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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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Use of Novel Oligosaccharides For Simultaneous Growth of Keystone Bacteria

David MillsUniversity of California, DavisDavis, California, United States
Grand Challenges Explorations
Microbial Biotherapeutics
1 May 2019

David Mills of the University of California, Davis in the U.S. will determine whether specific plant-based oligosaccharide formulations can drive mixed-culture growth of selected strains of intestinal bacteria for the low-cost and efficient production of live biotherapeutics. Microbial colonization in the human gut is important for overall health. It has been shown that oligosaccharides can provide a food niche to specifically enrich key colonizing bacteria, even in the competitive environment of the human gut. They will exploit this to grow multiple strains simultaneously in a controllable, scalable manner. They have recently developed analytical tools to characterize over 1,000 plant polysaccharides. These will be screened using bioinformatics methods and then in vitro to identify optimal oligosaccharide-therapeutic bacteria combinations that can support mixed-culture growth. They will then progress to bioreactor screening of the top candidate combinations. Once established, the live biotherapeutics will be formulated with their paired oligosaccharides for synbiotic application that may enable them to more readily colonize the human gut.

Massively Deployed GHz Ultrasonic Imagers for Pest Detection

Amit LalGeegah LlcIthaca, New York, United States
Grand Challenges Explorations
Crop Disease Surveillance
1 May 2019

Amit Lal of Geegah LLC in the U.S. will develop battery-powered ultrasonic imagers to collect and wirelessly transmit high-resolution images of soil and airborne pests for the early detection of crop threats across large farming areas in rural Africa. Crop losses due to pest infestation negatively impact both food security and local economies. Damage caused by nematodes is particularly difficult to detect because the symptoms visible above ground are not unique and are often incorrectly attributed to deficiencies in soil nutrients or moisture. Currently the only way to test for nematodes is through root and soil samples taken after harvest, when it is too late to respond to an infestation. They will integrate complementary metal-oxide semiconductors (CMOS) with GHz ultrasonic imagers to detect nematodes and survey soil properties over large areas to detect infestations before crop damage occurs and transmit the data in real time. They will optimize the sensor technology in a controlled laboratory setting to maximize sensitivity and specificity and minimize power consumption and then transition to a farm setting for incorporating data transmission via the radio frequency wireless network.

Using GIS for Reducing Inequities in Immunization in Urban Settings in Nairobi and Kisumu Counties

Caroline KabariaAfrican Population and Research CenterKitsuru, Kenya
Grand Challenges Explorations
Immunization Delivery
1 May 2019

Caroline Kabaria of the African Population & Health Research Center in Kenya will use geographic information systems (GIS) to map the location of health facilities and community health volunteers in Kenya to identify particularly marginalized slum populations that need better access to health services such as vaccinations. Nairobi and Kisumu contain over 100 slums where residents live in dense and unsanitary conditions. The specific health needs of these residents are difficult to assess from national statistics that often exclude them. To address this, they will conduct an in-depth assessment to identify equity gaps specifically in childhood immunizations. Community health volunteers will be trained to use GIS mapping techniques and to register households, and the data will be integrated with the existing district health information system (DHIS 2). This will be used to produce an interactive map of the two cities that includes the spatial and social structures of informal settlements and the location of health facilities. They will also provide training and guidance to local stakeholders on how to utilize the map to improve vaccination coverage.

Safi Sana: Tracking Waste for Social and Economic Value

Aart Van den BeukelSafi SanaWeesp, Netherlands
Grand Challenges Explorations
Water Sanitation Hygiene
1 May 2019

Aart Van den Beukel of Safi Sana in the Netherlands will enable digital monitoring of the entire waste and sanitation supply chain to improve quality control, reduce costs, and help communities transform waste into resources such as agricultural and energy products. Poor sanitation and waste management can drive poverty and disease, but it is difficult to monitor in low-resource settings. The sanitation and waste industry can also provide unique opportunities for social and economic benefit when communities are given access and support. They will install data collection systems to monitor all elements of waste processing such as GPS data from waste truck drivers to help improve efficiency and reduce contamination and costs. These data will be provided on a tailored, computer-based platform to relevant stakeholders and local communities, along with education and awareness training to encourage new waste-converting enterprises.

Transforming the Fecal Sludge Emptying Business

Hidenori HaradaKyoto UniversityKyoto, Japan
Grand Challenges Explorations
Water Sanitation Hygiene
1 May 2019

Hidenori Harada of Kyoto University in Japan will develop and test a largely automated system for the regular removal and safe disposal of fecal sludge from septic tanks in Asia. Billions of people rely on septic systems to collect human waste. Regular emptying and proper disposal of fecal sludge are critical to avoid potential contamination of clean water by backups, leaks and illegal dumping of waste. Hazardous sanitation problems occur when customers are unaware of the need to have their system emptied or when truck operators hired to empty sludge illegally dump the waste outside of a proper treatment site. They will institute a program by which tanks are – at no charge to the customer - equipped with tagged covers that provide access for safe emptying and enables them to be registered with a centrally-monitored system that will automatically notify customers when their tank needs to be emptied. Payment by households for emptying the tanks will be collected electronically, and the sludge will be removed and transported via trucks equipped with GPS to ensure proper disposal of the waste at a treatment center. The system will be tested in cooperation with a public emptier in Mandalay, Myanmar.

REAP: Risk-Explicit Agricultural Policy Prioritization

Christine LamannaWorld Agroforestry CentreNairobi, Kenya
Grand Challenges Explorations
Agricultural Policies
1 May 2019

Christine Lamanna and Todd Rosenstock of the World Agroforestry Centre in Kenya will develop a strategy that combines local knowledge and a Bayesian network model to prioritize agricultural policy using Tanzania’s Agriculture and Food Security Investment Plan as a case study. Agriculture is responsible for nearly one third of Africa’s gross domestic product, yet productivity suffers from limited infrastructure and lack of access to markets and financing. Many policy options exist to stimulate agricultural transformation, however countries struggle to prioritize them and progress is limited. They will develop a Bayesian network to model the cost and risks of implementing specific agricultural policies as well as the economic, social and environmental benefits. Using the Tanzanian plan as a case study, they will develop a data-driven model for policy prioritization that incorporates risk (financial, climate, logistical, political) and reflects stakeholder perspectives to create a sense of ownership over the process. This strategy will allow for direct and transparent comparison of diverse policy options and provide decision-makers with clear prioritization information.

Mobile Technology and Boat Taxis to Enhance Vaccine Coverage

Paul NamwanjaCommunity Health Centre BusabalaKampala, Uganda
Grand Challenges Explorations
Immunization Demand
1 May 2019

Paul Namwanja of the Community Health Centre, Busabala in Uganda will implement mobile technology for village health teams to monitor households and childhood vaccinations on remote islands in Uganda and to establish public-private partnerships with community health workers and boat owners to improve vaccine coverage. Vaccination rates on Ugandan islands are significantly lower than the national level because of unreliable transportation to access mainland healthcare centers; island residents rely on commercial fishing boats to travel and face long wait times for healthcare service. They will modify an existing mobile application for village health teams to create a registry of new and expectant mothers by recording household location and required vaccines. These data can then be shared with mainland health workers and used to facilitate access to a subsidized boat taxi service for travel to medical appointments. They will test their approach on six trial islands by providing the mobile phones and application along with training to health workers and recruiting boat drivers and evaluate its effect on vaccination coverage.

Vaccination Calendar Baby-Wrap: Carrying Infants to Vaccines

Anne De GrootGAIA Vaccine FoundationProvidence, Rhode Island, United States
Grand Challenges Explorations
Immunization Demand
1 May 2019

Anne De Groot of the GAIA Vaccine Foundation in the U.S., along with Mika Kunieda of Keio University in Japan and Eliza Squibb and Julia Shivers of ZTwist Design in Boston, will design and distribute printed fabric baby-wraps that use West African iconography to represent the infant vaccination schedule to new mothers in Niger to encourage vaccine completion and reduce child mortality in West Africa. Due to low literacy rates among women in Niger and lack of adapted vaccination information, there are high dropout rates for pediatric vaccination and 40% of Nigerien children are unprotected from measles. In partnership with the Niger Ministry of Health's Social Mobilisation team, the Vaccine Calendar Baby-Wrap addresses key barriers to vaccination coverage in Niger by leveraging local textile traditions to bridge the information gap between the Ministry of Health's efforts to promote free vaccination and mothers’ understanding of the schedule. This visual tool provides mothers with a personal understanding of the vaccination series while enabling them to become health advocates who can educate their peers. As a practical educational intervention for children's health, the Baby-Wrap serves as a strategy for improving information equity in populations with low literacy.

Smart Immunization Targeting by Combining Artificial Intelligence and Mobile Tools

Rumi ChunaraNew York UniversityNew York, New York, United States
Grand Challenges Explorations
Immunization Delivery
1 May 2019

Rumi Chunara of New York University in the U.S. will collect data from mobile phones of healthcare workers to develop algorithms that will help prioritize healthcare resources to increase vaccine coverage in Punjab, Pakistan. Immunization is one of the most cost-effective and successful public health strategies and is estimated to prevent up to three million deaths each year. Still, many rural areas of low- and middle-income countries have an under-vaccinated population due to a lack of formal education and awareness of the importance of vaccinations. They will collect data on disease incidence and vaccine resources and coverage from the mobile phones of 3,800 rural healthcare workers. These data will be used to train an artificial intelligence model to identify the ideal times and locations to target vaccine efforts. The model will also address accessibility and awareness issues by incorporating distance to healthcare centers and frequency of visits. Their approach will be evaluated by analyzing coverage before and after implementation. Once proven, it can be scaled to other areas in Pakistan.

Vaccination on Wheels - VOW

Jignesh PatelIndian Institute of Technology HyderabadHyderabad, Andhra Pradesh, India
Grand Challenges Explorations
Immunization Demand
1 May 2019

Jignesh Patel of the Indian Institute of Technology Hyderabad in India will increase vaccination coverage among low-income urban populations in India by designing a mobile vaccine service including a smartphone-based management application that provides customized vaccinations at homes and schools and at lower cost. Vaccination offers excellent protection against many diseases, however coverage is low among low-income populations in urban centers: immunization at private clinics is unaffordable, and public clinics have longer wait times leading to lost wages. They will develop an affordable, convenient, in-home vaccination service and a smartphone-based management application to schedule appointments, automate routes, record vaccination data and collect customer feedback. They will pilot test their approach among low-income populations in three cities by recruiting and training healthcare workers and drivers and evaluating its effect on vaccination coverage.

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