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The genetic make-up of an individual contributes to the susceptibility and response to viral infection. Although environmental, clinical and social factors have a role in the chance of exposure to SARS-CoV-2 and the severity of COVID-191,2, host genetics may also be important. Identifying host-specific genetic factors may reveal biological mechanisms of therapeutic relevance and clarify causal relationships of modifiable environmental risk factors for SARS-CoV-2 infection and outcomes. We formed a global network of researchers to investigate the role of human genetics in SARS-CoV-2 infection and COVID-19 severity. Here we describe the results of three genome-wide association meta-analyses that consist of up to 49,562 patients with COVID-19 from 46 studies across 19 countries. We report 13 genome-wide significant loci that are associated with SARS-CoV-2 infection or severe manifestations of COVID-19. Several of these loci correspond to previously documented associations to lung or autoimmune and inflammatory diseases3,4,5,6,7. They also represent potentially actionable mechanisms in response to infection. Mendelian randomization analyses support a causal role for smoking and body-mass index for severe COVID-19 although not for type II diabetes. The identification of novel host genetic factors associated with COVID-19 was made possible by the community of human genetics researchers coming together to prioritize the sharing of data, results, resources and analytical frameworks. This working model of international collaboration underscores what is possible for future genetic discoveries in emerging pandemics, or indeed for any complex human disease.
This assessment concept paper provides a methodological approach for the formative assessment and summative assessment of GIZ’s International Water Stewardship Programme (IWaSP) and its component partnerships. IWaSP promotes partnerships between the private sector (corporations and SMEs), the public sector and the society to tackle shared water risks and to manage water equitably to meet competing demands. This evaluative assessment concept describes the generic approach of the assessment, the cycle for the assessment of partnerships, the country coordination and the programme.
The overall goal of the assessment is to provide evidence for taxpayers in the donor countries and for citizens in the partnership countries. It also aims to examine the relevance of the programme’s approach, its underlying assumptions, and the heterogeneity of stakeholders and their specific interests. Since the assessment is also formative feedback to GIZ and IWaSP stakeholders, it aims to guide the future implementation of the partnerships and the programme.
The assessment is guided by several generic principles: assessing for learning (formative assessment); assessment of learning (summative assessment); iteration; structuring complex problems; unblocking results; and conformity with other assessment criteria set out by the OECD the Development Assistance Committee (DAC) and GIZ’s Capacity Works success factors (GTZ 2010).
These generic criteria are adapted to the three levels of the IWaSP structure. First, the assessment cycle for partnerships includes the validation of stakeholders (mapping), the analysis of secondary literature, face-to-face interviews and a process for feeding back the findings. Generic tools are provided to guide the assessment, such as a list of key documents and an interview guide. Partnerships will undergo a baseline, interim assessment and final assessment. As progress varies across individual IWaSP partnerships, the steps taken by each partnership to assess shared water risks, prioritise and agree interventions, are expected to differ slightly. In response to these differences the sequencing and content of the assessment may need to be adapted for the different partnerships.
Second, the country-level assessment considers issues such as the coordination of partnerships within a country, scoping strategies, and interaction between partnership and the programme. Information gathered during the partnership assessment feeds into the country-level assessment.
Third, the assessment cycle for the programme involves a document and monitoring plan analysis, reflection on the different perspectives of the programme staff, country staff and external stakeholders.
The final section is concerned with reporting. Several annexes are provided relating to the organisation and preparation of the assessment, including question guidelines and analysis procedures.