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

Challenges

<h2>INTRODUCTION</h2>

<p>Lymphatic Filariasis is a major public health issue in India. Even though the National Filaria Control Programme was established in 1955, it is estimated that there are over 30 million micro-filaremics, over 23 million cases of symptomatic filariasis and almost half-a-billion individuals that are potentially at risk of infection. The last 10 years have seen positive advances in the diagnostics, treatment and control of filariasis.</p>

<p>Circulating microfilariae can be detected by examining thick smears (20–60 μl) of finger-prick blood. The blood must be collected at a specific time – either at night or during the day – depending on the periodicity of the microfilariae. This method is inexpensive and feasible at individual and community levels for mapping the endemicity of lymphatic filariasis and monitoring mass drug administration (MDA).</p>

<p>The Filariasis Test Strip (FTS) is a rapid diagnostic test used to detect the <em>Wuchereria bancrofti</em>&nbsp;antigen in human blood samples.</p>

<h2>The Challenge</h2>

<p>This call-for-proposals aims to:</p>

<ul>
	<li>Explore alternative tests that meet or exceed the current Filarial Test Strip (FTS) or microfilaria detection tools.</li>
	<li>Seek novel methods for identifying viable adult filarial worms in the human body, i.e. the absence of signal must indicate the worms are either not present, dead or permanently sterilized (as would be needed for making decisions).</li>
	<li>Explore the identification of new methods specific for early exposure or pre-patent infection of Lymphatic Filariasis-causative species (as would be needed for surveillance).</li>
</ul>


Grand Challenges India

Diagnostics for Neglected Tropical Diseases - Lymphatic Filariasis

<p>Developing and validating approaches to foster maternal and child health is difficult due to the interaction of biological, environmental, and social factors. Furthermore, policy recommendations for such approaches frequently lack sufficient supporting scientific evidence, while clinical trials are expensive, time-consuming, and increasingly difficult to implement. There is now a key opportunity to accelerate research in this area by analyzing existing data arising from multiple sources in India and formulating public health recommendations that are data-driven and cost-effective.</p>


Data Science Approaches to Improve Maternal and Child Health in India

<p>Developing and validating approaches to foster maternal and child health is difficult due to the interaction of biological, environmental, and social factors. Furthermore, policy recommendations for such approaches frequently lack sufficient supporting scientific evidence, while clinical trials are expensive, time-consuming, and increasingly difficult to implement. There is now a key opportunity to accelerate research in this area by analyzing existing data arising from multiple sources in India and formulating public health recommendations that are data-driven and cost-effective.</p>


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


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

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


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


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

<p>The Government of India’s Department of Biotechnology and the Bill &amp; Melinda Gates Foundation are inviting proposals through Grand Challenges India for the program Immunization Data: Innovating for Action (IDIA) with technical partnership from the Government of India’s Ministry of Health and Family Welfare and the Department of Health Research (DHR) and the Indian Council of Medical Research (ICMR). The program seeks innovations in data systems for immunization to aid real-time visibility of the correlation between consumption and coverage of immunizations. It seeks solutions that address the challenges in immunization data systems in India that are different from current approaches and that have the potential to be scaled up in multiple settings. The program also encourages proposals for translating best practices and solutions developed by the private sector as well as academic research, including those from outside the health sector.</p>


Immunization Data: Innovating for Action (IDIA)

<p>The Government of India’s Department of Biotechnology and the Bill &amp; Melinda Gates Foundation are inviting proposals through Grand Challenges India for the program Immunization Data: Innovating for Action (IDIA) with technical partnership from the Government of India’s Ministry of Health and Family Welfare and the Department of Health Research (DHR) and the Indian Council of Medical Research (ICMR). The program seeks innovations in data systems for immunization to aid real-time visibility of the correlation between consumption and coverage of immunizations. It seeks solutions that address the challenges in immunization data systems in India that are different from current approaches and that have the potential to be scaled up in multiple settings. The program also encourages proposals for translating best practices and solutions developed by the private sector as well as academic research, including those from outside the health sector.</p>


<p>The Government of India’s Department of Biotechnology and the Bill &amp; Melinda Gates Foundation are inviting proposals through Grand Challenges India for the program Immunization Data: Innovating for Action (IDIA) with technical partnership from the Government of India’s Ministry of Health and Family Welfare and the Department of Health Research (DHR) and the Indian Council of Medical Research (ICMR). The program seeks innovations in data systems for immunization to aid real-time visibility of the correlation between consumption and coverage of immunizations.</p>

Immunization Data Innovating for Action (IDIA)

<p>This challenge focuses on new measurement tools and new combinations of approaches to ensure all children thrive – that they not only survive, but also have the chance to live healthy productive lives.&nbsp; The ultimate goal of this challenge is to determine what packages of interventions should be delivered to which group of individuals at what point in their life cycle to reduce the burden of fetal growth impairment and preterm birth, stunted postnatal growth, and impaired cognitive development.</p>

<p>This challenge joins the All Children Thriving platform, which links Grand Challenges programs targeting healthy birth, growth, and development, including the global programs <a href="http://www.grandchallenges.ca/saving-brains/" target="_blank">Saving Brains</a> and <a href="http://savinglivesatbirth.net/" target="_blank">Saving Lives at Birth</a> and a set of four new programs launched concurrently. These new programs are <a href="https://gcgh.grandchallenges.org/challenge/all-children-thriving-brazil" target="_blank">Grand Challenges Brazil: All Children Thriving</a>; Grand Challenges India: All Children Thriving; <a href="http://gcgh.grandchallenges.org/challenge/all-children-thriving-1" target="_blank">Grand Challenges South Africa: All Children Thriving</a>; and <a href="http://gcgh.grandchallenges.org/challenge/creating-and-measuring-integrated-solutions-healthy-birth-growth-and-development" target="_blank">Creating and Measuring Integrated Solutions for Healthy Birth, Growth, and Development</a> (a global program with awards to investigators in low- and middle-income countries).</p>


All Children Thriving - India

<p>The Grand Challenges India partnership opened its second grant opportunity, "Reinvent the Toilet Challenge - India." This program seeks to support the development of innovative, new sanitation technologies, products, and services. Projects should focus on stand-alone, affordable and environmentally and economically sustainable solutions that do not require connection to the sewer or electrical grid, to enable their deployment in rural and poor urban communities that often need them the most. Grants will be to Indian innovators, but partnerships with researchers in other countries are encouraged, especially where the opportunity exists to build on established collaborations.</p>


Reinvent the Toilet

<p>The Grand Challenges India partnership opened its first grant opportunity, "Achieving Healthy Growth through Agriculture and Nutrition." This program seeks approaches to reduce the high incidence of low birth weight, stunting, and wasting in Indian children less than 2 years of age and to prevent under nutrition in women of reproductive age. Grants will be to Indian innovators, but partnerships with researchers in other countries are encouraged, especially where the opportunity exists to build on established collaborations.</p>

Achieving Healthy Growth Through Agriculture and Nutrition

http://www.birac.nic.in/grandchallengesindia/index.php

<p>Treatment Adherence for TB is the first challenge launched under the Grand Challenges in TB Control program, which seeks to improve tuberculosis screening, detection, and treatment outcomes. Innovative solutions will be pilot tested in India with the intention of being scaled up there and being broadly relevant to developing countries in Africa and Asia. This challenge is part of a collaboration between the Biotechnology Industry Research Assistance Council (BIRAC) of the Government of India, United States Agency for International Development (USAID), and Bill &amp; Melinda Gates Foundation with India’s <a href="https://www.ikpknowledgepark.com/index.html" target="_blank">IKP Knowledge Park </a>as the implementation partner.</p>


Treatment Adherence for TB

<p>Grand Challenges Explorations - India was launched as a BIRAC India initiative in partnership with the Government of India’s Department of Biotechnology and the Bill &amp; Melinda Gates Foundation as funding partners and IKP Knowledge Park as implementation partner. Aligned with the challenges under Grand Challenges Explorations, its goal is new drugs, vaccines, delivery systems, diagnostics, medical devices, and service models that can be made available to people from all socioeconomic strata. Grand Challenges Explorations - India aims to address this goal by encouraging entrepreneurship in India.</p>


Grand Challenges Explorations - India

<p>Grand Challenges Explorations - India is a BIRAC India initiative with the Government of India’s Department of Biotechnology and the Bill &amp; Melinda Gates Foundation as funding partners and <a href="https://ikpgrantprograms.org/gce-india/" target="_blank" rel="noopener noreferrer">IKP Knowledge Park</a> as implementation partner. Aligned with the challenges under Grand Challenges Explorations, it fosters entrepreneurship in India with the goal of new drugs, vaccines, delivery systems, diagnostics, medical devices, and service models that can be made available to people from all socioeconomic strata.</p>
