Botnar Research Centre ramping up first activities for improving child health

The 10-year research and application programme of the Botnar Research Centre for Child Health (BRCCH) brings together scientists and clinical researchers from a variety of disciplines. The Centre aims to develop tangible results in paediatrics to prevent diseases, improve diagnosis and develop new treatments for global use in child and adolescent’s health.

Which healthcare solutions are urgently needed for children in Switzerland and elsewhere; how do the different partners – here and there – contribute; and what will ETH Zurich’s contribution be? In this first part of a 2-part interview, the BRCCH Director Georg Holländer, Professor for Paediatric Immunology at the University of Basel and head of the Department of Paediatrics, University of Oxford, and his Deputy Sai Reddy, D-BSSE Associate Professor for Systems and Synthetic Immunology, ETH Zurich, reply to the various questions surrounding the ramping up of research activities of the newly-founded Botnar Research Centre

The Centre aims to provide healthcare solutions for children worldwide. Can you give some examples: which healthcare solutions are urgently needed by children in Switzerland and what do children need in low and middle-income countries?

Georg Holländer: We envision that the need in northern hemisphere healthcare, i.e. industrialised nations, is comparable and similar in nature to what is needed in low and middle-income countries. However, the resources and the way how these resources are employed clearly differ. We don’t see that for example, a device would specifically be generated for one of these countries and could not necessarily be supplied in low or middle-income countries. We would wish to make sure that these devices are useful, robust and provide the kind of step-changing quality that we seek. For example, imaging technology is now possible to have in small hand-held devices. And these devices can be both used in remote areas in Africa for an individual who has gastro-intestinal symptoms of a kind where you need to decide: is that now something that requires surgical attention or will it resolve on its own. In principal in nature, this same device can also be used here in Switzerland, for quick decisions at home, if a doctor goes out on home visits and sees patients. Or under conditions where even in Switzerland resources are limited, for example when you are somewhere in a remote place, in the Alps, with a couple of youngsters over the summer where you would wish to have this useful device. We would think that the complexity of the nature of what is being diagnosed could be greatly assisted if the information would go from where it is acquired to a place where it is processed, analysed and then fed back to the person who held that device in the first place. So, for low and middle-income countries it could be that the device is being used in the periphery and the university hospital has the knowledge of processing the data and provides the necessary service. Or it could be across the globe in a university hospital here in Switzerland where this service is offered as a support for low and middle-income countries. Such a device could have its benefits here and clearly its benefits in low and middle-income countries.

You are referring to devices that are already existing and will be adapted to their use in other countries. Will novel technologies also come out of the Botnar Research Centre?

GH: Primarily, novel technologies are to be developed. As a second activity, devices will be adapted that have in principle value in Switzerland but are too complex, too big, too expensive and you can actually simplify it, modify it and make it more mobile in its application. To give another example: there are certain infections and genetic diseases of the eye which have been diagnosed by a set-up where you have a fairly large sized instrument which has to be transported to the patients so that the retina of the eye can be inspected. If you have a device which requires a lorry to get from A to B and if that lorry needs to get through the bush it will not happen. If however, it is now a device of small size which you put onto your mobile phone and the patient looks into it and you can have 95% of a qualified analysis done, than that would be step-changing: it is a clear improvement of something that was originally invented but because of its nature or its engineering could not be employed in low and middle-income countries. That would be something else we would wish to see realised within the Botnar Research Centre.

Sai Reddy: I think, in general, just the opportunity to take advantage of data sciences as they become much more ubiquitous and available and corresponding play an increasingly important role in digital and mobile health. So, it is not only on this device and instrument level but also on software level and the informations/data sciences level. Those disciplines are going to play a major role in the Botnar Research Centre. We also think that innovative molecular and cellular approaches to control health have been developed in the last few years and advanced areas such as regenerative medicine or translational immunology, genomics and molecular engineering, and cellular engineering. And all of these as well are starting to converge with data science and various approaches in machine learning and artificial intelligence.

GH: The latter is relevant because one aspect clearly is, both for the Fondation Botnar but also for us: can we use this data to predict and prevent disease. We wish to basically anticipate the progression of disease and intervene as early as possible. Data-driven algorithms will tell us what is the normal trajectory of a disease, where is it important to intervene so that a pathological state can be deflected.

A novel feature of BRCCH are research streams. What exactly happens here in Switzerland and what in low and middle-income countries?

SR: That is a tough question! I would say: at this point we are not creating any pre-determined definitions or expectations. We are allowing the science to lead the way. As individual projects and consortia come together and try to make this impact on child health, we are trusting the project partners to have a strategy how to implement their programme, we will not tell them in a top-down manner to - say - go to Tanzania and implement this method or device!

GH: The Botnar Research Centre is designed to be completely science-driven. So, if you require a particular critical input then we expect that the research projects are able to secure those with our help. We will also over time identify expertise that is missing in BRCCH and its affiliated members (or partners) and will then invest in new professorial posts to really provide the kind of knowhow, knowledge, and capacity required for those step-changing research projects. But as Sai said, we have no rigid concept of how a stream should look like. We really think that the coherence comes through content, which is the science.

What type of institutions will be involved in low and middle-income countries, and what will their contributions be?

SR: I think at this point because projects have not been funded yet and we don’t know yet what is going to happen there is no firm definition for the kind of institutions involved. There will be a better opportunity after we know what proposals have been funded and move forward to really define how that will look.

GH: You can think of various structures. It could be an institution that happens to run a day-clinic for the kind of patients for which you have developed a tool. Or a question that requires a clinical trial. It could be an institution that is slightly removed and provides local knowhow to shape with us for example, a software programme in a local language that allows disease monitoring. Whatever is an integral part of the success of the project that we fund: we are very happy to see partnerships established that help to contribute to the successful completion of what we fund.

Sai, where do you see the greatest innovation potential for ETH Zurich in its contribution to the BRCCH?

SR: ETH Zurich is very well known for many of the technological innovations and engineering expertise. Broadly you could say that ETH is very strong in artificial intelligence and machine learning, the D-BSSE as well is also very strong in system’s biology and genomics, and synthetic biology. We expect many of the excellent technologies developed at ETH to contribute to this research centre. Also, in addition to D-BSSE, other ETH-departments will contribute with their expertise in machine learning and computational biology, systems biology, synthetic biology as well as health sciences engineering.

Thank you!