<p>The Gates Foundation is part of the Grand Challenges partnership network. Visit <a href="https://www.grandchallenges.org" target="_blank">www.grandchallenges.org</a> to view the map of awarded grants across this network and grant opportunities from partners.</p>

<p>Grand Challenges supports exceptional scientists with the expertise to do breakthrough R&amp;D as well as the experience, networks, and skills to excel as scientific leaders. These champions co-create projects with global partners, mobilize key institutions in their countries, and improve public health in their communities and around the world.</p>

<p>Grand Challenges funds innovations to tackle the biggest problems in global health and development. Since 2004, through the Grand Challenges program, we have supported more than 2500 innovation projects in more than 90 countries.</p>

<p>For more than 20 years, Grand Challenges has built trusted relationships with global health funders and researchers. We tap into this powerful network to create unique scientific collaborations with a transformative impact on people's lives.</p>

<p>Innovation happens all along the journey from idea, to experiment, to product or policy, and finally to delivery at scale in communities. We fund innovation projects while supporting an environment of champions, systems, and partnerships to maximize the impact these projects make in people's lives.</p>

The 4 Pillars of the Grand Challenges Ecosystem

<p>Doing groundbreaking science requires the right mix of institutions, policies, and tools. Grand Challenges works with partners in low- and middle-income countries to build or strengthen the capacities they need to succeed in R&amp;D.</p>

We challenge innovators around the world to work on urgent priorities in global health and development. We issue new challenges regularly and award the most promising proposals with grant funding.&nbsp;

Past Challenges

<p>Appropriate antibiotic use has the power to save lives in the most vulnerable communities, and antimicrobial resistance (AMR) impacts multiple global health priority areas: HIV/AIDS, tuberculosis, maternal and neonatal health, pneumonia, and enteric and diarrheal diseases. It is critical to better understand the prevalence of AMR and its impact on mortality in developing countries so that access to appropriate antibiotics is ensured while inappropriate use of antibiotics is limited. In particular, there is a need to better understand resistance in bacterial infections of newborns and young children – and to this end, understanding what is the prevalence of AMR in the community, how it impacts mortality, and how it impacts health targets. Tackling AMR will require a global, coordinated approach and the linking together of different research communities for new perspectives on the problem.</p>

<p>Note that this request for proposals is being launched on sequential dates by four Grand Challenges partnerships: African researchers located in African organizations should apply through the joint Grand Challenges Africa/Grand Challenges South Africa portal; Brazilian researchers located in Brazilian organizations should apply through the Grand Challenges Brazil portal; and Indian researchers located in Indian organizations should apply through the Grand Challenges India portal.</p>

<h3>What we are looking for:</h3>

<p>We seek new approaches that have the potential to transform public health action on a regional or global scale by identifying and filling gaps in knowledge on the burden of resistance to antibacterial agents – we are not seeking incremental improvements in typical disease surveillance solutions. Specifically, we seek projects that propose innovation in the following areas:</p>

<ul>
	<li><strong>Data sources</strong>: Pilot tests of new sources of data, particularly those that would bring together different research communities for new perspectives on the problem</li>
	<li><strong>Analytical methods</strong>: Pilot tests of bioinformatics approaches, including those that combine or connect existing databases in novel ways</li>
	<li><strong>Biomarkers</strong>: Pilot tests of new biomarkers or combinations of biomarkers that could lead to new understanding of the actionable implications of antimicrobial resistance surveillance data</li>
	<li><strong>Low-cost technologies and products</strong>: Exploratory work in developing new technologies and products, including 1) those that specifically target improved infection prevention and control in healthcare settings to reduce reliance on healthcare provider behavior change, and 2) technologies to remove antibiotics from effluents</li>
</ul>

<h3>We will give highest priority to those projects that:</h3>

<ul>
	<li>Pilot test approaches that could be added to existing surveillance platforms, since we are not seeking to create new surveillance platforms</li>
	<li>Incorporate multiple of the areas of innovation listed above</li>
	<li>Could contribute to a portfolio of funded projects that addresses a country’s regional diversity and the diversity of vulnerable populations</li>
	<li>Explain how proposed approaches will be tested so that they have the highest likelihood of being relevant for implementation in the country’s public health system</li>
</ul>

<h3>Examples of what we are looking for:</h3>

<ul>
	<li>Characterizes type examples of the burden of AMR (e.g., exploring the role of AMR in community or hospital sepsis-related mortality, focusing on children)</li>
	<li>Includes data sources that could indirectly reflect AMR burden (e.g., antimicrobial usage patterns or specifically how vaccination against respiratory or diarrheal diseases impacts antimicrobial use)</li>
	<li>Addresses the diversity of vulnerable populations and the different aspects of the AMR burden that might be reflected in urban versus rural settings</li>
	<li>Includes data sources ranging from the level of the individual (e.g., microbiome across body sites) to the community (e.g., public toilets and sanitation systems), while maintaining a focus on gaining new understanding of the actionable consequences of AMR gene flow.</li>
	<li>Includes data sources that could reflect AMR transmission dynamics between communities (e.g., modes of transportation) or within communities over time (e.g., seasonal-related behaviors)</li>
	<li>Provides an ecological perspective, such as a One Health perspective integrating antimicrobial use in livestock or perspectives that can integrate environmental monitoring in the community setting with medical monitoring in the hospital setting – if these perspectives are explicitly linked to human health outcomes and particularly a focus on vulnerable populations</li>
	<li>Leverages opportunities to build in new ways on existing public health interventions or environmental monitoring platforms - and to bring together different research communities</li>
	<li>Contributes to control of infections in healthcare settings: novel techniques and products to control hospital infection rates and break the chain of transmission of bacteria in clinical settings</li>
	<li>Exploratory work into developing low-cost technologies to remove antibiotics and associated chemicals from effluents</li>
</ul>

<h3>We will NOT consider funding for:</h3>

<ul>
	<li>Proposals to develop diagnostic devices and technologies or for drug discovery. Although diagnostic devices and new drugs are potentially critical to AMR solutions, these areas are not unique to AMR challenges and should therefore be advanced more comprehensively against a broader landscape of possible needs and solutions. Thus, while excluded here, they may be part of a future request for proposals.</li>
	<li>Proposals without a clear application to surveillance or facilitating the development of new evidence describing the global burden of AMR</li>
	<li>Proposals seeking to apply existing tools in ways that do not transform our understanding of the global emergence or spread of AMR</li>
	<li>Incremental improvements to conventional solutions or typical disease surveillance. We will not consider local surveillance programs or projects or small improvements in surveillance, e.g., use of mobile data collection, automation of traditional processes, or improving access to existing tools or technologies.</li>
	<li>Proposals that simply expand the availability of primary data without a clear link to informing our understanding of global AMR epidemiology</li>
	<li>Applications proposing basic research</li>
	<li>Ideas not directly relevant to low- and middle-income contexts</li>
	<li>Genomic and other laboratory-based approaches that lack a clear application to AMR surveillance or epidemiology</li>
	<li>Ideas focused on quantifying resistance in animal or livestock populations or in environmental samples without a direct linkage to how data would impact public health practice</li>
	<li>Proposals involving clinical trials in human volunteers or patients (note: use of existing datasets or other outputs from clinical trials may be considered, as long as the proposed approach is feasible within the time and financial envelopes provided).</li>
</ul>


Grand Challenges India

Grand Challenges India: New Approaches to Characterize the Global Burden of Antimicrobial Resistance

<p>Appropriate antibiotic use has the power to save lives in the most vulnerable communities, and antimicrobial resistance (AMR) impacts multiple global health priority areas: HIV/AIDS, tuberculosis, maternal and neonatal health, pneumonia, and enteric and diarrheal diseases. It is critical to better understand the prevalence of AMR and its impact on mortality in developing countries so that access to appropriate antibiotics is ensured while inappropriate use of antibiotics is limited. In particular, there is a need to better understand resistance in bacterial infections of newborns and young children – and to this end, understanding what is the prevalence of AMR in the community, how it impacts mortality, and how it impacts health targets. Tackling AMR will require a global, coordinated approach and the linking together of different research communities for new perspectives on the problem.</p>
<h3>What we are looking for:</h3>
<p>We seek new approaches that have the potential to transform public health action on a regional or global scale by identifying and filling gaps in knowledge on the burden of resistance to antibacterial agents – we are not seeking incremental improvements in typical disease surveillance solutions. Specifically, we seek projects that propose innovation in the following areas:</p>
<ul>
<li><strong>Data sources</strong>: Pilot tests of new sources of data, particularly those that would bring together different research communities for new perspectives on the problem</li>
<li><strong>Analytical methods</strong>: Pilot tests of bioinformatics approaches, including those that combine or connect existing databases in novel ways</li>
<li><strong>Biomarkers</strong>: Pilot tests of new biomarkers or combinations of biomarkers that could lead to new understanding of the actionable implications of antimicrobial resistance surveillance data</li>
<li><strong>Low-cost technologies and products</strong>: Exploratory work in developing new technologies and products, including 1) those that specifically target improved infection prevention and control in healthcare settings to reduce reliance on healthcare provider behavior change, and 2) technologies to remove antibiotics from effluents</li>
</ul>
<h3>We will give highest priority to those projects that:</h3>
<ul>
<li>Pilot test approaches that could be added to existing surveillance platforms, since we are not seeking to create new surveillance platforms</li>
<li>Incorporate multiple of the areas of innovation listed above</li>
<li>Could contribute to a portfolio of funded projects that addresses a country’s regional diversity and the diversity of vulnerable populations</li>
<li>Explain how proposed approaches will be tested so that they have the highest likelihood of being relevant for implementation in the country’s public health system</li>
</ul>
<h3>Examples of what we are looking for:</h3>
<ul>
<li>Characterizes type examples of the burden of AMR (e.g., exploring the role of AMR in community or hospital sepsis-related mortality, focusing on children)</li>
<li>Includes data sources that could indirectly reflect AMR burden (e.g., antimicrobial usage patterns or specifically how vaccination against respiratory or diarrheal diseases impacts antimicrobial use)</li>
<li>Addresses the diversity of vulnerable populations and the different aspects of the AMR burden that might be reflected in urban versus rural settings</li>
<li>Includes data sources ranging from the level of the individual (e.g., microbiome across body sites) to the community (e.g., public toilets and sanitation systems), while maintaining a focus on gaining new understanding of the actionable consequences of AMR gene flow.</li>
<li>Includes data sources that could reflect AMR transmission dynamics between communities (e.g., modes of transportation) or within communities over time (e.g., seasonal-related behaviors)</li>
<li>Provides an ecological perspective, such as a One Health perspective integrating antimicrobial use in livestock or perspectives that can integrate environmental monitoring in the community setting with medical monitoring in the hospital setting – if these perspectives are explicitly linked to human health outcomes and particularly a focus on vulnerable populations</li>
<li>Leverages opportunities to build in new ways on existing public health interventions or environmental monitoring platforms - and to bring together different research communities</li>
<li>Contributes to control of infections in healthcare settings: novel techniques and products to control hospital infection rates and break the chain of transmission of bacteria in clinical settings</li>
<li>Exploratory work into developing low-cost technologies to remove antibiotics and associated chemicals from effluents</li>
</ul>
<h3>We will NOT consider funding for:</h3>
<ul>
<li>Proposals to develop diagnostic devices and technologies or for drug discovery. Although diagnostic devices and new drugs are potentially critical to AMR solutions, these areas are not unique to AMR challenges and should therefore be advanced more comprehensively against a broader landscape of possible needs and solutions. Thus, while excluded here, they may be part of a future request for proposals.</li>
<li>Proposals without a clear application to surveillance or facilitating the development of new evidence describing the global burden of AMR</li>
<li>Proposals seeking to apply existing tools in ways that do not transform our understanding of the global emergence or spread of AMR</li>
<li>Incremental improvements to conventional solutions or typical disease surveillance. We will not consider local surveillance programs or projects or small improvements in surveillance, e.g., use of mobile data collection, automation of traditional processes, or improving access to existing tools or technologies.</li>
<li>Proposals that simply expand the availability of primary data without a clear link to informing our understanding of global AMR epidemiology</li>
<li>Applications proposing basic research</li>
<li>Ideas not directly relevant to low- and middle-income contexts</li>
<li>Genomic and other laboratory-based approaches that lack a clear application to AMR surveillance or epidemiology</li>
<li>Ideas focused on quantifying resistance in animal or livestock populations or in environmental samples without a direct linkage to how data would impact public health practice</li>
<li>Proposals involving clinical trials in human volunteers or patients (note: use of existing datasets or other outputs from clinical trials may be considered, as long as the proposed approach is feasible within the time and financial envelopes provided).</li>
</ul>
<p>Note that this request for proposals is being launched in parallel by four Grand Challenges partnerships: African researchers located in African organizations should apply through the joint Grand Challenges Africa/Grand Challenges South Africa portal; Brazilian researchers located in Brazilian organizations should apply through the Grand Challenges Brazil portal; and Indian researchers located in Indian organizations should apply through the Grand Challenges India portal.</p>


<p>We seek new approaches that have the potential to transform public health action on a regional or global scale by identifying and filling gaps in knowledge on the burden of resistance to antibacterial agents, including the linking together of different research communities for new perspectives on the problem.</p>


Grand Challenges India New Approaches to Characterize the Global Burden of Antimicrobial Resistance

<p>Appropriate antibiotic use has the power to save lives in the most vulnerable communities, and antimicrobial resistance (AMR) impacts multiple global health priority areas: HIV/AIDS, tuberculosis, maternal and neonatal health, pneumonia, and enteric and diarrheal diseases. It is critical to better understand the prevalence of AMR and its impact on mortality in developing countries so that access to appropriate antibiotics is ensured while inappropriate use of antibiotics is limited. In particular, there is a need to better understand resistance in bacterial infections of newborns and young children – and to this end, understanding what is the prevalence of AMR in the community, how it impacts mortality, and how it impacts health targets. Tackling AMR will require a global, coordinated approach and the linking together of different research communities for new perspectives on the problem.</p>

<p>Note that this request for proposals is being launched on sequential dates by four Grand Challenges partnerships: African researchers located in African organizations should apply through the joint Grand Challenges Africa/Grand Challenges South Africa portal; Brazilian researchers located in Brazilian organizations should apply through the Grand Challenges Brazil portal; and Indian researchers located in Indian organizations should apply through the Grand Challenges India portal.</p>

<h3>What we are looking for:</h3>

<p>We seek new approaches that have the potential to transform public health action on a regional or global scale by identifying and filling gaps in knowledge on the burden of resistance to antibacterial agents – we are not seeking incremental improvements in typical disease surveillance solutions. Specifically, we seek projects that propose innovation in the following areas:</p>

<ul>
	<li><strong>Data sources</strong>: Pilot tests of new sources of data, particularly those that would bring together different research communities from different disciplines for new perspectives on the problem</li>
	<li><strong>Analytical methods</strong>: Pilot tests of bioinformatics approaches, including new ways to analyze, combine or connect existing databases</li>
	<li><strong>Biomarkers</strong>: Pilot tests of new biomarkers or combinations of biomarkers that could lead to new understanding of the actionable implications of antimicrobial resistance surveillance data</li>
	<li><strong>Low-cost technologies and products</strong>: Exploratory work in developing new technologies and products, including 1) those that specifically target improved infection prevention and control in healthcare settings to reduce reliance on healthcare provider behavior change, and 2) technologies to remove antibiotics from effluents</li>
</ul>

<h3>We will give highest priority to those projects that:</h3>

<ul>
	<li>Pilot test approaches that could be added to existing surveillance platforms, since we are not seeking to create new surveillance platforms</li>
	<li>Incorporate multiple of the areas of innovation listed above</li>
	<li>Could contribute to a portfolio of funded projects that addresses a country’s regional diversity and the diversity of vulnerable populations</li>
	<li>Explain how proposed approaches will be tested so that they have the highest likelihood of being relevant for implementation in the country’s public health system</li>
</ul>

<h3>Examples of what we are looking for:</h3>

<ul>
	<li>Characterizes type examples of the burden of AMR (e.g., exploring the role of AMR in community or hospital sepsis-related mortality, focusing on children)</li>
	<li>Includes data sources that could indirectly reflect AMR burden (e.g., antimicrobial usage patterns or specifically how vaccination against respiratory or diarrheal diseases impacts antimicrobial use)</li>
	<li>Addresses the diversity of vulnerable populations and the different aspects of the AMR burden that might be reflected in urban versus rural settings</li>
	<li>Includes data sources ranging from the level of the individual (e.g., microbiome across body sites) to the community (e.g., public toilets and sanitation systems), while maintaining a focus on gaining new understanding of the actionable consequences of AMR gene flow.</li>
	<li>Includes data sources that could reflect AMR transmission dynamics between communities (e.g., modes of transportation) or within communities over time (e.g., seasonal-related behaviors)</li>
	<li>Provides an ecological perspective, such as a One Health perspective integrating antimicrobial use in livestock or perspectives that can integrate environmental monitoring in the community setting with medical monitoring in the hospital setting – if these perspectives are explicitly linked to human health outcomes and particularly a focus on vulnerable populations</li>
	<li>Leverages opportunities to build in new ways on existing public health interventions or environmental monitoring platforms - and to bring together different research communities</li>
	<li>Contributes to control of infections in healthcare settings: novel techniques and products to control hospital infection rates and break the chain of transmission of bacteria in clinical settings</li>
	<li>Exploratory work into developing low-cost technologies to remove antibiotics and associated chemicals from effluents</li>
</ul>

<h3>We will NOT consider funding for:</h3>

<ul>
	<li>Proposals to develop diagnostic devices and technologies or for drug discovery. Although diagnostic devices and new drugs are potentially critical to AMR solutions, these areas are not unique to AMR challenges and should therefore be advanced more comprehensively against a broader landscape of possible needs and solutions. Thus, while excluded here, they may be part of a future request for proposals.</li>
	<li>Proposals without a clear application to surveillance or facilitating the development of new evidence describing the global burden of AMR</li>
	<li>Proposals seeking to apply existing tools in ways that do not transform our understanding of the global emergence or spread of AMR</li>
	<li>Incremental improvements to conventional solutions or typical disease surveillance. We will not consider local surveillance programs or projects or small improvements in surveillance, e.g., use of mobile data collection, automation of traditional processes, or improving access to existing tools or technologies.</li>
	<li>Proposals that simply expand the availability of primary data without a clear link to informing our understanding of global AMR epidemiology</li>
	<li>Applications proposing basic research</li>
	<li>Ideas not directly relevant to low- and middle-income contexts</li>
	<li>Genomic and other laboratory-based approaches that lack a clear application to AMR surveillance or epidemiology</li>
	<li>Ideas focused on quantifying resistance in animal or livestock populations or in environmental samples without a direct linkage to how data would impact public health practice</li>
	<li>Proposals involving clinical trials in human volunteers or patients (note: use of existing datasets or other outputs from clinical trials may be considered, as long as the proposed approach is feasible within the time and financial envelopes provided).</li>
</ul>


Grand Challenges Brazil

Grand Challenges Explorations - Brazil: New Approaches to Characterize the Global Burden of Antimicrobial Resistance

<p>Appropriate antibiotic use has the power to save lives in the most vulnerable communities, and antimicrobial resistance (AMR) impacts multiple global health priority areas: HIV/AIDS, tuberculosis, maternal and neonatal health, pneumonia, and enteric and diarrheal diseases. It is critical to better understand the prevalence of AMR and its impact on mortality in developing countries so that access to appropriate antibiotics is ensured while inappropriate use of antibiotics is limited. In particular, there is a need to better understand resistance in bacterial infections of newborns and young children – and to this end, understanding what is the prevalence of AMR in the community, how it impacts mortality, and how it impacts health targets. Tackling AMR will require a global, coordinated approach and the linking together of different research communities for new perspectives on the problem.</p>
<p>Note that this request for proposals is being launched on sequential dates by four Grand Challenges partnerships: African researchers located in African organizations should apply through the joint Grand Challenges Africa/Grand Challenges South Africa portal; Brazilian researchers located in Brazilian organizations should apply through the Grand Challenges Brazil portal; and Indian researchers located in Indian organizations should apply through the Grand Challenges India portal.</p>
<h3>What we are looking for:</h3>
<p>We seek new approaches that have the potential to transform public health action on a regional or global scale by identifying and filling gaps in knowledge on the burden of resistance to antibacterial agents – we are not seeking incremental improvements in typical disease surveillance solutions. Specifically, we seek projects that propose innovation in the following areas:</p>
<ul>
<li><strong>Data sources</strong>: Pilot tests of new sources of data, particularly those that would bring together different research communities from different disciplines for new perspectives on the problem</li>
<li><strong>Analytical methods</strong>: Pilot tests of bioinformatics approaches, including new ways to analyze, combine or connect existing databases</li>
<li><strong>Biomarkers</strong>: Pilot tests of new biomarkers or combinations of biomarkers that could lead to new understanding of the actionable implications of antimicrobial resistance surveillance data</li>
<li><strong>Low-cost technologies and products</strong>: Exploratory work in developing new technologies and products, including 1) those that specifically target improved infection prevention and control in healthcare settings to reduce reliance on healthcare provider behavior change, and 2) technologies to remove antibiotics from effluents</li>
</ul>
<h3>We will give highest priority to those projects that:</h3>
<ul>
<li>Pilot test approaches that could be added to existing surveillance platforms, since we are not seeking to create new surveillance platforms</li>
<li>Incorporate multiple of the areas of innovation listed above</li>
<li>Could contribute to a portfolio of funded projects that addresses a country’s regional diversity and the diversity of vulnerable populations</li>
<li>Explain how proposed approaches will be tested so that they have the highest likelihood of being relevant for implementation in the country’s public health system</li>
</ul>
<h3>Examples of what we are looking for:</h3>
<ul>
<li>Characterizes type examples of the burden of AMR (e.g., exploring the role of AMR in community or hospital sepsis-related mortality, focusing on children)</li>
<li>Includes data sources that could indirectly reflect AMR burden (e.g., antimicrobial usage patterns or specifically how vaccination against respiratory or diarrheal diseases impacts antimicrobial use)</li>
<li>Addresses the diversity of vulnerable populations and the different aspects of the AMR burden that might be reflected in urban versus rural settings</li>
<li>Includes data sources ranging from the level of the individual (e.g., microbiome across body sites) to the community (e.g., public toilets and sanitation systems), while maintaining a focus on gaining new understanding of the actionable consequences of AMR gene flow.</li>
<li>Includes data sources that could reflect AMR transmission dynamics between communities (e.g., modes of transportation) or within communities over time (e.g., seasonal-related behaviors)</li>
<li>Provides an ecological perspective, such as a One Health perspective integrating antimicrobial use in livestock or perspectives that can integrate environmental monitoring in the community setting with medical monitoring in the hospital setting – if these perspectives are explicitly linked to human health outcomes and particularly a focus on vulnerable populations</li>
<li>Leverages opportunities to build in new ways on existing public health interventions or environmental monitoring platforms - and to bring together different research communities</li>
<li>Contributes to control of infections in healthcare settings: novel techniques and products to control hospital infection rates and break the chain of transmission of bacteria in clinical settings</li>
<li>Exploratory work into developing low-cost technologies to remove antibiotics and associated chemicals from effluents</li>
</ul>
<h3>We will NOT consider funding for:</h3>
<ul>
<li>Proposals to develop diagnostic devices and technologies or for drug discovery. Although diagnostic devices and new drugs are potentially critical to AMR solutions, these areas are not unique to AMR challenges and should therefore be advanced more comprehensively against a broader landscape of possible needs and solutions. Thus, while excluded here, they may be part of a future request for proposals.</li>
<li>Proposals without a clear application to surveillance or facilitating the development of new evidence describing the global burden of AMR</li>
<li>Proposals seeking to apply existing tools in ways that do not transform our understanding of the global emergence or spread of AMR</li>
<li>Incremental improvements to conventional solutions or typical disease surveillance. We will not consider local surveillance programs or projects or small improvements in surveillance, e.g., use of mobile data collection, automation of traditional processes, or improving access to existing tools or technologies.</li>
<li>Proposals that simply expand the availability of primary data without a clear link to informing our understanding of global AMR epidemiology</li>
<li>Applications proposing basic research</li>
<li>Ideas not directly relevant to low- and middle-income contexts</li>
<li>Genomic and other laboratory-based approaches that lack a clear application to AMR surveillance or epidemiology</li>
<li>Ideas focused on quantifying resistance in animal or livestock populations or in environmental samples without a direct linkage to how data would impact public health practice</li>
<li>Proposals involving clinical trials in human volunteers or patients (note: use of existing datasets or other outputs from clinical trials may be considered, as long as the proposed approach is feasible within the time and financial envelopes provided).</li>
</ul>


Grand Challenges Explorations - Brazil New Approaches to Characterize the Global Burden of Antimicrobial Resistance

<p>Appropriate antibiotic use has the power to save lives in the most vulnerable communities, and antimicrobial resistance (AMR) impacts multiple global health priority areas: HIV/AIDS, tuberculosis, maternal and neonatal health, pneumonia, and enteric and diarrheal diseases. It is critical to better understand the prevalence of AMR and its impact on mortality in developing countries so that access to appropriate antibiotics is ensured while inappropriate use of antibiotics is limited. In particular, there is a need to better understand resistance in bacterial infections of newborns and young children – and to this end, understanding what is the prevalence of AMR in the community, how it impacts mortality, and how it impacts health targets. Tackling AMR will require a global, coordinated approach and the linking together of different research communities for new perspectives on the problem.</p><p>Note that this request for proposals is being launched on sequential dates by four Grand Challenges partnerships: African researchers located in African organizations should apply through the joint Grand Challenges Africa/Grand Challenges South Africa portal; Brazilian researchers located in Brazilian organizations should apply through the Grand Challenges Brazil portal; and Indian researchers located in Indian organizations should apply through the Grand Challenges India portal.</p><h3>What we are looking for:</h3><p>We seek new approaches that have the potential to transform public health action on a regional or global scale by identifying and filling gaps in knowledge on the burden of resistance to antibacterial agents – we are not seeking incremental improvements in typical disease surveillance solutions. Specifically, we seek projects that propose innovation in the following areas:</p><ul><li><strong>Data sources</strong>: Pilot tests of new sources of data, particularly those that would bring together different research communities for new perspectives on the problem</li><li><strong>Analytical methods</strong>: Pilot tests of bioinformatics approaches, including those that combine or connect existing databases in novel ways</li><li><strong>Biomarkers</strong>: Pilot tests of new biomarkers or combinations of biomarkers that could lead to new understanding of the actionable implications of antimicrobial resistance surveillance data</li><li><strong>Low-cost technologies and products</strong>: Exploratory work in developing new technologies and products, including 1) those that specifically target improved infection prevention and control in healthcare settings to reduce reliance on healthcare provider behavior change, and 2) technologies to remove antibiotics from effluents</li></ul><h3>We will give highest priority to those projects that:</h3><ul><li>Pilot test approaches that could be added to existing surveillance platforms, since we are not seeking to create new surveillance platforms</li><li>Incorporate multiple of the areas of innovation listed above</li><li>Could contribute to a portfolio of funded projects that addresses a country’s regional diversity and the diversity of vulnerable populations</li><li>Explain how proposed approaches will be tested so that they have the highest likelihood of being relevant for implementation in the country’s public health system</li></ul><h3>Examples of what we are looking for:</h3><ul><li>Characterizes type examples of the burden of AMR (e.g., exploring the role of AMR in community or hospital sepsis-related mortality, focusing on children)</li><li>Includes data sources that could indirectly reflect AMR burden (e.g., antimicrobial usage patterns or specifically how vaccination against respiratory or diarrheal diseases impacts antimicrobial use)</li><li>Addresses the diversity of vulnerable populations and the different aspects of the AMR burden that might be reflected in urban versus rural settings</li><li>Includes data sources ranging from the level of the individual (e.g., microbiome across body sites) to the community (e.g., public toilets and sanitation systems), while maintaining a focus on gaining new understanding of the actionable consequences of AMR gene flow.</li><li>Includes data sources that could reflect AMR transmission dynamics between communities (e.g., modes of transportation) or within communities over time (e.g., seasonal-related behaviors)</li><li>Provides an ecological perspective, such as a One Health perspective integrating antimicrobial use in livestock or perspectives that can integrate environmental monitoring in the community setting with medical monitoring in the hospital setting – if these perspectives are explicitly linked to human health outcomes and particularly a focus on vulnerable populations</li><li>Leverages opportunities to build in new ways on existing public health interventions or environmental monitoring platforms - and to bring together different research communities</li><li>Contributes to control of infections in healthcare settings: novel techniques and products to control hospital infection rates and break the chain of transmission of bacteria in clinical settings</li><li>Exploratory work into developing low-cost technologies to remove antibiotics and associated chemicals from effluents</li></ul><h3>We will NOT consider funding for:</h3><ul><li>Proposals to develop diagnostic devices and technologies or for drug discovery. Although diagnostic devices and new drugs are potentially critical to AMR solutions, these areas are not unique to AMR challenges and should therefore be advanced more comprehensively against a broader landscape of possible needs and solutions. Thus, while excluded here, they may be part of a future request for proposals.</li><li>Proposals without a clear application to surveillance or facilitating the development of new evidence describing the global burden of AMR</li><li>Proposals seeking to apply existing tools in ways that do not transform our understanding of the global emergence or spread of AMR</li><li>Incremental improvements to conventional solutions or typical disease surveillance. We will not consider local surveillance programs or projects or small improvements in surveillance, e.g., use of mobile data collection, automation of traditional processes, or improving access to existing tools or technologies.</li><li>Proposals that simply expand the availability of primary data without a clear link to informing our understanding of global AMR epidemiology</li><li>Applications proposing basic research</li><li>Ideas not directly relevant to low- and middle-income contexts</li><li>Genomic and other laboratory-based approaches that lack a clear application to AMR surveillance or epidemiology</li><li>Ideas focused on quantifying resistance in animal or livestock populations or in environmental samples without a direct linkage to how data would impact public health practice</li><li>Proposals involving clinical trials in human volunteers or patients (note: use of existing datasets or other outputs from clinical trials may be considered, as long as the proposed approach is feasible within the time and financial envelopes provided).</li></ul>

Grand Challenges Africa

Grand Challenges Africa: New Approaches to Characterize the Global Burden of Antimicrobial Resistance

<p>Appropriate antibiotic use has the power to save lives in the most vulnerable communities, and antimicrobial resistance (AMR) impacts multiple global health priority areas: HIV/AIDS, tuberculosis, maternal and neonatal health, pneumonia, and enteric and diarrheal diseases. It is critical to better understand the prevalence of AMR and its impact on mortality in developing countries so that access to appropriate antibiotics is ensured while inappropriate use of antibiotics is limited. In particular, there is a need to better understand resistance in bacterial infections of newborns and young children – and to this end, understanding what is the prevalence of AMR in the community, how it impacts mortality, and how it impacts health targets. Tackling AMR will require a global, coordinated approach and the linking together of different research communities for new perspectives on the problem.</p>
<p>Note that this request for proposals is being launched on sequential dates by four Grand Challenges partnerships: African researchers located in African organizations should apply through the joint Grand Challenges Africa/Grand Challenges South Africa portal; Brazilian researchers located in Brazilian organizations should apply through the Grand Challenges Brazil portal; and Indian researchers located in Indian organizations should apply through the Grand Challenges India portal.</p>
<h3>What we are looking for:</h3>
<p>We seek new approaches that have the potential to transform public health action on a regional or global scale by identifying and filling gaps in knowledge on the burden of resistance to antibacterial agents – we are not seeking incremental improvements in typical disease surveillance solutions. Specifically, we seek projects that propose innovation in the following areas:</p>
<ul>
<li><strong>Data sources</strong>: Pilot tests of new sources of data, particularly those that would bring together different research communities for new perspectives on the problem</li>
<li><strong>Analytical methods</strong>: Pilot tests of bioinformatics approaches, including those that combine or connect existing databases in novel ways</li>
<li><strong>Biomarkers</strong>: Pilot tests of new biomarkers or combinations of biomarkers that could lead to new understanding of the actionable implications of antimicrobial resistance surveillance data</li>
<li><strong>Low-cost technologies and products</strong>: Exploratory work in developing new technologies and products, including 1) those that specifically target improved infection prevention and control in healthcare settings to reduce reliance on healthcare provider behavior change, and 2) technologies to remove antibiotics from effluents</li>
</ul>
<h3>We will give highest priority to those projects that:</h3>
<ul>
<li>Pilot test approaches that could be added to existing surveillance platforms, since we are not seeking to create new surveillance platforms</li>
<li>Incorporate multiple of the areas of innovation listed above</li>
<li>Could contribute to a portfolio of funded projects that addresses a country’s regional diversity and the diversity of vulnerable populations</li>
<li>Explain how proposed approaches will be tested so that they have the highest likelihood of being relevant for implementation in the country’s public health system</li>
</ul>
<h3>Examples of what we are looking for:</h3>
<ul>
<li>Characterizes type examples of the burden of AMR (e.g., exploring the role of AMR in community or hospital sepsis-related mortality, focusing on children)</li>
<li>Includes data sources that could indirectly reflect AMR burden (e.g., antimicrobial usage patterns or specifically how vaccination against respiratory or diarrheal diseases impacts antimicrobial use)</li>
<li>Addresses the diversity of vulnerable populations and the different aspects of the AMR burden that might be reflected in urban versus rural settings</li>
<li>Includes data sources ranging from the level of the individual (e.g., microbiome across body sites) to the community (e.g., public toilets and sanitation systems), while maintaining a focus on gaining new understanding of the actionable consequences of AMR gene flow.</li>
<li>Includes data sources that could reflect AMR transmission dynamics between communities (e.g., modes of transportation) or within communities over time (e.g., seasonal-related behaviors)</li>
<li>Provides an ecological perspective, such as a One Health perspective integrating antimicrobial use in livestock or perspectives that can integrate environmental monitoring in the community setting with medical monitoring in the hospital setting – if these perspectives are explicitly linked to human health outcomes and particularly a focus on vulnerable populations</li>
<li>Leverages opportunities to build in new ways on existing public health interventions or environmental monitoring platforms - and to bring together different research communities</li>
<li>Contributes to control of infections in healthcare settings: novel techniques and products to control hospital infection rates and break the chain of transmission of bacteria in clinical settings</li>
<li>Exploratory work into developing low-cost technologies to remove antibiotics and associated chemicals from effluents</li>
</ul>
<h3>We will NOT consider funding for:</h3>
<ul>
<li>Proposals to develop diagnostic devices and technologies or for drug discovery. Although diagnostic devices and new drugs are potentially critical to AMR solutions, these areas are not unique to AMR challenges and should therefore be advanced more comprehensively against a broader landscape of possible needs and solutions. Thus, while excluded here, they may be part of a future request for proposals.</li>
<li>Proposals without a clear application to surveillance or facilitating the development of new evidence describing the global burden of AMR</li>
<li>Proposals seeking to apply existing tools in ways that do not transform our understanding of the global emergence or spread of AMR</li>
<li>Incremental improvements to conventional solutions or typical disease surveillance. We will not consider local surveillance programs or projects or small improvements in surveillance, e.g., use of mobile data collection, automation of traditional processes, or improving access to existing tools or technologies.</li>
<li>Proposals that simply expand the availability of primary data without a clear link to informing our understanding of global AMR epidemiology</li>
<li>Applications proposing basic research</li>
<li>Ideas not directly relevant to low- and middle-income contexts</li>
<li>Genomic and other laboratory-based approaches that lack a clear application to AMR surveillance or epidemiology</li>
<li>Ideas focused on quantifying resistance in animal or livestock populations or in environmental samples without a direct linkage to how data would impact public health practice</li>
<li>Proposals involving clinical trials in human volunteers or patients (note: use of existing datasets or other outputs from clinical trials may be considered, as long as the proposed approach is feasible within the time and financial envelopes provided).</li>
</ul>


Grand Challenges Africa New Approaches to Characterize the Global Burden of Antimicrobial Resistance

Grand Challenges South Africa

Grand Challenges South Africa: New Approaches to Characterize the Global Burden of Antimicrobial Resistance

Grand Challenges South Africa New Approaches to Characterize the Global Burden of Antimicrobial Resistance

<h2>The Opportunity</h2>

<p>Increasingly, antimicrobial resistance (AMR) and drug resistant infections are being recognized as a crosscutting threat to global health. High rates of resistant infections have been documented in healthcare and community settings, in all WHO regions, and for a broad range of microorganisms. Despite the global focus, considerable gaps remain in our understanding of burden and resistance patterns, including the burden of drug-resistant infections on children in the highest mortality countries in Africa and Asia. A reliable evidence base that accurately describes and characterizes the aggregate burden of AMR in low- and middle-income settings will be essential to inform global and national priority setting and to drive public health actions.</p>

<p>These data gaps are directly relevant to the current debate surrounding the appropriate balance of access to antimicrobials for vulnerable populations vs. excessive use in many settings. For example, pediatric mortality primarily associated with drug-susceptible infections would benefit from interventions focused on broadly increasing access to antibiotics; conversely, if drug resistant infections are disproportionately contributing to mortality, the focus would shift to judicious and selective use of antibiotics to preserve their value and better target resistant infections.</p>

<h2>The Challenge</h2>

<p>Our goal is to identify approaches that provide more robust and reliable evidence regarding the global scale, impact, and/or transmission dynamics of AMR, specifically as applicable to low- and middle-income settings. We also seek solutions that will provide an assessment of various drivers and the health impact of interventions on rates of resistance.</p>

<p>Because AMR is a complex problem with multiple interconnected drivers and our focus is on high mortality and data-poor geographies, these approaches will likely require new data streams and approaches (e.g. modeling) applied in a sufficiently robust way to lead to strategic guidance for decision-makers.</p>

<h3><strong>What we are looking for:</strong></h3>

<p>We are soliciting innovative ideas for models, tools, analytics, surveillance platforms, technologies, and other high impact approaches to generating evidence about the burden and impact of antimicrobial resistance in low and middle income settings, and improving its translation into practice. We are particularly seeking transformative and innovative approaches which identify and fill knowledge and practice gaps currently limiting progress in AMR surveillance and epidemiology.</p>

<p>Proposed projects should have the scope and potential to transform public health practices for AMR on a global or regional scale.</p>

<p>Specifically, we seek proposals that support the following.</p>

<ol>
	<li>Evaluating and prioritizing the impact of drivers of antimicrobial resistance, including existing interventions, environmental factors, etc.</li>
	<li>Accelerating the generation of robust, generalizable, evidence to characterize and track the global epidemiologic and economic burden of AMR.</li>
	<li>Understanding and describing the epidemiology of molecular resistance and transmission of AMR</li>
</ol>

<p>We will consider a wide variety of approaches, as outlined below, provided a case can be made for how the approach will facilitate and support the generation of generalizable evidence that will improve our ability to document and track the burden of AMR, and use the resulting data to inform policy making, prioritization, and action. Programs should show a clear path to scale widely across our priority geographies.</p>

<p>Proposals must i) have a testable hypothesis, ii) include an associated plan for how the idea will be tested or validated, and iii) yield interpretable and unambiguous data in Phase I in order to be considered for Phase II funding. Proposals and associated outputs must be directly relevant to developing contexts.</p>

<p>A few examples of work that would be considered for funding:</p>

<ul>
	<li>Proposals that quantify the contribution of various drivers and/or interventions on the global emergence and spread of AMR.</li>
	<li>Novel metrics and analytic approaches (e.g. using previously unappreciated data/sources or new analytical methods) to provide a more complete picture of the scale, impact, or dynamics of global AMR.</li>
	<li>Integrated approaches to understanding and describing the association between resistance patterns, anti-microbial use, access, and health and economic burden.</li>
	<li>Proposals focused on creating novel high-level, scalable systems architecture (e.g. data sources and streams) and activities necessary to transform global AMR epidemiology.</li>
	<li>Proposals that provide a detailed analysis of the economic and health systems impacts of AMR.</li>
	<li>Non-incremental innovative technology and surveillance platforms capable of accelerating the generation of robust evidence to document and track the burden of AMR. To be relevant to this call, the proposal should be scalable to a large number of contexts and/or provide generalizable insights.</li>
	<li>Methods to improve surveillance capacity and reporting of AMR <em>beyond enhanced routine surveillance and targeted surveys</em> (e.g. the application of genomics and machine learning).</li>
</ul>

<h3><strong>We will not consider funding for:</strong></h3>

<ul>
	<li>Proposals without a clear application to surveillance or facilitating the development of new evidence describing the global burden of AMR.</li>
	<li>Proposals seeking to apply existing tools in ways that do not transform our understanding of the global emergence and/or spread of AMR.</li>
	<li>Incremental improvements to conventional solutions or typical disease surveillance. We will not consider local surveillance programs or projects or small improvements in surveillance, (e.g. use of mobile data collection, automation of traditional processes, improving access to existing tools or technologies).</li>
	<li>Proposals that simply expand the availability of primary data without a clear link to informing our understanding of global AMR epidemiology.</li>
	<li>Applications proposing basic research.</li>
	<li>Ideas not directly relevant to low and middle income contexts.</li>
	<li>Proposals focused on upstream development of new diagnostics, therapeutics, or interventions to treat or control resistant infections, unless these can be actively implemented in a way that informs AMR epidemiology.</li>
	<li>Genomic and other laboratory-based approaches that lack a clear application to AMR surveillance and/or epidemiology.</li>
	<li>Ideas focused on quantifying resistance in animal/livestock populations or in environmental samples without a direct linkage to how data would impact public health practice.</li>
	<li>Proposals involving clinical trials in human volunteers or patients (note: use of existing datasets or other outputs from clinical trials may be considered, so long as the proposed approach is feasible within the time and financial envelopes provided).</li>
</ul>


Grand Challenges Explorations

Novel Approaches to Characterizing and Tracking the Global Burden of Antimicrobial Resistance (Round 17)

<h2>The Opportunity</h2>

<p>Increasingly, antimicrobial resistance (AMR) and drug resistant infections are being recognized as a crosscutting threat to global health. High rates of resistant infections have been documented in healthcare and community settings, in all WHO regions, and for a broad range of microorganisms. The increasing prevalence and geographic distribution of AMR threatens to undermine decades of progress in effective prevention and control of high-priority infectious diseases; these include multidrug-resistant TB, artemisinin resistance in malaria, and antibiotic resistance in the most common bacterial agents causing pneumonia, diarrheal disease, neonatal sepsis, enteric fever, sexually transmitted diseases, maternal infections, and other syndromic infections. A reliable evidence base that accurately describes and characterizes the global burden of AMR will be essential to addressing this challenge and will inform global and national priority setting, public health actions, and treatment decisions.</p>

<h2>The Challenge</h2>

<p>Despite the increasing global focus, considerable gaps remain in our understanding of AMR. There is an unmet need in the generation and dissemination of high-quality evidence describing the impact of resistant organisms on specific populations (e.g. children, newborns, and mothers), health outcomes (morbidity and mortality), costs, and target geographies. The relative impact of specific resistant pathogens is also poorly understood. Each of these gaps in evidence negatively impacts the community’s ability to fully understand the extent (incidence, prevalence), distribution (across geographies, specific populations, and settings), and diversity (across pathogens and populations) of AMR, and appropriately develop and prioritize interventions.</p>

<p>AMR is a complex problem with multiple interconnected drivers. A multipronged approach to evidence generation will be necessary to fully address knowledge gaps and effectively understand and control emerging resistance. A necessary first step will include strengthening surveillance capabilities and identifying novel methods to document and track burden, understand transmission, and describe the relative health impact of possible interventions.</p>

<h3>What We Are Looking For:</h3>

<p>We are soliciting innovative ideas for tools, technologies, models, analytics, surveillance platforms, and other approaches to generate evidence about the burden and impact of antimicrobial resistance and improve its translation into practice.</p>

<p>Specifically, we seek proposals that support the following:</p>

<ol>
	<li>Accelerating the generation of robust evidence to characterize and track the epidemiologic and economic burden of AMR</li>
	<li>Understanding and describing the epidemiology of resistance and transmission of AMR</li>
	<li>Evaluating and prioritizing the impact of existing and novel interventions on resistance patterns</li>
</ol>

<p>We are particularly seeking approaches which identify and fill knowledge and practice gaps currently limiting progress in AMR surveillance and epidemiology. We will consider a wide variety of approaches, as outlined below, provided a case can be made for how the approach will facilitate and support the generation of evidence that will improve our ability to document and track the burden of AMR, and use the resulting data to inform policy making, prioritization, and action.</p>

<p>Proposals must i) have a testable hypothesis, ii) include an associated plan for how the idea will be tested or validated, and iii) yield interpretable and unambiguous data in Phase I in order to be considered for Phase II funding. Proposals and associated outputs must be directly relevant to developing countries.</p>

<h3>A few examples of work that would be considered for funding:</h3>

<ul>
	<li>Innovative technology and surveillance platforms capable of accelerating the generation of robust evidence to document and track the burden of AMR. Specifically, we seek approaches that can provide detailed information about the extent (incidence, prevalence), distribution (across geographies, specific populations, and settings), and diversity (across pathogens and populations) of resistance.</li>
	<li>Methods to improve surveillance capacity and reporting of AMR beyond enhanced routine surveillance and targeted surveys (e.g. the application of genomics and machine learning).</li>
	<li>New approaches to analytic and/or epidemiologic modeling which accurately capture and quantify the contribution of AMR to global burden of disease, and the impact of resistant infections on health outcomes and costs.</li>
	<li>New metrics and analytic approaches (e.g. composite indexes) to describe and define the burden of AMR.</li>
	<li>Integrated approaches to understanding and describing the association between resistance patterns, anti-microbial use, access, and health and economic burden.</li>
</ul>

<h3>We will not consider funding for:</h3>

<ul>
	<li>Proposals without a clear application to surveillance or facilitating the development of new evidence describing the global burden of AMR.</li>
	<li>Applications proposing basic research not focused on in-scope work.</li>
	<li>Ideas not directly relevant to developing countries.</li>
	<li>Proposals focused on developing new targets, therapeutics, or interventions to treat or control resistant infections.</li>
	<li>Genomic and other laboratory-based approaches that lack a clear application to AMR surveillance and/or epidemiology .</li>
	<li>Proposals involving clinical trials in human volunteers or patients (note: use of existing datasets or other outputs from clinical trials may be considered, so long as the proposed approach is feasible within the time and financial envelopes provided).</li>
	<li>Ideas that provide only incremental improvements to conventional solutions (e.g. small improvements in surveillance, improving access to existing tools or technologies).</li>
</ul>
