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.

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.

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.

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.

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.

The 4 Pillars of the Grand Challenges Ecosystem

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.

Professor Abdoulaye Djimdé Named to UN Secretary General's Scientific Advisory Board

<a href="https://gcgh.grandchallenges.org/champion/abdoulaye-djimde" target="_blank">Professor Abdoulaye Djimdé</a> has been appointed to the <a href="https://www.un.org/scientific-advisory-board/en/board-members" target="_blank">United Nations Secretary-General's Scientific Advisory Board</a>, marking an important step in elevating African leaders' voices in global research and science policy conversations.A leading expert in malaria genomics and drug resistance, Prof. Djimdé is focused on building research capacity and scientific collaboration across the continent. He embodies the <a href="https://gcgh.grandchallenges.org/champions" target="_blank">Calestous Juma Science Leadership Fellowship's</a> vision to cultivate scientists who not only drive innovation but also guide decision-making and international cooperation.At a time when the world faces increasingly complex health and development challenges, Prof. Djimdé will bring an important and unique perspective to the board's work on science, technology, and innovation for sustainable development. "Scientific knowledge is strongest when it reflects diverse perspectives," Prof. Djimdé said in response to the appointment, "and I look forward to contributing African experience and expertise to conversations shaping the future of global health and development."

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;

Challenges

Grand Challenges

Addressing Physiological Barriers to Micronutrient Absorption from Fortified Foods

Before applying to this Grand Challenges request for proposals (RFP), applicants should familiarize themselves with the supporting documents, including the <a href="https://docs.gatesfoundation.org/documents/sample-terms-and-conditions.pdf" target="_blank" rel="noopener noreferrer">terms and conditions of the Gates Foundation</a>, the <a href="https://gcgh.grandchallenges.org/sites/default/files/files/strategies_to_improve_fortification_programs_rules_and_guidelines.pdf" target="_blank" rel="noopener noreferrer">Rules and Guidelines</a>, <a href="https://gcgh.grandchallenges.org/sites/default/files/files/strategies_to_improve_fortification_programs_application_instructions.pdf" target="_blank" rel="noopener noreferrer">Application Instructions</a>, and <a href="https://gcgh.grandchallenges.org/addressing-physiological-barriers-micronutrient-absorption-fortified-foods-frequently-asked" target="_blank" rel="noopener noreferrer">Frequently Asked Questions</a>.
If you are planning to apply to this RFP, we will be hosting a dedicated <a href="https://events.teams.microsoft.com/event/56546af0-f206-4898-9303-a5ebfac6e9a7@296b3838-4bd5-496c-bd4b-f456ea743b74" target="_blank" rel="noopener noreferrer">webinar</a> on April 2, from 8:30-9:30 AM Pacific Time. This session will provide a comprehensive overview of the RFP details and an opportunity to have your questions answered. To participate in the <a href="https://events.teams.microsoft.com/event/56546af0-f206-4898-9303-a5ebfac6e9a7@296b3838-4bd5-496c-bd4b-f456ea743b74" target="_blank" rel="noopener noreferrer">webinar</a>, please register and <a href="https://forms.office.com/Pages/ResponsePage.aspx?id=ODhrKdVLbEm9S_RW6nQ7dMKiReMZsCJFmCa42S92Da1UNkJHR1BPNkhSMVNDVDUwNEdKRlBQUExRVS4u" target="_blank" rel="noopener noreferrer">submit your questions in advance</a>. If you cannot attend live, the webinar will be recorded and available on this challenge page after the session.
<h2>Background</h2>
Despite the proven potential of large-scale food fortification to address micronutrient deficiencies, biological constraints may limit its impact in high-burden settings. Chronic inflammation - driven by recurrent infections, environmental enteric dysfunction (EED), poor sanitation, metabolic disorders, or other systemic stressors - can impair intestinal absorption and alter nutrient metabolism. For example, inflammation-induced upregulation of hepcidin reduces iron absorption and mobilization, diminishing the effectiveness of iron fortification even when dietary intake is sufficient. Inflammation and gut barrier dysfunction can also compromise the absorption of other micronutrients, including zinc and fat-soluble vitamins. In parallel, alterations in the gut microbiome may influence micronutrient bioavailability through competitive uptake, reduced endogenous vitamin synthesis, and amplification of mucosal inflammation. These physiological barriers are particularly salient in low-resource contexts where infection and undernutrition co-occur.
<h2>The Challenge</h2>
We are soliciting, through this Grand Challenges RFP, applications that advance innovative approaches to better understand, measure, and mitigate infection, inflammation- and microbiome-mediated constraints that limit the impact of fortification interventions. The goal is to overcome key biological barriers and unlock the full potential of fortification programs to accelerate equitable gains in nutrition and health. Solutions could include novel biomarkers to identify populations with impaired nutrient utilization, fortificant formulations optimized for inflammatory states, adjunctive strategies to restore gut function, or integrated interventions that address infection, gut health, and micronutrient delivery simultaneously. Addressing these biological barriers is essential to unlocking the full potential of fortification programs and accelerating equitable gains in nutrition and health.
The challenge aims to:
<ul>
<li>Identify the physiological parameters that can be modulated to improve micronutrient absorption.</li>
<li>Offer a solution for delivery and effective absorption of micronutrients such as iron in a target population where nutritional interventions have not been effective.</li>
<li>All stages of development would be accepted provided the potential impact is clearly defined. We will particularly consider new innovative product ideas, proof of concept and discovery of new approaches to achieve more effective fortification. The solution is not limited to a product; it can also be a strategic approach and is open to discovery R&amp;D program proposals to address unanswered scientific questions.&nbsp;</li>
</ul>
Funding Level
We will consider proposals for awards of up to $250,000 USD for each project, with a grant term of 18 months. Application budgets should be commensurate with the scope of work proposed. Indirect costs will be considered and should be included in the budget for the up to $250,000 USD award (subject to the&nbsp;<a href="https://docs.gatesfoundation.org/Documents/Indirect_Cost_Policy.pdf" target="_blank" title="https://docs.gatesfoundation.org/documents/indirect_cost_policy.pdf" rel="noopener noreferrer">Gates Foundation's indirect cost policy</a>).
Eligibility Criteria
This initiative is open globally to nonprofit organizations, for-profit companies, international organizations, government agencies and academic institutions. Multi stakeholder collaborations are encouraged. Individuals and organizations classified as individuals for U.S. tax purposes are not eligible to receive an award from the foundation as part of this initiative.&nbsp;
We are looking for proposals that consider:&nbsp;
<ul>
<li>Clear framing of the problem:
<ul>
<li>Explicit articulation of how inflammation, infection, EED, metabolic conditions, or gut dysbiosis limit micronutrient absorption and utilization.</li>
<li>Defined target population and context where fortification effectiveness is currently constrained.</li>
</ul>
</li>
<li>Strong biological rationale
<ul>
<li>Mechanistic understanding (e.g., hepcidin-mediated iron blockade, impaired fat absorption, microbiome–nutrient interactions).</li>
<li>Clear linkage between proposed solution and the underlying physiological barrier.</li>
</ul>
</li>
<li>Innovative and testable solution
<ul>
<li>Novel fortificant formulations, delivery approaches, or adjunctive therapies.</li>
<li>Microbiome-modulating, anti-inflammatory, or gut-repair strategies integrated with fortification.</li>
<li>Development or validation of practical biomarkers to identify or stratify affected populations.</li>
</ul>
</li>
<li>Feasibility and scalability
<ul>
<li>Practical pathway for integration into existing fortification platforms or delivery systems.</li>
<li>Cost-effective design appropriate for low-resource settings.</li>
<li>Consideration of regulatory, manufacturing, and supply chain implications.</li>
</ul>
</li>
<li>Measurement and evaluation plan
<ul>
<li>Clearly articulated theory of change with appropriate outcomes related to micronutrient absorption, status, and functional impact.</li>
<li>Inclusion of inflammation and/or gut function biomarkers where appropriate.</li>
<li>Rigorous study design with defined milestones and go/no-go criteria.</li>
</ul>
</li>
<li>Equity and context relevance
<ul>
<li>Focus on populations with high burdens of infection, undernutrition, or systemic inflammation.</li>
<li>Engagement with local partners and alignment with national nutrition strategies.</li>
</ul>
</li>
<li>Risk assessment and mitigation
<ul>
<li>Consideration of potential unintended consequences (e.g., microbiome disruption, pathogen proliferation, adverse nutrient interactions).</li>
<li>Defined strategy for mitigating and managing scientific and implementation risks.</li>
</ul>
</li>
<li>Team capability
<ul>
<li>Multidisciplinary expertise as required for the topic (nutrition, immunology, microbiome science, implementation science, product development).</li>
<li>Demonstrated ability to translate discovery into scalable impact.</li>
</ul>
</li>
</ul>
We will not fund proposals that focus on:
<ul>
<li>Agricultural and plant biology related topics of research.</li>
<li>Live biotherapeutics which will encounter regulatory challenges for use in food.</li>
<li>Public health data collection and population status assessment.</li>
<li>Policy making and advocacy.</li>
<li>Commercialization and marketing solely.</li>
</ul>

We are soliciting applications that advance innovative approaches to better understand, measure, and mitigate infection, inflammation- and microbiome-mediated constraints that limit the impact of fortification interventions. The goal is to overcome key biological barriers and unlock the full potential of fortification programs to accelerate equitable gains in nutrition and health.

Artificial Intelligence (AI) to Accelerate Charitable Giving

Before applying to this Grand Challenges request for proposals (RFP), applicants should familiarize themselves with the supporting documents, including the <a href="https://docs.gatesfoundation.org/documents/sample-terms-and-conditions.pdf" target="_blank" rel="noopener noreferrer">terms and conditions of the Gates Foundation</a>, the <a href="https://gcgh.grandchallenges.org/sites/default/files/files/ai_accelerate_charitable_giving_rules_and_guidelines.pdf" target="_blank" rel="noopener noreferrer">Rules and Guidelines</a>, <a href="https://gcgh.grandchallenges.org/sites/default/files/files/ai_accelerate_charitable_giving_applications_instructions.pdf" target="_blank" rel="noopener noreferrer">Application Instructions</a>, and <a href="https://gcgh.grandchallenges.org/artificial-intelligence-ai-accelerate-charitable-giving-frequently-asked-questions-faqs" target="_blank" rel="noopener noreferrer">Frequently Asked Questions</a>.
If you are planning to apply to this RFP, we will be hosting a dedicated <a href="https://events.teams.microsoft.com/event/f5a7bf0d-a822-4102-a6d3-5e1c5bbeb22f@296b3838-4bd5-496c-bd4b-f456ea743b74" target="_blank" rel="noopener noreferrer">webinar</a> on March 23, from 7:00-8:00 AM Pacific Time. This session will provide a comprehensive overview of the RFP details and an opportunity to have your questions answered. To participate in the <a href="https://events.teams.microsoft.com/event/f5a7bf0d-a822-4102-a6d3-5e1c5bbeb22f@296b3838-4bd5-496c-bd4b-f456ea743b74" target="_blank" rel="noopener noreferrer">webinar</a>, please register and <a href="https://forms.office.com/Pages/ResponsePage.aspx?id=ODhrKdVLbEm9S_RW6nQ7dMKiReMZsCJFmCa42S92Da1UNEFaUTNVMjNSUVYzVklVTk0zQkFJQzZWSC4u" target="_blank" rel="noopener noreferrer">submit your questions in advance</a>. If you cannot attend live, the webinar will be recorded and available on this challenge page after the session.
<h2>Background</h2>
The Gates Foundation's Philanthropic Partnerships Team (PPT) mobilizes resources and cultivates champions for global health and development (GH&amp;D), ensuring that philanthropy helps the world's most vulnerable children survive and thrive.
Many people want to make a difference but aren't always sure how to turn that intention into action. Our work helps donors move from interest to impact, working alongside individuals, foundations, advisors, and other sector partners while strengthening the broader systems that support effective giving.
Artificial intelligence (AI) is advancing rapidly, reshaping how people access information, make decisions, and engage with the world. For philanthropy, this creates an opportunity to rethink how AI can help donors discover causes and move from interest to action at moments when it matters most.
To explore this opportunity, PPT is launching the AI to Accelerate Charitable Giving Grand Challenges RFP to explore how AI can strengthen philanthropic practice and unlock new possibilities for generosity. The Challenge aims to enhance human decision-making with AI-powered tools, data, and insights that help donors give more and give sooner.
<h2>The Challenge</h2>
We are seeking applications and use cases of AI that address the core question: How might AI support donors to give more and give sooner?
This RFP is focused on supporting donor-facing applications and underlying systems of giving that test and demonstrate bold, innovative applications of AI that strengthen and expand philanthropic giving. Desired outputs include generating practical evidence and examples to inform broader practice across the philanthropic sector. We are particularly interested in solutions that increase support for GH&amp;D.
For this RFP, GH&amp;D refers broadly to efforts that improve health, economic opportunity, and human well-being in low- and middle-income countries. Within this field, we are especially interested in efforts that reduce preventable mortality, combat infectious diseases, and expand pathways out of extreme poverty, consistent with the <a href="https://www.gatesfoundation.org/ideas/articles/core-mission-child-health-success" target="_blank" rel="noopener noreferrer">Gates Foundation's long-term goals</a>.
Projects do not need to focus exclusively on GH&amp;D to be competitive. However, proposals that clearly demonstrate applicability to GH&amp;D challenges, or that generate insights relevant to these priorities, will receive additional consideration. We welcome proposals that address the needs of various donor types including everyday donors, high-net-worth individuals, foundations, or other entities relevant to the challenge areas below.
We invite proposals that address at least one of the following challenge areas:
1. Help donors connect with causes and understand where to give to achieve their giving goals
How can AI help people discover causes they care about, understand why they matter, and see where their giving can make a meaningful difference?
Many donors want to give but struggle to navigate a crowded and complex landscape of causes, organizations, and appeals. Geographic distance, limited context, and uncertainty about effectiveness can make it difficult to decide where to focus funds or where to begin.
We seek solutions that help donors make sense of their options, connect their values to specific opportunities, and build confidence that their contributions can make a meaningful difference across a range of issue areas, including GH&amp;D. Examples include:
<ul>
<li>AI-powered recommendation engines that match donors to issues they care about</li>
<li>Personalized learning tools that adapt content, depth, or recommendations as a donor's understanding, interests, and confidence evolve over time</li>
<li>Immersive or narrative tools that make global issues feel human and relatable</li>
<li>Applications that help donors visualize the impact their dollars can create</li>
</ul>
2. Turn interest and intent into donations
How can AI create pathways to help people move from motivation to meaningful contribution?
Many people are motivated to contribute yet fail to follow through because the giving process feels complex, overwhelming, or uncertain.
We seek solutions that reduce friction, enable follow-through on the intention to give, and foster sustained engagement beyond a single transaction. Examples include:
<ul>
<li>Tools that simplify logistical barriers to giving such as cross-border vetting, due diligence, or compliance challenges</li>
<li>Systems that build community or shared motivation among donors</li>
<li>Designs that make giving feel clear, safe, and meaningful</li>
</ul>
3. Develop the foundational systems and infrastructure that enable AI-powered giving
How can we ensure that AI systems reflect accurate philanthropic data and values so that giving and social impact are part of the information people access every day?
As AI increasingly shapes how people learn and make decisions, philanthropy must be represented in the underlying data and tools that drive these systems.
We seek focused, practical projects that ensure philanthropic data is visible, credible, and usable by AI systems in ways that support donor understanding, confidence, and giving. Examples include:
<ul>
<li>Data pipelines or open standards that expose charitable data to algorithms</li>
<li>Training models to better recognize and contextualize social impact</li>
<li>Applications that make nonprofit websites and payment platforms more interoperable with AI agents (i.e., enabling agents to donate to nonprofit organizations)</li>
<li>Solutions that detect and prevent fraud or misuse in donation processes supported by AI</li>
</ul>
AI Ethics and Responsibility
The Gates Foundation is committed to harnessing AI for social good while mitigating risks such as bias, inequity, and potential harm, particularly to vulnerable populations. As AI-enabled tools increasingly shape how people access information and make decisions, ethical and responsible use of AI is a foundational consideration that should inform how solutions are designed, tested, and deployed.
Applicants are not required to submit a separate response on ethical and responsible AI considerations. However, proposals should demonstrate thoughtful awareness of ethical issues as part of the project's learning and experimentation process, including how potential risks may evolve as systems are tested with real users. The Foundation may request clarification during the application review process as needed.
In evaluating proposals, reviewers will consider alignment with the Foundation's AI principles, which are summarized below:
<ol>
<li>AI efforts should align with the Foundation's mission to improve health, reduce poverty, and expand opportunities for those facing the greatest challenges.</li>
<li>AI solutions should be informed by the needs and perspectives of the community they are intended to serve.</li>
<li>Potential risks and unintended harms should be identified and addressed throughout the AI lifecycle, including monitoring for unintended consequences.</li>
<li>Personal and sensitive data must be handled responsibly and protected from misuse.</li>
<li>AI solutions should be designed for broad benefit and be accessible and usable in their intended contexts.</li>
<li>Be transparent about how AI is used, including its purpose, limitations, and governance.</li>
</ol>
Funding Level
We will consider applications requesting awards up to $150,000 USD per project, with a grant duration of up to 1 year. Budgets should align with the scale and complexity of the proposed work. Indirect costs are allowable and should be included within the total requested funding (subject to the Gates Foundation's <a href="https://docs.gatesfoundation.org/documents/indirect_cost_policy.pdf" target="_blank" rel="noopener noreferrer">indirect cost policy</a>).
Travel expenses for in-person convenings with peer grantees hosted by the Gates Foundation will be covered separately by the Foundation. Please only include additional travel costs within your proposed budget.
Eligibility Criteria
Applicants must be able to conduct all project activities and reporting in English and be willing and able to participate in up to three virtual and/or in-person learning convenings with peer grantees over the one-year grant period. Eligible entities for this initiative include:
<ul>
<li>Nonprofit and Civil Society Organizations, including registered nonprofits and charities, non-governmental organizations (NGOs), and community-based organizations.</li>
<li>Mission-Driven For-Profit Organizations. For-profit entities that have a clear public-benefit mission aligned with the goals of the RFP are eligible. Funding cannot be used for core commercial product development or general business operations. Proposed activities must advance equitable, responsible, or safe uses of AI in ways that benefit society.</li>
<li>Consortia, Partnerships, &amp; Collaborative Proposals. Proposals may be submitted through partnerships and other collaborative arrangements. In such cases, one lead organization must serve as the primary applicant and submit the proposal, with partner organizations included as sub-grantees.</li>
</ul>
For this initiative, the following entities are not eligible:
<ul>
<li>Individuals and organizations classified as individuals for U.S. tax purposes.</li>
<li>Government agencies or departments.</li>
<li>Academic institutions applying independently (unless part of a consortium led by an eligible organization).</li>
</ul>
Proposal Requirements
Recognizing that AI-enabled philanthropic tools are part of an evolving field, we value both measurable donor outcomes and the production of practical learning about what works, what does not, and why. Proposals are encouraged to contribute insights that can inform broader philanthropic practice, even where initial approaches require iteration.
We are looking for proposals that:
<ul>
<li>Have relevance to the challenge areas
<ul>
<li>Apply AI in clear, compelling ways to motivate donors to give more and give sooner, directly advancing one or more of the challenge areas. &nbsp;</li>
</ul>
</li>
<li>Illustrate expected impact
<ul>
<li>Articulate the meaningful change the project is expected to produce that can inform broader philanthropic practice. &nbsp;</li>
</ul>
</li>
<li>Plan for feasibility
<ul>
<li>Describe the methodology for pressure-testing and validating the proposed concept, including how AI tools, models, or data pipelines will be tested and evaluated in real-world conditions to assess feasibility. &nbsp;</li>
</ul>
</li>
<li>Have plans for measuring success
<ul>
<li>Describe how success will be assessed during the grant period including the indicators or methods used to evaluate both pilot outcomes (i.e., changes in donor behavior or confidence) and learning outcomes.</li>
<li>Explain how these insights will inform broader philanthropic practice. &nbsp;</li>
</ul>
</li>
<li>Describe potential scale
<ul>
<li>Articulate how the project could be sustained, scaled, or shared beyond the grant period.</li>
<li>Demonstrate the potential for adaptation or extension across geographies, donor types, philanthropic issues, or giving platforms.</li>
<li>Go beyond narrowly tailored, organization-specific use cases to create insights, tools, or approaches that improve donor experience or decision-making and have broader applicability across the philanthropic ecosystem. &nbsp;</li>
</ul>
</li>
<li>Use responsible AI practices and safeguards
<ul>
<li>Identify risks related to responsible AI use and describe plans to mitigate them, including fairness, transparency, privacy, and data governance.</li>
</ul>
</li>
</ul>
We will not consider funding for proposals that:
<ul>
<li>Do not address the core question: How might AI support donors to give more and give sooner?</li>
<li>Do not identify at least one challenge area and demonstrate how the proposed solution meaningfully aligns with it.</li>
<li>Do not apply AI as a central component of the proposed solution.</li>
<li>Lack clear relevance to donor decision-making and charitable giving, including meaningful applicability to GH&amp;D.</li>
<li>Do not include a practical plan to test, measure, and generate actionable learning within the grant period that informs broader philanthropic practice.</li>
<li>Primarily support commercial product development, general business operations, or private profit.</li>
<li>Fail to demonstrate responsible AI practices, including attention to bias, privacy, transparency, and data governance.</li>
<li>Request more than $150,000 USD, exceed a one-year grant term, or are submitted by ineligible entities.</li>
</ul>

Artificial intelligence (AI) is advancing rapidly, reshaping how people access information, make decisions, and engage with the world. For philanthropy, this creates an opportunity to rethink how AI can help donors discover causes and move from interest to action at moments when it matters most. To explore this opportunity, PPT is launching the AI to Accelerate Charitable Giving Fund to explore how AI can strengthen philanthropic practice and unlock new possibilities for generosity. The fund aims to enhance human decision-making with AI-powered tools, data, and insights that help donors give more and give sooner.

Breakthrough Innovations to Significantly Reduce the Cost of Severe Acute Malnutrition Treatment

Before applying, applicants should familiarize themselves with the supporting documents for this Grand Challenge, including <a href="https://docs.gatesfoundation.org/documents/sample-terms-and-conditions.pdf" target="_blank" rel="noopener noreferrer">the terms and conditions of the Gates Foundation</a>, the <a href="https://gcgh.grandchallenges.org/sites/default/files/files/reduce_cost_severe_acute_malnutrition_treatment_rules_and_guidelines.pdf" target="_blank" rel="noopener noreferrer">Rules and Guidelines</a>, <a href="https://gcgh.grandchallenges.org/sites/default/files/files/reduce_cost_severe_acute_malnutrition_treatment_application_instructions.pdf" target="_blank" rel="noopener noreferrer">Application Instructions</a>, and <a href="https://gcgh.grandchallenges.org/breakthrough-innovations-significantly-reduce-cost-severe-acute-malnutrition-treatment-grand" target="_blank" rel="noopener noreferrer">Frequently Asked Questions</a>
If you are planning to apply to this RFP, we will be hosting a dedicated <a href="https://events.teams.microsoft.com/event/d0518693-9f25-46b1-a48a-de12e5113440@296b3838-4bd5-496c-bd4b-f456ea743b74" target="_blank" rel="noopener noreferrer">webinar</a> on April 2, from 7:00-8:00 AM Pacific Time. This session will provide a comprehensive overview of the RFP details and an opportunity to have your questions answered. To participate in the <a href="https://events.teams.microsoft.com/event/d0518693-9f25-46b1-a48a-de12e5113440@296b3838-4bd5-496c-bd4b-f456ea743b74">webinar</a>, please register and <a href="https://forms.office.com/Pages/ResponsePage.aspx?id=ODhrKdVLbEm9S_RW6nQ7dMKiReMZsCJFmCa42S92Da1UNEFaUTNVMjNSUVYzVklVTk0zQkFJQzZWSC4u" target="_blank" rel="noopener noreferrer">submit your questions in advance</a>. If you cannot attend live, the webinar will be recorded and available on this challenge page after the session.
Please note that <a href="https://ciff.org/" target="_blank" title="https://ciff.org/" rel="noopener noreferrer">Children's Investment Fund Foundation (CIFF)</a> and&nbsp;<a href="https://www.givewell.org/" target="_blank" title="https://www.givewell.org/" rel="noopener noreferrer">GiveWell</a> have expressed interest in potentially funding projects submitted through this RFP. Representatives from these organizations will participate in the review process. Applicants will be notified if their proposal is selected for further consideration by either organization.
<h2>Background</h2>
Severe Acute Malnutrition (SAM) remains a leading contributor to child mortality globally. At the same time, global resources available for SAM treatment are flat or declining, while the burden of wasting remains high. Under these constraints, improving outcomes will require not only expanding budgets but fundamentally improving the cost-effectiveness of SAM treatment.
While Ready-to-Use Therapeutic Food (RUTF) is central to SAM treatment, it represents only one component of total treatment cost. In many contexts, logistics, staffing, supervision, visit frequency, and system overhead account for a substantial share of the total cost per child treated.
This Grand Challenge seeks innovations that can substantially increase the number of children treated per dollar spent by reducing the total cost per child treated, without changing the ex-factory price of RUTF or substituting RUTF with an alternative product.
This initiative is designed as an idea-sourcing and proof-of-concept mechanism to identify transformative, system-level innovations.
<h2>The Challenge</h2>
We seek innovative approaches capable of achieving a 20 - 30% or greater reduction in the total cost per child successfully treated for SAM in Sub-Saharan Africa and South Asia.
We recognize that reductions may result from a single breakthrough innovation or from a combination of product, logistics, protocol, and delivery efficiencies that collectively achieve meaningful cost reduction.
Solutions must:
<ul>
<li>Provide a validated pathway to a 20% - 30% or greater reduction in total cost per child treated.</li>
<li>Include a transparent cost model with clear assumptions, key drivers, and sensitivity analyses.</li>
<li>Demonstrate proof-of-concept feasibility (e.g., modeling, simulation, pilot data).</li>
<li>Present a credible pathway to normative and/or regulatory acceptance, where relevant.</li>
<li>Show a clear scalability pathway and explain why cost reductions are durable at scale.</li>
</ul>
Proposals must articulate a clear theory of change linking the innovation to specific reductions in cost components and demonstrate how these reductions are achieved and sustained.
Focus Areas
This call targets system-level levers that reduce the total cost of treating a child for SAM by 20% - 30% or greater, independent of reducing the RUTF unit price.
Applicants may propose innovations under one or more of the following focus areas:
<div class="responsive-table"><table>
<tbody>
<tr>
<td>Focus Area</td>
<td>Potential Approaches</td>
<td>Required Deliverables</td>
</tr>
<tr>
<td>
Logistics and Distribution Optimization
Logistics and distribution (transport, storage, losses, inefficiencies) often represent a significant share of total SAM treatment cost.
&nbsp;
</td>
<td>
<ul>
<li>Redesigned distribution networks reducing transport frequency or distance</li>
<li>Community- or facility-linked delivery models reducing parallel systems</li>
<li>Consolidated deliveries across other programs (e.g., immunization, MDAs, REACH)</li>
<li>Inventory optimization tools to reduce stockouts</li>
<li>Warehousing solutions</li>
<li>Storage optimization for shelf life and efficiency</li>
<li>Loss-reduction strategies (spoilage, leakage, diversion)</li>
<li>Digital demand forecasting tools</li>
<li>Route optimization or fleet management systems</li>
</ul>
</td>
<td>
<ul>
<li>Identification of targeted logistics / warehousing cost components</li>
<li>Clear causal pathway to a 20% - 30% or greater reduction in total cost per child treated</li>
<li>Analytical or pilot feasibility evidence</li>
<li>Contextual assumptions (e.g., emergency vs. non-emergency settings)</li>
</ul>
&nbsp;
</td>
</tr>
<tr>
<td>
Treatment Protocols and Regimen Design
Treatment protocols influence cost through product consumption, visit frequency, duration of care, and monitoring intensity.
This call seeks novel protocol concepts that go beyond existing simplified treatment approaches
</td>
<td>
<ul>
<li>Adaptive dosage or duration based on child response</li>
<li>Regimens reducing total RUTF consumption without compromising outcomes</li>
<li>Dynamic or phased treatment models</li>
<li>New admission, discharge, or monitoring criteria</li>
<li>Simplified or adaptive monitoring approaches</li>
<li>Point-of-care diagnostics guiding intensity</li>
<li>Digital or analytical decision-support tools</li>
<li>Regimen-level cost-effectiveness modeling and scenario analysis</li>
</ul>
Proposals relying solely on already widely adopted simplified protocols will be considered nonresponsive.
</td>
<td>
<ul>
<li>Clear differentiation from existing simplified protocols</li>
<li>Identification of affected cost drivers (e.g., RUTF use, visits, duration)</li>
<li>Analytical rationale demonstrating plausible 20% - 30% or greater cost reduction</li>
<li>Proof-of-concept evidence (modeling, retrospective analysis, simulations)</li>
<li>Discussion of safety assumptions</li>
</ul>
</td>
</tr>
<tr>
<td>
Program Delivery Models
Delivery models significantly affect total treatment cost, especially through staffing, visit schedules, supervision, and system overhead.
</td>
<td>
<ul>
<li>Community-based or decentralized care models</li>
<li>Task-shifting to community health workers or volunteers</li>
<li>Reduced-touchpoint or simplified monitoring strategies</li>
<li>Integrated service delivery models</li>
<li>Alignment with routine health systems to reduce parallel structures</li>
</ul>
</td>
<td>
<ul>
<li>Description of how the delivery model differs from current practice</li>
<li>Identification of affected delivery cost drivers</li>
<li>Modeling or evidence supporting plausible 20% - 30% or greater cost reduction</li>
<li>Discussion of quality and safety safeguards</li>
</ul>
</td>
</tr>
<tr>
<td>
Complicated (In-patient) SAM Care Optimization
Concepts that reduce the cost of inpatient/complicated SAM care while maintaining or improving clinical outcomes.
(In many settings, 10–20% of children with SAM require inpatient management due to medical complications, yet inpatient care can represent a disproportionately large share of total treatment costs.)
</td>
<td>
<ul>
<li>Innovations reducing length of stay without compromising safety</li>
<li>Clinical pathway optimization</li>
<li>Resource-efficient stabilization models</li>
<li>Integrated inpatient–outpatient transition strategies</li>
<li>Cost-efficient therapeutic, monitoring, or staffing models</li>
</ul>
</td>
<td>
<ul>
<li>Clear identification of inpatient cost drivers affected</li>
<li>Cost model demonstrating plausible 20 - 30% or greater reduction in total cost per child successfully treated</li>
<li>Evidence supporting clinical safety assumptions</li>
<li>Consideration of scalability and normative alignment</li>
</ul>
</td>
</tr>
</tbody>
</table></div>
Cross-Cutting Requirements
Successful proposals must provide:
<ul>
<li>
Cost Reduction Analysis and Proof of Concept
<ul>
<li>Clear articulation of the cost components affected (e.g., logistics, staff time, visits, supervision)</li>
<li>A baseline cost decomposition and explanation of how the proposed innovation changes the cost structure</li>
<li>A transparent and credible cost model quantifying a 20% - 30% or greater reduction in total cost per child treated</li>
<li>Proof-of-concept evidence supporting feasibility (e.g., modeling, pilot data, simulations) &nbsp;</li>
</ul>
All proposals must include a cost model clearly aligned with the proposed operational or technical innovation.
</li>
<li>For the purposes of this call, "cost per child treated" refers at minimum to the cost per child successfully discharged according to standard SAM program exit criteria.
<ul>
<li>Proposals must clearly describe safeguards to ensure that cost reductions do not compromise clinical outcomes, quality of care, or safety standards.</li>
</ul>
</li>
<li>Data Sharing and Transparency
<ul>
<li>Commitment to share relevant data (with appropriate safeguards) to support replication and policy processes</li>
<li>Contribution to cross-project learning where possible</li>
</ul>
</li>
<li>Environmental Considerations
<ul>
<li>Brief discussion of environmental implications (e.g., energy use, waste, system efficiencies) and how these are managed</li>
</ul>
</li>
<li>Responsible Use of AI and Digital Technologies (if applicable)
<ul>
<li>Clear articulation of data privacy and security safeguards</li>
<li>Consideration of explainability and usability for nonexpert users in LMIC contexts</li>
</ul>
</li>
</ul>
Funding Structure
For any of the Focus Areas we will consider proposals under two funding options. Please consider which is most relevant to your proposal.
<ul>
<li>Option A: We will consider several proposals for awards of up to $500,000 USD for each project, with a grant term of up to 18 months. Application budgets should be commensurate with the scope of work proposed.</li>
<li>Option B: We will consider several proposals for awards of up to $1,500,000 USD for each project, with a grant term of up to 36 months. Application budgets should be commensurate with the scope of work proposed.</li>
</ul>
Indirect costs should be included in the budget and should not exceed 10-15% of the total award (subject to the&nbsp;<a href="https://docs.gatesfoundation.org/Documents/Indirect_Cost_Policy.pdf" target="_blank" rel="noopener noreferrer">Gates Foundation's indirect cost policy</a>).
Eligibility
We welcome applications from universities and research institutes, nongovernmental organizations with strong technical capacity, for-profit entities / private sector companies (subject to <a href="https://globalaccess.gatesfoundation.org/" target="_blank" rel="noopener noreferrer">global access requirements</a>), and consortia combining scientific, manufacturing, and implementation expertise. Consortia led by or including LMIC-based organizations are strongly encouraged.
Individuals and organizations classified as individuals for U.S. tax purposes are not eligible to receive an award from the foundation as part of this initiative.
What we are looking for
Successful proposals will:
<ul>
<li>Demonstrate a 20% - 30% or greater reduction in total cost per child treated.</li>
<li>Include a transparent and credible cost model.</li>
<li>Show proof-of-concept feasibility.</li>
<li>Clearly articulate affected cost components and durable savings.</li>
<li>Present a credible pathway to scalability.</li>
<li>Address real-world adoption constraints and data availability.</li>
</ul>
We will not fund proposals that:
<ul>
<li>Fund clinical trials or definitive efficacy studies.</li>
<li>Scale or geographically expand existing simplified protocols.</li>
<li>Support routine implementation or business-as-usual operations.</li>
<li>Replicate existing approaches without step-change potential.</li>
<li>Lack a plausible pathway to a 20% - 30% or greater cost reduction.</li>
</ul>

This Grand Challenge seeks innovations that can substantially increase the number of children treated per dollar spent by reducing the total cost per child treated, without changing the ex-factory price of RUTF or substituting RUTF with an alternative product. This initiative is designed as an idea-sourcing and proof-of-concept mechanism to identify transformative, system-level innovations.

Cost-Disrupting Innovations to Reduce the Cost of Ready-to-Use Therapeutic Food

Before applying,&nbsp;applicants should familiarize themselves with the supporting documents for this Grand Challenge, including the <a href="https://docs.gatesfoundation.org/documents/sample-terms-and-conditions.pdf" target="_blank" rel="noopener noreferrer">terms and conditions of the&nbsp;Gates Foundation</a>, the&nbsp;<a href="https://gcgh.grandchallenges.org/sites/default/files/files/reduce_cost_of_ready-to-use_therapeutic_food_rules_and_guidelines.pdf" target="_blank" rel="noopener noreferrer">Rules and Guidelines</a>,&nbsp;<a href="https://gcgh.grandchallenges.org/sites/default/files/files/reduce_cost_of_ready-to-use_therapeutic_food_application_instructions.pdf" target="_blank" rel="noopener noreferrer">Application Instructions</a>, and&nbsp;<a href="https://gcgh.grandchallenges.org/cost-disrupting-innovations-reduce-cost-ready-use-therapeutic-food-frequently-asked-questions-faqs" target="_blank" rel="noopener noreferrer">Frequently Asked Questions (FAQs)</a>.
If you are planning to apply to this RFP, we will be hosting a dedicated <a href="https://events.teams.microsoft.com/event/d22d7b22-99e6-49c5-93fd-d31d2cd66660@296b3838-4bd5-496c-bd4b-f456ea743b74" target="_blank" rel="noopener noreferrer">webinar</a> on March 30, from 7:00-8:00 AM Pacific Time. This session will provide a comprehensive overview of the RFP details and an opportunity to have your questions answered. To participate in the <a href="https://events.teams.microsoft.com/event/d22d7b22-99e6-49c5-93fd-d31d2cd66660@296b3838-4bd5-496c-bd4b-f456ea743b74" target="_blank" rel="noopener noreferrer">webinar</a>, please register and <a href="https://forms.office.com/Pages/ResponsePage.aspx?id=ODhrKdVLbEm9S_RW6nQ7dMKiReMZsCJFmCa42S92Da1UNVBJQ0JERFZQNUhWTE5ZNDFDNE9HR1k1Si4u" target="_blank" rel="noopener noreferrer">submit your questions in advance</a>. If you cannot attend live, the webinar will be recorded and available on this challenge page after the session.
Please note that&nbsp;<a href="https://ciff.org/" target="_blank" rel="noopener noreferrer">Children's Investment Fund Foundation (CIFF)</a> and&nbsp;<a href="https://www.givewell.org/" target="_blank" rel="noopener noreferrer">GiveWell</a> have expressed interest in potentially funding projects submitted through this RFP. Representatives from these organizations will participate in the review process. Applicants will be notified if their proposal is selected for further consideration by either organization.
<h2>Background</h2>
Global resources available for the treatment of Severe Acute Malnutrition (SAM) are flat or declining, while the burden of wasting remains high. Under these constraints, improving outcomes will depend on seeking to expand budgets but also more on fundamentally improving the cost-effectiveness of SAM treatment.
This Grand Challenge seeks innovations that can substantially increase the number of children treated for SAM per dollar of spend. We are interested in solutions that achieve step-change improvements in economics by reducing the cost of Ready-to-Use Therapeutic Food (RUTF). Another Grand Challenges RFP looks at reducing the total cost of treating a child without changing the unit cost of RUTF or using a RUTF alternative.
The Grand Challenge is explicitly designed as an idea-sourcing and proof-of-concept mechanism.
<h2>The Challenge</h2>
We seek innovative approaches capable of achieving at least a 30% reduction in the ex-factory unit cost of RUTF in Sub-Saharan Africa and South Asia.
Cost reductions should be calculated relative to the applicant's own current ex-factory production baseline or a clearly justified comparator. Applicants should explicitly state baseline assumptions. Reductions are not required to be measured against a single global benchmark price.
This call focuses specifically on physical composition, ingredients, manufacturing, packaging, and factory-level production economics. Clinical trials and delivery-only approaches are out of scope.
All formulations must present a plausible pathway to meet the&nbsp;<a href="https://openknowledge.fao.org/server/api/core/bitstreams/aa5ce8b6-9a27-4a91-ac02-35523f4b3b04/content" target="_blank" rel="noopener noreferrer">Codex Guidelines for Ready-to-Use Therapeutic Foods (CXG 95 2022)</a>.
Solutions must:
<ul>
<li>Provide a validated pathway to ≥30% cost reduction.</li>
<li>Include a transparent cost model with clear assumptions and sensitivity analysis.</li>
<li>Demonstrate proof-of-concept feasibility (e.g., pilot manufacturing, engineering models, simulations).</li>
<li>Present a credible pathway to normative/regulatory acceptance and adoption.</li>
<li>Show a clear scalability pathway with durable cost reductions at scale.</li>
</ul>
Focus Areas
Applicants may propose innovations under one or more of the following focus areas:
<div class="responsive-table"><table>
<thead>
<tr>
<th>Focus Area</th>
<th>Potential Approaches</th>
<th>Required Deliverables</th>
</tr>
</thead>
<tbody>
<tr>
<td>
Protein Diversification and Dairy Replacement (Highest Priority)
Milk powder is the largest cost driver in standard RUTF. We seek high-quality protein solutions (PDCAAS ≥0.9, preference toward 1.0) that reduce cost while maintaining a credible pathway to Codex compliance.
</td>
<td>
<ul>
<li>Optimized dairy-based protein systems (≥50% dairy protein retained)</li>
<li>Partial dairy reduction (25–75%) using complementary proteins</li>
<li>Dairy-free high-quality protein blends (excluding fava/field beans)</li>
<li>Protein quality optimization technologies (fermentation, extrusion, fortification, enzymatic treatment)</li>
<li>Novel protein matrices enhancing absorption, efficiency, or stability &nbsp;</li>
</ul>
</td>
<td>
<ul>
<li>Prototype formulations meeting Codex/WHO specifications</li>
<li>PDCAAS ≥0.9 with documented amino acid profiles and digestibility</li>
<li>Stability testing (Climatic Zone IVb)</li>
<li>Sensory and acceptability data</li>
<li>Cost comparison model (USD/MT)</li>
<li>Roadmap for regulatory and normative uptake</li>
</ul>
</td>
</tr>
<tr>
<td>
Lipid Optimization and Stabilization
Oils are significant cost and volatility drivers. We seek lipid systems that enable use of lower-cost or local oils while maintaining shelf life and nutritional adequacy.
</td>
<td>
<ul>
<li>Stable regional oils or blends (e.g., sunflower, sesame, cottonseed, palm olein)</li>
<li>Processing or antioxidant systems enabling use of less refined oils</li>
<li>Encapsulation or matrix innovations to reduce oxidation</li>
<li>Approaches reducing reliance on high-barrier packaging&nbsp;</li>
</ul>
</td>
<td>
<ul>
<li>Fatty acid profile characterization</li>
<li>Oxidation stability data (target 24-month shelf life in Zone IVb)</li>
<li>Sensory assessment</li>
<li>Local supply and volatility assessment</li>
<li>Quantified cost impact (USD/MT)&nbsp;</li>
</ul>
</td>
</tr>
<tr>
<td>
Packaging Materials Science
Foil-based sachets are a major cost driver and difficult to recycle.
</td>
<td>
<ul>
<li>Low-cost multilayer laminates</li>
<li>Recyclable alternatives to foil</li>
<li>Downgauged materials</li>
<li>Packaging designs improving efficiency or reducing waste&nbsp;</li>
</ul>
</td>
<td>
<ul>
<li>Packaging prototypes and performance testing</li>
<li>Demonstrated 24-month shelf life in Zone IVb</li>
<li>Unit cost comparison vs. standard sachets</li>
<li>Environmental impact narrative&nbsp;</li>
</ul>
</td>
</tr>
<tr>
<td>
Production and Supply Innovations
Manufacturing and supply inefficiencies materially affect ex-factory cost.
</td>
<td>
<ul>
<li>Continuous/semi-continuous processing</li>
<li>Process intensification</li>
<li>Automation/digitization</li>
<li>Modular or scalable LMIC-appropriate equipment</li>
<li>Input sourcing and procurement innovations</li>
<li>Factory-integration strategies reducing logistics and working capital&nbsp;</li>
</ul>
</td>
<td>
<ul>
<li>Description of innovation vs. current practice</li>
<li>Proof-of-concept feasibility evidence</li>
<li>Cost comparison (current vs. proposed USD/MT)</li>
<li>Scalability and capital/payback assessment&nbsp;</li>
</ul>
</td>
</tr>
</tbody>
</table></div>
Cross-Cutting Requirements
All funded projects must address:
<ul>
<li>Clinical Safety and Nutritional Adequacy.
<ul>
<li>Compliance with Codex RUTF Guidelines (CXG 95-2022).</li>
<li>Energy density: 520–550 kcal/100g.</li>
<li>Protein: 10–12% energy.</li>
<li>Lipids: 45–60% energy.</li>
<li>PDCAAS ≥0.9 (preference toward 1.0).</li>
<li>Micronutrient and food safety compliance.</li>
</ul>
</li>
</ul>
Projects materially altering formulation must present a path to clinical noninferiority and normative acceptance.
<ul>
<li>LMIC Applicability &amp; Equity
<ul>
<li>Feasible manufacturing in LMICs</li>
<li>Strengthened regional production capacity</li>
<li>Encouragement of LMIC-led consortia</li>
</ul>
</li>
<li>Intellectual Property &amp; Global Access
<ul>
<li>Nonexclusive or affordable licensing in low-income and humanitarian markets</li>
<li>Evidence sharing with normative agencies</li>
</ul>
</li>
<li>Data Sharing &amp; Transparency</li>
<li>Environmental Considerations</li>
<li>Responsible Use of AI &amp; Digital Technologies&nbsp;</li>
</ul>
Funding Structure
For any of the Focus Areas we will consider proposals under two funding options. Please consider which is most relevant to your proposal.
<ul>
<li>Option A:&nbsp;We will consider proposals for awards of up to $500,000 USD across any of the categories within this call, with a grant term of up to 18 months. Application budgets should be commensurate with the scope of work proposed.</li>
<li>Option B:&nbsp;We will consider several proposals for awards of up to $1,500,000 USD for each project, with a grant term of up to 36 months. Application budgets should be commensurate with the scope of work proposed.</li>
</ul>
Indirect costs should be included in the budget and should not exceed 10-15% of the total award (subject to the&nbsp;<a href="https://docs.gatesfoundation.org/Documents/Indirect_Cost_Policy.pdf">Gates Foundation's indirect cost policy</a>).
Eligibility
We welcome applications from universities and research institutes, RUTF manufacturers and food processors, ingredient and packaging suppliers, engineering and technology firms, NGOs with strong technical capacity, and for-profit entities (subject to&nbsp;<a href="https://globalaccess.gatesfoundation.org/">global access requirements</a>). Consortia led by or including LMIC-based organizations are strongly encouraged. Individuals and organizations classified as individuals for U.S. tax purposes are not eligible to receive an award from the foundation as part of this initiative.&nbsp;
What we are looking for
Successful proposals will:
<ul>
<li>Demonstrate ≥30% ex-factory cost reduction.</li>
<li>Include a credible, transparent cost model.</li>
<li>Provide proof-of-concept feasibility evidence.</li>
<li>Present a regulatory and normative adoption pathway.</li>
<li>Show durable scalability.</li>
<li>Address LMIC manufacturability and equity considerations. &nbsp;</li>
</ul>
We will not fund proposals that:
<ul>
<li>Focus solely on policy advocacy or tariff reform.</li>
<li>Are standalone training or general capacity-building efforts.</li>
<li>Subsidize routine operations or infrastructure.</li>
<li>Are purely market studies.</li>
<li>Rely on price negotiation or procurement tactics without technological innovation.</li>
<li>Focus solely on clinical trials.</li>
<li>Focus solely on delivery models without product innovation.</li>
</ul>

This Grand Challenge seeks innovations that can substantially increase the number of children treated for Severe Acute Malnutrition (SAM) per dollar of spend. We are interested in solutions that achieve step-change improvements in economics by reducing the cost of Ready-to-Use Therapeutic Food (RUTF). Another Grand Challenges RFP looks at reducing the total cost of treating a child without changing the unit cost of RUTF or using a RUTF alternative.

Innovations in Cost-Disruptive Tools for Diagnosis and Screening

We define cost-disruptive tools for diagnosis and screening as approaches that target less than US$1 or devices with negligible incremental cost per use. For screening applications, cost targets should be interpreted per person screened; for diagnostic or monitoring applications, per test performed. Accordingly, this initiative aims to translate these cost-disruptive concepts into scalable solutions across high-priority disease areas.
This Grand Challenge seeks both devices that amortize capital to near-zero incremental cost and consumable $1-class tests that materially reset the cost curve in LMICs while meeting real-world point-of-care constraints.

Novel Interventions Targeting Placental and Gut Inflammation to Improve Fetal Growth

We seek solutions that can accelerate identification and early validation of interventions (novel or repurposed), including drug-based, biologic, dietary, and microbiome-informed approaches, that modulate inflammatory and or oxidative stress processes in the placenta-maternal gut axis, with the potential to improve fetal growth outcomes. We encourage applicants to pair ambitious ideas with a feasible plan to generate decision-grade evidence within the award duration.

This RFP is jointly launched by several Grand Challenges funding partners, including Grand Challenges Africa (Science for Africa Foundation), Grand Challenges Brazil (Brazilian Ministry of Health and the National Council on Research), Grand Challenges India (Biotechnology Industry Research Assistance Council), Grand Challenges South Africa (South African Medical Research Council), and the Gates Foundation. Each RFP may differ in its geographic focus, topic areas, and funding levels. Please review the eligibility criteria and specific requirements for each RFP carefully. The individual RFPs are listed separately <a href="https://gcgh.grandchallenges.org/challenges/JTdCJTIyc29ydCUyMiUzQSUyMmRlc2NlbmRpbmclMjIlMkMlMjJzb3J0RmllbGQlMjIlM0ElMjJkYXRlJTIyJTJDJTIybnVtYmVyUGVyUGFnZSUyMiUzQTEwJTJDJTIycGFnZU51bWJlciUyMiUzQTAlN0Q=/JTdCJTIyeWVhcnMlMjIlM0ElNUIlNUQlMkMlMjJjaGFsbGVuZ2VzJTIyJTNBJTVCJTIyMzk0JTIyJTVEJTJDJTIydGVybXMlMjIlM0ElNUIlNUQlMkMlMjJpbml0aWF0aXZlcyUyMiUzQSU1QiU1RCUyQyUyMmxvY2F0aW9ucyUyMiUzQSU1QiU1RCU3RA==" target="_blank">here</a>. If you qualify for more than one, we encourage you to apply to the RFP that best aligns with your proposed project and geographical location.Please note: Grand Challenges Brazil will review proposals submitted by Brazilian organizations through the link on this webpage. Proposals selected to receive financial support from the Brazilian Ministry of Health / GC Brazil must be led by researchers linked to non-profit Science, Technology and Innovation Institutions (Instituição Científica, Tecnológica e de Inovação – ICT), registered in Brazil.Before applying, applicants should familiarize themselves with the supporting documents for this Grand Challenge, including the Rules and Guidelines, Application Instructions, and Frequently Asked Questions.If you are planning to apply to this RFP, we will be hosting a dedicated webinar on November 20, from 6:00 to 7:00 AM Pacific Time. This session will provide a comprehensive overview of the RFP technical details and an opportunity to have your questions answered. To participate in the webinar, please <a href="https://events.teams.microsoft.com/event/2957503f-d95d-47b0-8bfa-b7d28f55266c@296b3838-4bd5-496c-bd4b-f456ea743b74" target="_blank">register</a> and <a href="https://forms.office.com/pages/responsepage.aspx?id=ODhrKdVLbEm9S_RW6nQ7dMKiReMZsCJFmCa42S92Da1UMFBSMVlMQUNLSlRDOVNOMFdNR0dSUUFXNC4u&amp;origin=lprLink&amp;route=shorturl" target="_blank">submit your questions</a> in advance. If you cannot attend live, the webinar will be recorded and available on this challenge page after the session.<h2>Background</h2>Local delivery of drugs into the vagina for prevention and treatment of female-specific conditions remains understudied and under-utilized despite clear potential advantages such as discreetness, potent local efficacy, large surface area for drug absorption, high potential for API dosage sparing, potential for fewer systemic side effects, as well as providing autonomy and empowerment of women. Several key drivers may be responsible for this lag, including paucity of mechanistic biological data, particularly from high-burden settings such as low- and middle-income countries (LMICs), to support the development of specific formulations for vaginal use as well as a persistent misconception that vaginally delivered products may not be embraced by women and their sexual partners. Several of our priorities for impactful products for sexual and reproductive health will require vaginal delivery for immediate, on-demand use. We seek to catalyze the development of innovative technologies and approaches that can safely and effectively deliver a wide range of vaginal products. We expect these approaches to have user appeal, including promotion of self-care capability and other beneficial features that women seek, hence the need to couple discovery research with high-quality end-user input.<h2>The Challenge</h2>We are soliciting applications that contribute to development of vaginal formulations that promote optimal drug delivery within the vaginal compartment while positively supporting the vaginal milieu, and that also possess beneficial effects, even if unrelated to the API intended effect, that a user might consider desirable, such as enhancement of sexual pleasure. We anticipate identifying product-agnostic features that promote vaginal health and that broadly appeal to women to advance product development and formulations for women's health. We welcome innovations at any stage of development that meet the scope of this call.Applicants may apply to address one or more of the following objectives of this challenge:<ol><li>Leverage biology for vaginally administered products: In this objective, we seek: 1) innovative formulations and delivery approaches that leverage the biology of the vaginal microenvironment to support development of novel delivery technologies and that have high potential for scalable, low-cost manufacturing options; and 2) novel components that could be incorporated into and improve existing formulations (e.g. films, tablets/inserts) that would promote maintenance of or transition to an optimal vaginal microbiome and/or promote other benefit to the vaginal mucosal epithelium. Specifically, we seek to assess and de-risk novel approaches to vaginal delivery that can leverage and support features of the vaginal milieu including mucus, host cells and microbes for drug delivery and as such we anticipate proposals including evaluation of the impact of these novel approaches or components on changes in the microbiome and vaginal host components (cells/cytokines, mucins, glycans, lectins, etc.).</li><li>Define characteristics of an ideal vaginal product: In this objective, we seek to support qualitative studies aimed at identifying and understanding specific features of a vaginally administered product that would most appeal to women such that many women, especially those of reproductive age in LMICs, would seek to use such a product (for example, 'what would you hope to achieve when using this product in your vagina?'). We are particularly interested in defining ancillary benefits (such as odor control, sexual enhancement, etc.) that could be derived from a vaginally delivered product that would likely not be supported by other routes of administration, as well as identifying major hurdles that may prevent a woman from seeking out or preferring a vaginal product. We acknowledge that there may be regional, cultural, demographic or other preference differences, and are seeking to identify desires or barriers that are commonly expressed by women across these demographic differences. Applicants may propose methods to prioritize preferences such that the vaginal product developed can benefit as many women as possible. In sum, we aim to gather insights into preferred and achievable characteristics that would transform vaginal products from 'tolerable' to 'desirable'.</li></ol>Funding LevelProjects with a duration of up to two years and a maximum requested budget of $250,000USD are eligible for funding. Exploratory projects with shorter durations/lower budgets that focus on high-risk, innovative areas are strongly encouraged and will be given priority. Budgets should be commensurate with the scope of work proposed and in line with allowable costs of the targeted funding organization for which the applicant is eligible. Indirect costs should be included in the budget and should not exceed 10-15% of the total award (subject to the <a href="https://docs.gatesfoundation.org/Documents/Indirect_Cost_Policy.pdf" target="_blank">Gates Foundation's indirect cost policy</a>).Eligibility CriteriaThis initiative is open to research institutes, nonprofit organizations, for-profit companies, international organizations, government agencies, and academic institutions. Please note that all applicants will be expected to comply with the Foundation's global access clause. We encourage groups to build upon existing and/or complimentary projects/studies/trials and to collaborate with other institutions. We particularly encourage applications from projects led by women and/or researchers at institutions based in LMICs and/or involving collaboration with women-led or LMIC-based organizations. Only individuals who are applying through a legally recognized corporate entity are eligible.We are looking for proposals that:<ul><li>Focus on vaginal delivery approaches that do not require retrieval and disposal after use and can be adapted for extended- or slow-release of active ingredients.</li><li>Use innovative, rigorous qualitative approaches that improve or deepen our understanding of standard acceptability metrics.</li><li>Generate biological or end-user data from low- and middle-income regions and comply with national regulations on data security, data protection and privacy.</li><li>Propose rigorous scientific approaches to study a clear research question and whose rationale is clearly supported by peer-reviewed literature.</li><li>Demonstrate feasibility with preliminary data in support of the proposed approach; if no preliminary data exists, then the proposal should be limited in scope.</li><li>Request the appropriate funds and time to achieve the objectives of the proposed work. Exploratory projects of lower cost but higher risk are strongly encouraged and will be prioritized.</li><li>Promote a diverse, inclusive, and supportive research environment, with priority for collaborations involving LMIC-based experts in reproductive health.</li></ul>We will not fund proposals that:<ul><li>Evaluate the impact of currently available vaginally inserted products on the vaginal milieu (e.g. menstrual products, contraceptive devices, over-the-counter probiotics, etc.).</li><li>Focus on approaches that would not be feasible or affordable in low- and middle-income countries, including personalized medicine. If these approaches are included, the feasibility of scalable, low-cost development should be explicitly stated.</li><li>Focus on the development of therapeutics or interventions for specific conditions, such as treatment for STIs or contraceptive products. While these types of interventions may be used as a test case within the proposal, the work itself should focus on formulations.</li><li>Are focused solely on basic exploratory scientific research without a clear translational pathway, including potential end-use scenarios, scalability considerations and regulatory or manufacturing implications.</li><li>Center solely on focus groups and interviews. These methods or qualitative approaches are acceptable if embedded within rigorous mixed-methods study designs that generate quantitative, actionable insights beyond anecdotal data or standard acceptability metrics such as affective attitudes.</li><li>Do not consider end user preferences or assume end-user preferences. For the purposes of this RFP, end-users can be defined as women of reproductive age in low- and middle-income countries. Proposals may focus on subgroups (e.g., adolescents, post-partum women), but the target group must be explicitly defined and justified.</li><li>Primarily depend on traditional acceptability questionnaires or surveys (e.g., “if x hypothetical product existed, how interested would you be in using it?”).</li><li>Do not directly address one of the core objectives as outlined above.</li><li>Cannot be accomplished within a two-year maximum project duration or within the stipulated budget maximum.</li><li>Support researchers or research teams who are affiliated with the tobacco industry, or who receive (or are applying for) funding from the tobacco industry, which includes manufacturers and distributors of e-cigarettes or vaping products.</li></ul>

Accelerating Innovation in Vaginal Formulations in Support of Women's Health

This RFP is jointly launched by several Grand Challenges funding partners, including Grand Challenges Africa (Science for Africa Foundation), Grand Challenges Brazil (Brazilian Ministry of Health and the National Council on Research), Grand Challenges India (Biotechnology Industry Research Assistance Council), Grand Challenges South Africa (South African Medical Research Council), and the Gates Foundation. Each RFP may differ in its geographic focus, topic areas, and funding levels. Please review the eligibility criteria and specific requirements for each RFP carefully. The individual RFPs are listed separately <a href="https://gcgh.grandchallenges.org/challenges/JTdCJTIyc29ydCUyMiUzQSUyMmRlc2NlbmRpbmclMjIlMkMlMjJzb3J0RmllbGQlMjIlM0ElMjJkYXRlJTIyJTJDJTIybnVtYmVyUGVyUGFnZSUyMiUzQTEwJTJDJTIycGFnZU51bWJlciUyMiUzQTAlN0Q=/JTdCJTIyeWVhcnMlMjIlM0ElNUIlNUQlMkMlMjJjaGFsbGVuZ2VzJTIyJTNBJTVCJTIyMzk0JTIyJTVEJTJDJTIydGVybXMlMjIlM0ElNUIlNUQlMkMlMjJpbml0aWF0aXZlcyUyMiUzQSU1QiU1RCUyQyUyMmxvY2F0aW9ucyUyMiUzQSU1QiU1RCU3RA==" target="_blank" rel="noopener noreferrer">here</a>. If you qualify for more than one, we encourage you to apply to the RFP that best aligns with your proposed project and geographical location.
Please note: Grand Challenges Brazil will review proposals submitted by Brazilian organizations through the link on this webpage. Proposals selected to receive financial support from the Brazilian Ministry of Health / GC Brazil must be led by researchers linked to non-profit Science, Technology and Innovation Institutions (Instituição Científica, Tecnológica e de Inovação – ICT), registered in Brazil.
Before applying, applicants should familiarize themselves with the supporting documents for this Grand Challenge, including the Rules and Guidelines, Application Instructions, and Frequently Asked Questions.
If you are planning to apply to this RFP, we will be hosting a dedicated webinar on November 20, from 6:00 to 7:00 AM Pacific Time. This session will provide a comprehensive overview of the RFP technical details and an opportunity to have your questions answered. To participate in the webinar, please <a href="https://events.teams.microsoft.com/event/2957503f-d95d-47b0-8bfa-b7d28f55266c@296b3838-4bd5-496c-bd4b-f456ea743b74" target="_blank" rel="noopener noreferrer">register</a> and <a href="https://forms.office.com/pages/responsepage.aspx?id=ODhrKdVLbEm9S_RW6nQ7dMKiReMZsCJFmCa42S92Da1UMFBSMVlMQUNLSlRDOVNOMFdNR0dSUUFXNC4u&amp;origin=lprLink&amp;route=shorturl" target="_blank" rel="noopener noreferrer">submit your questions</a> in advance. If you cannot attend live, the webinar will be recorded and available on this challenge page after the session.
<h2>Background</h2>
Local delivery of drugs into the vagina for prevention and treatment of female-specific conditions remains understudied and under-utilized despite clear potential advantages such as discreetness, potent local efficacy, large surface area for drug absorption, high potential for API dosage sparing, potential for fewer systemic side effects, as well as providing autonomy and empowerment of women. Several key drivers may be responsible for this lag, including paucity of mechanistic biological data, particularly from high-burden settings such as low- and middle-income countries (LMICs), to support the development of specific formulations for vaginal use as well as a persistent misconception that vaginally delivered products may not be embraced by women and their sexual partners. Several of our priorities for impactful products for sexual and reproductive health will require vaginal delivery for immediate, on-demand use. We seek to catalyze the development of innovative technologies and approaches that can safely and effectively deliver a wide range of vaginal products. We expect these approaches to have user appeal, including promotion of self-care capability and other beneficial features that women seek, hence the need to couple discovery research with high-quality end-user input.
<h2>The Challenge</h2>
We are soliciting applications that contribute to development of vaginal formulations that promote optimal drug delivery within the vaginal compartment while positively supporting the vaginal milieu, and that also possess beneficial effects, even if unrelated to the API intended effect, that a user might consider desirable, such as enhancement of sexual pleasure. We anticipate identifying product-agnostic features that promote vaginal health and that broadly appeal to women to advance product development and formulations for women's health. We welcome innovations at any stage of development that meet the scope of this call.
Applicants may apply to address one or more of the following objectives of this challenge:
<ol>
<li>Leverage biology for vaginally administered products: In this objective, we seek: 1) innovative formulations and delivery approaches that leverage the biology of the vaginal microenvironment to support development of novel delivery technologies and that have high potential for scalable, low-cost manufacturing options; and 2) novel components that could be incorporated into and improve existing formulations (e.g. films, tablets/inserts) that would promote maintenance of or transition to an optimal vaginal microbiome and/or promote other benefit to the vaginal mucosal epithelium. Specifically, we seek to assess and de-risk novel approaches to vaginal delivery that can leverage and support features of the vaginal milieu including mucus, host cells and microbes for drug delivery and as such we anticipate proposals including evaluation of the impact of these novel approaches or components on changes in the microbiome and vaginal host components (cells/cytokines, mucins, glycans, lectins, etc.).</li>
<li>Define characteristics of an ideal vaginal product: In this objective, we seek to support qualitative studies aimed at identifying and understanding specific features of a vaginally administered product that would most appeal to women such that many women, especially those of reproductive age in LMICs, would seek to use such a product (for example, 'what would you hope to achieve when using this product in your vagina?'). We are particularly interested in defining ancillary benefits (such as odor control, sexual enhancement, etc.) that could be derived from a vaginally delivered product that would likely not be supported by other routes of administration, as well as identifying major hurdles that may prevent a woman from seeking out or preferring a vaginal product. We acknowledge that there may be regional, cultural, demographic or other preference differences, and are seeking to identify desires or barriers that are commonly expressed by women across these demographic differences. Applicants may propose methods to prioritize preferences such that the vaginal product developed can benefit as many women as possible. In sum, we aim to gather insights into preferred and achievable characteristics that would transform vaginal products from 'tolerable' to 'desirable'.</li>
</ol>
Funding Level
Projects with a duration of up to two years and a maximum requested budget of $250,000USD are eligible for funding. Exploratory projects with shorter durations/lower budgets that focus on high-risk, innovative areas are strongly encouraged and will be given priority. Budgets should be commensurate with the scope of work proposed and in line with allowable costs of the targeted funding organization for which the applicant is eligible. Indirect costs should be included in the budget and should not exceed 10-15% of the total award (subject to the <a href="https://docs.gatesfoundation.org/Documents/Indirect_Cost_Policy.pdf" target="_blank" rel="noopener noreferrer">Gates Foundation's indirect cost policy</a>).
Eligibility Criteria
This initiative is open to research institutes, nonprofit organizations, for-profit companies, international organizations, government agencies, and academic institutions. Please note that all applicants will be expected to comply with the Foundation's global access clause. We encourage groups to build upon existing and/or complimentary projects/studies/trials and to collaborate with other institutions. We particularly encourage applications from projects led by women and/or researchers at institutions based in LMICs and/or involving collaboration with women-led or LMIC-based organizations. Only individuals who are applying through a legally recognized corporate entity are eligible.
We are looking for proposals that:
<ul>
<li>Focus on vaginal delivery approaches that do not require retrieval and disposal after use and can be adapted for extended- or slow-release of active ingredients.</li>
<li>Use innovative, rigorous qualitative approaches that improve or deepen our understanding of standard acceptability metrics.</li>
<li>Generate biological or end-user data from low- and middle-income regions and comply with national regulations on data security, data protection and privacy.</li>
<li>Propose rigorous scientific approaches to study a clear research question and whose rationale is clearly supported by peer-reviewed literature.</li>
<li>Demonstrate feasibility with preliminary data in support of the proposed approach; if no preliminary data exists, then the proposal should be limited in scope.</li>
<li>Request the appropriate funds and time to achieve the objectives of the proposed work. Exploratory projects of lower cost but higher risk are strongly encouraged and will be prioritized.</li>
<li>Promote a diverse, inclusive, and supportive research environment, with priority for collaborations involving LMIC-based experts in reproductive health.</li>
</ul>
We will not fund proposals that:
<ul>
<li>Evaluate the impact of currently available vaginally inserted products on the vaginal milieu (e.g. menstrual products, contraceptive devices, over-the-counter probiotics, etc.).</li>
<li>Focus on approaches that would not be feasible or affordable in low- and middle-income countries, including personalized medicine. If these approaches are included, the feasibility of scalable, low-cost development should be explicitly stated.</li>
<li>Focus on the development of therapeutics or interventions for specific conditions, such as treatment for STIs or contraceptive products. While these types of interventions may be used as a test case within the proposal, the work itself should focus on formulations.</li>
<li>Are focused solely on basic exploratory scientific research without a clear translational pathway, including potential end-use scenarios, scalability considerations and regulatory or manufacturing implications.</li>
<li>Center solely on focus groups and interviews. These methods or qualitative approaches are acceptable if embedded within rigorous mixed-methods study designs that generate quantitative, actionable insights beyond anecdotal data or standard acceptability metrics such as affective attitudes.</li>
<li>Do not consider end user preferences or assume end-user preferences. For the purposes of this RFP, end-users can be defined as women of reproductive age in low- and middle-income countries. Proposals may focus on subgroups (e.g., adolescents, post-partum women), but the target group must be explicitly defined and justified.</li>
<li>Primarily depend on traditional acceptability questionnaires or surveys (e.g., “if x hypothetical product existed, how interested would you be in using it?”).</li>
<li>Do not directly address one of the core objectives as outlined above.</li>
<li>Cannot be accomplished within a two-year maximum project duration or within the stipulated budget maximum.</li>
<li>Support researchers or research teams who are affiliated with the tobacco industry, or who receive (or are applying for) funding from the tobacco industry, which includes manufacturers and distributors of e-cigarettes or vaping products.</li>
</ul>

We are soliciting applications that contribute to development of vaginal formulations that promote optimal drug delivery within the vaginal compartment while positively supporting the vaginal milieu, and that also possess beneficial effects, even if unrelated to the API intended effect, that a user might consider desirable, such as enhancement of sexual pleasure.

Accelerating Innovation in Vaginal Formulations in Support of Womens Health

Before applying, applicants should familiarize themselves with the supporting documents for this Grand Challenge, including the terms and conditions of the <a href="https://submit.gatesfoundation.org/res/p/RFPTermsConditions/" target="_blank">Gates Foundation</a>, the <a href="https://gcgh.grandchallenges.org/sites/default/files/files/low-cost_nutritients_cost_rules_and_guidelines.pdf" target="_blank">Rules and Guidelines</a>, <a href="https://gcgh.grandchallenges.org/sites/default/files/files/low_cost_nutrients_application_instructions.pdf" target="_blank">Application Instructions</a>, and <a href="https://gcgh.grandchallenges.org/accelerating-development-innovative-exceptionally-low-cost-maternal-and-child-nutrient-ingredients" target="_blank">Frequently Asked Questions</a>.If you are planning to apply to this RFP, we will be hosting a dedicated webinar on November 12, from 7:00 to 8:00 AM Pacific Time. This session will provide a comprehensive overview of the RFP details and an opportunity to have your questions answered. To participate in the webinar, please <a href="https://events.teams.microsoft.com/event/e41294d9-be6c-4906-a5db-bd5aedaa5e75@296b3838-4bd5-496c-bd4b-f456ea743b74" target="_blank" title="https://events.teams.microsoft.com/event/73a86f86-39cf-419c-8eff-333f5dc22ca7@296b3838-4bd5-496c-bd4b-f456ea743b74">register</a> and <a href="https://forms.office.com/r/sUWxxATXyT?origin=lprLink" target="_blank" title="https://forms.office.com/pages/responsepage.aspx?id=odhrkdvlbem9s_rw6nq7dnyuf4phutfbmfmat6jkpdduqk5dtlk1tvjqwldktdbpreduntrlqzjrtc4u">submit your questions in advance</a>. If you cannot attend live, the webinar will be recorded and available on this challenge page after the session.<blockquote>This is a call for transformative innovation. We seek solutions that ensure every mother and child – regardless of where they live – can access the essential nutrients to survive and thrive.</blockquote><h2>Background</h2>Malnutrition remains one of the most urgent and pervasive threats to maternal, newborn, and child health in low- and middle-income countries (LMICs). It contributes to nearly half of all under-five child deaths and is a significant driver of maternal and child morbidity and mortality. During the first 1,000 days of a child's life (from conception to a child's second birthday), nutritional deficiencies can cause irreversible physical and cognitive impairments, limiting educational attainment, economic productivity, and lifelong health. In LMICs, where poverty, limited health services, and food insecurity intersect, the burden of malnutrition disproportionately affects the most vulnerable populations, exacerbating inequities and hindering progress toward global development goals.Targeted interventions that improve maternal nutrition before and during pregnancy are essential for breaking this cycle.Despite decades of evidence demonstrating the importance of adequate intakes and effectiveness of nutrition interventions, many solutions are inaccessible in LMICs due to high costs of nutrients and final products.The nutrients we are particularly interested in are calcium, choline, and omega-3 long chain polyunsaturated fatty acids (specifically docosahexaenoic acid – DHA).Calcium supplementation has been recommended by the World Health Organization (WHO) (1.5–2.0 g elemental calcium daily in populations with low dietary intake) since 2011 as a strategy to reduce the risk of preeclampsia in pregnant women. In two recent randomized trials in India and Tanzania, a low-dose regimen (500 mg elemental calcium daily) was found to be noninferior to the high-dose regimen (1,500 mg) in reducing preeclampsia incidence, supporting the possibility of a simpler, lower-dose strategy.Choline is an essential nutrient that supports fetal brain development, memory function, and placental health, with increasing evidence linking adequate maternal intake to improved child neurocognitive outcomes. The U.S. National Academies of Medicine, the American Academy of Pediatrics, and the European Food Safety Authority (EFSA) all recommend adequate intakes (450–480 mg/day), yet studies consistently show that most pregnant women consume less than recommended, making insufficiency highly prevalent.DHA supports fetal brain, eye, and nervous system development. A Cochrane meta-analysis found that omega-3 supplementation including DHA in pregnancy reduces the risk of preterm birth (before 37 weeks and before 34 weeks). The WHO and the Food and Agriculture Organization (FAO) recommend ≥200 mg/day of DHA for pregnant and lactating women, while the EFSA advises 100–200 mg/day DHA in addition to regular omega-3 intake. This is consistent with recommendations from professional societies such as the American College of Obstetricians and Gynecologists and the International Society for the Study of Fatty Acids and Lipids. Despite this alignment across authorities, dietary surveys show that most pregnant women worldwide do not meet these targets, particularly in regions with low fish consumption.The United Nations International Multiple Micronutrient Antenatal Preparation (UNIMMAP) is a standard formulation that provides a base reference for antenatal multiple micronutrient supplementation and is used in this call for proposals.<h2>The Challenge</h2>High input costs, complex production processes, and limited manufacturing capacity in LMICs keep the price of essential nutrient ingredients and products prohibitively high. As a result, millions of women and children cannot access proven, lifesaving interventions.At the same time, there is a clear opportunity: innovations across the entire product lifecycle - raw material sourcing, ingredient formulation, manufacturing methods, and packaging - can dramatically lower costs while maintaining quality. Advances in biotechnology, materials science, food technology, and other industries provide models that could be adapted to nutrition.We are not seeking incremental improvements. This call is for transformative, bold solutions that can reduce costs by at least 50% compared to current baselines, while maintaining or improving safety, efficacy, and user acceptability. We want to support the development and validation of scalable, sustainable strategies that make high-quality nutrient ingredients and products affordable for LMIC health systems and ensure equitable access for every mother and child.Based on Latham BioPharm Group research, the commonly available pharmaceutical quality ingredients for the nutrients of interest are calcium carbonate, choline bitartrate, choline chloride, and algal DHA powder. The lowest prices reported are 2.1 USD/kg, 5.8 USD/kg, 1.2 USD/kg, and 52 USD/kg (30% purity) respectively. The target cost for exceptionally low-cost nutrient ingredients should be at least 50% below the lowest price identified.Focus AreasApplicants may propose projects under one of the following options:<table class="table"><thead><tr><th>Option</th><th>Scope</th><th>Key Requirements</th></tr></thead><tbody><tr><td>A</td><td>Development of exceptionally low-cost nutrient ingredients (calcium, choline, DHA)</td><td><ul><li>≥50% cost reduction compared to current lowest prices (CaCO₃ $2.1/kg, choline chloride $1.2/kg, algal DHA powder $52/kg, etc.)</li><li>Must meet pharmacopeial standards and International Council for Harmonisation (ICH) Q7 Good Manufacturing Practice (GMP) requirements</li><li>Expected to be stable, allergen-free, culturally inclusive (vegetarian, halal, kosher), and taste neutral</li></ul></td></tr><tr><td>B</td><td>Development of a low-cost prenatal supplement (UNIMMAP MMS + 500 mg/day calcium)</td><td><ul><li>Target cost &lt; US$2 per 180-day regimen</li><li>Informed by consumer research (acceptability, usability, palatability)</li><li>Demonstrated 3 month real-time and 6-month accelerated stability at ICH Q1 (Zone IVb)</li><li>Ideally meet WHO GMP requirements</li></ul></td></tr><tr><td>C</td><td>Development of an advanced prenatal supplement (MMSplus: UNIMMAP MMS + 500 mg/day calcium + 100 mg/day nicotinamide + 450 mg/day choline + 200 mg/day DHA)</td><td><ul><li>Multiple dosage forms or units acceptable (not limited to a single tablet)</li><li>Informed by consumer research - Demonstrated 3 month real-time and 6-month accelerated stability at ICH Q1 (Zone IVb)</li><li>Ideally meet WHO GMP requirements</li></ul></td></tr></tbody></table>Funding Level<table class="table"><thead><tr><th>Option</th><th>Scope</th><th>Target (summary)</th><th>Funding</th><th>Duration</th></tr></thead><tbody><tr><td>A</td><td>Exceptionally low-cost nutrient ingredients (Calcium, Choline, DHA)</td><td>≥50% cost reduction vs current lowest prices; pharmaceutical quality; stable, allergen-free, culturally inclusive</td><td>Up to US$500,000 per ingredient</td><td>Up to 18 months</td></tr><tr><td>B</td><td>Low-cost prenatal supplement (MMS + 500 mg Calcium)</td><td>Less than US$2 per 180-day regimen; consumer informed; 6-month accelerated stability in Zone IVb</td><td>Up to US$200,000</td><td>Up to 12 months</td></tr><tr><td>C</td><td>Advanced prenatal supplement (MMSplus)</td><td>Consumer informed; 6-month accelerated stability in Zone IVb</td><td>Up to US$400,000</td><td>Up to 12 months</td></tr></tbody></table> Application budgets should be commensurate with the scope of work proposed. Indirect costs should be included in the budget and should not exceed 10-15% of the total award (subject to the <a href="https://docs.gatesfoundation.org/Documents/Indirect_Cost_Policy.pdf" target="_blank">Gates Foundation's indirect cost policy</a>).EligibilityThis initiative is open globally to nonprofit organizations, for-profit companies, international organizations, government agencies, and academic institutions. We invite innovators from nutrition, biotechnology, food technology, pharmaceuticals, and beyond to apply. Only individuals who are applying through a legally recognized corporate entity are eligible.What We Are Looking ForSuccessful proposals will demonstrate bold thinking, technical rigor, and a pathway to scale. Specifically, we are seeking proposals that:<ul><li>Present transformative cost-reduction strategies, not incremental improvements, with a clear pathway to achieve ≥50% cost reduction.</li><li>Provide specific steps and/or end-to-end solutions, including credible cost modeling at scale (e.g., 3 million regimens per year).</li><li>Demonstrate technical feasibility with the ability to generate meaningful data within 12–18 months.</li><li>Clearly outline team capabilities and expertise, with strong preference for collaborations involving LMIC partners.</li><li>Include a justified budget, which will be reviewed for alignment with scope and deliverables.</li><li>Consider and enable manufacturing in LMICs, ensuring cultural and dietary inclusivity (vegetarian, halal, kosher).</li><li>Are informed by consumer research, addressing acceptability, usability, and adherence.</li></ul>We encourage applicants to identify and build collaborations with organizations that bring complementary expertise. Where appropriate, the Foundation may facilitate connections among applicants working on related challenges.We will not fund proposals that:<ul><li>Rely solely on price negotiation or procurement tactics (e.g., bulk purchasing).</li><li>Offer only stepwise, incremental improvements with minimal cost impact.</li><li>Focus on delivery models (e.g., distribution, supply chain tools, or market shaping) without product innovation.</li><li>Address nutrients or products outside the defined scope.</li></ul>

Accelerating Development of Innovative, Exceptionally Low-Cost Maternal and Child Nutrient Ingredients and Products

Before applying, applicants should familiarize themselves with the supporting documents for this Grand Challenge, including the terms and conditions of the <a href="https://submit.gatesfoundation.org/res/p/RFPTermsConditions/" target="_blank" rel="noopener noreferrer">Gates Foundation</a>, the <a href="https://gcgh.grandchallenges.org/sites/default/files/files/low-cost_nutritients_cost_rules_and_guidelines.pdf" target="_blank" rel="noopener noreferrer">Rules and Guidelines</a>, <a href="https://gcgh.grandchallenges.org/sites/default/files/files/low_cost_nutrients_application_instructions.pdf" target="_blank" rel="noopener noreferrer">Application Instructions</a>, and <a href="https://gcgh.grandchallenges.org/accelerating-development-innovative-exceptionally-low-cost-maternal-and-child-nutrient-ingredients" target="_blank" rel="noopener noreferrer">Frequently Asked Questions</a>.
If you are planning to apply to this RFP, we will be hosting a dedicated webinar on November 12, from 7:00 to 8:00 AM Pacific Time. This session will provide a comprehensive overview of the RFP details and an opportunity to have your questions answered. To participate in the webinar, please <a href="https://events.teams.microsoft.com/event/e41294d9-be6c-4906-a5db-bd5aedaa5e75@296b3838-4bd5-496c-bd4b-f456ea743b74" target="_blank" title="https://events.teams.microsoft.com/event/73a86f86-39cf-419c-8eff-333f5dc22ca7@296b3838-4bd5-496c-bd4b-f456ea743b74" rel="noopener noreferrer">register</a> and <a href="https://forms.office.com/r/sUWxxATXyT?origin=lprLink" target="_blank" title="https://forms.office.com/pages/responsepage.aspx?id=odhrkdvlbem9s_rw6nq7dnyuf4phutfbmfmat6jkpdduqk5dtlk1tvjqwldktdbpreduntrlqzjrtc4u" rel="noopener noreferrer">submit your questions in advance</a>. If you cannot attend live, the webinar will be recorded and available on this challenge page after the session.
<blockquote>This is a call for transformative innovation. We seek solutions that ensure every mother and child – regardless of where they live – can access the essential nutrients to survive and thrive.
</blockquote>
<h2>Background</h2>
Malnutrition remains one of the most urgent and pervasive threats to maternal, newborn, and child health in low- and middle-income countries (LMICs). It contributes to nearly half of all under-five child deaths and is a significant driver of maternal and child morbidity and mortality. During the first 1,000 days of a child's life (from conception to a child's second birthday), nutritional deficiencies can cause irreversible physical and cognitive impairments, limiting educational attainment, economic productivity, and lifelong health. In LMICs, where poverty, limited health services, and food insecurity intersect, the burden of malnutrition disproportionately affects the most vulnerable populations, exacerbating inequities and hindering progress toward global development goals.
Targeted interventions that improve maternal nutrition before and during pregnancy are essential for breaking this cycle.
Despite decades of evidence demonstrating the importance of adequate intakes and effectiveness of nutrition interventions, many solutions are inaccessible in LMICs due to high costs of nutrients and final products.
The nutrients we are particularly interested in are calcium, choline, and omega-3 long chain polyunsaturated fatty acids (specifically docosahexaenoic acid – DHA).
Calcium supplementation has been recommended by the World Health Organization (WHO) (1.5–2.0 g elemental calcium daily in populations with low dietary intake) since 2011 as a strategy to reduce the risk of preeclampsia in pregnant women. In two recent randomized trials in India and Tanzania, a low-dose regimen (500 mg elemental calcium daily) was found to be noninferior to the high-dose regimen (1,500 mg) in reducing preeclampsia incidence, supporting the possibility of a simpler, lower-dose strategy.
Choline is an essential nutrient that supports fetal brain development, memory function, and placental health, with increasing evidence linking adequate maternal intake to improved child neurocognitive outcomes. The U.S. National Academies of Medicine, the American Academy of Pediatrics, and the European Food Safety Authority (EFSA) all recommend adequate intakes (450–480 mg/day), yet studies consistently show that most pregnant women consume less than recommended, making insufficiency highly prevalent.
DHA supports fetal brain, eye, and nervous system development. A Cochrane meta-analysis found that omega-3 supplementation including DHA in pregnancy reduces the risk of preterm birth (before 37 weeks and before 34 weeks). The WHO and the Food and Agriculture Organization (FAO) recommend ≥200 mg/day of DHA for pregnant and lactating women, while the EFSA advises 100–200 mg/day DHA in addition to regular omega-3 intake. This is consistent with recommendations from professional societies such as the American College of Obstetricians and Gynecologists and the International Society for the Study of Fatty Acids and Lipids. Despite this alignment across authorities, dietary surveys show that most pregnant women worldwide do not meet these targets, particularly in regions with low fish consumption.
The United Nations International Multiple Micronutrient Antenatal Preparation (UNIMMAP) is a standard formulation that provides a base reference for antenatal multiple micronutrient supplementation and is used in this call for proposals.
<h2>The Challenge</h2>
High input costs, complex production processes, and limited manufacturing capacity in LMICs keep the price of essential nutrient ingredients and products prohibitively high. As a result, millions of women and children cannot access proven, lifesaving interventions.
At the same time, there is a clear opportunity: innovations across the entire product lifecycle - raw material sourcing, ingredient formulation, manufacturing methods, and packaging - can dramatically lower costs while maintaining quality. Advances in biotechnology, materials science, food technology, and other industries provide models that could be adapted to nutrition.
We are not seeking incremental improvements. This call is for transformative, bold solutions that can reduce costs by at least 50% compared to current baselines, while maintaining or improving safety, efficacy, and user acceptability. We want to support the development and validation of scalable, sustainable strategies that make high-quality nutrient ingredients and products affordable for LMIC health systems and ensure equitable access for every mother and child.
Based on Latham BioPharm Group research, the commonly available pharmaceutical quality ingredients for the nutrients of interest are calcium carbonate, choline bitartrate, choline chloride, and algal DHA powder. The lowest prices reported are 2.1 USD/kg, 5.8 USD/kg, 1.2 USD/kg, and 52 USD/kg (30% purity) respectively. The target cost for exceptionally low-cost nutrient ingredients should be at least 50% below the lowest price identified.
Focus Areas
Applicants may propose projects under one of the following options:
<div class="responsive-table"><table>
<thead>
<tr>
<th>Option</th>
<th>Scope</th>
<th>Key Requirements</th>
</tr>
</thead>
<tbody>
<tr>
<td>A</td>
<td>Development of exceptionally low-cost nutrient ingredients (calcium, choline, DHA)</td>
<td>
<ul>
<li>≥50% cost reduction compared to current lowest prices (CaCO₃ $2.1/kg, choline chloride $1.2/kg, algal DHA powder $52/kg, etc.)</li>
<li>Must meet pharmacopeial standards and International Council for Harmonisation (ICH) Q7 Good Manufacturing Practice (GMP) requirements</li>
<li>Expected to be stable, allergen-free, culturally inclusive (vegetarian, halal, kosher), and taste neutral</li>
</ul>
</td>
</tr>
<tr>
<td>B</td>
<td>Development of a low-cost prenatal supplement (UNIMMAP MMS + 500 mg/day calcium)</td>
<td>
<ul>
<li>Target cost &lt; US$2 per 180-day regimen</li>
<li>Informed by consumer research (acceptability, usability, palatability)</li>
<li>Demonstrated 3 month real-time and 6-month accelerated stability at ICH Q1 (Zone IVb)</li>
<li>Ideally meet WHO GMP requirements</li>
</ul>
</td>
</tr>
<tr>
<td>C</td>
<td>Development of an advanced prenatal supplement (MMSplus: UNIMMAP MMS + 500 mg/day calcium + 100 mg/day nicotinamide + 450 mg/day choline + 200 mg/day DHA)</td>
<td>
<ul>
<li>Multiple dosage forms or units acceptable (not limited to a single tablet)</li>
<li>Informed by consumer research - Demonstrated 3 month real-time and 6-month accelerated stability at ICH Q1 (Zone IVb)</li>
<li>Ideally meet WHO GMP requirements</li>
</ul>
</td>
</tr>
</tbody>
</table></div>
Funding Level
<div class="responsive-table"><table>
<thead>
<tr>
<th>Option</th>
<th>Scope</th>
<th>Target (summary)</th>
<th>Funding</th>
<th>Duration</th>
</tr>
</thead>
<tbody>
<tr>
<td>A</td>
<td>Exceptionally low-cost nutrient ingredients (Calcium, Choline, DHA)</td>
<td>≥50% cost reduction vs current lowest prices; pharmaceutical quality; stable, allergen-free, culturally inclusive</td>
<td>Up to US$500,000 per ingredient</td>
<td>Up to 18 months</td>
</tr>
<tr>
<td>B</td>
<td>Low-cost prenatal supplement (MMS + 500 mg Calcium)</td>
<td>Less than US$2 per 180-day regimen; consumer informed; 6-month accelerated stability in Zone IVb</td>
<td>Up to US$200,000</td>
<td>Up to 12 months</td>
</tr>
<tr>
<td>C</td>
<td>Advanced prenatal supplement (MMSplus)</td>
<td>Consumer informed; 6-month accelerated stability in Zone IVb</td>
<td>Up to US$400,000</td>
<td>Up to 12 months</td>
</tr>
</tbody>
</table></div>
 Application budgets should be commensurate with the scope of work proposed. Indirect costs should be included in the budget and should not exceed 10-15% of the total award (subject to the <a href="https://docs.gatesfoundation.org/Documents/Indirect_Cost_Policy.pdf" target="_blank" rel="noopener noreferrer">Gates Foundation's indirect cost policy</a>).
Eligibility
This initiative is open globally to nonprofit organizations, for-profit companies, international organizations, government agencies, and academic institutions. We invite innovators from nutrition, biotechnology, food technology, pharmaceuticals, and beyond to apply. Only individuals who are applying through a legally recognized corporate entity are eligible.
What We Are Looking For
Successful proposals will demonstrate bold thinking, technical rigor, and a pathway to scale. Specifically, we are seeking proposals that:
<ul>
<li>Present transformative cost-reduction strategies, not incremental improvements, with a clear pathway to achieve ≥50% cost reduction.</li>
<li>Provide specific steps and/or end-to-end solutions, including credible cost modeling at scale (e.g., 3 million regimens per year).</li>
<li>Demonstrate technical feasibility with the ability to generate meaningful data within 12–18 months.</li>
<li>Clearly outline team capabilities and expertise, with strong preference for collaborations involving LMIC partners.</li>
<li>Include a justified budget, which will be reviewed for alignment with scope and deliverables.</li>
<li>Consider and enable manufacturing in LMICs, ensuring cultural and dietary inclusivity (vegetarian, halal, kosher).</li>
<li>Are informed by consumer research, addressing acceptability, usability, and adherence.</li>
</ul>
We encourage applicants to identify and build collaborations with organizations that bring complementary expertise. Where appropriate, the Foundation may facilitate connections among applicants working on related challenges.
We will not fund proposals that:
<ul>
<li>Rely solely on price negotiation or procurement tactics (e.g., bulk purchasing).</li>
<li>Offer only stepwise, incremental improvements with minimal cost impact.</li>
<li>Focus on delivery models (e.g., distribution, supply chain tools, or market shaping) without product innovation.</li>
<li>Address nutrients or products outside the defined scope.</li>
</ul>

High input costs, complex production processes, and limited manufacturing capacity in LMICs keep the price of essential nutrient ingredients and products prohibitively high. As a result, millions of women and children cannot access proven, lifesaving interventions.
This call is for transformative, bold solutions that can reduce costs by at least 50% compared to current baselines, while maintaining or improving safety, efficacy, and user acceptability. We want to support the development and validation of scalable, sustainable strategies that make high-quality nutrient ingredients and products affordable for LMIC health systems and ensure equitable access for every mother and child.

Accelerating Development of Innovative Exceptionally Low-Cost Maternal and Child Nutrient Ingredients and Products

**NOTE: This opportunity was open only to institutions who had been invited directly by email.Before applying, applicants should familiarize themselves with the supporting documents for this Grand Challenge, including the <a href="https://gcgh.grandchallenges.org/sites/default/files/files/enteric_and_diarrheal_diseases_data_analysis_rules_and_guidelines.pdf" target="_blank">Rules and Guidelines</a>, <a href="https://gcgh.grandchallenges.org/sites/default/files/files/enteric_and_diarrheal_diseases_data_analysis_application_instructions.pdf" target="_blank">Application Instructions</a>, and <a href="https://gcgh.grandchallenges.org/strengthening-analytic-capacity-enteric-and-diarrheal-diseases-low-and-middle-income-settings" target="_blank">Frequently Asked Questions</a>.<h2>Background</h2>Enteric and diarrheal diseases remain a leading cause of morbidity and mortality in low- and middle-income countries (LMICs), particularly among children under five. Over the past two decades, substantial investments have been made in large-scale epidemiological studies generating rich datasets on enteric pathogens, risk factors, and outcomes across diverse LMIC settings. Despite the volume and potential of this data, much of it remains underutilized, with limited secondary analysis conducted by in-country researchers. Empowering LMIC-based investigators to lead secondary analyses not only enhances the contextual relevance of findings but also strengthens local research capacity and ownership of health solutions. Therefore, there is a significant opportunity to catalyze novel insights into enteric and diarrheal disease etiology, sequelae, interventions, and policy, while promoting equitable research partnerships and advancing global health equity.<h2>The Challenge</h2>This RFP seeks to develop the capacity for leading data analysis related to enteric and diarrheal diseases in low-and-middle income settings.Specifically, the objectives of the challenge will be:<ul><li>Develop novel insights from existing data</li><li>Promote LMIC leadership and independence in global health research</li><li>Strengthen analytical capacity in LMICs</li><li>Inform policy and program decision-making</li><li>Advance open science and data stewardship</li></ul>Funding LevelWe will consider proposals for awards of up to $100,000 USD in direct costs for each project, with a grant term of up to 1 year. Application budgets should be commensurate with the scope of work proposed. Indirect costs will be considered, and should be included in the budget for up to $15,000 USD award (subject to the <a href="https://docs.gatesfoundation.org/Documents/Indirect_Cost_Policy.pdf" target="_blank">Gates Foundation's indirect cost policy</a>).Eligibility CriteriaThis initiative is open to nonprofit organizations, for-profit companies, international organizations, government agencies and academic institutions that 1) are based in a LMIC country<a href="#_ftn1" title="" id="_ftnref1" name="_ftnref1">1</a>; and 2) have received funding from the Gates Foundation as a direct awardee or sub-grantee on enteric and diarrheal disease-related investments. We particularly encourage applications involving projects led by women or from women-led organizations. Applicants should align within their institutions before submitting a proposal as no more than one award will be given to a single institution.We are looking for proposals that:<ul><li>Are led by junior or mid-level researchers that: 1) have experience in the field of enterics and want to lead more analytics work, 2) have analytical skills who want to gain experience in applications in enterics or 3) have experience in both enterics and data analysis and would like to expand their analytic skillset in specific ways.</li><li>Focus on enteric and diarrheal diseases (including but not limited to diarrhea and diarrheal etiologies, typhoid/enteric fever and invasive nontyphoidal Salmonella, Hepatitis E and A)&nbsp;including but not limited to disease epidemiology, genomics, vaccine performance, disease dynamics, treatment effects, diagnostic performance, cost-effectiveness, and/or mathematical models.</li><li>Prioritize policy-relevant analytic questions.</li><li>Demonstrate institutional support and partnerships necessary for growth in analytic skills and successful completion of the objectives.</li><li>Conduct analyses beyond what was funded by the parent study and/or published.</li><li>Result in at least one pre-print manuscript and one policy brief.</li><li>Include support for investigators through a mentor, mentoring team, and/or training plan (e.g., coursework) to develop the analytic skills needed to successfully complete the proposed research. These resources may be provided by the applicant's home institution or a partner institution (located anywhere in the world) supported by a subgrant.</li><li>Contribute to sustainable capacity building for data analysis to be conducted at the home institution in future research projects.</li></ul>We will not fund proposals that:<ul><li>Aim to collect or generate new data through this funding.</li><li>Propose descriptive analyses alone.</li><li>Propose analyses that overlap with results already funded and/or published.</li><li>Are not led by an LMIC investigator.</li><li>Do not demonstrate how this award would strengthen local capacity to conduct and lead analysis of future datasets.</li><li>Do not have timely access to necessary data.</li><li>Do not focus on enteric and diarrheal diseases.</li><li>Do not demonstrate a clear commitment to open science and making their findings, processes and/or tools developed accessible and reusable.</li></ul><a href="#_ftnref1" title="" id="_ftn1" name="_ftn1">1</a> See <a href="https://data.worldbank.org/country/XO" target="_blank">World Bank - Low Income Countries for definitions</a>). Subject to the eligibility requirements in the Rules &amp; Guidelines, investigators in low- and middle-income countries are invited (in connection with the organization with which they are affiliated) to apply through the Gates Foundation’s application portal. We reserve the right to determine eligibility for this call based on these characteristics. Grants will go to investigators in low- and middle-income countries, but we encourage partnerships with investigators in other countries regardless of location, especially where the opportunity exists to build on existing collaborations.

Strengthening Analytic Capacity for Enteric and Diarrheal Diseases in Low-and-Middle Income Settings

**NOTE: This opportunity is open only to institutions who have been invited directly by email.
Before applying, applicants should familiarize themselves with the supporting documents for this Grand Challenge, including the <a href="https://gcgh.grandchallenges.org/sites/default/files/files/enteric_and_diarrheal_diseases_data_analysis_rules_and_guidelines.pdf" target="_blank" rel="noopener noreferrer">Rules and Guidelines</a>, <a href="https://gcgh.grandchallenges.org/sites/default/files/files/enteric_and_diarrheal_diseases_data_analysis_application_instructions.pdf" target="_blank" rel="noopener noreferrer">Application Instructions</a>, and <a href="https://gcgh.grandchallenges.org/strengthening-analytic-capacity-enteric-and-diarrheal-diseases-low-and-middle-income-settings" target="_blank" rel="noopener noreferrer">Frequently Asked Questions</a>.
<h2>Background</h2>
Enteric and diarrheal diseases remain a leading cause of morbidity and mortality in low- and middle-income countries (LMICs), particularly among children under five. Over the past two decades, substantial investments have been made in large-scale epidemiological studies generating rich datasets on enteric pathogens, risk factors, and outcomes across diverse LMIC settings. Despite the volume and potential of this data, much of it remains underutilized, with limited secondary analysis conducted by in-country researchers. Empowering LMIC-based investigators to lead secondary analyses not only enhances the contextual relevance of findings but also strengthens local research capacity and ownership of health solutions. Therefore, there is a significant opportunity to catalyze novel insights into enteric and diarrheal disease etiology, sequelae, interventions, and policy, while promoting equitable research partnerships and advancing global health equity.
<h2>The Challenge</h2>
This RFP seeks to develop the capacity for leading data analysis related to enteric and diarrheal diseases in low-and-middle income settings.
Specifically, the objectives of the challenge will be:
<ul>
<li>Develop novel insights from existing data</li>
<li>Promote LMIC leadership and independence in global health research</li>
<li>Strengthen analytical capacity in LMICs</li>
<li>Inform policy and program decision-making</li>
<li>Advance open science and data stewardship</li>
</ul>
Funding Level
We will consider proposals for awards of up to $100,000 USD in direct costs for each project, with a grant term of up to 1 year. Application budgets should be commensurate with the scope of work proposed. Indirect costs will be considered, and should be included in the budget for up to $15,000 USD award (subject to the <a href="https://docs.gatesfoundation.org/Documents/Indirect_Cost_Policy.pdf" target="_blank" rel="noopener noreferrer">Gates Foundation's indirect cost policy</a>).
Eligibility Criteria
This initiative is open to nonprofit organizations, for-profit companies, international organizations, government agencies and academic institutions that 1) are based in a LMIC country<a href="#_ftn1" title id="_ftnref1" name="_ftnref1">1</a>; and 2) have received funding from the Gates Foundation as a direct awardee or sub-grantee on enteric and diarrheal disease-related investments. We particularly encourage applications involving projects led by women or from women-led organizations. Applicants should align within their institutions before submitting a proposal as no more than one award will be given to a single institution.
We are looking for proposals that:
<ul>
<li>Are led by junior or mid-level researchers that: 1) have experience in the field of enterics and want to lead more analytics work, 2) have analytical skills who want to gain experience in applications in enterics or 3) have experience in both enterics and data analysis and would like to expand their analytic skillset in specific ways.</li>
<li>Focus on enteric and diarrheal diseases (including but not limited to diarrhea and diarrheal etiologies, typhoid/enteric fever and invasive nontyphoidal Salmonella, Hepatitis E and A)&nbsp;including but not limited to disease epidemiology, genomics, vaccine performance, disease dynamics, treatment effects, diagnostic performance, cost-effectiveness, and/or mathematical models.</li>
<li>Prioritize policy-relevant analytic questions.</li>
<li>Demonstrate institutional support and partnerships necessary for growth in analytic skills and successful completion of the objectives.</li>
<li>Conduct analyses beyond what was funded by the parent study and/or published.</li>
<li>Result in at least one pre-print manuscript and one policy brief.</li>
<li>Include support for investigators through a mentor, mentoring team, and/or training plan (e.g., coursework) to develop the analytic skills needed to successfully complete the proposed research. These resources may be provided by the applicant's home institution or a partner institution (located anywhere in the world) supported by a subgrant.</li>
<li>Contribute to sustainable capacity building for data analysis to be conducted at the home institution in future research projects.</li>
</ul>
We will not fund proposals that:
<ul>
<li>Aim to collect or generate new data through this funding.</li>
<li>Propose descriptive analyses alone.</li>
<li>Propose analyses that overlap with results already funded and/or published.</li>
<li>Are not led by an LMIC investigator.</li>
<li>Do not demonstrate how this award would strengthen local capacity to conduct and lead analysis of future datasets.</li>
<li>Do not have timely access to necessary data.</li>
<li>Do not focus on enteric and diarrheal diseases.</li>
<li>Do not demonstrate a clear commitment to open science and making their findings, processes and/or tools developed accessible and reusable.</li>
</ul>
<a href="#_ftnref1" title id="_ftn1" name="_ftn1">1</a> See <a href="https://data.worldbank.org/country/XO" target="_blank" rel="noopener noreferrer">World Bank - Low Income Countries for definitions</a>). Subject to the eligibility requirements in the Rules &amp; Guidelines, investigators in low- and middle-income countries are invited (in connection with the organization with which they are affiliated) to apply through the Gates Foundation’s application portal. We reserve the right to determine eligibility for this call based on these characteristics. Grants will go to investigators in low- and middle-income countries, but we encourage partnerships with investigators in other countries regardless of location, especially where the opportunity exists to build on existing collaborations.

**NOTE: This opportunity is open only to institutions who have been invited directly by email.

The information regarding this Grand Challenges Request for Proposals was last updated on June 6, 2025.Before applying, applicants should familiarize themselves with the supporting documents for this Grand Challenge, including the <a href="https://gcgh.grandchallenges.org/sites/default/files/files/controlled_trials_on_stis_and_rtis_rules_and_guidelines.pdf" target="_blank">Rules and Guidelines</a>, <a href="https://gcgh.grandchallenges.org/sites/default/files/files/controlled_trials_on_stis_and_rtis_application_instructions.pdf" target="_blank">Application Instructions</a>, and&nbsp;<a href="https://gcgh.grandchallenges.org/randomized-controlled-trial-sexually-transmitted-infections-stis-and-reproductive-tract-sequelae" target="_blank">Frequently Asked Questions</a>.We are planning a webinar to provide more information and answer your questions on June 17 from 7:00-8:00 AM Pacific Time. To participate, <a href="https://events.teams.microsoft.com/event/96243f4f-c909-4175-9cc6-aa5fa3699391@296b3838-4bd5-496c-bd4b-f456ea743b74" target="_blank">please register</a> and <a href="https://forms.office.com/Pages/ResponsePage.aspx?id=ODhrKdVLbEm9S_RW6nQ7dNyUf4PhutFBmFMAT6JKpddUMzJGQUZFNEZDWExXTTZVM0xYTDQzV0pKUy4u" target="_blank">submit your questions</a> ahead of time.<h2>Background</h2>Sexually active young women in low- and middle-income countries (LMICs) experience a high incidence of sexually transmitted infections (STIs), limited access to screening and treatment, and poorly characterized but significant reproductive tract morbidity from untreated infection. Global estimates put the prevalence of gonorrhea and chlamydia among women at 0.8% and 4.0%, respectively, with incidence rates of 1.9 and 3.6 cases per 100 person-years.<a href="#_ftn1" title="" id="_ftnref1" name="_ftnref1">[1]</a> However, these estimates are limited by sparse data, with few sources providing representative measures of disease frequency, including asymptomatic infections. Studies among young women in LMICs interested in HIV pre-exposure prophylaxis have measured incidence rates per 100 person-years of 12-53 for chlamydia, 6-20 for gonorrhea, and 6-7 for trichomoniasis.<a href="#_ftn2" title="" id="_ftnref2" name="_ftnref2">[2]</a> Due to the asymptomatic nature of most infections and reliance on syndromic management, most STIs in women go undetected. Untreated STIs have been linked to a range of poor health outcomes, including pelvic inflammatory disease (PID), chronic pelvic pain, infertility, and ectopic pregnancy. However, these estimates of association are imprecise and draw primarily from cross-sectional, case-control, and retrospective cohort studies, mostly conducted in high-income countries. Gaps in available data limit our ability to draw robust inferences on the risk of sequelae following an infection, the timing of pathogenesis, or how factors such as the presence of symptoms or repeat infection may modify these risks.Better data on the risk of PID and related sequelae are critical to inform prevention and treatment guidelines, motivate funding for product development and provision of services, and shift care-seeking and care-provision behaviors. Research on the prevalence and risk of PID in LMICs has been challenging due to a lack of accurate and scalable diagnostic methods for PID along with funding gaps that limit consistent and comprehensive diagnosis.&nbsp; Although diagnosing subclinical PID remains challenging, targeted research is critical to better understand the risk of developing clinical PID and to evaluate the effectiveness of STI screening and treatment in preventing reproductive tract complications. Strengthening the evidence base in this area will not only advance our understanding of STI-related morbidity but may also stimulate the development and application of improved diagnostic tools to reduce the burden of PID and related outcomes.<h2>The Challenge</h2>This Grand Challenge on Randomized Controlled Trial on Sexually Transmitted Infections (STIs) and Reproductive Tract Sequelae in Non-Pregnant Women aims to fill critical gaps in understanding of the risk of PID and related sequelae attributable to STIs and to evaluate the impact of etiologic STI screening and treatment on morbidity. With this Grand Challenge we welcome letters of intent (LOIs) from organizations to conduct a randomized controlled trial (RCT) in sub-Saharan Africa comparing STI screening and standard of care syndromic management. The primary outcome of this study should be PID, with secondary outcomes possibly including chronic pelvic pain, ectopic pregnancy, and infertility. The study should provide insight into the risk of outcomes following infection with gonorrhea, chlamydia, and/or trichomoniasis and the impact and cost-effectiveness of etiologic screening to prevent morbidity.Funding LevelWe will consider applications requesting awards ranging from $8 million to $10 million USD per project, with a grant duration of up to 48 months. Budgets should align with the scale and complexity of the proposed work. Indirect costs are allowable and should be included within the total requested funding. (subject to the <a href="https://docs.gatesfoundation.org/Documents/Indirect_Cost_Policy.pdf" target="_blank">Gates Foundation's indirect cost policy</a>).Eligibility Criteria<ul><li>This initiative is open to nonprofit organizations, for-profit companies, international organizations, government agencies, and academic institutions.</li><li>Study design must be randomized controlled trial or comparable, robust prospective in Sub-Saharan African settings.</li><li>We encourage groups to build upon existing and/or complimentary projects/studies/trials and to collaborate with other institutions.</li><li>We particularly encourage applications involving projects led by African Primary Investigators (PIs), women, early-career researchers, and practitioners seeking to innovate in women's health measurement, or from women-led organizations and applications from institutions based in LMICs.</li></ul>We are looking for proposals that:<ul><li>Are designed to provide insight into the timing of pathogenesis. This insight could come from comparison of outcomes across arms with varying screening intervals and/or from more frequent collection and storage of samples for subsequent batch testing.</li><li>Consider symptom tracking tools (such as symptom diaries) that could be used to track the onset, type, and severity of symptoms. Ideally, based on validated instruments.</li><li>Ideally enable stratification of risk by the presence of symptoms, co-infection, and repeat infection.</li><li>Ideally provide data to estimate STI incidence and the duration of untreated infection.</li><li>Collect detailed sexual behavior data, including the number of current and recent partners, partner type, partnership duration, concurrency, frequency of sex, type of sex, use of condoms, and characteristics and behaviors of partners.</li><li>Captures costs of screening, treatment, and management of sequelae.</li><li>Engage stakeholders and utilize community advisory boards.</li></ul>We will not fund proposals that:<ul><li>Have trial sites that are not based in sub-Saharan Africa.</li><li>Do not include PID as a primary outcome.</li><li>Include women who are pregnant at baseline.</li><li>Include women with a known diagnosis of infertility at baseline as part of the outcome analysis population.</li><li>Restrict the study population based on HIV status without justification.</li><li>Propose purely observational, retrospective, or modeling-only design.</li><li>Do not address the timing of pathogenesis or provide a strategy for identifying or analyzing the onset of sequelae following STI.</li><li>Do not plan for ethical, community, and gender-informed engagement.</li><li>Lack consideration of downstream policy relevance, such as linking findings to potential influence on screening, syndromic management, or STI prevention guidelines.</li></ul><a href="#_ftnref1" title="" id="_ftn1" name="_ftn1">[1]</a> World Health Organization. (2025). Global and regional STI estimates. The Global Health Observatory. https://www.who.int/data/gho/data/themes/topics/global-and-regional-sti-estimates<a href="#_ftnref2" title="" id="_ftn2" name="_ftn2">[2]</a> Kiweewa, et al. (2019). JAIDS, 22(2), e25257. <a href="https://doi.org/10.1002/jia2.25257" target="_blank">https://doi.org/10.1002/jia2.25257</a>; Stewart et al. (2020). AIDS, 34(5), 651–658. <a href="https://doi.org/10.1097/QAD.0000000000002472">https://doi.org/10.1097/QAD.0000000000002472</a>; Delany-Moretlwe (2023). Sex Transm Infect, 99(7), 433–439. <a href="https://doi.org/10.1136/sextrans-2022-055696" target="_blank">https://doi.org/10.1136/sextrans-2022-055696</a>.

Randomized Controlled Trial on Sexually Transmitted Infections (STIs) and Reproductive Tract Sequelae in Non-Pregnant Women

The information regarding this Grand Challenges Request for Proposals was last updated on June 6, 2025.
Before applying, applicants should familiarize themselves with the supporting documents for this Grand Challenge, including the <a href="https://gcgh.grandchallenges.org/sites/default/files/files/controlled_trials_on_stis_and_rtis_rules_and_guidelines.pdf" target="_blank" rel="noopener noreferrer">Rules and Guidelines</a>, <a href="https://gcgh.grandchallenges.org/sites/default/files/files/controlled_trials_on_stis_and_rtis_application_instructions.pdf" target="_blank" rel="noopener noreferrer">Application Instructions</a>, and&nbsp;<a href="https://gcgh.grandchallenges.org/randomized-controlled-trial-sexually-transmitted-infections-stis-and-reproductive-tract-sequelae" target="_blank" rel="noopener noreferrer">Frequently Asked Questions</a>.
We are planning a webinar to provide more information and answer your questions on June 17 from 7:00-8:00 AM Pacific Time. To participate, <a href="https://events.teams.microsoft.com/event/96243f4f-c909-4175-9cc6-aa5fa3699391@296b3838-4bd5-496c-bd4b-f456ea743b74" target="_blank" rel="noopener noreferrer">please register</a> and <a href="https://forms.office.com/Pages/ResponsePage.aspx?id=ODhrKdVLbEm9S_RW6nQ7dNyUf4PhutFBmFMAT6JKpddUMzJGQUZFNEZDWExXTTZVM0xYTDQzV0pKUy4u" target="_blank" rel="noopener noreferrer">submit your questions</a> ahead of time.
<h2>Background</h2>
Sexually active young women in low- and middle-income countries (LMICs) experience a high incidence of sexually transmitted infections (STIs), limited access to screening and treatment, and poorly characterized but significant reproductive tract morbidity from untreated infection. Global estimates put the prevalence of gonorrhea and chlamydia among women at 0.8% and 4.0%, respectively, with incidence rates of 1.9 and 3.6 cases per 100 person-years.<a href="#_ftn1" title id="_ftnref1" name="_ftnref1">[1]</a> However, these estimates are limited by sparse data, with few sources providing representative measures of disease frequency, including asymptomatic infections. Studies among young women in LMICs interested in HIV pre-exposure prophylaxis have measured incidence rates per 100 person-years of 12-53 for chlamydia, 6-20 for gonorrhea, and 6-7 for trichomoniasis.<a href="#_ftn2" title id="_ftnref2" name="_ftnref2">[2]</a> Due to the asymptomatic nature of most infections and reliance on syndromic management, most STIs in women go undetected. Untreated STIs have been linked to a range of poor health outcomes, including pelvic inflammatory disease (PID), chronic pelvic pain, infertility, and ectopic pregnancy. However, these estimates of association are imprecise and draw primarily from cross-sectional, case-control, and retrospective cohort studies, mostly conducted in high-income countries. Gaps in available data limit our ability to draw robust inferences on the risk of sequelae following an infection, the timing of pathogenesis, or how factors such as the presence of symptoms or repeat infection may modify these risks.
Better data on the risk of PID and related sequelae are critical to inform prevention and treatment guidelines, motivate funding for product development and provision of services, and shift care-seeking and care-provision behaviors. Research on the prevalence and risk of PID in LMICs has been challenging due to a lack of accurate and scalable diagnostic methods for PID along with funding gaps that limit consistent and comprehensive diagnosis.&nbsp; Although diagnosing subclinical PID remains challenging, targeted research is critical to better understand the risk of developing clinical PID and to evaluate the effectiveness of STI screening and treatment in preventing reproductive tract complications. Strengthening the evidence base in this area will not only advance our understanding of STI-related morbidity but may also stimulate the development and application of improved diagnostic tools to reduce the burden of PID and related outcomes.
<h2>The Challenge</h2>
This Grand Challenge on Randomized Controlled Trial on Sexually Transmitted Infections (STIs) and Reproductive Tract Sequelae in Non-Pregnant Women aims to fill critical gaps in understanding of the risk of PID and related sequelae attributable to STIs and to evaluate the impact of etiologic STI screening and treatment on morbidity. With this Grand Challenge we welcome letters of intent (LOIs) from organizations to conduct a randomized controlled trial (RCT) in sub-Saharan Africa comparing STI screening and standard of care syndromic management. The primary outcome of this study should be PID, with secondary outcomes possibly including chronic pelvic pain, ectopic pregnancy, and infertility. The study should provide insight into the risk of outcomes following infection with gonorrhea, chlamydia, and/or trichomoniasis and the impact and cost-effectiveness of etiologic screening to prevent morbidity.
Funding Level
We will consider applications requesting awards ranging from $8 million to $10 million USD per project, with a grant duration of up to 48 months. Budgets should align with the scale and complexity of the proposed work. Indirect costs are allowable and should be included within the total requested funding. (subject to the <a href="https://docs.gatesfoundation.org/Documents/Indirect_Cost_Policy.pdf" target="_blank" rel="noopener noreferrer">Gates Foundation's indirect cost policy</a>).
Eligibility Criteria
<ul>
<li>This initiative is open to nonprofit organizations, for-profit companies, international organizations, government agencies, and academic institutions.</li>
<li>Study design must be randomized controlled trial or comparable, robust prospective in Sub-Saharan African settings.</li>
<li>We encourage groups to build upon existing and/or complimentary projects/studies/trials and to collaborate with other institutions.</li>
<li>We particularly encourage applications involving projects led by African Primary Investigators (PIs), women, early-career researchers, and practitioners seeking to innovate in women's health measurement, or from women-led organizations and applications from institutions based in LMICs.</li>
</ul>
We are looking for proposals that:
<ul>
<li>Are designed to provide insight into the timing of pathogenesis. This insight could come from comparison of outcomes across arms with varying screening intervals and/or from more frequent collection and storage of samples for subsequent batch testing.</li>
<li>Consider symptom tracking tools (such as symptom diaries) that could be used to track the onset, type, and severity of symptoms. Ideally, based on validated instruments.</li>
<li>Ideally enable stratification of risk by the presence of symptoms, co-infection, and repeat infection.</li>
<li>Ideally provide data to estimate STI incidence and the duration of untreated infection.</li>
<li>Collect detailed sexual behavior data, including the number of current and recent partners, partner type, partnership duration, concurrency, frequency of sex, type of sex, use of condoms, and characteristics and behaviors of partners.</li>
<li>Captures costs of screening, treatment, and management of sequelae.</li>
<li>Engage stakeholders and utilize community advisory boards.</li>
</ul>
We will not fund proposals that:
<ul>
<li>Have trial sites that are not based in sub-Saharan Africa.</li>
<li>Do not include PID as a primary outcome.</li>
<li>Include women who are pregnant at baseline.</li>
<li>Include women with a known diagnosis of infertility at baseline as part of the outcome analysis population.</li>
<li>Restrict the study population based on HIV status without justification.</li>
<li>Propose purely observational, retrospective, or modeling-only design.</li>
<li>Do not address the timing of pathogenesis or provide a strategy for identifying or analyzing the onset of sequelae following STI.</li>
<li>Do not plan for ethical, community, and gender-informed engagement.</li>
<li>Lack consideration of downstream policy relevance, such as linking findings to potential influence on screening, syndromic management, or STI prevention guidelines.</li>
</ul>
<a href="#_ftnref1" title id="_ftn1" name="_ftn1">[1]</a> World Health Organization. (2025). Global and regional STI estimates. The Global Health Observatory. <a href="https://www.who.int/data/gho/data/themes/topics/global-and-regional-sti-estimates">https://www.who.int/data/gho/data/themes/topics/global-and-regional-sti…</a>
<a href="#_ftnref2" title id="_ftn2" name="_ftn2">[2]</a> Kiweewa, et al. (2019). JAIDS, 22(2), e25257. <a href="https://doi.org/10.1002/jia2.25257" target="_blank" rel="noopener noreferrer">https://doi.org/10.1002/jia2.25257</a>; Stewart et al. (2020). AIDS, 34(5), 651–658. <a href="https://doi.org/10.1097/QAD.0000000000002472">https://doi.org/10.1097/QAD.0000000000002472</a>; Delany-Moretlwe (2023). Sex Transm Infect, 99(7), 433–439. <a href="https://doi.org/10.1136/sextrans-2022-055696" target="_blank" rel="noopener noreferrer">https://doi.org/10.1136/sextrans-2022-055696</a>.

This Grand Challenge on Randomized Controlled Trial on Sexually Transmitted Infections (STIs) and Reproductive Tract Sequelae in Non-Pregnant Women aims to fill critical gaps in understanding of the risk of PID and related sequelae attributable to STIs and to evaluate the impact of etiologic STI screening and treatment on morbidity.