Scaling up delivery of HIV services in Africa through harnessing trends across global emerging innovations.

Globally, innovations for HIV response present exciting opportunities to enhance the impact and cost-effectiveness of any HIV program. However, countries especially in the African region are not on equal footing to effectively harness some of the existing innovations to accelerate impact on HIV services delivery. This paper aims to add to the discourse on innovative solutions to support countries to make informed decisions related to technologies that can be adapted in different contexts to strengthen HIV programs. A scoping review which involved a search of innovations that can be used in response to the HIV epidemic was carried out between June 2021 and December 2022. The results showed that a high level of technological advancement occurred in the area of digital technologies and devices. Out of the 202 innovations, 90% were digital technologies, of which 34% were data collection and analytics, 45% were mobile based applications, and 12% were social media interventions. Only 10% fell into the category of devices, of which 67% were rapid diagnostic tools (RDTs) and 19% were drone-based technologies among other innovative tools. The study noted that most of the innovations that scaled relied on a strong ICT infrastructure backbone. The scoping review presents an opportunity to assess trends, offer evidence, and outline gaps to drive the adoption and adaptation of such technologies in Africa.

Leveraging innovation technologies to respond to malaria: a systematized literature review of emerging technologies.

BACKGROUND: In 2019, an estimated 409,000 people died of malaria and most of them were young children in sub-Saharan Africa. In a bid to combat malaria epidemics, several technological innovations that have contributed significantly to malaria response have been developed across the world. This paper presents a systematized review and identifies key technological innovations that have been developed worldwide targeting different areas of the malaria response, which include surveillance, microplanning, prevention, diagnosis and management. METHODS: A systematized literature review which involved a structured search of the malaria technological innovations followed by a quantitative and narrative description and synthesis of the innovations was carried out. The malaria technological innovations were electronically retrieved from scientific databases that include PubMed, Google Scholar, Scopus, IEEE and Science Direct. Additional innovations were found across grey sources such as the Google Play Store, Apple App Store and cooperate websites. This was done using keywords pertaining to different malaria response areas combined with the words "innovation or technology" in a search query. The search was conducted between July 2021 and December 2021. Drugs, vaccines, social programmes, and apps in non-English were excluded. The quality of technological innovations included was based on reported impact and an exclusion criterion set by the authors. RESULTS: Out of over 1000 malaria innovations and programmes, only 650 key malaria technological innovations were considered for further review. There were web-based innovations (34%), mobile-based applications (28%), diagnostic tools and devices (25%), and drone-based technologies (13%. DISCUSSION AND CONCLUSION: This study was undertaken to unveil impactful and contextually relevant malaria innovations that can be adapted in Africa. This was in response to the existing knowledge gap about the comprehensive technological landscape for malaria response. The paper provides information that countries and key malaria control stakeholders can leverage with regards to adopting some of these technologies as part of the malaria response in their respective countries. The paper has also highlighted key drivers including infrastructural requirements to foster development and scaling up of innovations. In order to stimulate development of innovations in Africa, countries should prioritize investment in infrastructure for information and communication technologies and also drone technologies. These should be accompanied by the right policies and incentive frameworks.

Towards a Healthcare Innovation Scaling Framework-The Voice of the Innovator.

This paper investigates the systemic challenges that African healthcare innovators experience in the quest to scale their innovations. The aim is to aggregate insights and to conceptualize a foundation towards building a framework that can be used as a guide by intermediary organizations and global partners to support collaborative innovation in African countries. These insights were gained from analyzing a dataset of survey responses obtained from a follow-up on 230 innovators who took part in the inaugural WHO Africa Innovation Challenge that was held in 2018. The insights led to the identification of 10 key foundational blocks that assist in ecosystem management in a bid to strengthen national health innovation ecosystems and to improve the sustainability and integration of innovations in the health system.

Data revolution, health status transformation and the role of artificial intelligence for health and pandemic preparedness in the African context.

BACKGROUND: Artificial Intelligence (AI) platforms, increasingly deployed in public health, utilize robust data systems as a critical component for health emergency preparedness. Yet, Africa faces numerous challenges in the availability, analyses, and use of data to inform health decision-making. Countries have limited access to their population data. Those with access, struggle to utilize these data for program improvements. Owing to the rapid growth of mobile phone ownership and use in the region, Africa is poised to leverage AI technologies to increase the adoption, access and use of data for health. To discuss and propose solutions for responsible development and adoption of innovations like AI in Africa, a virtual workshop was organized from the 21st to 24th June, 2021. This report highlights critical policy dimensions of strengthening digital health ecosystems by high-level policymakers, technical experts, academia, public and private sector partners. METHOD: The four days' workshop focused on nine sessions, with each session focusing on three themes. Discussions during the sessions concentrated on public and private sectors, the academia and multilateral organizations' deployment of AI. These discussions expanded participants' understanding of AI, the opportunities and challenges that exist during adoption, including the future of AI for health in the African region. Approximately 250 participants attended the workshop, including countries representatives from ministries of Health, Information and Technology, Developmental Organizations, Private Sector, Academia and Research Institutions among others. RESULTS: The workshop resolved that governments and relevant stakeholders should collaborate to ensure that AI and digital health receive critical attention. Government ownership and leadership were identified as critical for sustainable financing and effective scale-up of AI-enabled applications in Africa. Thus, government is to ensure that key recommendations from the workshop are implemented to improve health sector development in Africa. CONCLUSIONS: The AI workshop was a good forum to deliberate important issues regarding AI for health in the African context. It was concluded that there is a need to focus on vital priorities in deploying AI in Africa: Data protection, privacy and sharing protocols; training and creating platforms for researchers; funding and business models; developing frameworks for assessing and implementing AI; organizing forums and conferences on AI; and instituting regulations, governance and ethical guidelines for AI. There is a need to adopt a health systems approach in planning for AI to reduce inefficiencies, redundancies while increasing effectiveness in the use of AI. Thus, robust collaborations and partnerships among governments and various stakeholders were identified as key.

The COVID-19 pandemic: research and health development in the World Health Organisation Africa region.

Concerns have been expressed about the view point of WHO AFRO concerning research for health in the African Region. WHO AFRO considers research a critical component in the improvement of health in the Africa region. Ensuring the effectiveness of our strategies, policies and programmes requires evidence. In the context of the ongoing COVID-19 outbreak, WHO research interests cover key areas of the response. The WHO AFRO consider research as critical in our efforts at protecting people against health emergencies and pandemics like the COVID-19 and ensuring universal access to proven interventions. In view of this, the WHO has taken steps to strengthen capacity for research in the region. The results of these efforts may take time to manifest but will surely do as we persist in our drive, with support from our partners.

The covid-19 pandemic: research and health development in the World Health Organisation Africa region

Concerns have been expressed about the view point of WHO AFRO concerning research for health in the African Region. WHO AFRO considers research a critical component in the improvement of health in the Africa region. Ensuring the effectiveness of our strategies, policies and programmes requires evidence. In the context of the ongoing COVID-19 outbreak, WHO research interests cover key areas of the response. The WHO AFRO consider research as critical in our efforts at protecting people against health emergencies and pandemics like the COVID-19 and ensuring universal access to proven interventions. In view of this, the WHO has taken steps to strengthen capacity for research in the region. The results of these efforts may take time to manifest but will surely do as we persist in our drive, with support from our partners

The RBBP6/ZBTB38/MCM10 axis regulates DNA replication and common fragile site stability.

Faithful DNA replication is essential for the maintenance of genome integrity. Incomplete genome replication leads to DNA breaks and chromosomal rearrangements, which are causal factors in cancer and other human diseases. Despite their importance, the molecular mechanisms that control human genome stability are incompletely understood. Here, we report a pathway that is required for human genome replication and stability. This pathway has three components: an E3 ubiquitin ligase, a transcriptional repressor, and a replication protein. The E3 ubiquitin ligase RBBP6 ubiquitinates and destabilizes the transcriptional repressor ZBTB38. This repressor negatively regulates transcription and levels of the MCM10 replication factor on chromatin. Cells lacking RBBP6 experience reduced replication fork progression and increased damage at common fragile sites due to ZBTB38 accumulation and MCM10 downregulation. Our results uncover a pathway that ensures genome-wide DNA replication and chromosomal stability.

Solution structure of RING finger-like domain of retinoblastoma-binding protein-6 (RBBP6) suggests it functions as a U-box.

Retinoblastoma-binding protein-6 (RBBP6) plays a facilitating role, through its RING finger-like domain, in the ubiquitination of p53 by Hdm2 that is suggestive of E4-like activity. Although the presence of eight conserved cysteine residues makes it highly probable that the RING finger-like domain coordinates two zinc ions, analysis of the primary sequence suggests an alternative classification as a member of the U-box family, the members of which do not bind zinc ions. We show here that despite binding two zinc ions, the domain adopts a homodimeric structure highly similar to those of a number of U-boxes. Zinc ions could be replaced by cadmium ions without significantly disrupting the structure or the stability of the domain, although the rate of substitution was an order of magnitude slower than any previous measurement, suggesting that the structure is particularly stable, a conclusion supported by the high thermal stability of the domain. A hallmark of U-box-containing proteins is their association with chaperones, with which they cooperate in eliminating irretrievably unfolded proteins by tagging them for degradation by the proteasome. Using a yeast two-hybrid screen, we show that RBBP6 interacts with chaperones Hsp70 and Hsp40 through its N-terminal ubiquitin-like domain. Taken together with the structural similarities to U-box-containing proteins, our data suggest that RBBP6 plays a role in chaperone-mediated ubiquitination and possibly in protein quality control.

RBBP6 interacts with multifunctional protein YB-1 through its RING finger domain, leading to ubiquitination and proteosomal degradation of YB-1.

RBBP6 (retinoblastoma binding protein 6) is a 250-kDa multifunctional protein that interacts with both p53 and pRb and has been implicated in mRNA processing. It has also been identified as a putative E3 ubiquitin ligase due to the presence of a RING finger domain, although no substrate has been identified up to now. Using the RING finger domain as bait in a yeast two-hybrid screen, we identified YB-1 (Y-box binding protein 1) as a binding partner of RBBP6, localising the interaction to the last 62 residues of YB-1. We showed, furthermore, that both full-length RBBP6 and the isolated RING finger domain were able to ubiquitinate YB-1, resulting in its degradation in the proteosome. As a result, RBBP6 was able to suppress the levels of YB-1 in vivo and to reduce its transactivational ability. In the light of the important role that YB-1 appears to play in tumourigenesis, our results suggest that RBBP6 may be a relevant target for therapeutic drugs aimed at modifying the activity of YB-1.