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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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"Help, the Mother Is Bleeding!" An Interactive Voice-Controlled Virtual Mentor to Support Birth Attendants in Resource-Constrained Settings

Tiffany LundeenPreterm Birth Initiative East AfricaSan Francisco, California, United States
Grand Challenges for Development
Saving Lives at Birth
1 Mar 2018

"Help, the Mother is Bleeding!" An interactive voice-controlled virtual mentor to support birth attendants in resource-constrained settings

"Just-Add-Water" Nucleic Acid Amplification

Apostolos AlissandratosThe Australian National UniversityActon, Australian Capital Territory, Australia
Grand Challenges Explorations
Diagnostics Systems
1 May 2018

Apostolos Alissandratos of the Australian National University in Australia will develop a biotechnology platform for the low-cost production of simple, just-add-water diagnostic tests for the early detection of infectious diseases in resource-limited settings. Diagnosis of infectious diseases generally involves detecting pathogen-specific nucleic acids in human samples, which requires unstable reagents, costly procedures, and skilled workers. They have engineered a safe bacterium that produces the biochemical reagents needed to detect the pathogenic nucleic acids as an extract. They will develop a method to freeze-dry this extract so that it is stable at room temperature, simplifying production and storage, and a protocol for incorporating it into a reaction mixture that only requires the addition of water to an individual tube for a diagnostic polymerase chain reaction. They aim to reduce the cost per test by at least 100-fold, and will evaluate their approach for detecting a malaria-causing pathogen.

"Krik Krak": Mental Health for Pregnant Haitian Teens

Guitele RahillUniversity of South FloridaTampa, Florida, United States
Grand Challenges Explorations
Maternal Mental Health
1 May 2018

Guitele Rahill and Manisha Joshi of the University of South Florida in the U.S. will harness the Haitian tradition of storytelling to produce online videos, brochures, and posters that support pregnant teenagers in Haiti who are at high risk of depression. There has been an increase in unplanned teenage pregnancies since the 2010 earthquake, due in part to the loss of parents, and a rise in transactional sex and sexual assaults facilitated by very limited resources. Pregnancy places a substantial additional stress on these children, which in turn causes long-term difficulties for their children. In Haiti, to tell a story you announce "Krik?", and to hear it you respond "Krak!" They will use this familiar story-telling framework and actors who resemble the target group to teach pregnant teenagers about childbirth, motherhood, and how to cope with depression. They will conduct two focus groups of six pregnant teens to identify the specific challenges they face, and use their feedback to help ensure the approach will work.

"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.

10+10+30 Infant Vaccines Communication via Radio in Ethiopia

Bernard AppiahTexas A&M School of Public HealthCollege Station, Texas, United States
Grand Challenges Explorations
Immunization Delivery
1 May 2018

Bernard Appiah of Texas A&M School of Public Health in the U.S. will produce a one-hour community radio program to be aired twice per week comprising a 10-minute radio drama serial on infant vaccines, a 10-minute panel discussion by community health workers, and a 30-minute phone-in by listeners, to improve on-time childhood vaccinations in Ethiopia. In 2016, on-time and full immunization coverage in Ethiopia was only achieved for 39% of children between one and two years of age, despite long-term efforts to improve it. One of the main reasons for this was lack of communication with mothers about immunizations. To address this, they will harness the popularity of community radio in Ethiopia. They will engage mothers, community health workers, and radio actors to help design a radio drama incorporating relevant topics on childhood immunizations, and train 20 health workers to be part of radio panel discussions. They will air the radio program for six months in two districts, and determine its impact on timely immunization coverage in a selected cohort of mothers with infants.

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 Blended Intervention: Digital Mental Health Game and Mentoring for Treatment of Common Perinatal Mental Disorders in Adolescent Refugee Mothers

Rebecca DempsterHIASSilver Spring, Maryland, United States
Grand Challenges Explorations
Maternal Mental Health
1 May 2018

Rebecca Dempster of HIAS in the U.S. will develop an online game- and mentorship-based intervention to improve the mental health of refugee adolescent mothers in Kenya that integrates into their daily lives and helps them develop new skills. Digital games can help treat mental health disorders such as depression particularly in young people because they have a natural appeal and are easy to access from home. They will recruit ten young mothers, a psychologist, and software programmers to design a mental health game so that it can be used to identify those with mental health disorders and connect them with counselors, and provides interactive challenges to help treat and protect against those disorders as well as build relevant life skills. They will then train these young mothers to act as mentors to support the online game, and pilot test their approach on a sample of 15 refugee adolescent mothers over three months to evaluate feasibility, acceptability, and effect on maternal depression.

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 Crowd-Sourcing Approach to Large-Scale Monitoring of Pests by Smallholder Farmers

Menale KassieInternational Centre of Insect Physiology and EcologyNairobi, Kenya
Grand Challenges Explorations
Crop Disease Surveillance
1 Nov 2018

Menale Kassie of the International Centre of Insect Physiology and Ecology in Kenya along with Ram Fishman and Opher Mendelsohn from Tel Aviv University in Israel will take a community-based crowdsourcing approach to crop protection of smallholder farms in low-resource settings by developing a simple software platform for basic feature phones to monitor pest incidence. Human-based monitoring of crops is the most accurate way to identify pests, but there are too few public monitoring agents in low-resource settings, leaving the majority of farms unprotected. Engaging the smallholder farmers to monitor their own crops is a promising solution, but most of them lack sophisticated equipment like smart phones and have low technical knowledge, so simpler solutions are needed. Therefore, they will adapt commercially-available software that collates and analyzes pest incidence data for basic feature phones and, together with smallholder farmers, design simple interfaces for SMS communication. They will test their approach by performing a pilot study to monitor wheat and maize, covering one to two counties in Kenya, and teach smallholder farmers and government agents how to use the monitoring system and compare the data with that collected by expert field agents.

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 Digital Platform for 21st Century Education

Saurabh AgarwalDeeper Learning Innovations Private LimitedLucknow, Uttar Pradesh, India
Grand Challenges
Teaching and School Leadership
1 Nov 2018

Saurabh Agarwal of Deeper Learning Innovations Private Limited in India will build an interactive, digital teaching platform using advanced data analytics and artificial intelligence algorithms to enable teachers across the globe to more effectively teach life skills to every child. Teaching standards in developing countries suffer from limited access to quality content, restricted teaching methods for teachers, and a lack of ways to transfer knowledge and skills to other teachers and parents. Life skills such as problem solving and communication that are needed to address 21st century challenges such as health, wellness, and gender equality are far better learned by experience and reflection, rather than reading and lectures. They will build the platform and incorporate life skills modules designed by learning experts and teachers containing multi-lingual and contextualized content for global access, a teacher's discussion forum, and a module designed by teachers to help parents support their child's education. The goal is to make the platform freely available and accessible to all teachers across the globe.

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.

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.

A Human Powered Precision Seeder

Ricardo Capúcio de ResendeUniversidade Federal de ViçosaViçosa, Minas Gerais, Brazil
Grand Challenges Explorations
Women Farmers
17 Oct 2013

Ricardo Capúcio de Resende of Universidade Federal de Viçosa in Brazil will design and test a new machine to enable women smallholder farmers in sub-Saharan Africa to more efficiently and effectively plant seeds. He has designed a new seeder concept using only two rotating parts, which is light, easy to use and maintain, and can simultaneously plant two crops. He will query local manufacturers and users to further develop the design, and then produce prototypes that will be bench- and field-tested for manufacturability and performance. The results will be used to produce the final seeder design, and this design concept could be applied to other agricultural machines.

A Low-Cost Decentralized Sanitary System

Bin FanResearch Center for Eco-environmental Sciences (RCEES), Chinese Academy of Sciences (CAS); and Chinese Committee for SCOPE (Scientific Committee on Problems of the Environment)Beijing, China
Grand Challenges Explorations
Sanitation Technologies
31 Mar 2011

Bin Fan of the Research Center for Eco-environmental Sciences in China seeks to develop a decentralized sanitation system which uses a low-cost waterless, vacuum system to collect excrement and kitchen waste. The combined waste can then be processed into organic fertilizer.

A Low-Cost, Electricity-Free Oxygen Concentrator

Bryn SobottUniversity of MelbourneMelbourne, Victoria, Australia
Grand Challenges for Development
Saving Lives at Birth
16 Dec 2013

Our proposal will provide this life-saving treatment to isolated, extremely resource poor people by obviating the need for electricity. This will be achieved by applying recently developed hydrological engineering approaches to extract the pressure differential required for the adsorption process exploited by Oxygen concentrators. This project aims to develop and test an electricity free Oxygen concentrator suitable for a developing world health facility. This represents a major paradigm shift, as to-date the problem has been interpreted as how to supply electricity to an Oxygen concentrator. In comparison with solar and generator based approaches the prototype will require significantly less capital cost and maintenance. Further, construction out of locally available components will empower the community to independently and sustainably access this life-saving treatment.

A Method to Generate Bacteriophages Targeting Enterobacteria

Mark van RaaijConsejo Superior de Investigaciones Cientificas (CSIC)Madrid, Spain
Grand Challenges Explorations
Synthetic Biology
3 Oct 2011

Mark van Raaij of the Spanish National Research Council (CSIC) at the National Center for Biotechnology in Spain will work to build a library of engineered bacteriophages that can recognize, infect, and kill a range of enterobacteria such as Salmonella and E. coli.

A Mobile Workflow-Based Solution for Closed Loop Monitoring of Adherence to TB Treatment

Shashank GargHandheld Solutions and Research Labs Pvt LtdBangalore, Karnataka, India
Grand Challenges India
Tuberculosis Treatment
21 Jul 2014

Shashank Garg and team will develop a mobile solution that addresses problems in adherence to TB treatment through the key technologies of mobile phone-based electronic forms, workflow management, identity management, and electronic health records. The objective is to achieve automated tracking and monitoring of individual TB patients for adherence to the TB treatment protocol. ASHA workers will use the mobile application for collection of dosage intake data in the field. A workflow system will provide a closed loop through SMS alerts in case a patient defaults. Along with identity management and a TB treatment record, the system will ensure patients are able to seek treatment even on migration, thus maintaining continuity of treatment. This mobile solution is novel because it will use a form-based mobile application capable of running in disconnected or offline mode, with data connectivity being required only for the duration of data upload to the server.

A Mobile-Based Training Platform for ASHA workers

Pushpendra SinghIIIT-DelhiNew Delhi, Delhi, India
Grand Challenges Explorations
Immunization Delivery
1 May 2018

Pushpendra Singh of IIIT Delhi in India will develop interactive training and mentoring sessions for community health workers in India (ASHAs) using mobile phones and interactive voice response systems so they can provide better public healthcare in rural communities. Current training programs are run by medical professionals and require the workers to visit a health center, which may be inconvenient. The lack of medical experts has also reduced the frequency of these programs. These limitations could be overcome with online sessions whereby one expert trains multiple health workers remotely. They have already developed the format of the sessions, which involves an expert delivering a defined curriculum to groups of health workers followed by a question and answer session, and shown that it improved the knowledge and confidence of the health workers in a pilot test. They will now scale up the testing to 500 health workers, and also evaluate the platform as a peer-to-peer learning mechanism for health workers to share their experiences and learn from each other without the need for an expert.

A Mouse Model for Heat-Stable Enterotoxin Diarrhea

James NataroUniversity of VirginiaCharlottesville, Virginia, United States
Grand Challenges Explorations
Enteric Disease Models
15 Apr 2014

James Nataro of the University of Virginia in the U.S. is developing new mouse models of environmental enteric dysfunction (EED) to explore how enteric pathogens commonly found among children in developing countries can affect intestinal function and cause growth retardation. In Phase I, they developed mouse models for five of the common pathogens and found that, as in humans, malnutrition (protein or zinc deficiency) enhanced the severity of infection, associated growth retardation, or the presence of intestinal inflammation. In Phase II, they will study the molecular mechanisms involved and analyze human candidate EED-associated biomarkers and metabolic states in their new mouse models to better compare them to the human disease. They will also test the effect of simultaneous and repeat infections on growth, and treat one of the models with alanine-glutamine to determine whether they can be used to evaluate new drugs.

A New Method for Handling Dysfunctional Labor

Eva Wiberg-ItzelKarolinska InstitutetStockholm, Sweden
Grand Challenges Explorations
Mothers and Newborns
19 Apr 2011

Eva Wiberg-Itzel of the Karolinska Institute in Sweden proposes to develop an easy and informative test which measures the concentration of lactate in the amniotic fluid of laboring women to help obstetricians and midwifes predict labor outcomes. Measuring lactate levels can give care providers an early indication of whether interventions are needed to reduce maternal and infant mortality in developing countries.

A New Model for Studying in utero Disease Using Newborn Hair

Benjamin YuUniversity of California, San DiegoSan Diego, California, United States
Grand Challenges Explorations
Nutrition
13 Oct 2011

Benjamin Yu of the University of California San Diego in the U.S. will isolate and sequence RNA found in the hair and nails of newborns to study whether specific RNA changes can be found in low-birthweight babies. This molecular tool could help uncover nutritional or environmental factors that cause newborn disease.

A New Target for Mosquitocides

Jeffrey BloomquistUniversity of FloridaGainesville, Florida, United States
Grand Challenges in Global Health
Chemical Vector Control
1 Aug 2011

Jeffrey R. Bloomquist of the University of Florida in the U.S. will investigate a voltage-sensitive potassium channel as a new target for mosquitocides.

A New Tool for Harvesting Cassava

Samuel OkurutNational Agricultural Research OrganizationKampala, Uganda
Grand Challenges Explorations
Women Farmers
11 Oct 2013

Samuel Okurut and a team from the National Agricultural Research Organization in Uganda will develop a simple low-cost tool for women smallholder farmers to more easily and efficiently harvest cassava, which is a major staple food in the developing world. The classical, manual method for harvesting cassava is labor and cost intensive, involving hoeing and digging in a bent posture. The new tool will be developed with input from women farmers and key stakeholders, and designed to be operated in a more upright posture. The cost-benefit of the tool will be tested in the field, and the feasibility of training and local fabrication will be explored.

A Non-invasive Cell Phone Imaging Probe for Diagnosing Malaria

Alberto BilencaBen-Gurion University of the NegevBeer-Sheva, Israel
Grand Challenges Explorations
Cell Phone Applications
4 Dec 2011

Alberto Bilenca of Ben-Gurion University of the Negev in Israel will develop a cell phone imaging system that can non-invasively detect malaria parasites in the blood. The system uses a polarized red laser pointer to illuminate tissue such as a finger tip, and a zoom lens and polarizing filter on existing cell phone cameras, to create images that depict hemozoin crystals in blood following malaria parasite infection, as well as micro-obstructions in the circulatory system that result from the infection.

A Novel Agent for Management of Postpartum Hemorrhage: Adaptation of the Xstat Mini-Sponge Applicator for Obstetric Use

Maria RodriguezOregon Health and Science UniversityPortland, Oregon, United States
Grand Challenges for Development
Saving Lives at Birth
1 Jan 2013

Postpartum hemorrhage (PPH) is the leading cause of maternal mortality in low-income countries. The majority of these deaths occur outside the health care system, and so an intervention that could be used in any setting and with minimal training could save lives. We will use an animal model to demonstrate appropriate uterine fill, and a proof-of-concept study to show stoppage of post-delivery bleeding and test ease of removal. Standard care for treating PPH consists of massage, uterotonics, and tamponade (i.e., "holding pressure"). Devices used to treat PPH via tamponade are not easily adaptable to low-resource settings with diverse climates and providers. A novel agent, the XSTAT mini sponge dressing, has proven successful in the acute cessation of traumatic non-compressible bleeding analogous to PPH. This device utilizes pre-packaged, environmentally stable, compressed medical sponges soaked with a hemostatic agent and administered by a light-weight applicator. The sponges, once deployed, exert uniform pressure to address multiple sources of bleeding and are easily removable.

A Novel Way to Increase Intestinal Immunity to Poliovirus

Simon CardingUniversity of East AngliaNorwich, United Kingdom
Grand Challenges Explorations
Poliovirus Eradication
18 Apr 2011

Simon Carding of the University of East Anglia in the United Kingdom will test the feasibility of a new technology using live commensal gut bacteria for the controlled delivery of poliovirus antigens to the intestinal mucosa to generate protective viral immunity.

A Novel, Simple Method to Find Inexpensive Drugs for Preeclampsia Treatment

Timothy LyonsQueen's University BelfastBelfast, United Kingdom
Grand Challenges for Development
Saving Lives at Birth
15 Nov 2014

Preeclampsia (PE) is a disease without targeted treatments. We propose a simple strategy to solve this problem: we will establish a cell-based assay to screen clinically-available, mostly generic and inexpensive, drugs that may have a therapeutic effect on PE. To do this, we will utilize new scientific knowledge, showing that anti-angiogenic factors released from the placenta trigger maternal vascular injury essential for the development of PE. The drugs to be screened are chosen as relatively safe to pregnant women based on FDA labels; most of them are already on pharmacy shelves in developing countries, being used for diseases other than PE. Since they have not previously been tested for efficacy in PE, it is very likely that some may have beneficial effects.

A Pediatric Immune Enteroid Model of Gut Enteropathy

Marcela PasettiUniversity of Maryland, BaltimoreBaltimore, Maryland, United States
Grand Challenges Explorations
Enteric Disease Models
8 Oct 2014

Marcela Pasetti of the University of Maryland in the U.S. will generate an in vitro model of the gut using intestinal stem cells and immune cells to better mimic the damaged and inflamed guts of young children in developing countries for testing new treatments. Current so-called human enteroid models lack additional relevant cell types found in the intestine, particularly immune cells, which are known to play an important role in gut health and function. They will expose their new miniature pediatric gut model to enteric pathogens and test the ability of human breast milk and bovine hyperimmune colostrum to repair the subsequent damage.

A Population-Based Cohort Study in Matlab, Bangladesh: Establishing a Center of Excellence in Preterm Birth and Stillbirth Investigation

Anisur RahmanInternational Centre for Diarrhoeal Disease Research, BangladeshDhaka, Bangladesh
Grand Challenges in Global Health
Preventing Preterm Birth
1 Feb 2014

Anisur Rahman of the Matlab Health Research Centre at the International Centre for Diarrhoeal Disease Research, Bangladesh (ICCDR,B) will lead a prospective cohort study of pregnant women, building on the ICDDR,B community-based surveillance site, to enroll more than 4,000 pregnant women over three years. His team will visit women monthly at their homes for early identification of pregnancy, followed by accurate gestational age dating by ultrasound and follow up throughout pregnancy and at delivery for collection of clinical data and specimens. The study includes standardized systems for documentation of complications of pregnancy and assessment of birth outcomes. Data and specimens will be used to advance innovative research into the causes of preterm birth and identify novel strategies for prevention.

A Portable Brain Scanner with Telemonitoring Platform for Detection and Management of Neonatal Hypoxic Ischemic Encephalopathy

Abhijit DasArogya Medtech Pvt. LtdKolkata, , India
Grand Challenges India
India-GCE
7 Mar 2018

Abhijit Das of Arogya Medtech Pvt. Ltd. in India will develop a device - CEREBROS - that is a modular unit combining electroencephalography (EEG) and near infrared spectroscopy (NIRS) together with an Internet of Things (IoT) component incorporating a telemonitoring platform. This system enables continuous remote monitoring of cerebral hypoxia and seizures and early detection and management of hypoxic ischemic encephalopathy (HIE) at point-of-care. The device is in the form of a wearable cap for neonates. It will also include a multivariate classifier incorporating quantitative EEG metrics and cerebral oximetry metrics, which will identify disease-specific patterns that can be presented remotely by a neonatologist simultaneously in voice, text, pictures, or video or animations. The device could be provided, through both public and private care providers, under an affordable rental or pay-per-use model. The device provides an easy-to-use alternative to structural imaging (CT or MRI) that has better sensitivity and specificity, especially for neonates or infants less than 2 years old.

A Probiotic-Based Oral Synthetic Vaccine Delivery System

Daniel GonzálezUniversity of Texas at San AntonioSan Antonio, Texas, United States
Grand Challenges Explorations
Synthetic Biology
7 Oct 2011

Daniel González of the University of Texas at San Antonio in the U.S. will work to engineer a probiotic yeast into a strain that can deliver antigens directly to the intestinal mucosal immune system. This yeast strain could be developed into an oral vaccine delivery vehicle that can accommodate a wide variety vaccine candidates.

A Randomized Clinical Trial With Oral Magnesium Supplementation in Pregnancy

Joao Guilherme Bezerra AlvesInstituto de Medicina Integral Professor Fernando FigueiraRecife, Pernambuco, Brazil
Grand Challenges Brazil
Preterm Birth Burden
6 Dec 2013

Joao Guilherme Bezerra Alves from the Instituto de Medicina Integral Professor Fernando Figueira in Brazil will perform a randomized controlled trial to assess whether a daily oral supplement of magnesium citrate can prevent placental vascular disease, which can lead to preterm birth. Placental vascular disease restricts the flow of nutrients to the fetus and can cause growth restriction and maternal hypertensive disorders. Magnesium is known to promote placental vascular flow, and magnesium citrate is safe, inexpensive and easily absorbed in the body. They will perform a clinical trial in two large hospitals in Brazil in which 3,000 pregnant women will be offered a daily magnesium supplement or a placebo control starting from up to 20 weeks of gestation and continuing until birth. The effect on various outcomes including placental function, preterm labor, and mother and child health will be evaluated.

A Revolutionary Sanitation Technology with Superhydrophobic Materials

Chunlei GuoUniversity of RochesterRochester, New York, United States
Grand Challenges Explorations
Sanitation Technologies
26 Sep 2011

Chunlei Guo of the University of Rochester in the U.S. proposes to develop superhydrophobic materials that not only repel waste for use as a self-cleaning surface for latrines, but also can be used to capture and slough clean water into storage containers before it evaporates or is contaminated.

A Rift Valley Fever Vaccine for Use in Humans and Animals

George WarimweJenner InstituteOxford, United Kingdom
Grand Challenges Explorations
Human and Animal Health
23 Oct 2013

George Warimwe of the Jenner Institute at the University of Oxford in the United Kingdom will develop a vaccine to protect a variety of species, including humans, sheep and cattle, against Rift Valley fever, which can cause serious illness. Current vaccines that are in development have safety concerns for use in humans. They have developed a Rift Valley fever vaccine using a replication-deficient simian adenovirus as a safe vector that is easy and inexpensive to manufacture, and have tested its safety and immunogenicity in mice, and begun field-testing in sheep in Kenya. They will test safety and immunogenicity of the vaccine and the effect of an adjuvant in calves and goats, and compare this with the data from mice and sheep.

A Scalable, Inhaled Drug Delivery System for Alveolar-Macrophage Targeted Tuberculosis Chemotherapy

Feng QuianTsinghua UniversityBeijing, China
Grand Challenges Explorations
China Tsinghua-GCE
1 Jan 2013

Feng Qian of Tsinghua University in China will work to develop an inhaled drug particle using a scalable formulation process to deliver tuberculosis drugs directly into the lungs. They will develop micro-particles containing current TB drugs and will test their utility when inhaled.

A Sensitive Epigenetic Tool for Prediction of Pre-eclampsia

Mahua ChoudhuryTexas A&M Research FoundationCollege Station, Texas, United States
Grand Challenges Explorations
Mothers and Newborns
13 Apr 2011

Mahua Choudhury of University of Colorado in the U.S. will develop a database of epigenetic signatures, changes in DNA and proteins caused by non-genetic factors such as poor nutrition, smoking and environmental contaminants, that could be used as predictors of pre-eclampsia. This information will be used to develop a cost- effective diagnostic tool to detect these markers in blood or urine.

A Simple Tool and Mobile Phone Application to Improve Community-Based Case Management of Premature and Jaundiced Newborns

Anne LeeBrigham and Women's HospitalBoston, Massachusetts, United States
Grand Challenges for Development
Saving Lives at Birth
1 Oct 2014

We aim to develop and validate simple, low-cost, low-technology tools to improve community-based identification, referral, and care of premature and jaundiced newborns by frontline health workers.

A Simple, Rapid Assessment Tool to Identify and Triage Preterm Infants

Anne LeeJohns Hopkins UniversityBaltimore, Maryland, United States
Grand Challenges for Development
Saving Lives at Birth
1 Jan 2011

Preterm birth leads to more annual neonatal deaths (1 million) than any other single cause; these deaths primarily occur in low income settings where many infants are born at home and gestational age is rarely assessed. Innovative ways to identify preterm infants in the community are needed to facilitate rapid and appropriate targeting of interventions and referral. Newborn clinical assessment by medically trained personnel allows accurate estimation of gestational age, but methods are complex and simplified methods have not been developed and validated for use by community health workers (CHWs). We have developed a simple, color-coded pictorial scorecard intended for use by CHWs to identify early preterm (<34 weeks=red zone) and late preterm (34-37 weeks= yellow zone) infants. Validation of this simple tool for use by CHWs may help reduce the large burden of newborn deaths related to prematurity.

A Small Animal Model of ETEC-Mediated Diarrhea

Sandhya VisweswariahIndian Institute of ScienceBangalore, , India
Grand Challenges Explorations
Enteric Disease Models
25 Apr 2014

Sandhya Visweswariah of the Indian Institute of Science in India will generate a mouse model for studying secretory diarrhea, which causes significant mortality in young children. Secretory diarrhea is often caused by the bacterium Escherichia coli, which produces a toxin that binds to a cell surface receptor (the guanylyl cyclase C receptor) in the gastrointestinal tract thereby causing diarrhea. They will genetically engineer a mouse in which they can hyperactivate this receptor specifically in intestinal cells to potentially trigger secretory diarrhea. The effect on the gastrointestinal tract and any accompanying molecular changes will then be analyzed and could lead to the discovery of new therapeutic targets.

A Small Animal Model of Onchocerciasis

Joseph TurnerLiverpool School of Tropical MedicineLiverpool, United Kingdom
Grand Challenges Explorations
Neglected Tropical Diseases
10 Apr 2013

Joseph Turner of the Liverpool School of Tropical Medicine in the United Kingdom will develop a small animal model of the parasitic disease onchocerciasis, also called river blindness, which is the second leading infectious cause of blindness. Treatment options for filarial infections are currently limited and lack effectiveness. Thus, small animal models of filarial infections are invaluable for preclinical testing of candidate drugs. In Phase I, they established the mouse model by infecting mice lacking an adaptive immune system with Onchocerca parasites isolated from infected cows, and tested its feasibility for screening drugs. In Phase II, they will expand their model, and use it for preclinically testing the safety and efficacy of several candidate drugs currently under development.

A Small Animal Model to Validate Onchocerca Macrofilaricides

Warwick GrantLa Trobe UniversityBundoora, Victoria, Australia
Grand Challenges Explorations
Neglected Tropical Diseases
12 Apr 2013

Warwick Grant of La Trobe University in Australia will develop a small animal parasite model to test candidate drugs for treating the parasitic nematode Onchocerca volvulus, which causes river blindness in humans. They will establish infection of the related parasite Cercopithifilaria johnstoni in rats and evaluate the pathology for similarity to the human disease. The model will then be validated for testing human anti-onchocercal drug candidates by analyzing the effect of drugs with proven success in patients. Once the model has been fully validated, they aim to perform routine assessments of candidate drugs.

A Solar Steam Sterilizer for Treatment of Human Waste

Naomi HalasRice UniversityHouston, Texas, United States
Grand Challenges Explorations
Sanitation Technologies
23 Sep 2011

Naomi Halas and colleagues at Rice University in the U.S. will design and test a prototype sterilizer that employs metallic nanoparticles to absorb solar energy for converting water to steam sufficient for sterilization of human waste. Steam is a highly effective method of sterilization, but intensive energy and infrastructure requirements have limited its small-scale use. In Phase I, they successfully built and tested a solar steam generator-driven autoclave prototype that can quickly transfer and sterilize sufficient volumes of unprocessed human waste. In Phase II, they will adapt the technology to enable the conversion of waste into briquettes suitable for use as cooking fuel, and further develop it for field tests in Kenya.

A Time-Saving Tool for Stripping Groundnut Pods

Tobias OkerNational Agricultural Research OrganizationKampala, Uganda
Grand Challenges Explorations
Women Farmers
2 Oct 2013

Tobias Oker and a team from the National Agricultural Research Organization in Uganda will develop a simple plucking tool to more efficiently remove the pods from groundnuts, which is currently done by hand and is labor-intensive and time-consuming for women. They will query farming communities on current harvesting methods to refine their design, and evaluate performance, labor cost, and perceptions in the field using prototypes compared to traditional methods. They will also train users and local manufacturers to fabricate the tools and encourage their use.

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