SUSTAINABLE SCIENCES INSTITUTE
113 EVERGREEN AVENUE, MILL VALLEY, CA 94102 www.sustainablesciences.org

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Organizations Filed Purposes: THE SUSTAINABLE SCIENCES INSTITUTE (DUNS XXX-XX-XXXX, EIN XXX-XX-XXXX) IS A 501C(3) INCORPORATED IN SAN FRANCISCO, CALIFORNIA IN 1998. SSI IS DEDICATED TO DEVELOPING ENDOGENOUS SCIENTIFIC RESEARCH CAPACITY IN RESOURCE-POOR SETTINGS WITH PRESSING HEALTH PROBLEMS. TO THIS END, SSI PROVIDES UNIQUE PROGRAMS TO DEVELOP AND SUPPORT SCIENTIFIC AND PUBLIC HEALTH COMMUNITIES AND SYSTEMS. SUBSIDIARIES OF SSI ARE INCORPORATED IN NICARAGUA (2004) AND EGYPT (2011). THERE IS ONE BOARD OF DIRECTORS LOCATED IN SAN FRANCISCO. ALL FUNDS ARE ADMINISTERED THROUGH SSI'S SAN FRANCISCO HEADQUARTERS WITH NICARAGUAN AND EGYPTIAN FIELD COMPONENTS IMPLEMENTED BY LOCAL STAFF. SSI'S PRESIDENT, EVA HARRIS PHD (PROFESSOR OF IMMUNOLOGY AND INFECTIOUS DISEASE, UNIV. OF CALIFORNIA, BERKELEY) BEGAN SSI'S FOUNDATIONAL WORK IN 1988 UNDER THE APPLIED MOLECULAR BIOLOGY/APPROPRIATE TECHNOLOGY TRANSFER PROGRAM AND WAS AWARDED A MACARTHUR GENIUS FELLOWSHIP IN 1997. SSI'S VICE PRESIDENT, DR. ED WAKIL (DIRECTOR, SAN FRANCISCO

THE ORGANIZATION PROVIDES TO THE DEVELOPING WORLD WITH TECHNICAL TRAINING, TOOLS AND SUPPLIES AND ONGOING COACHING TO HEALTH PROFESSIONALS AND SCIENTISTS.

RESEARCH ON INFECTIOUS DISEASE IN NICARAGUA SSI CARRIES OUT RESEARCH ON INFECTIOUS DISEASES IN NICARAGUA WITH COMMITTED RESEARCH FUNDING OF APPROXIMATELY $7 MILLION OVER THE NEXT THREE YEARS FROM GOVERNMENT SOURCES (NATIONAL INSTITUTES OF HEALTH, CENTERS FOR DISEASE CONTROL AND PREVENTION, US AGENCY FOR INTERNATIONAL DEVELOPMENT) VIA DIRECT AWARDS AND SUBCONTRACTS FROM LARGE RESEARCH UNIVERSITIES (UNIVERSITY OF CALIFORNIA, COLORADO STATE UNIVERSITY, UNIVERSITY OF MICHIGAN, MT. SINAI SCHOOL OF MEDICINE, STANFORD UNIVERSITY). SSI ALSO RECEIVES FUNDING FROM PRIVATE FOUNDATIONS (IBRAHIM EL-HEFNI TECHNICAL TRAINING FOUNDATION, BILL AND MELINDA GATES FOUNDATION, INSTITUTO SLIM PARA LA SALUD, UBS OPTIMUS FOUNDATION) AND CONTRACTS FROM SMALLER PRIVATE ORGANIZATIONS (SEVIDENT, PAXVAX). IN 2016, THE ZIKA PANDEMIC HIT LATIN AMERICA, INCLUDING OUR SITE IN NICARAGUA, REVEALING ZIKA'S RELATIONSHIP TO DEVASTATING CONGENITAL BIRTH DEFECTS. IN COLLABORATION WITH NICARAGUAN COLLEAGUES, SSI REFOCUSED ITS EXISTING DENGUE AND CHIKUNGUNYA RESEARCH TO ADDRESS URGENT QUESTIONS ABOUT ZIKA; EFFORTS TO DEVELOP AND EVALUATE NEW DIAGNOSTIC AND RESEARCH TECHNIQUES WERE INCORPORATED INTO EXISTING HOSPITAL AND COHORT STUDIES. SSI ALSO LAUNCHED STUDIES OF ZIKA'S INCIDENCE AND HOUSEHOLD TRANSMISSION PATTERNS, A LONGITUDINAL STUDY OF ZIKA IN PREGNANT WOMEN AND INFANTS, AND AN INNOVATIVE COMMUNITY-BASED INTERVENTION FOR ZIKA PREVENTION. THIS INTEGRATED APPROACH ENABLES STUDY OF ZIKA'S CLINICAL ASPECTS, EPIDEMIOLOGICAL AND IMMUNOLOGICAL RESPONSES, MODELING OF THE INTERACTIONS BETWEEN IMMUNE RESPONSES, AND EXPANSION OF COMMUNITY-BASED EFFORTS TO PREVENT ZIKA AS WELL AS DENGUE. THIS RESEARCH CONTINUES TO SHOWCASE OUR COLLABORATING SITE IN NICARAGUA WHICH HAS BECOME INTERNATIONALLY RENOWNED FOR ARBOVIRUS DIAGNOSIS, RESEARCH AND EPIDEMIOLOGY. IN NICARAGUA, SSI'S STUDIES HAVE RECEIVED FAVORABLE NATIONAL PRESS, STRONG GOVERNMENT SUPPORT, AND HIGH REGARD WITHIN THE COMMUNITIES WHERE WORK IS CONDUCTED. FOR THE LAST TEN YEARS, SSI HAS BEEN WORKING TOWARDS UNDERSTANDING THE EPIDEMIOLOGY AND CLINICAL PRESENTATION OF INFLUENZA AND OTHER RESPIRATORY VIRUS INFECTIONS IN NICARAGUA. IN LATE 2015, SSI-NICARAGUA WAS SELECTED AS ONE OF FOUR SITES TO CONDUCT A CDC-FUNDED STUDY EXAMINING INFLUENZA PREVENTION AMONG INFANTS THROUGH VACCINATION. THIS STUDY, AND ANOTHER EXAMINING INFLUENZA TRANSMISSION WITHIN HOUSEHOLDS, ARE CONDUCTED IN CLOSE COLLABORATION WITH THE NICARAGUAN MINISTRY OF HEALTH AND THE UNIVERSITY OF MICHIGAN. SSI RECEIVES CONTINUED SUPPORT OF ITS INFLUENZA COHORT STUDY FROM THE NIH CENTER OF EXCELLENCE FOR INFLUENZA RESEARCH AND SURVEILLANCE AT THE ST. JUDE CHILDREN'S RESEARCH HOSPITAL. SSI, IN COLLABORATION WITH THE NICARAGUAN MINISTRY OF HEALTH AND THE UNIV. OF CALIFORNIA AT BERKELEY, CONTINUES TO OPERATE THE PEDIATRIC DENGUE COHORT STUDY (NOW IN ITS 14TH YEAR) AND THE HOSPITAL-BASED STUDY (NOW IN ITS 20TH YEAR) IN MANAGUA. THESE COHORT STUDIES SUPPLY THE INFRASTRUCTURE AND BIOREPOSITORY THAT ALLOWS SSI AND ITS PARTNERS TO BE LEADERS IN GLOBAL ARBOVIRUS RESEARCH. EACH YEAR APPROXIMATELY 3,600 CHILDREN PARTICIPATE PROVIDING INVALUABLE BIOLOGICAL SAMPLES USED TO STUDY DETERMINANTS OF PROTECTION FROM, AND RISK OF, DENGUE, ZIKA AND CHIKUNGUNYA DISEASE. IN 2017, OUR RESEARCH RESULTED IN A NUMBER OF HIGH-IMPACT PUBLICATIONS AND SCIENTIFIC PRESENTATIONS. SSI IS ADAPTING ITS DENGUECHAT TOOL FOR COMMUNITY-BASED RESEARCH ON ZIKA. THE DENGUECHAT TOOL, DEVELOPED AT UNIV. OF CALIFORNIA AT BERKELEY, IS A FREE TECHNOLOGY THAT SUPPORTS COMMUNITY-LEVEL MOSQUITO CONTROL EFFORTS. THE PLATFORM ALLOWS A HEALTH TEAM - BRIGADISTAS DE SALUD Y VIDA - TO CAPTURE ENTOMOLOGICAL DATA, VISUALIZE HIGH-RISK AREAS, AND MEASURE IMPACT OVER TIME. DENGUECHAT EMPOWERS THE COMMUNITY TO PRODUCE AND SYSTEMATIZE LOCAL, REAL-TIME DATA TO MAKE DECISIONS ABOUT MOSQUITO CONTROL TO PREVENT DENGUE, CHIKUNGUNYA AND ZIKA. THE PLATFORM'S BLOG ALLOWS COMMUNITY BRIGADES TO CONNECT, COMPETE, AND SHARE INFORMATION ENCOURAGING THEM TO BECOME KEY MOTIVATORS IN COMMUNITY MOBILIZATION AND HEALTH PROMOTION EFFORTS. IN THE FIVE COMMUNITIES WHERE DENGUECHAT WAS PILOTED, SIGNIFICANT REDUCTION IN MOSQUITO INFESTATION WAS MEASURED. WE ARE ADAPTING THIS PLATFORM TO ZIKA WITH THE AIM MONITORING VECTOR INFESTATION AND TRACKING ZIKA RISK IN MANAGUA'S URBAN AND RURAL NEIGHBORHOODS.

RESEARCH ON HEPATITIS C IN EGYPT AND BIO-REPOSITORY DEVELOPMENT TO IMPROVE UNDERSTANDING OF HEPATITIS C AND RELATED LIVER DISEASES, SSI-EGYPT AND ITS OPERATIONAL BRANCH IN CAIRO FOCUS ON DEVELOPING INVESTIGATORS' RESEARCH AND LABORATORY SKILLS THROUGH SUPPORT OF STUDIES AND ADVANCED TRAINING. SSI'S COLLABORATIVE ACTIVITIES IN EGYPT ARE APPROVED AND CERTIFIED BY THE GOVERNMENT OF EGYPT'S (GOE) MINISTRY OF FOREIGN AFFAIRS AND MINISTRY OF SOLIDARITY. MENOUFIYA UNIVERSITY'S NATIONAL LIVER INSTITUTE (MUNLI), IN COLLABORATION WITH SSI, SUPPORT A CENTER OF CLINICAL AND RESEARCH EXCELLENCE KNOWN AS THE NATIONAL LIVER INSTITUTE SUSTAINABLE SCIENCES INSTITUTE COLLABORATIVE RESEARCH CENTER (NLISSICRC). IN 2017-18, NLISSICRC STAFF ENGAGED IN TRANSLATIONAL RESEARCH PROJECTS, BANKING BIO-SAMPLES, AND PROMOTION OF TRAINING AND EDUCATION. DATA OBTAINED THROUGH THESE EFFORTS ARE DISSEMINATED AT LOCAL AND INTERNATIONAL SCIENTIFIC MEETINGS AND IN PUBLICATIONS. RESEARCH SUPPORT BY NLISSICRC HELPS INVESTIGATORS MEET REQUIREMENTS FOR COMPLETION OF THEIR GRADUATE DEGREES, AND TO OBTAIN PILOT DATA SUPPORTING THEIR APPLICATIONS FOR LARGER LOCAL AND INTERNATIONAL FUNDING OPPORTUNITIES. AS OF 2017, NLISSICRC HAD OVER 3,000 BIO-SAMPLES STORED IN ITS BIO-BANK AND ADDITIONAL SAMPLES ARE PROCESSED DAILY. NLISSICRC ANNUAL WORKSHOPS CONTINUE TO PROVIDE NLI STAFF WITH ADVANCED EDUCATION ON THE APPLICATION OF MOLECULAR BIOLOGY, TISSUE CULTURE, AND GENETIC ANALYSIS TO THE STUDY OF LIVER DISEASES.

CAPACITY-BUILDING WORKSHOPS LED BY SSI'S SCIENTIFIC DIRECTOR, MARIA ELENA PENARANDA PHD, SSI'S CAPACITY-BUILDING PROGRAM TRAINS AND TRANSFERS TECHNOLOGIES TO NASCENT SCIENTISTS AND HEALTH PROFESSIONALS AROUND THE WORLD VIA IN-COUNTRY, SHORT-TERM, INTENSIVE HANDS-ON WORKSHOPS. WORKSHOPS ARE FUNDED BY GOVERNMENT CONTRACTS, NON-GOVERNMENTAL ORGANIZATIONS, SCIENTIFIC INSTITUTIONS, UNIVERSITIES, PRIVATE FOUNDATIONS AND INDIVIDUAL DONORS. WORKSHOP TOPICS INCLUDE: TECHNIQUES FOR COST-EFFECTIVE DIAGNOSIS AND EPIDEMIOLOGICAL ANALYSIS OF REGION-ENDEMIC INFECTIOUS DISEASES, RESEARCH DESIGN, MANUSCRIPT WRITING FOR PUBLICATION, AS WELL AS PROPOSAL WRITING AIMED AT HELPING SCIENTISTS CRYSTALIZE THEIR IDEAS AND SUCCESSFULLY APPLY FOR LARGER FUNDING OPPORTUNITIES. SSI ENGAGES TALENTED BIOMEDICAL SCIENTISTS AND PROGRAM DIRECTORS - AND BY EXTENSION THEIR INSTITUTIONS - TO SERVE AS LOCAL TRAINERS AND MENTORS. USING THIS "TRAIN THE TRAINERS" APPROACH, SSI HAS DEVELOPED A NETWORK OF EXPERIENCED PEER TRAINERS AND TUTORS THAT HAS CONDUCTED OVER 100 WORKSHOPS AND TRAINED MORE THAN 2,500 HEALTH RESEARCHERS FROM 33 LOW INCOME COUNTRIES IN AFRICA, ASIA AND THE AMERICAS. THIS "TRAIN THE TRAINERS" MODEL, COMBINED WITH OUR LONG-TERM COMMITMENT, HAS BUILT ENDURING AND RESILIENT NETWORKS THAT EXPAND REGIONAL CAPACITY TO CONDUCT CLINICAL AND BASIC RESEARCH, DEVELOP CRITICAL SKILLS AND KNOWLEDGE BASE AMONG COLLEAGUES, AND SUPPORT REGIONAL SCIENTISTS TO EFFECT REAL CHANGE IN THE HEALTH OF THEIR COMMUNITIES. SSI'S WORK IS RECOGNIZED AS A MODEL FOR TECHNOLOGY TRANSFER AND CAPACITY BUILDING BY THE WORLD HEALTH ORGANIZATION (WHO), PAN AMERICAN HEALTH ORGANIZATION (PAHO), U.S. NATIONAL SCIENCE FOUNDATION, U.S. NATIONAL ACADEMY OF SCIENCES, THE GATES FOUNDATION, AND THE MINISTRIES OF HEALTH IN SEVERAL COUNTRIES. IN 2017, SSI TRAINED 116 HEALTH PROFESSIONALS IN SIX CAPACITY-BUILDING WORKSHOPS ON LABORATORY TECHNIQUES, SCIENTIFIC WRITING AND RESEARCH PROPOSAL PREPARATION. THE CENTER FOR EMERGING AND NEGLECTED DISEASES (CEND) INVITED SSI TO TEACH A PROPOSAL WRITING WORKSHOP FOR MASTER'S AND DOCTORAL STUDENTS AT MAKERERE UNIVERSITY IN KAMPALA, UGANDA. DUE TO SSI'S EXPERIENCE IMPLEMENTING THE LATEST TECHNIQUES FOR DETECTING AND DIAGNOSING ZIKA, DENGUE AND CHIKUNGUNYA VIRUSES, SSI ALSO RECEIVED A GRANT FROM THE CONSERVATION FOOD AND HEALTH FOUNDATION (CFHF) TO CONDUCT LABORATORY TRAINING IN CENTRAL AMERICA. THE WORKSHOP TOOK PLACE IN HONDURAS, WITH PARTICIPATION OF SCIENTISTS FROM PANAMA, NICARAGUA, EL SALVADOR, HONDURAS AND GUATEMALA.

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