PROJECT SUMMARY Significance: Mothers and children in Bangladesh and other low-mid income countries suffer disproportionately from maternal and infant malnutrition, neonatal mortality from diarrhea and respiratory infections, and maternal mortality from childbirth, vaccine failure and impaired child development. The UVA-icddrb Research Unit (RU) addresses critical needs of women and young children by bringing to the Network strengths in infectious diseases, lactation, pharmacology, neurocognitive development, human genetics, maternal-fetal medicine, immunology, vaccinology and CTSA coordination. The RU has access to nearly 8000 pregnant women annually at our existing clinical trial sites, is highly attuned to ethical and cultural issues with local community and ethical review boards, and leads Network studies of COVID-19 in pregnancy and maternal anemia. Investigators: The RU Principal Investigator (PI) William Petri and Senior Foreign Investigator (SFI) Rashidul Haque have for 30 years co-led multidisciplinary teams studying maternal-child health, with over 170 co- publications and ten on-going or completed clinical studies in the last five years. They are joined at icddr,b and UVA by a diverse and multidisciplinary core team of 19 accomplished investigators in maternal-child health. Innovation: The RU conceptualized the multi-site study of COVID-19 infection during pregnancy that demonstrated minimal impact on birth outcomes, is leading a study of the role of maternal anemia on low-birth weight infants, has multi-site Network-approved protocols on maternal nutritional supplements and on asymptomatic bacteriuria and has pioneered electronic data capture for the Network. Special capabilities include infectious diseases, pharmacology, lactation, and novel clinical trial designs through the CTSA. Approach: The RU has conducted 12 clinical trials since 2016 with 99% adherence to follow-up visits, and access to 8000 pregnant women annually in existing clinical trial sites. Science to policy translation catalyzed by the partnership of the icddr,b with the Government of Bangladesh, as evidenced by the worldwide implementation of oral rehydration solution, discovered at icddr,b and adoption nationwide, and the Matlab model of community -based care. Environment: The RU has unparalleled multidisciplinary strength, laboratory facilities and access to urban and rural populations of mothers and children. The icddr,b is one of the foremost global health institutes in the developing world with over 200 active clinical trials/protocols. The UVa Division of Infectious Diseases and International Health has a unique focus on Global Health, with over $16 million in annual grant support and over two dozen active clinical protocols. UVa-icddrb unique and complementary expertise will continue to bring unparalleled strengths to the Network’s goal of making sustainable improvements in maternal and child health.