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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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"Lego" like Sanitation System: Pit Latrines Made of Biocomposites

Antonio AvilaUniversidade Federal de Minas GeraisBelo Horizonte, Minas Gerais, Brazil
Grand Challenges Explorations
Sanitation Technologies
15 Apr 2011

Antonio Avila of Universidade Federal de Minas Gerais in Brazil proposes to develop building blocks made from biocomposites that will replace conventional brick and cement constructions for pit latrines. The team will test these building blocks strength and their rate of biodegradation to determine their suitability for building latrines that will decompose once the pits are filled, allowing for the eventual reintroduction of the land for farming and other community uses.

3-D Human Small Intestinal Organoid for Enteric Infections

Cirle WarrenUniversity of VirginiaCharlottesville, Virginia, United States
Grand Challenges Explorations
Enteric Disease Models
15 Apr 2014

Cirle Warren of the University of Virginia in the U.S. will develop a three dimensional cell culture model (organoid) of the human intestine to study diarrheal diseases. They will build the organoids in a bioreactor using three intestinal cell types, and test different scaffolds to simulate the complex cellular and structural architecture of the human gut. The organoids will then be infected with Cryptosporidium, a common cause of diarrhea in developing countries, and analyzed for altered structural and molecular characteristics to gain insight into the host infection response. This model could also be used to identify new drug targets and evaluate candidate drugs.

99DOTS: Using Mobile Phones to Monitor and Improve Adherence to Tuberculosis Medications

Bill ThiesInnovators in Health (India)Patna, Bihar, India
Grand Challenges India
Tuberculosis Treatment
12 Aug 2014

Bill Thies and the team of 99DOTS aim to achieve 99% TB drug adherence using a combination of basic mobile phones and augmented blister packaging to provide real-time medication monitoring at drastically reduced cost. The approach is to utilize a custom envelope, or blister card, into which each pack of medication is inserted and sealed by the care provider. When the patient dispenses medication from the blister pack, the pills also break through perforated flaps on the blister card. On the back side of each flap is a hidden number. Patients submit these numbers using their mobile phone as evidence that they have dispensed medication. To avoid incurring any mobile charges, the numbers are used to complete a phone number and deliver a "Missed call" (Missed calls are free if they are not pointed to a VoiceMail). Using this system patients also receive a series of daily reminders (via SMS and automated calls). Missed doses trigger SMS notifications to care providers, who follow up with personal, phone-based counseling. Real-time adherence reports are also made available on the web.

A "Smart Diaphragm" for the Early Detection of Preterm Labor

Larry RandUniversity of California San FranciscoSan Francisco, California, United States
Grand Challenges Explorations
Mothers and Newborns
18 Apr 2011

Larry Rand and colleagues at the University of California, San Francisco in the U.S. will develop a vaginal diaphragm to detect changes in cervical collagen and wirelessly alert health providers before preterm labor begins. This device would identify a new pre-labor "window" during which intervention could reduce mortality and disability resulting from preterm birth among at-risk pregnant women. In Phase I, they designed an easy to use and low-cost device incorporating electrical impedance detection circuitry and fiber optic cable to accurately measure collagen concentration in the cervix of pregnant women over time. Prototypes were built for clinical tests to evaluate the capacity for identifying pregnant women at risk of preterm birth, as well as comfort and acceptability. In Phase II they will optimize the device to make it more robust and user-friendly and expand clinical testing to rural settings in South Africa. They will also develop phone-to-cloud technology for wirelessly collecting the measurements from the device through a mobile phone to a server (cloud) for analysis, and to enable return of the prognosis.

A Bacteriophage Platform for Programmable Killing of Bacteria

Chase BeiselNorth Carolina State UniversityRaleigh, North Carolina, United States
Grand Challenges Explorations
Bacteriophage
1 Nov 2015

Chase Beisel of North Carolina State University in the U.S. will exploit non-lytic bacteriophage for promoting infant gut health and treating enteric infections in low-resource settings. Generally, lytic phage are being studied for treating diseases, but they suffer from a number of limitations including causing resistance and the release of endotoxins, which can damage healthy cells. They will use the CRISPR-Cas9 defense system to engineer non-lytic P1 phage to specifically target the bacteria Shigella sonnei, which is a leading cause of enteric diseases in children in the developing world. The engineered phage, which can be produced at low cost, will be tested for ability to efficiently infect and kill the targeted bacteria.

A Device to Treat Post Partum Hemorrhage

Glenna BettUniversity at BuffaloBuffalo, New York, United States
Grand Challenges Explorations
Mothers and Newborns
18 Apr 2011

Glenna Bett of SUNY University at Buffalo in the U.S. proposes to develop a device to treat postpartum hemorrhage suitable for use even when medical facilities are absent or minimal, and in non-sterile environments. If successful, this has the potential to reduce perinatal deaths worldwide.

A Disposable Sub-system for Nucleic Acid Sample Preparation Without Instrumentation or User Intervention

Robert CaryMesa Tech International, Inc.Santa Fe, New Mexico, United States
Grand Challenges in Global Health
Point-of-Care Diagnostics
20 Jun 2011

Robert (Bruce) Cary of Mesa Tech International, Inc. in the U.S. proposes to develop nucleic acid purification systems that use a novel configuration of lateral flow materials to bind and wash nucleic acids to yield amplification-­ready samples. These devices could provide purified samples from clinical specimens within minutes without user intervention, instrumentation, electricity or costly materials.

A Glycan Formula as Diet Additive Against Mosquito-Borne Viral Transmission

Gong ChengTsinghua UniversityBeijing, China
Grand Challenges Explorations
China Tsinghua-GCE
1 Mar 2015

Gong Cheng of Tsinghua University in China will develop a glycan formula as a diet additive that specifically inhibits the lectin-based viral receptors in mosquitos, thereby providing a practical approach against dissemination of multiple mosquito-borne viruses.

A Household Yeast Biosensor for Cholera

Virginia CornishColumbia UniversityNew York, New York, United States
Grand Challenges Explorations
Synthetic Biology
6 Oct 2011

Virginia Cornish and Nili Ostrov at Columbia University in the U.S. propose to engineer baker's yeast to produce the red tomato pigment lycopene when exposed to the cholera pathogen in drinking water. This safe and simple sensor could be inexpensively manufactured and highly effective for household monitoring of cholera in water by communities at risk for infection.

A Human Endogenous Retrovirus Vaccine to Eliminate Latent HIV

Mario OstrowskiUniversity of TorontoToronto, Ontario, Canada
Grand Challenges Explorations
HIV Infection
29 Sep 2011

Mario Ostrowski of the University of Toronto in Canada will test the theory that alterations of host cells by HIV might also activate human endogenous retroviruses in the same cells. Ostrowski will express antigens of an endogenous retrovirus to study whether they might also mark HIV infected cells, providing a basis for the development of a new HIV vaccine.

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