risk assessment, testing, results and treatment, as well as mobile apps fostering behavioural change, similar to those in the internationally recognised, award-winning “Dean Street Express” and “Dean Street PRIME” innovations (http://express.dean.st /; http://prime.dean.st/ ). 
5. Co-develop guidelines and research protocols to investigate the impact of a new biomedical intervention for HIV, pre-exposure prophylaxis (PrEP), which is in the process of being implemented in Brazil and parts of the EU, on the incidence of STIs and associated AMR.
6. Produce jointly-authored scientific publications and presentations at national and international conferences and for expert organisations.
7. Support the business case being developed by PHE Global Public Health for funding from the UK Cross-Government Prosperity Fund which seeks to assist countries to develop, support poverty reduction and reduce inequalities, including gender inequalities. 
8. Provide a foundation for establishing a global surveillance network and a framework for developing innovative research proposals to major EU and other relevant funding programmes in a range of low, middle and high-income countries.  

Which are the potential impacts yielded from your network for?

1. Improved  healthcare delivery through implementation of innovative, timely and cost-effective service models for STI screening in key populations.
2. Better detection and treatment of STIs through establishment of advanced microbiological, molecular and genomic testing systems.
3. A more effective global response to combat the spread of STIs, associated AMR and poor health outcomes through establishment of sustainable and responsive STI surveillance systems.

What are the main activities carried out so far, and the main achievements in strengthening EU-BR research and innovation (R&I) cooperation in your thematic area?

1. Successful two-day workshop held in São Paulo including 19 presentations and four  extended discussion sessions, and where priorities for inclusion in applications for research and development funding were discussed and agreed.
2. Reciprocal three-day workshop held in London, which resulted in:

a. Visits to two innovative STI service providers in London (Dean Street Express and ClinicQ) by Brazilian participants to explore potential for service delivery developments in Brazil.

b. Description and specification for each pathogen of samples to be collected and diagnostic platforms to be used for culture and molecular STI testing. 

c. Comprehensive description and specification of the existing  and proposed data sample sources and clinical and epidemiological data for enhanced surveillance.

d. Identification of important gaps in research.

e. Specification of four key work-packages for programme grant applications with associated objectives and research questions. 

3. Meeting with WHO lead for STI AMR to discuss scope and opportunities for expansion of STI-Net was held and the importance of establishing a global collaboration on STI AMR was agreed.

Which are the most beneficial outcomes of bringing together the participants of the network in the foreseen events/meetings?

Face to face meetings and events:

1. Facilitate improved understanding of existing resources¸ knowledge and skills that are available both within and across countries, which in turn, maximises the potential for more effective and efficient use.
2. Enable identification of common interests and priorities.
3. Strengthen professional links.
4. Build trust, cooperation and commitment to a shared goal.

What are the plans for the future? 

• Identify work package teams and leads for development of a major programme grant.
• Write technical descriptive proposals for each work package.
• Identify appropriate funding calls and/or mechanisms.
• Explore opportunities for financial support from diagnostic companies.
• Develop a platform to connect with global STI surveillance networks through collaborations with leading academics, public health professionals and the World Health Organization.