ࡱ > bjbj[[ 9 9 % % % 2 4 3 % ; b t7 p 7 ( 8 8 8 D E *F H 6 8 8 8 8 8 8 $ O \ rF LC " nC N rF rF \ 8 8 @ V V V rF 8 8 6 V rF 6 V V X} 8 h\l G < 6 " 0 ; r 6 T l rF rF V rF rF rF rF rF \ \ V rF rF rF ; rF rF rF rF rF rF rF rF rF rF rF rF rF : T i t l e o f P r o p o s a l T i t l e ( m a x i m u m 5 0 w o r d s o r 3 5 0 c h a r a c t e r s ) A c r o n y m A c r o n y m ( m a x i m u m 2 0 c h a r a c t e r s ) D u r a t i o n ( m o n t h s ) E D C T P c o n t r i b u t i o n ( ) C o o r d i n a t o r I n s t i t u i o n C o u n t r y N a m e G e n d e r P a r t i c i p a n t s T a b l e O f C o n t e n t s Summary information Title(maximum 50 words or 350 characters) Acronym(maximum 20 characters) Abstract(maximum 400 words) Keywords (maximum 5 keywords) Proposed start date Proposed duration Excellence Residency (maximum 250 words) Employment contract (maximum 25 words) Previous Project(maximum 500 words) Publications (5-20)(each maximum 150 words) Presentations(maximum 500 words) Career Summary and Motivation statement(maximum 1200 words) Proposal(maximum 5000 words) Letter of support from the director of the Host Organisation Graphic File in support of application Clinical trials (If relevant) Impact Career development (maximum 1500 words) Expected impact (maximum 2500 words) Data management and ownership (maximum 1500 words) Results and dissemination (maximum 1500 words) Implementation Mentor Previous activities (maximum of 500 words) Publications (maximum of 1000 words) Letter of support from the mentor Letter of support from the Director of the Host Organisation References(maximum of 50 references) Workplan (Maximum of 1500 words) Work Packages Work package(s) List of deliverables from work packages List of milestones from work packages Gantt chart or similar document upload (optional, limit 1 page) Risk Management List of critical risks for implementation Budget Budget justification (maximum 6000 words) Budget justification (maximum 6000 words) Budget justification support document (optional) Supporting information and related applications Ethics issues table Declarations Nomination and exclusion of reviewers Nomination of independent expert reviewers (limit 3 individuals) Exclusion ofindependent expert reviewers (limit 3 individuals) Please note the following important points: This template is provided to assist applicants in preparing their EDCTP2 proposals. Please be advised that all information must be transferred to the application form online. Only applications prepared and submitted online via EDCTPgrants will be accepted by EDCTP. This template reflects the PDF rendering of the online application form. The order of the questions may differ in the online application system EDCTPgrants. In the case of a discrepancy between the word form and the online form on EDCTPgrants, the online form takes precedence. It is strongly advised that applicants allow ample time to prepare and submit the online form. Do not wait until the final day to submit your application, or you run the risk of missing the deadline. Also note that the online system allows for a save and return of content already filled in. Administrative Data of Participating Organisations Coordinator Name of legal entity that will act as the CoordinatorThe Coordinator is the legal entity (host organisation) that submits the application in conjunction with the fellow. The Coordinator (host organisation) must be an established legal entity in sub-Saharan Africa that employs the fellow or guarantees employment to the fellow for the duration of this fellowship and for two years post-fellowship. Participant Identification Code (PIC number) HYPERLINK "https://ec.europa.eu/research/participants/portal/desktop/en/organisations/register.html" \t "_blank" [PIC number information]PIC number is the 9-digit Participant Identification Code allocated to legal entities that are registered in the HYPERLINK "https://ec.europa.eu/research/participants/portal/desktop/en/organisations/register.html" \t "_blank" Beneficiary Register of the European Commission. EDCTP will only sign grant agreements with organisations that have a PIC number. You may submit an application to EDCTPgrants without having first obtained a PIC number but you are advised to apply immediately to the European Commission to obtain a PIC number. The instructions for registration can be found here and you can also search whether your organisation already has a PIC number: HYPERLINK "https://ec.europa.eu/research/participants/portal/desktop/en/organisations/register.html" \o "Pic number registration" \t "_blank" [PIC number information] Official address of the registered legal entityAddress1 Address2 Address3 City Postcode Country Web page Legal Representative Name of Legal RepresentativeEmail of Legal RepresentativeA legal representative is a natural person who has been empowered (directly or indirectly) by a legal entity to enter into legal commitments on its behalf. Legal status of organisation Private or Public organisation Public means any legal entity established as public body by national law or an international organisation. Established as public body by national law means: incorporated as a public body in the act of creation or recognised as a public body by national law and governed by public law. Public bodies may act under and be subject to private law for some or most of their activities. A legal entity that has a public service mission but which was established under private law is not considered to be a public body. Legal status of organisation 'Not-for-profit means a legal entity that is by its legal form non-profit-making or has a legal or statutory obligation not to distribute profits to its shareholders or individual members. Decisions on (not) distributing profits made by its managing board, associates, stakeholders, members or representatives are not sufficient proof of the non-profit nature. It can be a public or a private entity. Coordinator's Organisation statusPlease select the most relevant category for the organisation. For more information see the HYPERLINK "http://ec.europa.eu/research/participants/data/ref/h2020/grants_manual/lev/h2020-guide-lev_en.pdf" \t "_blank" H2020 guide to Beneficiary registration, validation and financial viability check The information provided should match the organisation information that you provided on registration with EDCTPgrants and be consistent with the information provided to the European Commission when you register(ed) for the PIC number. Summary Information TitleThe title should reflect the contents of the proposal (25 words) Acronym Abstract The abstract should be a short summary, of maximum 400 words, to explain clearly: The aims and objectives of the proposal How they will be achieved The fit with the scope and objectives of EDCTP and the call topic description How the proposal will contribute to the expected impacts in the workplan and the call topic description Do not include any confidential information. Use plain typed text, avoiding formulae and other special characters. Please note that the abstract will be made publicly available should your proposal be funded. Keywords Keyword ListBy clicking on the+ symbol, an expandedlist of keywords applicable to the EDCTP remit will appear. Please choose keywords which describe the scope of your proposal. Other keywords relevant to your field can be added using the Add Other Keyword link. The total number of keywords should not exceed five. Other keywords Proposed start dateThe actual start date may be later than this date and will depend on when the grant agreement is signed. It is expected that the grant agreement will be signed approximately 8 months following the deadline of the call for proposals. Bearing this in mind, please select an appropriate date, making the start date the first day of the month. Proposed durationPlease refer to the call text and select the appropriate duration in months.Excellence Please make sure your details are correct and up-to-date in the Basic information section of your EDCTPgrants profile. Data from your CV are used to pre-fill certain sections of the application. If you wish to update your CV, you must first save and close the online application, then proceed to edit the 'Basic information' section under 'Manage my Details' on the left hand side menu. TitleNationalityCountryForename(s)GenderDate of BirthSurnameOrganisation Career summary - employmentStart DateEnd DateJob TitleEmployer Career summary - qualificationsFromToDegreeInstitutionCountrySubject Career summary - grants heldDateTitleAwarding Body Residency Please explain how you meet the eligibility criterion: The fellow must be a resident of or be willing to relocate to a sub-Saharan African country (250 words max). Employment contract Please explain how you meet the eligibility criterion: The fellow must be employed or have guaranteed employment by the applicant (the host organisation) where they intend to remain working for a minimum of two years after the expiration of the grant. Please make reference to the current employment contract you have with the host organisation (250 words max). Previous Projects Please list up to 5 projects you have been involved in that may be relevant to this application. The list of projects should include the project title, start and end date, the funding agency, the grant amount and a brief description of your role and responsibilities in the project. Please highlight those grants where you were the principal or co-investigator. The description of your roles and responsibilities should also include details of any junior researchers trained or mentored under your supervision, the level of training, as well as the outcome of this training/mentoring (500 words max) Publications Publications List Please list up to 10 of your publications that are most significant and/or most relevant to this application, in particular those publications where you are first or last author. Please highlight your name in bold in the cited publications. Publications should be referenced in Vancouver style [Author Surname Initials. Title of article. Title of journal, abbreviated. Date of Publication: Volume Number (Issue Number): Page Numbers] and the DOI reference provided, where available. Example: Oscar W, Arrami N. Choosing Wind Energy. Renew Sust Energ Rev. 2008:456 (22): 398-400. doi:11.1106/j.rser.2008.05.003 Publication Details Presentations Please list up to 10 presentations (oral or poster) given in the last five years. If you have not given any presentations, enter none. Give details of up to 10 presentations (oral or poster) given in the last five years, by listing: Type and Title of the presentation Name of the meeting/conference where the presentation was given Location Dates For example: Poster/Talk; Title; 20th International AIDS Conference; Melbourne, Australia; 20-25 July 2014 If you have not given any presentations, enter none. Career Summary and Motivation statement Provide a summary of your career to date, that includes the following information: Your major achievements to date (including details of any prizes/awards received) Details of your current and most recent posts, your role and responsibilities in these posts and the experience you have gained Your research interests (including diseases or technical areas of expertise) Reasons why you wish to undertake this fellowship Reasons why you have chosen to undertake your fellowship at the host organisation Details of your career development plan during the EDCTP fellowship , making reference to the call objectives Details of how you propose to advance your career at the host organisation after the fellowship (1200 words max) Proposal Provide a detailed description of the purpose, aims, objectives and methods of the research and training activities you intend to conduct during the fellowship. The description should include details of: Importance and relevance of the proposed activities to EDCTP2 and to the call topic The concept underpinning the project, including the ideas, models or assumptions Aims and specific objectives of the proposal and how they fit with the scope and objectives of EDCTP2 and the call topic description. The objectives should be clear, realistic and measurable within the duration of the project. Objectives should be consistent with the expected exploitation and impact of the project The approach and methods to be used, with details of the studies to be performed, coordination and support activities, capacity development and networking activities Expected key deliverables Please note: Citation of relevant literature should be included in your proposal but the list of references cited should be given in the next section (5000 words max). Clinical trials: Do you intend to conduct a clinical trial during your fellowship Upload 'Completed' clinical trials essential information documentImpact Career Development Please provide a description of how this fellowship will contribute to your career development and future goals, as per the call objectives: 1.To promote career development and retention of postdoctoral researchers and postgraduate medical researchers in the research field and in sub-Saharan Africa. 2.To equip the fellows with the ability to establish themselves as independent researchers and with the skills to initiate and manage their own research and team at host organisations in sub-Saharan Africa. Please ensure that you provide a clear and concise individual capacity development plan with measurable indicators of how the project will advance your personal development towards scientific leadership (1500 words max). Expected impact Please provide a description of the expected impact of this fellowship, as per the call objectives: 1.To promote career development and retention of postdoctoral researchers and postgraduate medical researchers in the research field and in sub-Saharan Africa. 2.To equip the fellows with the ability to establish themselves as independent researchers and with the skills to initiate and manage their own research and team at host organisations in sub-Saharan Africa. Describe how you plan to apply and disseminate the experience gained during this fellowship award at the host organisation and how you intend to develop your career at the host organisation after the fellowship (2500 words max). Data management and ownership Please give details of your plans to store, manage and share the data and knowledge that will be generated by this project When giving details of your plans, take into consideration: The nature of the data that will be generated/collected and how it will be curated and preserved The value of the data to other researchers and to potential users in a range of sectors (e.g. health, commercial, social, environment, governmental, policy) and potential relevance to policy making, setting standards, skills and educational training How the data will be exploited and/or shared/made accessible for verification and re-use Details of the data ownership, any limits to the data sharing, for example to protect study participants or intellectual property, must be provided (1500 words max) Results and dissemination Give an overview of the communication measures for promoting the project and of how the anticipated results from this project will be taken forward during and after the project to achieve maximum impact In your overview, please take into consideration: Generalisability of the results beyond this project Plans to publish the findings in open access journals Potential users/target audience of the results and how the communications will be tailored to the needs of the various audiences, including groups beyond the projects own community Partnerships and linkages that the consortium currently has or plans to develop in order to disseminate the findings and take forward the results (15000 words max) References ReferencesImplementation Previous activities Please list of up to five relevant previous projects or activities connected to the subject of the proposal. Please list the activity with a summary of the major outputs. For example: Activity name - narrative summary of major output (500 words max) Publications Please list up to five (5) of the co-applicants publications, and/or products, services (including widely-used datasets or software), or other achievements that are most significant or relevant to this call for proposals References should be listed in Vancouver style: Journal articles: Author Surname Initials. Title of article. Title of journal, abbreviated. Date of Publication: Volume Number (Issue Number): Page Numbers and the DOI reference provided, where available. Example: Oscar W, Arrami N. Choosing wind energy. Renew Sust Energ Rev. 2008:456 (22): 398-400. doi:11.1106/j.rser.2008.05.003 Books: Author Surname Initials. Title: subtitle. Edition (if not the first). Place of publication: Publisher; Year Example: Cook GC and Zumla AI. Mansons Tropical Diseases. 22nd Edition. Oxford: Elsevier Ltd; 2009 Letter of support from the Mentor The letter of support must be a signed pdf on the letterhead of the Mentors organisation and must give details of the support that will be provided by the Mentor to the Fellow during the grant. The letter should also indicate the Mentors input into the preparation of the application. Letter of support from the Director of the Host Organisation The letter of support must be a signed pdf on the letterhead of the Mentors organisation and must give details of the support that will be provided by the Mentor to the Fellow during the grant. The letter should also indicate the Mentors input into the preparation of the application. Work Plan Overview of workplan Please give a summary description of the overall structure of the proposed workplan, including information about the constituent work packages, and how they inter-relate. Please note that subsequent sections of the form request full details of each work package and its deliverables and milestones. The number of work packages should be proportionate to the scale and complexity of the project. For Senior Fellows, please consider creating a separate work package for the training of each postgraduate student, as well as a work package(s) for the research project. Fellows may also wish to consider the inclusion of additional work packages such as training, dissemination and exploitation or communication activities. Definitions: Work package - major sub-division of the proposed project Deliverable - distinct output of the project, meaningful in terms of the projects overall objectives, and constituted by a report, a document, a technical diagram, software or other output Milestones - control points in the project that help to chart progress. Milestones may correspond to the completion of a key deliverable, allowing the next phase of the work to begin. They may also be needed at intermediary points so that, if problems have arisen, corrective measures can be taken. A milestone may be a critical decision point in the project where, for example, the consortium must make a key decision concerning the next steps. Notes on how to complete the workplan and work packages sections of the form: Overview of workplan: Brief description of the overall structure of the proposed workplan A numbered list of the individual work packages, a brief summary of each workpackage and details of the relationship between them Indicate the timing of the different work packages and their components (A Gantt chart or similar document may be uploaded) Work packages: For each individual work package, you should provide the following:- Detailed description of the activities under each work package List of the deliverables and milestones per work package Please ensure that you provide sufficient details and the information is presented according to the logical structure of the project and the stages in which it is to be carried out. Include details of the resources to be allocated to each work package (1500 words max). Work Packages Work package identifier Work package title Organisation that leads the work package Start month of work package End month of work package Objectives Description of work to be conducted in the work package List of Deliverables from Work packages List deliverables here List of Milestones from Work packages List deliverables hereRisk Management Critical risks for implementation Description of riskWork package involvedProposed risk-mitigation measuresBudget This section requests details of the estimated budget for the proposal. The budget form is organised according to the following categories: Personnel, Travel, Capital Equipment, Other goods and services, Sub-contracting. When filling in the budget categories, you must enter the organisation (participant) to which the budget request relates. The budget is not split into years, rather the amount to be entered is for the entire lifetime of the proposed project. EDCTP only requires a single overall category total per organisation. Each organisation with an overall proposed project total should only appear once within each budget category. More information about the budget form preparation for H2020 can be found at the following links: Planning your project H2020 Rules for Participation Annotated H2020 grant agreement with explanations of the budgetary items Please note that the online budget form will apply a flat rate of 25% indirect costs to the budget request, where applicable. (Only subcontracting costs do not receive the 25% indirect costs.) IMPORTANT: Check the budget total with the indirect costs added. You must make sure that once the 25% indirect costs are added to your proposal it does not take the budget above the maximum amount per proposal. If your budget total goes above the maximum amount it will be ineligible. A. Direct personnel costs - ACTUAL Actual costs -Actually incurred personnel costs A.1 Employees (or equivalent) A.2 Natural persons under direct contract A.3 Seconded persons [A.6 Personnel for providing access to research infrastructure] A.1 This budget category covers the costs of personnel working for the beneficiary under an employment contract (or equivalent appointing act) and assigned to the action. The personnel costs must be limited to salaries (including during parental leave), social security contributions, taxes and other costs included in the remuneration, if they arise from national law or the employment contract (or equivalent appointing act). A.2 This budget category covers the costs of personnel working under a direct contract (that is not an employment contract) with the beneficiary. This budget category covers typically the costs for field workers, in-house consultants and similar persons that will work on the action (i.e. self-employed natural persons working part-time or full-time for the action under a contract which is not governed by labour law). A.3 This budget category covers the costs of personnel that work on the action and that are seconded by a third party as an in-kind contribution against payment. Seconded means the temporary transfer of personnel from a third party to the beneficiary. The seconded person is still paid and employed by the third party, but works for the beneficiary. S/he is at the disposal of the beneficiary. Please note: Each organisationshould only appear oncewithin each category Within each category a particular organisation should only appear once, there is no need to itemise the details beyond the organisation level. e.g. for this particular category an example budget may look similar to: Note: Each organisation should only appear once within each category OrganisationEstimat e d b u d g e t f o r e a c h p a r t i c i p a n t ( ) A . D i r e c t p e r s o n n e l c o s t s - U N I T U n i t C o s t s - P e r s o n n e l c o s t s o n t h e b a s i s o f a n a m o u n t p e r u n i t c a l c u l a t e d b y t h e b e n e f i c i a r y i n a c c o r d a n c e w i t h i t s u s u a l c o s t a c c o u n t i n g p r a c t i c e s A . 1 E m p l o y e e s ( o r e q u i v a l e nt) A.2 Natural persons under direct contract A.3 Seconded persons [A.6 Personnel for providing access to research infrastructure] A.1 This budget category covers the costs of personnel working for the beneficiary under an employment contract (or equivalent appointing act) and assigned to the action. The personnel costs must be limited to salaries (including during parental leave), social security contributions, taxes and other costs included in the remuneration, if they arise from national law or the employment contract (or equivalent appointing act). A.2 This budget category covers the costs of personnel working under a direct contract (that is not an employment contract) with the beneficiary. This budget category covers typically the costs for field workers, in-house consultants and similar persons that will work on the action (i.e. self-employed natural persons working part-time or full-time for the action under a contract which is not governed by labour law). A.3 This budget category covers the costs of personnel that work on the action and that are seconded by a third party as an in-kind contribution against payment. Seconded means the temporary transfer of personnel from a third party to the beneficiary. The seconded person is still paid and employed by the third party, but works for the beneficiary. S/he is at the disposal of the beneficiary. OrganisationEstimated budget for each partic i p a n t ( ) B . D i r e c t c o s t s o f s u b c o n t r a c t i n g I f n e c e s s a r y t o i m p l e m e n t t h e a c t i o n , t h e b e n e f i c i a r i e s m a y a w a r d s u b c o n t r a c t s c o v e r i n g t h e i m p l e m e n t a t i o n o f c e r t a i n a c t i o n t a s k s . S u b c o n t r a c t i n g m a y c o v e r o n l y a l i m i t e d p a r t o f t h e a c t i o n . T h e b e n e ficiaries must award the subcontracts ensuring the best value for money or, if appropriate, the lowest price. In doing so, they must avoid any conflict of interests. Please note that the subcontracting costs do not receive the additional 25% indirect costs. Organisation E s t i m a t e d b u d g e t f o r e a c h p a r t i c i p a n t ( ) C - D i r e c t c o s t s o f f i n a n c i a l s u p p o r t O r g a n i s a t i o n P r o p o s e d O r g a n i s a t i o n T o t a l f o r E n t i r e P r o j e c t 1 ( ) D . O t h e r d i r e c t c o s t s D . 1 T r a v e l T h i s b u d g e t c a t e g o r y c o v e r s t h e t r a v e l c o s t s a n d r elated subsistence allowances spent for the action. Travel and subsistence costs may relate to the personnel of the beneficiaries as well as to external experts that participate in the action on an ad hoc basis (e.g. attending specific meetings), if the experts participation is detailed in the project. D.2 Equipment Funding for equipment, infrastructure or assets should be entered in this section. This may include the purchase costs (whether the item is new or second-hand), as well as the costs of renting or leasing equipment, infrastructure or other assets. For items of equipment costing less than 5000 Euros please enter this under the category other goods and services. Please note that the requested items must be essential for the action. D.3 Other goods and services This budget category covers the costs for goods and services that are purchased for the action (or contributed in-kind against payment), including: study costs ( consumables, supplies, reagents, raw materials, scientific publications, small equipment) needed to implement the action training costs networking costs (meetings and workshops) dissemination costs (including open access during the action) and conference fees for presenting project-related research costs related to intellectual property rights (IPR) (including costs to protect the results or royalties paid for access rights needed to implement the action) costs for certificates on financial statements (CFS) and certificates on methodology (unless unnecessary, for instance because the total direct costs per organisation are less than EUR 325 000) translation costs (if translation is necessary for the actions implementation and is justified) other essential costs to carry out the action [D.4 Costs of large research infrastructure] Please note: Each organisation should only appear once within each category Within each category a particular organisation should only appear once, there is no need to itemise the details beyond the organisation level. Note: Each organisation should o n l y a p p e a r o n c e w i t h i n e a c h c a t e g o r y O r g a n i s a t i o n E s t i m a t e d b u d g e t f o r e a c h p a r t i c i p a n t ( ) S u m m a r y T o t a l s - B y O r g a n i s a t i o n D o e s n o t i n c l u d e t h e 2 5 % o v e r h e a d c a l c u l a t i o n . T o t a l T o t a l S u m m a r y T o t a l s - B y C a t e g o r y I n c l u d e s C a t e g o r y E - I n d i r e c t O v e r h e a d C o s t s w h i c h i s c a l c u l a t e d a u t o m a t i c a l l y T o t a l ( ) E D C T P A P e r s o n n e l A c t u a l E D C T P A P e r s o n n e l U n i t E D C T P B S u b c o n t r a c t i n g E D C T P C F i n a n c i a l s u p p o r t E D C T P D O t h e r d i r e c t c o s t s E D C T P E I n d i r e c t c o s t s T otal Budget justification Please provide a detailed description and justification for the requested budget for the proposal making reference to the project activities. Use this section to give details of any cofunding or activities that are supported from other sources (3000 words max). Supporting Information and Related Applications Is this or a related application currently being submitted elsewhere? Has this, or a similar, application been submitted to EDCTP in the past two years?Ethics Issues Table a. Does your research involve human participants? b. Does your research involve vulnerable populations? c. Does your research involve physical interventions on the study participants? d. Does it involve invasive techniques? e. Does your research involve human cells or tissues? f. Does your research involve personal data collection and/or processing? g. Does your research involve further processing of previously collected personal data (secondary use)? h. Do you plan to export any material including personal data from non-EU countries into the EU? i. If your research involves low and/or middle income countries, are benefits sharing measures foreseen? j. Could the situation in the country put the individuals taking part in the research at risk? k. Does your research involve the use of elements that may cause harm to the environment, to animals or plants? l. Does your research involve the use of elements that may cause harm to humans, including research staff? m. Does your research have the potential for biosecurity applications? n. Does your research have the potential for malevolent/criminal/terrorist abuse? o. Does your research involve Human Embryonic Stem Cells (hESCs)? p. Does your research involve the use of human embryos? q. Does your research involve the use of human foetal tissues/cells? r. Does your research involve the use of human foetal tissues/cells? 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