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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 Cell-Based Screen for Discovery of a Macrofilaricide

Kelly JohnstonLiverpool School of Tropical MedicineLiverpool, United Kingdom
Grand Challenges Explorations
Neglected Tropical Diseases
8 Oct 2013

Kelly Johnston and others from the Liverpool School of Tropical Medicine in the United Kingdom will develop a cell line from a parasitic filarial nematode worm that can proliferate continuously in vitro to enable high-throughput screening of candidate anti-filarial drugs. Current drug screening efforts are limited by the complex life cycle of the worms and the difficulties of obtaining sufficient numbers of worms. They will isolate worm cells from various life cycle stages and use a high-content screening approach to monitor thousands of cells cultured under different conditions to increase the probability of detecting a stably growing cell line. Once one or more stable cell lines have been produced, they will establish optimal culture conditions for drug screening assays.

A Continuous in vitro Culture System for Cryptosporidium

L. David SibleyWashington University in St. LouisSt. Louis, Missouri, United States
Grand Challenges Explorations
Human and Animal Health
10 Oct 2013

L. David Sibley at Washington University in St. Louis in the U.S. is developing a long-term in vitro intestinal epithelial culture system for the intracellular parasite Cryptosporidium, which causes severe diarrheal disease in both humans and animals, and is refractory to many anti-parasitic drugs. Currently, Cryptosporidium can only be grown in infected calves or in short-term in vitro cultures, which cannot be used for the high-throughput chemical screens needed to identify new drugs. In Phase I, they optimized the in vitro culture of isolated intestinal stem cells from human and mouse biopsies, and identified factors to control their differentiation into primary epithelial monolayers, which can better support the growth of intestinal pathogens. This led to around a five-fold increase in the rate of asexual replication of Cryptosporidium, which was enough to successfully test a chemical growth inhibitor. In Phase II, they will further improve culture conditions to support longer-term in vitro growth of Cryptosporidium, which will then be tested for stability and infectivity. They will also develop antibodies against specific developmental stages to help identify culture conditions that enable the parasite to undergo a complete life cycle, which will be valuable for culturing and screening efforts.

A Decoy Artificial Snail Host (DASH) to Control S. mansoni

Edwin RoutledgeBrunel UniversityLondon, United Kingdom
Grand Challenges Explorations
Neglected Tropical Diseases
9 Oct 2013

Edwin Routledge of Brunel University in the United Kingdom will work towards developing an artificial snail decoy to attract the parasite Schistosoma mansoni, which causes chronic disease. The parasites first develop inside aquatic snails, which they locate via chemical cues (chemoattractants), before they can infect humans. Routledge will identify the relevant chemoattractants by isolating and fractionating chemicals from the snails, and test the ability of these chemicals to attract the parasites. Effective chemoattractants will be characterized and ultimately incorporated into a biodegradable matrix to generate an artificial snail that is easy to deploy in the field and can trap and destroy the parasites, thereby reducing human transmission.

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 Fortified School Meal Product to Deworm School Children

Elijah SongokKenya Medical Research InstituteNairobi, Kenya
Grand Challenges Explorations
Neglected Tropical Diseases
8 Apr 2013

Elijah Songok of the Kenya Medical Research Institute in Kenya will design and test a fortified school meal product with deworming properties for treating soil transmitted helminths (parasitic worms) among schoolchildren in developing countries. Schoolchildren are most at risk of infection-associated morbidities such as stunting and chronic dysentery. However, current mass drug administration strategies are associated with the development of drug resistance, and may not be sustainable long term. They will fortify cornflour with seed extracts of the tropical fruit, Carica papaya (pawpaw), which can significantly increase clearance of the parasite, and use it to make porridge, which is cheap and a common school meal snack in developing countries. They will test its efficacy in a randomized pilot study in six elementary schools in rural Kenya.

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