Breakthrough Solutions and Cost-Disruptive Innovations for Screening and Diagnosis

The program is therefore particularly interested in supporting transformative, high-risk, high-reward innovations that materially alter the performance, cost structure, and deployment models of diagnostic and screening technologies and solutions. By prioritizing solutions that are affordable, scalable, and deployable at the point of need, such efforts can bridge critical access gaps and enable timely detection and treatment. Ultimately, these innovations have the potential to strengthen India’s public health response, reduce disease burden, and contribute to global efforts toward equitable health-care access.

The Challenge

The Cost-disruptive novel screening and diagnosis tools program under GCI seeks transformative novel tools or approaches or devices and ultra-low-cost solutions for screening and/or diagnostics prioritizing near point-of-care and low-incremental-cost formats that can meet real-world operational constraints and really disrupt the accessibility and availability landscape. Here, cost-disruptive screening tools and diagnostics are defined as solutions with a target price point of approximately INR100 or US$1 per test or devices with negligible incremental cost per use. For screening applications, cost targets should be interpreted per person screened; for diagnostic or monitoring applications, per test performed. This initiative aims to advance cross-sector, platform, and multimodal solutions to enable scalable screening, same-visit decision-making, and translating the cost-disruptive concepts into scalable solutions across high-priority disease areas.

This challenge aims to advance a staged and diversified portfolio across maturity levels, supporting high-risk early concepts, mid- and late- stage adaptation via clear Technology Readiness Level or phase criteria and milestone-based approach anchored to rigorous performance and cost plausibility.

Scope of the RFP

Grand Challenges India is soliciting proposals on transformative, high-risk, high-reward innovations that fundamentally rethink how diagnosis or screening is performed, including novel approaches, tools and devices, new sensing modalities, software-defined diagnostics, and artificial intelligence-enabled or software-only approaches that materially change performance, cost structure, or deployment models. Cross-sector or cross-disease innovations clearly presenting a clear, technically credible adaptation plan with relevant use case are encouraged. The proposals must include a technically credible, milestone-based plan and a pathway for operability and scale-up. The RFP seeks proposal addressing one or more of the objectives under specific priority areas.

Priority Area 1: Tuberculosis (TB)

Tuberculosis (TB) remains a major public health challenge for India with reported 10.7 incident TB cases in 2024, and 1.23 million deaths from the disease (WHO TB report 2025). The existent gaps in screening and detection have been shown to drive transmission, and also contribute to delays in achieving the national goal of TB elimination in India. These gaps include symptom-based screening, high per test costs, operational complexity, continued reliance on outdated sputum-based samples and microscopy, and molecular tests, inability to detect extrapulmonary TB, pediatric TB, gap in latent infection screening, infrastructure dependency and operational complexity etc. Evidence has demonstrated that achieving meaningful population impact will require cost-disruptive screening tools that are far more scalable, affordable, and operationally feasible than most current options available. This challenge aims to address the screening and diagnostic gap by supporting highly scalable and extremely low-cost tools (including assays and durable device-based technologies) leveraging current technological and AI advancements for both community-level, symptom-agnostic screening and breakthrough near-patient diagnosis.

Innovations identifying individuals likely to have TB (including asymptomatic or subclinical disease) for downstream confirmatory testing, biomarker based accurate testing, developing affordable screening or triage tests and prioritizing non-sputum, low-incremental-cost formats compatible with population-scale deployment for TB enabling community-level symptom-agnostic screening, and aiding national goal of TB elimination are sought under this challenge. The solutions should align with WHO TB screening Target Product Profile (TPP) and National TB Elimination Program (NTEP) requirements to demonstrate a credible path to very low incremental cost per person screened, and practical deployment outside centralized laboratories. Non-sputum, easy to gain sample and near patient, flexi-format approaches are of high interest. The innovation or solution should address one or more of the following objectives:

• Community and primary-care symptom-agnostic screening tools (non-sputum approaches) advancing cross-sector platform and multimodal solutions to enable scalable screening,
• Diagnostic tools or devices aligned with WHO TB diagnostic TPPs and NTEP requirements including true point-of-care tests that enable rapid confirmation outside centralized laboratories.

Priority Area 2: Emerging Pathogens

Conventional diagnostic development remains pathogen-specific and laboratory-dependent. While highly accurate, centralized molecular platforms often lack flexibility, rapid scalability, and cost profiles suitable for decentralized LMIC use. During COVID-19, rapid antigen and molecular point-of-care platforms shortened time to detection, therefore highlighting the potential and need for rapidly reconfigurable diagnostic architectures for emerging pathogen in Indian context, capable of adapting to new analytes without full platform redesign and with the capability for automated reporting to public health surveillance systems. These key characteristics are essential to shorten the time from pathogen emergence to detection, scalability and population-level action. The disruptive solutions capable of integrating with surveillance and early warning systems in low-resource settings, and combining technical agility with data traceability are desirable. These enabling requirement ensures that the results generated at the point-of-care are structured, transmitted, and retained within national monitoring and surveillance systems, thus preventing data loss from fragmented or disconnected workflows. Relevant WHO Target product profiles (TPPs) or national priority list in Indian context for priority emerging pathogens should be referred to meet the required performance and operational characteristics.

This challenge is seeking rapidly reconfigurable diagnostics, modular, open-architecture platforms capable of quick adaptation for new analytes and new or emerging pathogens and equipped with integrated data systems that can automate reporting to public health monitoring and surveillance systems, supporting true point-of-care triage and screening.

Priority Area 3: Syndromic Panel

Syndromic testing for undifferentiated febrile illness and acute respiratory syndromes represents a critical and under-addressed priority in India's infectious disease landscape. These presentations are routinely managed empirically for malaria or typhoid, while co-circulating pathogens such as dengue, scrub typhus, leptospirosis, and emerging arboviruses remain undetected until late in clinical progression or outbreak transmission chains. Studies from India have consistently demonstrated a substantial etiological overlap, frequent co-infections, and a significant proportion of illnesses in community with no confirmed pathogen identified, highlighting a deep blind spot that fragmented and siloed diagnostics and screening approaches cannot resolve.

This challenge aims to target syndromes/infections where testing is inaccessible, less-accurate and need new innovations, sharply minimizing the diagnostic delays and improving the clinical decision-making. Field-deployable, reconfigurable multiplex and syndromic panels that can stratify etiological agents, support co-infection interpretation, and generate real-time epidemiological signals are urgently needed to improve individual patient outcomes and strengthen public health system to detect outbreak-prone pathogens earlier in transmission chains.

• Low-cost platforms capable of high-order multiplexing (≥10 targets) that can enable improved diagnostic workflows with less pre-test information (e.g., syndromic panels) and are needed for surveillance applications.
• Syndromic panels that support co-detection, stratify viral versus bacterial etiologies, with pathway to link near-patient testing to surveillance systems.
• Compact, low-cost multiplex assays for priority febrile illness causing pathogens (dengue, malaria, scrub typhus etc.), and acute respiratory infections.
• Multimodal platforms that can multiplex different assays types (e.g., immunoassay and NAAT) in a single test.
• Relevant Target product profiles or national priority list in Indian context for prevalent pathogens in undifferentiated febrile illness and acute respiratory syndromes should be referred.

Priority Area 4: Enteric infections

Enteric infections including typhoid and diarrheal pathogens remain a major driver of morbidity and mortality in low- and middle-income countries, especially among young children. These infections continue to fuel outbreaks and a major challenge in their management are non-specific presentation often overlapping with other common infections and unavailability of accurate, affordable and rapid diagnostic tools. These diagnostic gaps often lead to missed, inaccurate or delayed diagnoses, and incorrect treatment contributing to inappropriate use of antibiotics. These factors also have compounding effect on overall treatment cost and management of enteric infections such as enteric fever, typhoid, pediatric diarrhea. Accurate and affordable near-patient diagnostics are therefore essential to address the diagnostic gap, clinical decision-making and antimicrobial stewardship. These tools also have usefulness for vaccine policy decisions and surveillance.

For typhoid fever, diagnostic challenges associated with conventional standard testing, blood culture is highly laboratory and resource dependent, time-consuming and has limited sensitivity for low circulating bacterial loads. The target product profiles for typhoid are available from WHO and India which define a clear performance-based pathway and could be benefitting to design cost-disruptive and breakthrough typhoid diagnostics. Differentiation between diarrhea caused by bacterial-vs-viral pathogen, though complex but highly desirable for appropriate evidence-based treatment and management. Pediatric diarrhea, which is etiologically heterogeneous, quantitative, flexible multi-target panels that can evolve with vaccine and surveillance needs are therefore central for scalable enteric diarrheal diagnostics. This challenge seeks breakthrough solutions for high-burden enteric pathogens such as Salmonella Typhi.

• Novel rapid, (near) point-of-care affordable diagnostic tests for detection of enteric pathogens.
• Detection of Salmonella enterica serovar Typhi & Paratyphi, resistant gene panels targeting the prevalent resistance gene circulating in India, differentiation of typhoid and paratyphoid fever.
• Differentiation of bacterial-vs-viral diarrhea, performance expectations for high-quality enteric diagnostics
• WHO and India-specific Target product profiles outlining prevalent pathogens (e.g., for enteric fever) and defining minimal and preferred performance characteristics for near-patient testing should be referred.

Across these use cases, innovations must address the circulating prevalent pathogens in Indian context and meet functional requirements for sensitivity, specificity, turnaround time, decentralization, and affordability. Technologies of interest include novel assays, low-cost molecular architectures, host-pathogen signatures, or other emerging modalities capable of delivering credible diagnostic performance during the same patient encounter while maintaining a pathway to population-scale, cost-disruptive implementation.

We are looking for proposals that have following cross-cutting criteria:

The proposals should be grounded in evidence that directly supports the central idea, presenting a pathway for development and/or later-stage adaptation and scale, using clear technology readiness level criteria and milestone-based approach. Proposal should not be in ideation phase. The solutions should focus on:

• rapid actionable results during a single patient encounter (fast turnaround time),
• operability by minimally trained users in decentralized settings (ease of use)
• functions reliably in low-resource environments (LMIC robustness- heat, dust, intermittent power, limited infrastructure).
• minimizes or eliminates cold-chain requirements through thermostable reagents and temperature-stable device design.
• reduces reliance on disposable consumables and favors durable, reusable hardware architectures with negligible incremental cost per screening.
• a credible pathway to approximately INR100 or US$1 per test or near-zero incremental cost per person screened for devices (cost demonstration).
• incorporates transformative innovation and/or novel architectures such as multimodal sensing, high-order multiplexing, software-defined diagnostics, AI-enabled interpretation, or software-only approaches.

We particularly encourage applications from women-led organizations and applications involving projects led by women. As this initiative seeks disruptive innovative solutions, multidisciplinary team collaborations are strongly encouraged.

For this challenge, we are NOT seeking proposals that:

1. Are implementation, procurement, delivery, or roll-out projects without substantive R&D, or primarily consisting of large clinical trials or definitive field studies led by the applicant (limited, development-oriented evaluation may be appropriate).
2. Are discovery-only biomarker projects without a clear pathway to a deployable prototype within the grant period, or propose only incremental modifications of well-established approaches without a plausible, clearly articulated step-change in cost, scalability, or screening value.
3. Request funding levels that are not supported by commensurate technical readiness, feasibility evidence, and a credible pathway to validation.
4. Have no plausible pathway to meet cost and operational constraints (including reliance on expensive consumables or complex infrastructure without a credible mitigation plan).
5. Are unwilling to share prototypes, reagents, and/or data as needed for BIRAC review process and pre-grant requisites.