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.
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Jesse Gitaka of Mount Kenya University in Kenya in collaboration with David Anderson of Burnet Institute in Australia, will develop a diagnostic device for iron deficiency anemia that is suitable for resource-limited settings. Iron deficiency anemia can cause maternal death, prematurity and stunting. Current diagnostic tests require expensive equipment or are not specific enough to distinguish between the different causes of anemia. They will develop a device that detects the low levels of hemoglobin found in immature red blood cells, called reticulocytes. The device will use magnetic beads and microfluidics to physically separate reticulocytes from whole blood, and then absorbance to measure the red color of hemoglobin and thereby determine levels. They will use samples from healthy donors to develop algorithms that can calculate the amount of hemoglobin per reticulocyte to provide an accurate diagnosis.
Maurício Barretto of Fiocruz in Brazil will integrate COVID-19 data from Brazil into existing harmonized datasets from over 500 million people across the world, to better inform public health strategies. International data on COVID-19 is needed to help lift the world out of the pandemic. However, there is little real-world data from South Asia or Brazil. They will map data from the COVID-19 surveillance database for the State of Bahia, which covers a population of 15 million people, to the common data model known as OMOP, which brings together disparate data into a common format. They will run analytical tools on these mapped data to characterize COVID-19 forms and disease outcomes, to quantify the use of COVID-19 treatments in routine practice and to identify risk factors that can be used to predict disease severity and help better manage patients.
Haroon Hafeez of Shaukat Khanum Memorial Cancer Hospital and Research Centre in Pakistan will integrate COVID-19 data from Pakistan into existing harmonized datasets from over 500 million people across the world, to better inform public health strategies. International data on COVID-19 is needed to help lift the world out of the pandemic. However, there is little real-world data from South Asia or Brazil. They will map the anonymized electronic medical records from over 7.8 million people, including over 20,000 COVID-19 positive patients, from a hospital in Lahore to the common data model known as OMOP, which brings together disparate data into a common format. They will run analytical tools on these mapped data to characterize COVID-19 forms and disease outcomes, to quantify the use of COVID-19 treatments in routine practice and to identify risk factors that can be used to predict disease severity and help better manage patients.
Lyle McKinnon of the University of Manitoba in Canada will test whether a specific type of immune cell known as tissue resident memory T cells, which are found in the nasal cavity during SARS-CoV-2 infection, help limit disease severity and viral replication. The nasal mucosa is the first place in the body that is exposed to the SARS-CoV-2 virus. However, little is known about the local immune response and how this may influence disease progression, which varies dramatically between people. They have developed a nasal sampling protocol and will use it to characterize nasal T cells from COVID-19 positive patients in three sites in Winnipeg, Canada, and Nairobi, Kenya, to see if it correlates with clinical outcomes. They will also compare the activation of these nasal tissue T cells in uninfected individuals before and after SARS-CoV-2 vaccination to determine their role in vaccination-mediated immunity.
Hamed Alemohammad of Open Imagery Network Inc. in the U.S. will collect and curate high-quality agricultural mapping data from drone imagery in Kenya that has commercial value and can also be openly accessed for public good purposes. High quality and timely geospatial data is often only collected in the commercial sector, which makes it too expensive for the public and philanthropic sectors to access and use to address development challenges. To resolve this, they will develop a minimum viable product to demonstrate the potential for collecting high-quality, annotated agricultural data that has commercial value and can also be openly accessed. The imaging data will be obtained from an approximately 40 square kilometre area, annotated to identify field boundaries and building footprints, and made available through their partner, PLACE, who have digital infrastructure and a data trust for providing commercial licenses.
Fatma Guerfali of Institut Pasteur de Tunis in Tunisia and Jesse Gitaka of Mount Kenya University in Kenya, will implement wastewater SARS-CoV-2 surveillance in diverse sanitation settings in Kenya and Tunisia to help determine the true number of people infected with SARS-CoV-2, which is currently underestimated. The detection of SARS-CoV-2 RNA in sewage can be used to monitor virus circulation in the population. However, this is more challenging in settings with diverse sanitation practices, such as in many parts of Africa. They will quantify SARS-CoV-2 RNA in untreated wastewater from diverse sanitation settings and correlate them with clinical testing to determine their accuracy. They will also develop epidemiological models using a web-based informatics platform, which integrates geo-spatial, temporal and SARS-CoV-2 RNA analysis, to test the performance of longitudinal SARS-CoV-2 RNA wastewater surveillance from hospitals and public sanitation systems.
Geoffrey Siwo of the University of Notre Dame in the U.S. will use a computational approach to identify broad-spectrum antiviral drugs that trigger an innate immune response and could be used against a range of viruses. Traditional drug discovery approaches target viral proteins, but this requires prior knowledge of the virus and can lead to the development of resistance. In contrast, compounds that trigger the host’s natural biological defense mechanism inside each cell are less likely to cause resistance, and can be used for treating novel viruses as well as for vaccine adjuvants. They will develop an artificial intelligence (AI) approach that uses predicted broad-spectrum antivirals to generate a large variety of related molecules. These will be compared with a library of approved drugs to identify compounds with similar chemistries. The top 100 compounds will be tested for broad anti-viral activity in multiple human cell lines.
Danielle Ehret of the Vermont Oxford Network in the U.S. in collaboration with Krista Donaldson of Equalize Health also in the U.S. and Mahlet Abayneh of the Ethiopian Pediatrics Society, will develop a web-based clinical training course to train staff in neonatal intensive care units in Ethiopia to better recognize respiratory distress syndrome in preterm infants, and to safely deliver continuous positive airway pressure (CPAP) to reduce mortality rates. Respiratory distress syndrome causes almost half of all preterm deaths in neonatal units in Ethiopia. These would be preventable if the staff had received adequate clinical training. However, the recent pandemic forced a halt to the national hands-on training program that was planned in 2020. As an alternative, they will host monthly training webinars focused on diagnosis and treatment, and develop an observation checklist to assess the quality of CPAP delivery. They will evaluate their approach by quantifying staff training rates, diagnoses of respiratory distress syndrome, and treatment and mortality rates.
Iwnetim Abate and Loza Tadesse of SCIFRO Inc with Manu Prakash of Stanford University both in the U.S. will develop an education platform to inspire and equip African college students to solve local health problems through science using simple, inexpensive tools such as paper-based centrifuges and chemistry kits. Less than 8% of sub-Saharan Africans get to attend tertiary education, and there are limited options for pursuing a career in science. This means that even with the recent rise in inexpensive scientific equipment, many local problems of Africans remain unsolved. They will develop easy-to-follow pedagogy and teaching kits and use them to conduct a pilot study by holding a month-long summer workshop for 100 Ethiopian college students in Addis Ababa. The workshop will demystify the scientific process and motivate the students to begin tackling local projects, which will be monitored online. They will also invite 20 college instructors to participate and provide them with kits to distribute to their local schools and colleges.
Yasmin Chandani of inSupply Health Limited and Pratap Kumar of Health-E-net Limited both in Kenya will develop a simple digital health tool to support the maternal and child health supply chains for low-literate, nomadic communities spread sparsely across Kenya. Counties in semi-arid lands have poor maternal and child health indicators caused by vast distances, low literacy rates, no fixed health facilities, and no data on supply chains. To address this, they will develop software to combine paper-based methods with feature-phone cameras for community health workers to easily record data on stocks and supplies. The recorded data will be integrated into existing workflows to inform supply chain managers and support ordering and resupply decisions. They will perform a twelve-month pilot study in Turkana County that will involve training community health workers to use the tool, and they will evaluate its performance in accurately recording stocks dispensed and received during resupply. They will also collect qualitative feedback from health workers to help improve the tools design.