Urgent shortages of medicines in low-income countries lead to millions of unnecessary deaths at birth every year. One pervasive challenge causing such shortages is how to move the right commodities to the right place on time and at cost. We propose to develop an open-source distribution management system which leverages our existing real-time dataset of stock transactions at thousands of facilities in Africa to drive automated improvements in practice. Specifically, we will make optimal usage of limited resources to improve route planning and scheduling, respond to delivery or cold chain failures, strengthen communication, and reduce inappropriate resource utilization. These tools could save governments hundreds of thousands in the cost of fuel, trucks, drivers, and wasted/lost stock, while also improving reliable access to better quality, life-saving commodities.

To increase vaccination coverage, we propose to develop a microneedle patch that co-administers the influenza and tetanus toxoid vaccines. Our approach is specifically designed to meet the needs of pregnant women and children under the age of 5 in developing countries by (i) seeking to prevent tetanus and influenza infection (ii) co-administering both vaccines with a simple-to-apply, thermostable patch that generates no sharps waste, thus improving safety by avoiding hypodermic needles. This type of vaccine administration requires minimally trained personnel, and is painless and therefore more acceptable to those being vaccinated. Additionally, because the vaccine patches are dry and do not need reconstitution they have improved thermal stability, and so can be shipped to remote areas and stored for prolonged periods without refrigeration.

The Nanobiosym Gene-RADAR nanotechnology platform enables rapid, accurate, mobile, gold-standard viral load monitoring at the point-of-care at an affordable cost. In collaboration with Partners in Health in Rwanda, Nanobiosym will deliver, pilot, and evaluate Gene-RADAR, to provide early detection of HIV and demonstrate the eradication of mother-to-child transmission (MTCT) through its mobile health applications. In combination with timely antiretroviral therapy (ART) this platform could save thousands of young Rwandan lives. Nanobiosym's Gene-RADAR nanodiagnostic enables real-time analysis of genetic fingerprints contained in a drop of blood or saliva, as well as the first-of-its-kind capability to quantify the HIV viral load in a field setting at an affordable price. Its ability to measure viral load during gestation, delivery, and post-partum in mothers and infants will enable earlier detection and customization of ART in real time, eliminating the need for costly and resource intensive lab infrastructure. By calibrating ART and routinely monitoring viral load, Gene-RADAR will enable doctors in the developing world to screen, customize, and adjust the dosing regimen for maximum impact on MTCT.

Population Services International (PSI) proposes to conduct a proof-of-concept study followed by a larger clinical trial in two public sector hospitals through FOGSI in India, to determine if a new intrauterine device (IUD) inserter, specifically designed for the postpartum setting, will improve service delivery. Pregna International will provide the inserters free of cost, and Stanford University will provide technical expertise in study design and implementation. The primary objective of the study is to determine the safety, acceptability (provider/consumer comfort and confidence), feasibility, and efficacy of postpartum intrauterine device (PPIUD) inserters.