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.
Sara Grobbelaar of Stellenbosch University in South Africa will develop a platform that can analyze existing real-time data on the stocks of health products at clinics across South Africa and present it to all players in the supply chain to ensure products are available when needed. In partnership with a Northern academic institution they will collect and sort relevant data, analyze trends, and develop decision-making tools. The platform will allow analysis, modeling, and forecasting in the health product supply chain so that unexpected changes such as supply disruptions or epidemics can be accommodated.
Agnes Mindila of the Jomo Kenyatta University of Agriculture and Technology in Kenya will develop a software application along with blockchain technology to monitor the supply chains delivering vaccines from the producers to the health workers to ensure good quality vaccines are available when needed. They will use blockchain technology, which involves digitally storing information in blocks that are shared across a network of computers and can be continually updated. They will also develop and test a software application so that everyone in the supply chain can access and record information about a specific vaccine to improve transparency and ensure the vaccine is authentic.
Roice Fulton of the Denominator Group in Switzerland will test the value of blockchain, which is a decentralized secure database, for stakeholders such as distributors and health workers to record and monitor the movement of a vaccine along a supply chain, to ensure the availability of sufficient levels of working vaccines. Following the route of a vaccine from the producer to the patient would ensure its safety and allow for better monitoring of stock and supply chain performance, which would improve vaccine availability and help identify ways to increase efficiency and lower costs. Blockchain is an efficient and secure way to share information. They will test their approach in Tanzania, which has a fairly robust supply chain, by tailoring blockchain to integrate with existing platforms, and evaluate its ability to reliably monitor vaccines.
Joanna Bichsel of Kasha in Rwanda will adapt their mobile ecommerce platform to enable women in Kenya to confidentially order health products such as contraceptives and sanitary pads by mobile phone. There are many social barriers preventing women in developing countries from accessing products at health clinics. Their platform, Kasha, requires only a mobile phone to order and pay for products that are then delivered to local pick-up points. They have successfully implemented Kasha in Rwanda and will now perform a pilot study in several counties in Kenya. They will customize the platform to the language and existing technology in Kenya, and develop private and public partnerships to tap into existing distribution networks, thereby minimizing costs. Their pilot study will evaluate how well the platform is received by Kenyan women, and how effective it is at delivering products.
Yuehwern Yih of Purdue University in the U.S. will develop a cloud-based digital tracking tool to record data from local health centers in Uganda on the health status of pregnant women and the turnover of their stock, as well as diagnostic laboratory data, to optimize ordering and improve the availability of medical supplies. They will develop applications mimicking the current time-consuming paper-based registry formats to digitally record the relevant data, and adapt a material requirement planning system, which is used in manufacturing to track parts and maintain stocks. They will test their approach in two Ugandan hospitals to evaluate its effect on the efficiency of ordering and maintaining supplies, and on patient health.
Zawadi Mageni of the Ifakara Health Institute in the United Republic of Tanzania will train local shopkeepers to deliver essential medical supplies to remote areas. Delivery of health products to hard-to-reach areas is problematic due to the poor surrounding transport infrastructure, which suffers further during the rainy seasons. This often means that essential products are out of stock. However, shopkeepers in these areas, with their local knowledge and support, still regularly travel to their central suppliers to maintain their own stocks. These shopkeepers could also be used to deliver medical supplies. They will identify test villages in Tanzania, and the location of medical stores for pick-up points. They will develop a database to map the local health centers and establish an inventory of their medical supplies. Selected shopkeepers will be enrolled and trained, and they will evaluate their approach for avoiding stock-outs of medical products.
Shahnoza Eshonkhojaeva of Sinostream AB in Sweden will use machine-learning algorithms to predict the amount of medicines and supplies needed at individual health clinics in low-resource settings, and to inform medical stores for delivery. Their approach involves obtaining daily consumption patterns that are recorded on smart paper stock cards at rural health clinics, which requires no training, internet access, or electricity. These cards will then be scanned at district health service centers, the data digitized, and algorithms used to calculate consumption patterns and waste, and automatically predict future demand. They will build a prototype system and field test it in Uganda to evaluate how well it avoids under- or overstocking products, and the cost-saving and time-saving benefits of having an automated stock management system.
Jim Duggan of the National University of Ireland, Galway, in Ireland will develop a simulator for public health supply chains in low- to middle-income countries that incorporates the stakeholders and steps needed to provide health care products from the manufacturer to the individual under different conditions, to optimize their performance and ultimately improve health. A key challenge is to ensure that the right medicines are available when needed, particularly when demand is high, for example during epidemics. The supply chain model will be built using the systems dynamic tool and tested in collaboration with public health professionals for its ability to improve the supply of health care products, and to support information sharing and decision making.
Bulara Mpiti of the Clinton Health Access Initiative (CHAI) in the U.S. will use the clinical sample transportation network in Lesotho to increase the efficiency of delivering viable vaccines to local health facilities. Most health facilities in Lesotho experience stock-outs of essential vaccines, which are caused by weak supply chains from the stores at district offices. The health facilities are also visited at least once per week by motorcyclists from delivery agencies to pick-up clinical samples for rapid transport to diagnostic laboratories, which are located in the same district offices as the vaccine stores. They will engage these delivery agencies to also manage the ordering and transport of vaccines in the other direction, from district stores to health facilities. To test their approach, they will perform a pilot in selected districts and train vaccine supply managers, health workers, and sample transporters.
Mitesh Thakkar and Harsh Shetty of Arthify Inc. in the U.S. will use radio-frequency identification tags (RFID) on vaccine packages that can be detected by near-field communication (NFC) now found on most smartphones to better track vaccines and improve supply chains in developing countries. They will develop an application for health workers to automatically read the tags and store the data in a cloud, which can then be used to take inventories. They will also build a website so that the data can be easily monitored by supply chain managers to analyze performance and predict demand. They will test their platform for accuracy, feasibility, and cost in a network of 20 primary health centers with 100 sub-centers.