20 February 2019

Global Alliance to Prevent Prematurity and Stillbirth (GAPPS)

2017

Commitment Progress

All of the work of GAPPS is aligned with the objectives of the Every Woman, Every Child initiative, and in particular the Every Newborn Action Plan. GAPPS leads a collaborative, global effort to increase awareness and accelerate innovative research and interventions that will improve maternal, newborn and child health outcomes around the world. GAPPS works to improve understanding of the causes and mechanisms of premature birth and stillbirth; success in these areas could ultimately impact up to 15 million preterm births and up to 3 million stillbirths each year.

As examples of our commitment, here are 4 projects currently underway:

1. The Preventing Preterm Birth Initiative, part of the Bill & Melinda Gates Foundation’s Grand Challenges in Global Health seeks to discover biological mechanisms that lead to preterm birth and develop innovative strategies for prevention, with particular focus on solutions relevant to low- and middle-income countries, where 99% of the world’s infant deaths occur. The initiative has recently  funded 3 additional systems biology studies to investigate mechanisms leading to preterm birth and has initiated 2 additional studies within international cohorts. The first study seeks to assess blood markers of gestational age in cord blood in Bangladesh and Zambia and the second is piloting a newborn screening program in Bangladesh.

2. The GAPPS Repository is the first standardized, widely-accessible collection of high-quality specimens linked to data from diverse populations of pregnant women. The repository supports research on normal and abnormal pregnancies, including how pregnancy affects maternal and child health after delivery, as well as fetal origins of diseases. The collection includes contributions from women representing a range of racial, ethnic, regional and socioeconomic backgrounds. Researchers can use existing specimens and data or arrange for prospective collections to meet specific project aims. The GAPPS Repository also offers technical assistance to increase harmonization across research sites to advance basic and translational research. The repository model has been expanded to several sites in low- and middle-income countries, including Zambia and Bangladesh, to create harmonized efforts to improve research and development for upstream discovery and downstream implementation/operations research. Funding support for the Zambia cohort site has recently been expanded and the repository continues ongoing enrollment across all sites (US and LMICs). Since this commitment was initiated, the GAPPS repository has resourced 12 scientific investigations evaluating mechanisms of preterm birth. We have also begun partnering with the novel NIH ECHO study, which is evaluating the effect of environmental factors during pregnancy on childhood health outcomes. The GAPPS Repository is providing specimens including urine, plasma, and placenta samples, as well as medical record abstractions and questionnaires completed by mothers throughout pregnancy. More than 1,100 Repository participants will also be recruited for follow up visits to understand the current health of their children

3. GAPPS, in conjunction with the Eunice Kennedy Shriver National Institute of Child Health and Human Development, March of Dimes and the Bill & Melinda Gates Foundation, has been developing a coalition of global funders of research on preterm birth to be known as the Global Coalition to Advance Preterm birth Research (G-CAPR). The mission of the G-CAPR is to identify and advance priority research through expanded networks, communications, and collaborations among organizations to fund the research needed to reduce preterm birth. Currently, the coalition is exploring opportunities to study the economic impact of preterm birth in low, middle, and high income countries.

4. In 2014, GAPPS was awarded a five-year United States Agency for International Development (USAID) cooperative agreement designed to expand delivery of evidence-based strategies, building on existing, integrated platforms in maternal, newborn, child and adolescent health and family planning in 23 USAID priority countries in Africa and Asia, called the Every Preemie – SCALE project. Every Preemie is a consortium of GAPPS, Project Concern International (PCI), and the American College of Nurse-Midwives (ACNM). USAID, through its Global Health office and its country missions, as well as national Ministries of Health, are key partners, as are organizations including academic institutions, national programs, and NGOs at the country level. GAPPS leads evidence and knowledge sharing, program learning, and implementation research activities for the project and convenes a Global Technical Working Group on Implementation Challenges and Solutions to provide a multi-discipline forum for emerging evidence, research and learning relevant across the range of preterm birth and low birth weight interventions and maternal and newborn health implementation in low-income countries. With more than 80 members worldwide, the group meets several times each year. GAPPS has also contributed to the development of five technical briefs highlighting safe and effective use of specific inpatient newborn care interventions. These documents are designed to provide stakeholders with evidence-based information regarding safe and effective inpatient care in low resource settings to avoid harm and improve health outcomes for newborns. Every Preemie is also developing implementation research capacity in several LMICs by supporting implementing partners to demonstrate success in improving prenatal care and treatment of preterm birth and low birth weight infants. The demonstration countries include: Bangladesh, Ethiopia, India, and Malawi. Demonstration projects include testing a simple method of gestational age estimation during pregnancy, evaluating the implementation of a multi-partner maternal and newborn health service delivery model from the community to the district hospital level, assessing the safe and effective use of antenatal corticosteroids (ACS) among women in imminent preterm labor, and assessing implementation of the Family-Led Care model designed to improve quality of facility-based care for early/small babies.

2015

Global Alliance to Prevent Prematurity and Stillbirth (GAPPS) commits to continuing to lead a collaborative global effort to increase awareness and accelerate innovative research and interventions to improve maternal, newborn, and child health outcomes around the world in support of the Global Strategy (2016-2030). The Preventing Preterm Birth Initiative will expand its portfolio with research using a systems biology approach to discover biological mechanisms underlying preterm birth and develop innovations for prevention, especially relevant to low- and middle-income countries. The GAPPS Repository – the first standardized, widely-accessible collection of high-quality specimens linked to data from pregnant women – will continue to drive harmonized efforts to improve discovery and implementation research by supporting expansion to study sites in low- and middle-income countries.

GAPPS will encourage collaboration among organizations that fund the research needed to reduce the global burden of preterm birth in its capacity as secretariat for the Global Coalition to Advance Preterm Birth Research. Additionally, GAPPS will partner on global advocacy campaigns to encourage increased financial commitments of the United States Government on maternal, newborn and child health, with a focus on expanding funding for research, prevention, and care.

2014-Every Newborn Action Plan

Global Alliance to Prevent Prematurity and Stillbirth (GAPPS) commits to continuing to lead a collaborative global effort to increase awareness and accelerate innovative research and interventions to improve maternal, newborn, and child health (MNCH) outcomes around the world. Three examples of their commitment are: 1) The Preventing Preterm Birth Initiative seeks to discover biological mechanisms underlying preterm birth and develop innovations for prevention, especially relevant to low- and middle-income countries (LMICs). In the next two years, at least one discovery will be moved forward to development of an intervention to reduce/prevent preterm birth; 2) The GAPPS Repository is the first standardized, widely-accessible collection of high-quality specimens linked to data from pregnant women. The model is expanding to study sites in LMICs for harmonized efforts to improve discovery and implementation research; and 3) The Global Coalition to Advance Preterm birth Research (G-CAPR) will be announced in July 2014 as a coalition of global funders of research on preterm birth, which includes GAPPS, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, March of Dimes, and the Bill & Melinda Gates Foundation, among others.

The mission of G-CAPR is to identify and advance priority research through expanded networks, communication, and collaboration among organizations to fund the research needed to reduce the global burden of preterm birth. Additionally, GAPPS will partner on global advocacy campaigns to encourage increased financial commitments of the US Government on MNCH, with a focus on funding research.

2012—Born Too Soon

Global Alliance to Prevent Prematurity and Stillbirth commits to leading global efforts to discover the causes and mechanisms of preterm birth and stillbirth. Research leadership includes stewardship of the Preventing Preterm Birth initiative, a Grand Challenges in Global Health from the Bill & Melinda Gates Foundation; operating the GAPPS Repository of maternal and newborn samples for researchers of pregnancy and newborn health; and guidance on research harmonization.

Additionally, GAPPS commits to expanding collaborative efforts to demonstrate the critical need for strategic investments in pregnancy and post-birth scientific research where large health gains can be achieved through the development of new, low-cost, high-impact innovations and developing a global advocacy campaign to promote the need for research and catalyze funding for it. GAPPS will work to make every birth a healthy birth.

2010

Global Alliance to Prevent Prematurity and Stillbirth commits to develop and uphold a Code of Conduct that puts forth standards of excellence for all repositories to be upheld in partnership with countries where repositories are being established; collaborate with its Research Harmonization Committee to developing repositories in consideration of efforts to enhance national capacity of the country’s healthcare and research sectors; work collaboratively with the local community to develop innovative approaches to engagement in research; evaluate the effectiveness of upholding the Code of Conduct and identify areas for further enhancement of operations in each country on an annual basis. Engage cross-sectors (nutrition, water, sanitation) in such efforts with the resolve of conducting the most comprehensive research to achieve improved birth outcomes. Share best practices in research at a conference in 2012 for all organizations and publish a case statement outlining the critical need for strategic investments in pregnancy and post-birth scientific research where large health gains can be achieved through the development of new, low-cost, high-impact innovations and develop a global advocacy campaign to catalyze funding to promote the utilization of new science, technology and tools to advance research and development on pregnancy and early life.

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