Grand Challenges is a family of initiatives fostering innovation to solve key global health and development problems. Each initiative is an experiment in the use of challenges to focus innovation on making an impact. Individual challenges address some of the same problems, but from differing perspectives.

Challenges

This Challenge seeks innovative approaches to enhance climate adaptation for agriculture in Africa in ways that link directly with and strengthen the ecosystem of local actors and institutions. Specifically, the objective of the challenge will be to support innovations that strengthen agriculture-related risk management processes and adaptation prioritization, planning, and investment, through intra-Africa research collaboration on data, data science, and modeling.

For more information, please visit the <a href="https://scienceforafrica.foundation/funding" rel="noopener" target="_blank">Grand Challenges Africa</a> website; to apply to this request for proposals, use the link to the right.

Grand Challenges Africa

African Agriculture Climate Adaptation Research System

This Challenge seeks innovative approaches to enhance climate adaptation for agriculture in Africa in ways that link directly with and strengthen the ecosystem of local actors and institutions. Specifically, the objective of the challenge will be to support innovations that strengthen agriculture-related risk management processes and adaptation prioritization, planning, and investment, through intra-Africa research collaboration on data, data science, and modeling.
For more information, please visit the <a href="https://scienceforafrica.foundation/funding" rel="noopener noreferrer" target="_blank">Grand Challenges Africa</a> website; to apply to this request for proposals, use the link to the right.

This Challenge seeks innovative approaches to enhance climate adaptation for agriculture in Africa in ways that link directly with and strengthen the ecosystem of local actors and institutions. Specifically, the objective of the challenge will be to support innovations that strengthen agriculture-related risk management processes and adaptation prioritization, planning, and investment, through intra-Africa research collaboration on data, data science, and modeling.

This Challenge seeks innovations that contribute to the development of safe and effective non-hormonal contraceptives that meet the needs and interests of women and that address key barriers in accessing and using currently available methods. We are seeking non-hormonal contraceptives that are easy to access, discreet, convenient, and non-invasive. Additionally, it is important that these methods have tolerable side effects and do not impact the menstrual cycle.

For more information, please visit the <a href="https://scienceforafrica.foundation/funding" target="_blank">Grand Challenges Africa</a> website; to apply to this request for proposals, use the link to the right.

Strengthening the Contraceptive Research and Development Ecosystem in Africa: Accelerating Innovations in Non-Hormonal Contraception for Women

This Challenge seeks innovations that contribute to the development of safe and effective non-hormonal contraceptives that meet the needs and interests of women and that address key barriers in accessing and using currently available methods. We are seeking non-hormonal contraceptives that are easy to access, discreet, convenient, and non-invasive. Additionally, it is important that these methods have tolerable side effects and do not impact the menstrual cycle.
For more information, please visit the <a href="https://scienceforafrica.foundation/funding" target="_blank" rel="noopener noreferrer">Grand Challenges Africa</a> website; to apply to this request for proposals, use the link to the right.

This Challenge seeks innovations that contribute to the development of safe and effective non-hormonal contraceptives that meet the needs and interests of women and that address key barriers in accessing and using currently available methods. We are seeking non-hormonal contraceptives that are easy to access, discreet, convenient, and non-invasive. Additionally, it is important that these methods have tolerable side effects and do not impact the menstrual cycle.

Strengthening the Contraceptive Research and Development Ecosystem in Africa Accelerating Innovations in Non-Hormonal Contraception for Women

<h2>Background</h2>

The COVID-19 pandemic has brought unprecedented challenges for Africa, with every country potentially at risk for unmitigated spread of SARS-CoV-2. Like most health systems in the world, there is a significant risk for current levels of care to be overwhelmed by sheer volume of patients requiring intensive care and ventilatory support. In addition, health care workers are at risk of acquiring SARS-CoV-2 and given limited infection control practices in many settings, there is also risk of nosocomial transmission of SARS-CoV-2 among patients.

The emergence of new SARS-CoV-2 variants is further raising concerns of the possibility of re-infection among those previously infected with the 'wild type' virus. A recent survey conducted by the African Academy of Sciences Scientific Priority setting initiative found that the most important questions that African scientists, health care workers and public health officials should study included the detailed epidemiology and transmission dynamics in African settings, as well as infection prevention and control for health care workers. These are questions that are widely applicable across the continent yet require local context and expertise to address in a timely and effective manner.

Pathogen genomic sequencing (PGS) has been increasingly used in wealthy countries to help respond to outbreaks of infectious diseases, from MDR bacteria to Ebola to Yellow Fever, Measles, and Polio. Already, PGS has been shown to be important in understanding the transmission dynamics and epidemiology of SARS-CoV-2 in the US, Europe, and China. PGS has been used for outbreak size estimation based on phylodynamic analyses and to identify and characterize new variants.

The emergence of new SARS-CoV-2 variants in multiple locations across the world, including in Africa, has highlighted the need for genomic sequencing in surveillance and epidemiology. PGS has enabled the identification of emergent strains and provided the ability to monitor their spread. Genomic data has allowed for characterization of mutations, providing insights into possible mechanistic changes and biological implications. These insights provide the first clue of potential impact on the effectiveness of therapeutics, such as monoclonal antibodies, and vaccines that may warrant further investigation. Furthermore, the ability for genomic sequencing to differentiate which SARS-CoV-2 variant someone has been infected with, makes PGS an important tool for aiding in the investigation of changes to transmissibility and impact on clinical outcomes of new variants.

Genomic sequencing of SARS-CoV-2 can also help in effectively managing and controlling the epidemic in the continent by providing information to allow a precise identification of transmission clusters and of mutations of the virus. The information obtained can also help in tailoring new vaccine and/or treatment efforts within Africa by for example combining genetic, clinical, and epidemiological data.

Contrary to initial models and forecasts, the reported number of cases and mortality rates reflect a markedly less severe epidemiologic picture of COVID-19 in Africa. Consequently, SARS-CoV-2 sequencing (COVID-19 genomics) may also shed some light on the underlying factors possibly explaining these differences between Africa and those other parts of the world. It is important to note that human genomics will not be covered by this call. Furthermore, sequencing can help to monitor and characterize the changes to the genetic epidemiology of the COVID-19 pandemic after vaccine introduction. Unfortunately, PGS is not in widespread use in Africa. A rapid introduction of PGS in Africa will help in the fight to control SARS-CoV-2 and help prepare the continent for the next epidemic not yet identified.

Over the past three years, the Africa CDC has established expertise in PGS. In 2020 along with partners, Africa CDC launched the Africa Pathogen Genomics Initiative, which will include many activities to strengthen the capacity for and public health use of PGS in Africa. One such activity is the development of a continental laboratory network that will eventually have advanced sequencing capacity at national public health institutes across at least 20 African countries. Africa CDC has the mandate and vision to bring together African thought leaders in PGS in a coherent and sustainable peer network through the pan-continent Africa Pathogen Genomics Initiative. The challenge will support the parallel development of a cadre of African scientists and public laboratories who can contribute substantively to this initiative.

<h2>The Challenge</h2>

Grand Challenges Africa, in partnership with the Bill &amp; Melinda Gates Foundation and the Swedish International Development Cooperation Agency (SIDA) invites proposals that will primarily support public-health-use cases of PGS in African settings to respond to the Covid-19 pandemic. Grand Challenges Africa (GC Africa) is a program that seeks to promote Africa-led scientific innovations to help countries better achieve the Sustainable Development Goals by awarding seed and full grants to the continent's most impressive solutions and has covered topics such as Data Science Approaches to Improve Maternal and Child Health in Africa, Innovation for WASH (Water, Sanitation, and Hygiene) in Urban Settings, &amp; Drug Discovery. Through this partnership, we seek to make awards that will support increased understanding of SARS-CoV-2 in Africa for use in public health decision making.

Specifically, the objectives of the challenge will be:

<ol>
	<li>Use of PGS to establish routine genomic surveillance and understand the epidemiology and transmission of SARS-CoV-2</li>
	<li>Use of PGS in public health field epidemiology response for SARS-CoV-2 to investigate new virus variants and their impact on the epidemiology of Covid-19</li>
	<li>Use of PGS to monitor the impact of vaccine introduction on the epidemiology of SARS-CoV-2 in terms of transmission dynamics and/or incidence of virus variants.</li>
	<li>Use PGS to inform the development of diagnostics and/or therapeutics and/or monitor the impact of new product introduction.</li>
</ol>

Projects addressing more than one challenge (e.g. clinical and field epidemiology) are encouraged. In some geographies many of these challenges exist simultaneously, at different times for different populations; in other geographies only one or two of these challenges predominate. Applications should clearly state which of these challenges is being targeted and provide clear rationale for why the project is likely to address the challenge.

Applications should also state how the knowledge generated from their proposal would be produced in a timely manner in order to inform public health decision making. We expect that PGS data on SARS-CoV-2 will be shared immediately with local government health officials as well as uploaded to a standard repository for genetic data such as GISAID, NCBI or ENA, all in compliance with applicable data protection laws. Such sharing is important for the public health response locally but also globally.

Responding to the above challenges requires a multidisciplinary approach. Thus, collaborative work is highly encouraged.

What we are looking for:

We will highly preference funding for projects in national public health institutes or other public laboratories with links to the public health systems that focus on pathogen genomic sequencing.

All applications should:

<ul>
	<li>Describe how laboratory and staff can immediately put to use PGS technology at your site to respond to at least one of the challenges listed above.</li>
	<li>Describe how the data generated from your project will be used to inform public health decision making in your country and/or region in a timely manner. How will you communicate your findings and engage with stakeholders to ensure uptake and use of your findings for these public health purposes?</li>
	<li>Given the fast-moving nature of the research field into SARS-CoV-2, how will you ensure that the results that your work produces are timely, and the question being addressed is still relevant at the time when the results are available.</li>
	<li>Describe the sampling approach for obtaining specimens for genomic sequencing and how the sampling approach will be optimized to answer at least one of the challenges outlined above. In addition, describe how metadata and clinical, epidemiological or other data will be collected and combined with the PGS data to answer at least one of the challenges listed above.</li>
	<li>Articulate how the capacity built through the proposed project will strengthen your institute’s approach to using PGS for surveillance beyond the covid-19 pandemic.</li>
</ul>

A few of the many options we will consider include (but are not limited to) support for:

<ul>
	<li>Laboratory equipment, supplies and reagents needed for next generation pathogen genomic sequencing (PGS). Centers with Sanger sequencing capabilities can also apply.</li>
	<li>Field supplies for sample collection, transportation, storage and preparation.</li>
	<li>Collection of linked epidemiological data and meta-data.</li>
	<li>Laptop or computer with appropriate software for the analysis; high speed internet access and cloud compute time, if not provided through the Africa CDC lab network.</li>
	<li>Salary for personnel (including for example laboratory personnel, epidemiologist, field staff to collect samples).</li>
	<li>Training specific for PGS technology or bioinformatics, either online or in person.</li>
	<li>Travel to Africa CDC to support network development or to present findings at an international conference.</li>
	<li>Costs for high performance computing, where applicable.</li>
</ul>

We will not consider funding for projects that do not primarily respond to SARS-CoV-2 public health response. Human genomics will not be covered by this call.

NOTE: This opportunity was open to an invited set of African investigators.

Covid-19 Pathogen Genomic Sequencing (PGS) in Africa

Note: This call for applications was targeted at persons already holding a grant or a sub-grant in the DELTAS Africa, Grand Challenges Africa, H3Africa, FLAIR or any other program of the AAS.

<h2>BACKGROUND</h2>

The COVID-19 pandemic has brought unprecedented challenges for Africa, with every country potentially at risk for unmitigated spread of SARS-CoV2. Like most health systems in the world, there is a risk for current levels of care to be overwhelmed by sheer volume of patients requiring intensive care and ventilatory support. In addition, health care workers are at risk of acquiring SARS-CoV2 and given limited infection control practices in many settings, there is also risk of nosocomial transmission of SARS-CoV2 among patients.

The African Academy of Sciences (AAS) is keen to play a central role in building African Research and Development (R&amp;D) capacity to fight COVID-19 by managing day-to-day running of the proposed fund for COVID-19 R&amp;D priorities in Africa. A recent survey of African scientists conducted by the AAS developed initially from an AAS "All Hands" webinar on COVID-19 held on 26th March 2020 and conducted from the 4th to 8th of April 2020 established a priority list of Research and Development questions for the COVID-19 outbreak in Africa. The <a href="https://gcgh.grandchallenges.org/sites/default/files/files/research-and-development-goals-for-covid-19-in-africa.pdf" target="_blank">results of the survey can be found here.</a>

This call, supported by Sida (Sweden), Wellcome Trust, and the Bill and Melinda Gates Foundation, is, therefore, a call to action for African scientists to attend to the research and development needs of the COVID-19 outbreak for the continent as identified by African scientists. There is need to provide robust scientific evidence to the country emergency response teams. The priorities listed are widely applicable across the continent yet require local context and expertise in order to address in a timely and effective manner the issues arising even as the outbreak evolves.

The call is open to institutions that are based in Africa.

<h2>Objective</h2>

This call will focus on areas of priority for research and development in COVID-19 outbreak control as identified by African scientists. These areas of focus include but are not limited to;

<ul>
	<li>Epidemiological studies;</li>
	<li>Clinical management;</li>
	<li>Infection prevention and control, including health care protection;</li>
	<li>Candidate vaccines, diagnostics and therapeutics;</li>
	<li>Ethical considerations for research;</li>
	<li>Social sciences in a pandemic response.</li>
</ul>

To be more specific, below is an example of priority questions for this call. Questions that seek to deliver any of the below will be prioritized. For reference please check the <a href="https://gcgh.grandchallenges.org/sites/default/files/files/research-and-development-goals-for-covid-19-in-africa.pdf" target="_blank">results of the AAS COVID-19 survey here</a>.

<ul>
	<li>Understand the effectiveness of movement control strategies to prevent secondary transmission in health care and community settings;</li>
	<li>Optimize the effectiveness of PPE and its use in reducing the risk of transmission in health care and community settings;</li>
	<li>Develop new PPE approaches using local materials and manufacturing processes;</li>
	<li>Understand behavioral and cultural factors influencing compliance with evidence-based Infection Prevention and Control measures;</li>
	<li>Describe the transmission dynamics of COVID-19 and understand the spread of disease nationally, regionally and globally;</li>
	<li>Describe disease severity and susceptibility to facilitate effective clinical and public health response to COVID-19 identify groups at high risk of severe infection;</li>
	<li>Perform rapid population cross-sectional surveys to establish the extent of virus transmission using a standardized sampling framework;</li>
	<li>Establish suitable cohorts and prospectively collect laboratory and outcome data;</li>
	<li>Have a special focus on potentially at-risk groups including malnourished individuals and people with HIV, TB, Sickle Cell, and uncontrolled chronic disease patients;</li>
	<li>Evaluate the impact of control and mitigation measures e.g., modelling to estimate the effects of social distancing measures and other non-pharmaceutical interventions;</li>
	<li>Develop protocols for the management of severe disease in the absence of intensive care facilities;</li>
	<li>Determine interventions that improve the clinical outcome of COVID-19 infected patients;</li>
	<li>Determine optimal clinical practice strategies to improve the processes of care e.g., develop criteria for early diagnosis, when to discharge, when to use adjuvant therapies for patients and contacts;</li>
	<li>Develop innovative approaches to use as alternatives to ventilation;</li>
	<li>Identify prognostic factors for severe disease;</li>
	<li>Develop platform(s) to maximize the commonality of data collection across trials, and collaborations between trials;</li>
	<li>Define the natural history of COVID-19 infection through careful standardized and comprehensive clinical and laboratory description of cases;</li>
	<li>Determine how best to link key research questions with researchers in affected regions who are able to recruit patients;</li>
	<li>Develop mechanisms to support coordinated collaboration to implement clinical trials for evaluation of safety/efficacy of therapeutics;</li>
	<li>Develop a Multicenter Master Protocol to evaluate efficacy and safety;</li>
	<li>Identification of existing candidates for clinical evaluation in addition to the ones already prioritized;</li>
	<li>Support basic science to identify new drug targets;</li>
	<li>Develop a multi-country Master Protocol for Phase 2b/Phase 3 vaccine evaluation to determine whether candidate vaccines are safe and effective before widespread distribution;</li>
	<li>Build capacity development for basic science and pre-clinical development of new vaccines;</li>
	<li>Identify therapeutic candidates for clinical evaluation in addition to the ones already prioritized;</li>
	<li>Establish processes for speeding up an ethical review of COVID-19 related research proposals;</li>
	<li>Establish a panel of African ethicists to provide rapid support to local ethical committees assessing COVID-19 related research proposals;</li>
	<li>Define a research governance framework that enables effective and ethical collaboration between multiple stakeholders, including WHO, the global research community, subject matter experts, public health officials, funders, and ethicists;</li>
	<li>Sustained education, access, and capacity building to facilitate effective cross-working and collaboration across the research thematic areas;</li>
	<li>Identify key knowledge gaps and research priorities in relation to ethical issues arising out of proposed restrictive public health measures (e.g., quarantine, isolation, cordon sanitaire);</li>
	<li>Support work to develop cheaper, faster easier to use in field antigen tests (for virus detection);</li>
	<li>Support work to develop cheaper, faster easier to use in field antibody tests (for determining exposure);</li>
	<li>Support the development of diagnostics products to improve clinical processes;</li>
	<li>Support work to examine alternative approaches to delivering testing e.g., centralized versus devolved lab facilities;</li>
	<li>Characterize immunity (naturally acquired, population and vaccine-induced, including mucosal immunity);</li>
	<li>Develop tools and conduct studies to monitor phenotypic change and potential adaptation of the virus;</li>
	<li>Establish capacity for genotyping virus e.g., to detect new mutations over time;</li>
	<li>Pathogen genetic sequencing and network development that primarily responds to SARS-CoV-2 public health response <a href="https://gcgh.grandchallenges.org/sites/default/files/files/aas_pathogen_genetic_sequencing_information_for_the_covid-19_call_01052020.pdf" target="_blank">according to this document</a>;</li>
	<li>Determine virus stability in the environment;</li>
	<li>Understand virus compartments, shedding and natural history of the disease;</li>
	<li>Develop disease models in animals;</li>
	<li>Examine optimal ways of communicating about potential interventions in high-density low socioeconomic status urban settings;</li>
	<li>Ensure that knowledge is produced according to local, national and regional needs;</li>
	<li>Investigate ways of ensuring transparency of information flow and mitigating false information spread by various mechanisms;</li>
	<li>Develop guidelines and Standard Operating Procedures (SOPs) to operationalize epidemic mitigation mechanisms;</li>
	<li>Engage with communities to bring their voices to decision-making processes;</li>
	<li>Develop and connect global research networks with response partners;</li>
	<li>Understand how social and economic impacts need to be mitigated;</li>
	<li>Investigate innovative approaches to short-term economic support of vulnerable populations such as cash transfer by mobile money mechanisms;</li>
	<li>Promote the prioritization of knowledge needs according to epidemic dynamics;</li>
	<li>Develop innovative interdisciplinary science;</li>
	<li>Ensure that non-social scientists easily understand knowledge outputs and methodological limitations;</li>
	<li>Support work to understand the non-intended consequences of epidemic-control decisions;</li>
	<li>Support work to understand contextual vulnerability of work in COVID-19 outbreak control;</li>
	<li>Understand how decisions in the field may inadvertently undermine response goals;</li>
	<li>Design and test suitable risk reduction strategies at the human-animal-environment interface;</li>
	<li>Improve the understanding of socioeconomic and behavioral risk factors for spill-over and transmission between animals and humans;</li>
	<li>Identify animal source and route of transmission (hosts, any evidence of continued spill-over to humans and transmission between animals and humans).</li>
</ul>

We will not consider funding for:

<ul>
	<li>Projects that do not primarily respond to the research and development goals of the COVID-19 public health outbreak response;</li>
	<li>Projects focusing on implementation or delivery services for the COVID-19 outbreak control;</li>
	<li>Projects solely focused on network building, capacity building and infrastructure projects without a working hypothesis;</li>
	<li>Complex and high-risk projects that cannot be undertaken within the 24 months available;</li>
	<li>Projects with minimal contribution towards the R&amp;D priorities of the COVID-19 outbreak.</li>
</ul>

Funding Amount

The maximum amount allowable for a single grant is US$200,000 to be held for two (2) years.

COVID-19 Research and Development Priorities in Africa

Preamble

The African Academy of Sciences (AAS), the <a href="https://www.bmbf.de/bmbf/en/home/home_node.html" target="_blank">German Federal Ministry of Education and Research</a> (Bundesministerium für Bildung und Forschung, BMBF) and the <a href="https://www.gatesfoundation.org/" target="_blank">Bill &amp; Melinda Gates Foundation</a> have come together in a transformative partnership to support African investigators to accelerate MNCH targets towards the Sustainable Development Goals (SDGs) for health.

The first initiative of the partnership is to launch a new Grand Challenge: Focusing on top priorities for MNCH in Africa – solutions to meet the Sustainable Development Goal 3 targets for maternal, neonatal and child health.

<h2>The Challenge</h2>

This challenge focuses on the top priorities for MNCH in Africa 2019 and aligns with the findings of the MNCH research prioritization using The Child Health and Nutrition Research Initiative (CHNRI) process conducted in 2019 in Africa. CHNRI uses the principles of wisdom of the crowds to systematically collect and transparently score research options against important criteria in a particular field. In a three-stage democratic process lasting 7 months, the MNCH expert convening 2019, aggregated thoughts from MNCH experts working in Africa and showed that there is a need to concentrate on four areas of importance in MNCH that remain a grand challenge for Africa. These are:

<ul>
	<li>better health during pregnancy</li>
	<li>better care at birth</li>
	<li>better post-birth care for women and their newborns</li>
	<li>better hospital care of sick newborns</li>
</ul>

The aggregated research priorities are across the spectrum of health research and in all four domains of description (epidemiology), discovery (new interventions), development (improvement of existing interventions), and delivery (implementation research, including health systems).

This is, therefore, a call for proposals looking for big, bold, innovative ideas that can have the greatest impact on African maternal and neonatal health with the potential for future sustainability and scaling.

This will be the third maternal and neonatal child health call and the eighth call from GC Africa since its inception in 2016.

These grand challenges innovation grants will be issued and administered under the banner of Grand Challenges Africa (GC Africa), a program of the AAS implemented through the AAS funding and program management platform – the Alliance for Accelerating Excellence in Science in Africa (AESA), which was created in partnership with the <a href="https://www.nepad.org/" target="_blank">African Union Development Agency</a> (AUDA: formerly (NEPAD Agency) and global partners including the Bill &amp; Melinda Gates Foundation.

Funding for this call

GC Africa and partners will fund African investigators through this GC Africa Innovation Seed Grants' (GCA-ISG) call (round 8). Subject to the eligibility requirements in the GCA Rules &amp; Guidelines, African investigators are invited to apply, with the support of the primary organization where they are affiliated, and where the major part of the work will be undertaken. Applications MUST be submitted through the AAS Ishango Online Application Portal. Grants will go to institutions and investigators in African countries.

Though not a must, we encourage initiating South to South partnerships and partnerships between African lead PIs and co-investigators in Germany or other Northern countries especially where the opportunity exists to combine synergies and promote innovations in MNCH. New and existing collaborations will be welcomed.

Applicants can be at any level of experience and working in any discipline from organizations such as colleges and universities, government units, hospitals, research institutions, for-profit and non-profit organizations.

Funding levels

The GCA-ISG grants will fund projects up to USD $100,000 for 2 years. These awards are meant to provide an opportunity to test particularly bold, proof of concept ideas, including applying approaches from outside the fields indicated for this call. New approaches could be piloted as additions to ongoing projects. Winners of the GCA-ISG grants will have an opportunity to apply for follow-on, transition to scale funding in the future. Please note that support for phase II or transition to scale funding is NOT part of this call. Funded at up to $1 million per three-year project, phase II awards require substantial preliminary data and are meant to provide an opportunity to develop, refine, and rigorously test combinations of activities, including sets of interventions for which some or all have previously shown promise in controlled or limited settings. We expect that successful projects funded under this seed call, and which demonstrate promising results, will have the opportunity to apply for Phase II follow-on funding either to GC Africa or directly to our partners.

In all cases, individual project budgets should be representative of the scope and magnitude of the proposed studies and carefully designed to get the best possible value out of the award. The AAS does rigorous budget challenges during the due diligence process. The applicant’s recipient institution, organization or company will also be required to provide assurances on their capacity to manage the grant through detailed letters of support from the appropriate research or innovation support office, previous or current partners. The AAS reserves the right to undertake due diligence site visits to organizations hosting successful candidates before making final awards. Due diligence will include a request to fill out the Good Financial Grants Practice (GFGP) financial governance assessments to allow AAS to determine an institution's eligibility and capacities for managing the grant.

<h2>Background</h2>

While great strides have been made in reducing mortality in Africa, maternal and neonatal mortality rates remain unacceptably high. Estimates show that over half the global maternal deaths and over three-quarters of neonatal deaths occur in sub-Saharan Africa.

The WHO argues that "the major direct causes of maternal morbidity and mortality include hemorrhage, infection, high blood pressure, unsafe abortion, and obstructed labor. These complications may arise unexpectedly. Investing in health systems - especially in training midwives and in making emergency obstetric care available round-the-clock - is key to reducing maternal mortality".

The close relationship between mothers and their infants results in shared aetiologies and as a result, around half of the newborn deaths are due to mother transmitted infections, including tetanus. Critically, the risk of dying during the first day of life in Africa is close to 1% with the top three causes being infections, birth asphyxia and complications of preterm birth which together account for 88% of the newborn deaths. Effective interventions to help reduce this mortality would target the management of labor and delivery, preterm births, timely diagnosis and treatment of serious infectious diseases, malnutrition and non-communicable diseases in both mothers and children.

Addressing the barriers to the use of care and creating an environment within households and communities that support women in seeking the needed care is also key.

<h2>Program Goal</h2>

This call is focused on the SDG3 targets with the overall objective of focusing African scientists to work in local and global partnerships on the ambitious but achievable goals of accelerating knowledge generation, developing and deploying interventions and innovations. These should advance the prevention of maternal deaths, preterm birth, and neonatal deaths and improve the implementation of policies and innovations that will improve care for the mother and child in the first 1000 days of life. The ultimate goal of this challenge is to determine what packages of interventions should be delivered to which group of individuals (mother or infant or both) to reduce the burden of maternal and neonatal deaths in Africa. While new innovations and interventions are required, much progress can be made if we find innovative approaches to deliver already available interventions i.e., we will also be looking for proposals that focus on innovative approaches to deliver existing life-saving innovations.

This joint initiative of GC Africa partners (AAS, BMBF, and Gates foundation) also aims to nurture and strengthen the innovation ecosystem in Africa by supporting the development of sustainable research networks that will contribute to solving Africa's challenges in Global Health. We want to develop a community of African leaders in MNCH research and innovation; strengthen the development of innovative solutions facilitating the resolution of challenges in global health and development that Africa is facing; reinforce research and training capacity, and equitable partnerships in African institutions through skills transfer between international networks and organizations hosting the grand challenges projects; and facilitate sustainable multidisciplinary partnerships between research groups in Africa. Enable the adoption of new technologies, innovations and policies to prevent maternal and neonatal deaths.

<h2>Program Objectives</h2>

We are looking for innovations that:

<ol>
	<li>Package known interventions in a way that ensures they are delivered efficiently and cost-effectively and or promote MNCH in otherwise excluded communities.</li>
	<li>Apply new technologies to enable rapid identification of risks or management of conditions (communicable and non-communicable) that lead to poor outcomes in pregnancy, birth and in the first month of life.</li>
	<li>Apply precision medicine techniques to identify or manage common exposures in Africa that may increase susceptibility to communicable and non-communicable diseases in mothers and children under 5 years of age.</li>
</ol>

What We are Looking for

To reach these objectives, we are looking for projects that propose innovation in the following areas:

<ul>
	<li>Delivery tools: Innovative approaches or new ways to deliver already available interventions i.e., proposals that focus on packages / innovative approaches to deliver existing proven life-saving innovations</li>
	<li>Measurement tools: Pilot tests of new measurement tools, such as those based on a new technology or new biomarkers to enable the timely diagnosis, monitoring or management of maternal conditions that can lead to significant improvement of fetal and neonatal outcomes as well as prevent maternal mortality and morbidity.</li>
	<li>Analytical tools: Pilot tests of new analytical tools that use existing biorepositories or existing health and development databases for retrospective analysis.</li>
</ul>

We will give the highest priority to projects that:

<ul>
	<li>Build on ongoing work in some way, and that address well-identified barriers and constraints to delivery of interventions and to implementation of locally-relevant programs.</li>
	<li>Incorporate multiple areas of innovation listed above, e.g., developing and/or testing new, single or multiple products or candidates, especially sets of interventions targeting combinations of outcomes spanning the spectrum of objectives outlined above for this call.</li>
	<li>Clearly incorporate measures of success reasonable for the time span of the grant (18-24 months).</li>
	<li>Have a project plan where after two years- the end of phase I grant period- grantees will be in a position to explore how the results from their project could inform the design of a more extensive collaborative package of work that can be submitted for Phase II funding.</li>
	<li>Could contribute to a portfolio of funded projects that address a country’s key priorities or regional challenges</li>
	<li>Explain how proposed innovations and interventions will eventually be tested in communities so that they have the highest likelihood of being relevant for implementation more broadly in the country’s public health system.</li>
	<li>Respect diversity as well as gender equity and address the need to provide health equity for diverse vulnerable populations as captured by the SDG targets.</li>
	<li>Promote the career of young scientists.</li>
</ul>

Examples of what we will consider funding: 
Innovations that:

<ul>
	<li>address the handling of emergency obstetric and neonatal complications and or including the detection of danger signs by caregivers</li>
	<li>enhance the quality of care for sick newborns through early identification, monitoring and appropriate therapeutic measures for the management of neonatal sepsis</li>
	<li>provide rapid diagnosis of infectious pathogens that lead to preterm births</li>
	<li>determine the relationship between long term exposure to microbes (pathogens or not) and maternal and neonatal mortality</li>
	<li>encourage high coverage of known effective interventions to reduce maternal and neonatal mortality such as tetanus vaccination, antibiotic therapy to treat infections in mothers, screening for diabetes and hypertension</li>
	<li>use a systems approach to identify predictors of poor outcome in mothers and babies to allow for targeted interventions</li>
	<li>are aimed at understanding vaginal and neonatal microbiomes in relation to the burden of preterm birth sequelae, stunted postnatal growth, and impaired cognitive development as a result of alterations to the neonatal microbiomes</li>
	<li>improve training results and skills retention on obstetricians, GPs, and midwives</li>
	<li>feasible methods of delivery of the package for postpartum care at the community level</li>
	<li>determine the relation between the long-term treatment of chronic diseases such as HIV and poor neonatal outcomes</li>
	<li>improve maternal nutrition including micronutrients during pregnancy and its impact on intrauterine growth development and other neonatal outcomes</li>
	<li>design and test new algorithms, and point of care diagnostic tests for sepsis, including postnatal sepsis, for mothers and babies, care of sick newborns and children, in the face of new epidemic emergencies</li>
	<li>develop and test innovative and affordable means of monitoring labor progress including during contraction augmentation</li>
	<li>propose the most effective and more affordable tools to be deployed in the lowest level of health facilities to provide lifesaving care to sick neonates in African countries (e.g., availability of oxygen, functional newborn units)</li>
	<li>attract and retain skilled birth attendants in remote, rural areas</li>
	<li>improve the quality of care during labor in a cost-effective manner</li>
	<li>mitigate hypoxic ischemic encephalopathy and builds indicators predictive for long term neurodevelopmental outcomes</li>
	<li>improve the understanding between undiagnosed NCDs in pregnant women and complicated births and low birth weight</li>
	<li>enhance the effectiveness of task shifting and its impact on the quality of intrapartum care</li>
	<li>improve the attendance of women to ANC clinics especially in marginalized communities</li>
	<li>evaluate common metabolic disruptors/predictors such as glucose, acidosis, electrolytes</li>
	<li>utilize new strategies including biomarkers and point of care screening tools for comprehensive antenatal care and early detection of high-risk pregnancies (pre-eclampsia, prematurity, infections), and optimize preventive measures</li>
	<li>develop predictors of occurrence and severity of encephalopathies in Africa</li>
	<li>detect or manage the contributors to common problems that afford a treatment/prevention option like ABO/Rh blood typing, apnea/oxygen etc.</li>
	<li>measure fetal and sickle hemoglobin or early interventions to manage various aspects of the disease</li>
	<li>wearable sensors for Heart Rate /Respiratory Rate/BP/EEG/Temperature etc.</li>
	<li>improve timely second stages of delivery on pregnancy outcomes (PPH and birth asphyxia, obstetric fistula) and or proposes new ways of dealing with the conditions</li>
	<li>deliver solutions to underlying infections in pregnancy on pregnancy outcomes (abortions, Anemia, Preterm labor) and neonatal outcomes (Asphyxia, IUGR, prematurity, sepsis, mortality)</li>
</ul>

This call is not intended to support projects that focus on: 

<ul>
	<li>Basic research that does not provide a clear path to development and testing of prevention, diagnosis and treatment strategies</li>
	<li>Projects without the potential to expand in scale to provide solutions to a greater number or diversity of people</li>
	<li>Projects lacking metrics to determine success or failure and to allow decisions about the appropriateness of follow-on/phase II funding</li>
	<li>Solutions that are only variations of existing approaches e.g., replication of an approach in new geography in the absence of added innovation</li>
	<li>Projects that cannot be implemented in LMIC countries in Africa</li>
</ul>

Promoting Intra-African and global collaborations

We will promote scientific collaborations between African researchers, and between different organizations across the continent. Though not compulsory the call will encourage partnerships between African, German and by extension researchers in other parts of the globe. We will hold expert workshops in MNCH and encourage skills and data sharing between individually funded projects. We expect that such sharing will help to ensure that the goals of the innovative approaches in individual projects are ultimately integrated with each other. Furthermore, we expect that sharing experimental methods, data, and resources will ultimately improve the ability to compare and validate local research findings and to develop innovations, interventions, and products that can have an impact on a greater scale. The reviewers to this call will evaluate how well applications address these requirements and how well collaborations between researchers meet the basic criteria of equitable, sustainable partnerships that benefit all parties including benefits to communities most affected by the challenges in MNCH.

Collaborative efforts could include:

<ul>
	<li>Short visits: Where a team organizes to visit another for the sake of knowledge sharing and technology transfer. The costs for this should be included in the budget.</li>
	<li>Cohort harmonization: when collaborating with projects with existing cohorts or establishing new cohorts, investigators will be expected to participate, whenever possible, in cohort harmonization. Study sites will be expected to develop and follow standard operating procedures and quality control protocols for specimen collections and participate in the establishment of a minimum common set of data and specimens to be collected across the program.</li>
</ul>

Data sharing: Projects will submit a data sharing plan that is equitable, ethical, and efficient.

Top Priorities for Maternal, Neonatal, and Child Health in Africa

The <a href="https://www.aasciences.africa/" target="_blank" rel="noopener noreferrer">African Academy of Sciences (AAS)</a>, the <a href="https://www.bmbf.de/en/index.html" target="_blank" rel="noopener noreferrer">German Federal Ministry of Education and Research</a> (Bundesministerium für Bildung und Forschung, BMBF) and the <a href="http://www.gatesfoundation.org" target="_blank" rel="noopener noreferrer">Bill &amp; Melinda Gates Foundation</a> have come together in a transformative partnership to support African investigators to accelerate MNCH targets towards the Sustainable Development Goals (SDGs) for health.

Top Priorities for Maternal Neonatal and Child Health in Africa

Data Science Approaches to Improve Maternal and Child Health in Africa

This request for proposals represents a partnership between the Bill &amp; Melinda Gates Foundation, <a href="https://www.unicef.org/innovation/" target="_blank">UNICEF</a>, <a href="http://www.arm.com" target="_blank">Arm</a>, and <a href="https://aasciences.ac.ke/" target="_blank">The African Academy of Sciences (AAS)</a>.&nbsp;African entrants located in African organizations should apply through the <a href="https://www.aasciences.africa/funding" target="_blank">Grand Challenges Africa (a program of The AAS) portal</a>; entrants located throughout the rest of the world should apply through the Bill &amp; Melinda Gates Foundation portal. At The AAS, this request for proposals is funded in partnership with the <a href="https://www.sida.se/English/" target="_blank">Swedish International Development Agency (SIDA)</a>.

<h2>THE OPPORTUNITY</h2>

While there are several dimensions of rapid urbanization that demand innovative solutions, we see the main area of need emerging in Water, Sanitation and Hygiene (WASH). Billions of people worldwide living in densely populated informal and/or low income urban settlements suffer from inadequate sanitation; 4.5 billion people lack access to sanitation altogether, with as many as one billion people worldwide defecating in the open, and an additional three billion using toilets from which the waste is not safely managed – meaning that either it is not safely contained or, once emptied, is not safely treated. Over sixty percent of the human waste that is collected in the developing world is discharged untreated into the environment.

Clearly, there is a dire and pervasive need for awareness and information around: incidents of contamination, threats to delivery (e.g., from drought, heat waves, power outages), alternative approaches, emergency protocols, and overall monitoring of effectiveness and cost-effectiveness of the delivered service. Many solutions and delivery models already exist, and there is great opportunity to scale and redesign them to be effective in challenging urban contexts. Digital technology-based solutions can help bridge gaps and open doors – both online and on the ground – providing greater access to information, faster and more affordable communication, and expanded choices. For example, sensors placed strategically at different points in the value chain can collect and notify us of this type of information, whereas mapping platforms and ICT technologies can get that information to the right places for response and action.

When deployed in the right way, emerging and existing technologies can be critical in shaping cities to be centers of liveability, productivity, opportunity, and growth for children and their communities. We know that cities are hubs of diversity, growth, and innovation, and they should provide boundless opportunities for young people to survive, thrive, learn, participate, integrate, and reach their full potential.

<h2>THE CHALLENGE</h2>

How can we find solutions to make it easier to access safe, clean water and sanitation services for the urban poor?

We seek digital technology-based solutions that promote access to essential resources and services (clean water, sanitation) and can make a difference in reducing morbidity and mortality to promote healthy, safe, and productive lives. We know that technology does not automatically or inevitably improve people's lives; creative solutions must be contextually grounded and designed in response to on-the-ground needs of women, children, and families living in challenging urban environments.

What We Are Looking For:

Ideal solutions may target individuals, families, communities, urban planners, service providers, or WASH/ food infrastructure, networks, and systems. Solutions may include but are not limited to: services, models, or tools intended to improve overall access to WASH services and that apply a deeper understanding of our users' (customers/providers) needs when designing programs, services, and products/interventions. &nbsp;We seek solutions that are interactive, contextual, scalable, and relevant to WASH systems strengthening. We are specifically interested in work targeting: clean drinking water, household sanitation and hygiene, and urban pollution.

Criteria for success include solutions that:

<ul>
	<li>Provide data/evidence for effective solutions that 1) reduce the barrier to entry, 2) verify performance of municipal water or sanitation utilities, and 3) improve service delivery</li>
	<li>Broaden the toolkit of local solutions for urban areas to encourage municipalities, utility companies, and entrepreneurs to participate in creating and expanding access to services</li>
	<li>Develop a system that integrates with monitoring systems (i.e., community health, water quality, etc.)</li>
	<li>Have the potential to build on existing Public-Private or Public-Academic Partnerships, which will be essential to achieve results at scale</li>
	<li>Are cost effective</li>
</ul>

Potential solutions may respond to questions around how we might:

<ul>
	<li>Monitor the level of environmental contamination, bacteriological contamination, or service failure across urban contexts and map trends in real-time</li>
	<li>Create new ways to collect, recycle, and dispose of domestic human waste and improve access to adequate services that ultimately lead to safely treated waste</li>
	<li>Connect low-income urban settlement populations with reliable and affordable sanitation service delivery models, including monitoring systems</li>
	<li>Set up remote operation and maintenance of existing urban WASH assets</li>
	<li>Establish awareness programming to improve understanding of sanitation-related risks amongst dwellers in low income urban settlements</li>
	<li>Integrate hygiene promotion programs with urban activities (such as marketplaces, schools, etc.)</li>
	<li>Monitor sanitation infrastructure construction and conditions (latrines, wells, treatment systems, etc.)</li>
	<li>Design monitoring and incentive models to increase compliance with regulatory requirements within decentralized or distributed treat/pre-treatment systems</li>
	<li>Conduct groundwater mapping in affected drought areas</li>
	<li>Fill the data gap on measuring the proportion of waste emptied from pits and septic tanks and taken to treatment, including:
	<ul>
		<li>Tracking service providers (e.g., vacuum trucks, hand carts) from household to disposal site</li>
		<li>Measuring sludge volumes delivered to treatment sites</li>
		<li>Quantifying solids contents of sludge delivered to treatment plants</li>
		<li>Quantifying treatment efficiency of fecal sludge treatment plants ("effective treatment")</li>
	</ul>
	</li>
</ul>

Examples of types of solutions we want:

<ul>
	<li>Technologies that help improve or strengthen WASH quality, accessibility, delivery, distribution, and awareness and will support the most vulnerable children living in cities</li>
	<li>Tools/platforms that connect urban communities with the tools, services, and relationships they need to measure, alert, organize, and respond to specific urban concerns</li>
	<li>Tech-enabled tools that expand urban planning and policy processes (specifically those related to WASH concerns) to include vulnerable populations, especially youth</li>
	<li>Generative data collection + analysis methodologies to improve our sense of what specific WASH problems exist where and for whom</li>
	<li>Solutions may involve deepening understanding (moving towards proof of concept), and/or experimentation, and/or evaluating promising ongoing programs</li>
	<li>New solutions for influencing people to behave differently in relationship to their hygiene (preventative and treatment seeking)</li>
	<li>Solutions may target gaps in knowledge, gaps in delivery systems to meet demand for care, or bottlenecks blocking those with knowledge and demand from seeking services (access, cost, stigma, taboos, distance, etc.)</li>
</ul>

We hope to see work that recognizes contextual constraints:

<table>
	<tbody>
		<tr>
			<td>Social/Cultural Constraints</td>
			<td>High linguistic diversity 
			Low digital and basic literacy rates 
			Low involvement of vulnerable populations in planning and design processes</td>
		</tr>
		<tr>
			<td>Political Constraints</td>
			<td>Possibility of prohibitive security concerns 
			Complexity of political systems can be hard to manage; need adequately designed policy frameworks</td>
		</tr>
		<tr>
			<td>Economic Constraints</td>
			<td>Unequal and limited access to financial and banking systems 
			Budget uncertainty (for sustained operations) can be high when costs per person need to be low</td>
		</tr>
		<tr>
			<td>Environmental Constraints</td>
			<td>Harsh environmental conditions are the norm in many vulnerable urban areas (e.g., earthquake risk, extreme heat and wind, highly polluted/toxic conditions) 
			Higher intensity and frequency of natural hazards</td>
		</tr>
		<tr>
			<td>Infrastructural and Technical Constraints</td>
			<td>Brittle mobile cellular networks <a href="http://reports.weforum.org/global-risks-2015/part-2-risks-in-focus/2-3-city-limits-the-risks-of-rapid-and-unplanned-urbanization-in-developing-countries/" target="_blank">(WEF Global Risks Report</a>) 
			Insufficient ICT infrastructure, systems, platforms, and standards 
			Low prevalence of mobile data plans</td>
		</tr>
	</tbody>
</table>

&nbsp;

For more details please read the constraints section in the use case handbook UNICEF's Office of innovation developed on <a href="https://drive.google.com/file/d/1LUXGtx6jhBMPvVSKHt85rmLe-CKt4bmk/view" target="_blank">Innovating for children in an urbanizing world.</a>

Priority consideration will be given to solutions that:

<ul>
	<li>Address current inequities in access to WASH needs</li>
	<li>Prioritize marginalized populations, considering specifically those marginalized by their physical/intellectual disability, economic status, race, ethnicity, religion, age, marital status, gender, caste, sexuality, profession, location, literacy or lack thereof, and access to media and communications</li>
	<li>Address a diverse geographic range of urban environments (we hope to select solutions from different regions)</li>
	<li>Consider UNICEF Office of Innovation's Design Principles:
	<ul>
		<li>Design with the User</li>
		<li>Understand the existing ecosystem</li>
		<li>Design for scale</li>
		<li>Build for sustainability</li>
		<li>Be data driven</li>
		<li>Use open standards, open data, open source, open innovation (*if/where possible)</li>
		<li>Reuse and improve</li>
		<li>Do no harm</li>
		<li>Be collaborative</li>
	</ul>
	</li>
</ul>

To be considered, ideas must constitute transformative rather than incremental improvements in urban water and sanitation solutions and be low cost. We define low cost as interventions targeted for populations with individuals living on less than $1 per day, deliverable, and scalable in low- and middle-income countries. Proposals must (i) have a testable hypothesis, (ii) include an associated plan for how the idea would be tested or validated, and (iii) yield interpretable and unambiguous data in Phase I, in order to be considered for Phase II funding.

Geographic considerations:

We will prioritize selection of ideas that addresses WASH challenges in urban environments where all partners supporting this call actively work.&nbsp;This includes prioritizing WASH interventions in countries with high burden of open defecation and areas of substantial momentum in sanitation service delivery.&nbsp;For urban WASH, focus areas should support low income urban settlements, small towns, cities under protracted conflict, and cholera hotspots.

We will not consider funding for:

<ul>
	<li>Ideas that are not directly relevant to low and middle-income countries</li>
	<li>Projects that don't clearly consider the current context of available services/systems</li>
	<li>Ideas that simply translate traditional approaches to an ICT platform (mobile, tablet, or web-based tools and aids)</li>
	<li>Interventions that require our long-term financial support</li>
	<li>Educational programs or campaigns without clearly articulated, measurable behavior outcomes or the ability to be taken to scale</li>
	<li>Ideas for which proof of concept cannot be demonstrated within the scope of the Phase 1 award ($100k over 18 months)</li>
	<li>Approaches that repeat conventional solutions without novel application</li>
	<li>Basic research not directly linked to Urban WASH or measurable outcomes and focused purely on research tools for researchers and implementers</li>
	<li>Ideas that do not address at least one of these specific areas: infrastructure interventions, education, campaigns, and models and tools to improve overall access to WASH needs that also apply a deeper understanding of our users' (customers/providers) needs when designing programs, services, and products/interventions</li>
	<li>Approaches that present unacceptable ethical or safety risks</li>
	<li>Projects earmarking foundation funds for lobbying activity (e.g., attempts to influence legislation or legislative action) or efforts to influence political campaigns for public office</li>
</ul>

Grand Challenges Africa: Innovation for WASH in Urban Settings

Grand Challenges Africa Innovation for WASH in Urban Settings

<h2>Background</h2>

Drug discovery excellence is a critical prerequisite for success in drug development and remains a highly neglected area for the African continent. The lack of market incentives has biased drug discovery efforts globally away from diseases most prevalent in the developing world. Collaborative efforts of multidisciplinary teams – in drug discovery and other fields – shows that success and efficiency increases significantly when individual contributors combine their complementary capabilities. The whole is greater than the sum of its parts. State-of-the-art approaches to implementing drug discovery projects, especially when the goal is to also build drug discovery capability on the African continent, need to be supported.

Available data show very little drug discovery activity in Africa compared to the rest of the world. This may be related to a lag in technological development; lower infrastructure and service support; sparsely distributed human resources exacerbated by the continued brain drain; and lower funding and support, coupled with depressed interest by the pharmaceutical industry in diseases of poverty. Furthermore, there is a general lack of training in drug discovery, which also holds back the overall development of drug discovery on the continent. Despite these challenges, there is some progress being made and reasons to be optimistic for the future of drug discovery in Africa.

<h2>Program Goal</h2>

We seek to support exciting new drug discovery projects in Africa. A secondary objective is to strengthen drug discovery capabilities in Africa and create a project-driven virtual African drug discovery network.

This call is a partnership between the African Academy of Sciences (AAS), the Bill &amp; Melinda Gates Foundation (BMGF), Medicines for Malaria Venture (MMV) and the University of Cape Town (UCT) Drug Discovery and Development Centre (H3D).

Applications will be assessed and selected based on scientific merit and their potential to advance the drug discovery process. Selected applicants will also benefit from a network of drug discovery scientists in Africa and across the globe, linking them to peers, mentors and providing them with access to resources and technologies.

There will be a strong preference for Letters of Intent focusing on Malaria or Tuberculosis (TB) but good ideas in Neglected Tropical Diseases will also be considered.

What we are looking to accomplish:

<ul>
	<li>Identify new chemical entities (NCEs) with potential for drug development in diseases of local relevance for Africa, starting with hits for subsequent hit-to-lead and lead optimization campaigns.</li>
	<li>Expand research capacity for drug discovery within qualifying institutions.</li>
	<li>Strengthen the drug discovery network by building intra-Africa and global links including those identified as having basic and translational science capacities.</li>
</ul>

To be eligible, applicants must: 

<ul>
	<li>Have a creative idea for a drug discovery project based on one or more of the following:
	<ul>
		<li>biological targets</li>
		<li>biological screens or assays</li>
		<li>small molecule starting points (hits or leads including purified and characterized natural products)</li>
		<li>in-vitro and in vivo DMPK | ADME assays and related technologies</li>
	</ul>
	</li>
	<li>Work in drug discovery on the African continent</li>
	<li>Be willing, interested, and able to collaborate with expertise across the continent to share and develop best practices and approaches for drug discovery</li>
</ul>

These drug discovery projects will be undertaken in the context of the current landscape of drug discovery in Africa. While funding will be allocated to specific research projects, the program also seeks to develop capacity for drug discovery excellence in new regions, either through collaborative work with existing centers of excellence, or by supporting efforts to enhance drug discovery research capacity in a new region. To support and enhance existing drug discovery excellence, long term partnerships will be encouraged and should be demonstrated. For new partnerships, plans to maintain a productive collaborative relationship should be outlined. Applicants will describe their creative idea, but also how their proposals add value to existing infrastructure and expertise, and particularly how any duplicated activities will lead to a sustained opportunity for drug discovery within the region. Drug discovery also demands accurate and detailed record keeping, so ability to develop robust data systems will be required.

What we are NOT looking for:

<ul>
	<li>Characterization of natural product extracts, including semi-purified or otherwise</li>
	<li>Bioprospecting studies for chemical entities, genes, micro-organisms and macro-organisms</li>
	<li>Biomarkers and diagnostics</li>
	<li>Projects solely focused on network building, capacity building and infrastructure projects for drug discovery without specific biological targets or screening assays or small molecule starting points</li>
	<li>Total synthesis or developing synthetic methods</li>
</ul>

Duration of Award: The maximum duration of the award to grantees will be two years, subject to satisfactory attainment of agreed-upon milestones.

Size of Award: Each project has a term of 24 months beginning from the project start date and the amount awarded is up to USD $100,000.

&nbsp;

NOTE: A second round of this request for proposals was run in 2020.

Grand Challenges Africa: Drug Discovery

The African Academy of Sciences (AAS), the Bill &amp; Melinda Gates foundation, Medicines for Malaria Venture (MMV) and the University of Cape Town Drug Discovery and Development Centre (H3D) have partnered to support new drug discovery projects in Africa, focusing on malaria, tuberculosis, and neglected tropical diseases. A secondary objective is to strengthen drug discovery capabilities in Africa and create a project-driven virtual African drug discovery network.

Grand Challenges Africa Drug Discovery

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.

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.

<h3>What we are looking for:</h3>

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:

<ul>
	<li>Data sources: Pilot tests of new sources of data, particularly those that would bring together different research communities for new perspectives on the problem</li>
	<li>Analytical methods: Pilot tests of bioinformatics approaches, including those that combine or connect existing databases in novel ways</li>
	<li>Biomarkers: 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>Low-cost technologies and products: 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

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.
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.
<h3>What we are looking for:</h3>
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:
<ul><li>Data sources: Pilot tests of new sources of data, particularly those that would bring together different research communities for new perspectives on the problem</li>
<li>Analytical methods: Pilot tests of bioinformatics approaches, including those that combine or connect existing databases in novel ways</li>
<li>Biomarkers: 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>Low-cost technologies and products: 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>

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.

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

<h2>The Opportunity</h2>

While great strides have been made in reducing mortality in Africa, maternal and neonatal mortality rates remain unacceptably high. Estimates show that over half the global maternal deaths and over three-quarters of neonatal deaths occur in sub-Saharan Africa<a href="#_bookmark1">[1]</a><a id="_bookmark1_1" name="_bookmark1_1"></a><a href="#_bookmark2">[2]</a><a id="_bookmark2_2" name="_bookmark2_2"></a>. More than half of maternal deaths are directly or indirectly attributed to infectious causes such as HIV, Malaria in pregnancy, sepsis, and sexually transmitted diseases (STDs) resulting in complications at birth that often lead to death. In addition, undiagnosed and untreated non-communicable diseases (NCDs) are significant contributors to acute maternal and neonatal morbidity and mortality. The close relationship between mothers and their infants results in shared aetiologies and as a result, around half of new-born deaths are due to mother transmitted infections, including tetanus<a href="#_bookmark3">[3]</a><a id="_bookmark3_3" name="_bookmark3_3"></a>. Management of these infections is further complicated by anti-microbial resistance(AMR). Critically, the risk of dying during the first day of life in Africa is close to 1% with the top three causes being infections, birth asphyxia and complications of preterm birth which together account for 88% of the new-born deaths<a href="#_bookmark4">[4]</a><a id="_bookmark4_4" name="_bookmark4_4"></a>. In addition, intrapartum and antenatal stillbirths are found in almost equal numbers to neonatal deaths and many of these are due to readily preventable causes such as maternal infection (e.g. syphilis) and better labour management to prevent neonatal asphyxia. Effective interventions to help reduce this mortality would target management of labour and delivery, still births, preterm births, timely diagnosis and treatment of infectious and non-communicable diseases, while also addressing malnutrition in both mothers and children.

<h2>Program Goal</h2>

This call is focused on the SDG3 targets with the overall objective of focusing African scientists to work in local and global partnerships on the ambitious but achievable goals of accelerating knowledge generation, developing and deploying interventions and innovations that will advance the prevention of maternal deaths, preterm birth and neonatal deaths and improve implementation of policies and innovations that will improve care for the mother and child in the first month of life and prevent death due to non-communicable causes in pregnant women and children under 5 years of age . The goal of this challenge is to determine what precise packages of interventions should be delivered to which group of individuals (mother or infant or both) to reduce the burden of maternal and neonatal deaths in Africa.

<h2>Program Objectives</h2>

We are looking for projects that:

<ol>
	<li>Apply new technologies to enable rapid identification of exposures (communicable and non- communicable) that lead to poor outcomes in pregnancy, birth and in the first month of life.</li>
	<li>Apply precision medicine approaches and techniques to identify microbes and other exposures in Africa that may increase susceptibility to non-communicable diseases (cancer, cardiovascular diseases etc.) in mothers and children under 5 years of age.</li>
	<li>Provide innovative policy and clinical practice approaches and pathways that will enable the rapid and widespread adoption of:
	<ul>
		<li>Available well tested interventions whose uptake has been slow, but which would make profound impact if adopted and incorporated into ongoing MNCH programmes;</li>
		<li>New innovations and technologies that can help Africa leapfrog and achieve rapid progress, in preventing maternal and neonatal deaths.</li>
	</ul>
	</li>
</ol>

What we are looking for:

To reach these objectives, we are looking for projects that propose innovation in the following areas:

<ul>
	<li>Measurement tools: Pilot tests of new measurement tools, such as those based on a new technology or new biomarkers to enable the timely diagnosis and treatment of maternal/neonatal infections and NCDs that can lead to significant improvement of fetal and neonatal outcomes as well as prevent sill births, maternal mortality and morbidity.</li>
	<li>Intervention packages: Tests of new interventions – especially combinations of interventions – that:
	<ol>
		<li>develop a new human cohort with unique advantages over existing cohorts, such as the potential for developing a unique biorepository; or</li>
		<li>add an activity, such as a prospective pilot trial of an intervention or new measurement tool, to ongoing work with a human cohort, including at sites of intervention trials and sites for public health surveillance</li>
	</ol>
	</li>
	<li>Analytical tools: Pilot tests of new analytical tools that use existing biorepositories or existing health and development databases for retrospective analysis</li>
</ul>

Examples of what we will consider funding:

<ul>
	<li>Rapid diagnosis of infectious/microbial pathogens that lead to preterm births;</li>
	<li>Relation between undiagnosed NCDs in pregnant women and complicated births and low birth weight;</li>
	<li>Relation between long term exposure to microbes (pathogenic or non-pathogenic) and maternal and neonatal mortality;</li>
	<li>Neonatal sepsis (ideally bacteria/virus specific and even with AMR patterns);</li>
	<li>Common metabolic disruptors/predictors such as glucose, acidosis, electrolytes;</li>
	<li>Predictors of occurrence and severity of encephalopathies in Africa;</li>
	<li>Contributors to common problems that afford a treatment/prevention option like ABO/Rh blood typing, apnea/oxygen etc;</li>
	<li>Measures of fetal and sickle hemoglobin;</li>
	<li>Wearable sensors for Heart Rate /Respiratory Rate/BP/EEG/Temperature etc.;</li>
	<li>Interventions that encourage high coverage of known effective interventions to reduce maternal and neonatal mortality such as tetanus vaccination, antibiotic therapy to treat infections in mothers, screening for diabetes and hypertension;</li>
	<li>Systems approaches to identify predictors of poor outcome in mothers and babies to allow for targeted interventions;</li>
	<li>Studies aimed at understanding vaginal and neonatal microbiomes in relation to the burden of preterm birth sequelae, stunted postnatal growth, and impaired cognitive development because of alterations to the neonatal microbiomes;</li>
	<li>Relation between long- term treatment of chronic diseases such as HIV and poor neonatal outcome;</li>
	<li>Studies to provide a better understanding of the specific causes of antenatal and/or intrapartum stillbirths.</li>
</ul>

Examples of policy topic areas that would be relevant include, but are not limited to:

<ul>
	<li>Integration of MNCH into national health strategies;</li>
	<li>Human rights based approaches to MNCH including related reproductive health issues;</li>
	<li>Innovative approaches to mobilization of financial resources in support of MNCH programmes;</li>
	<li>Human resource issues including training, task shifting, deployment, retention, accreditation of medical personnel working in MNCH areas etc.;</li>
	<li>Better provision of essential health infrastructure, medicines and commodities, including specialized MNCH services and quality of service;</li>
	<li>Approaches to data usage and evaluating progress in MNCH and related reproductive health areas;</li>
	<li>Programs targeted at specifically addressing the prevention of stillbirths.</li>
</ul>

We will not consider funding for:

<ul>
	<li>Basic research that does not provide a clear path to development and testing of prevention, diagnosis and treatment strategies;</li>
	<li>Projects without the potential to expand in scale to provide solutions to a greater number or diversity of people;</li>
	<li>Projects lacking metrics to determine success or failure and to allow decisions about the appropriateness of follow-on/phase II funding;</li>
	<li>Solutions that are only slight improvements over existing approaches e.g., replication of an approach in a new geography in the absence of added innovation;</li>
	<li>Projects that cannot be implemented in LMIC countries in Africa;</li>
	<li>Approaches that simply propose/reproduce what is already widely available, and which fail to address key barriers to implementation; or only seek to modify policies that are already in practice;</li>
	<li>Proposals which could be well meaning but have the potential to enhance vulnerability, discrimination and marginalization of women and children;</li>
	<li>Ideas and approaches whose implementation would be financially too demanding for low resource settings;</li>
	<li>Policies and health management approaches that potentially could hinder widespread adoption of well proven technologies such as vaccine rollouts, screening opportunities, treatment compliance, especially those that target adolescent girls and young mothers;</li>
	<li>Projects earmarking African Academy of Sciences funds for lobbying activity (e.g., attempts to influence legislation or legislative action) or efforts to influence political campaigns for public office.</li>
</ul>

References

<a id="_bookmark1" name="_bookmark1"></a><a href="#_bookmark1_1">[1]</a>Alkema, L., et al., Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Maternal Mortality Estimation Inter-Agency Group. Lancet, 2016. 387(10017): p. 462-74.

<a id="_bookmark2" name="_bookmark2"></a><a href="#_bookmark2_2">[2]</a>Bhutta, Z.A., et al., Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost? Lancet, 2014. 384(9940): p. 347-70.

<a id="_bookmark3" name="_bookmark3"></a><a href="#_bookmark3_3">[3]</a>Lawn, J.E., et al., Born too soon: accelerating actions for prevention and care of 15 million newborns born too soon. Reprod Health, 2013. 10 Suppl 1: p. S6.

<a id="_bookmark4" name="_bookmark4"></a><a href="#_bookmark4_4">[4]</a>Lawn, J.E., et al., Every Newborn: progress, priorities, and potential beyond survival. Lancet, 2014. 384(9938): p. 189-205.

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