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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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Mechanisms of Intrauterine Group B Streptococcal Infections During Pregnancy

David AronoffUniversity of MichiganAnn Arbor, Michigan, United States
Grand Challenges in Global Health
Preventing Preterm Birth
1 Jan 2012

David Aronoff of the University of Michigan in the U.S., with an interdisciplinary team of experts in microbiology, immunology, reproductive biology, and vaccine development, will examine how infections of the female reproductive tract interact with and evade the immune system, resulting in infections of the uterus that cause preterm birth and stillbirth. This work will research potential targets for prevention of invasive infections of the female genital tract, including plans to investigate strains of group B Streptococcus (GBS) from low-income countries for vaccine and drug development. Funding partners: Global Alliance to Prevent Prematurity and Stillbirth (GAPPS) and Bill & Melinda Gates Foundation.

Optimization and Evaluation of Flocked Swab Transport Systems for the Identification of Enteric Pathogens

David GoldfarbUniversity of PennsylvaniaPhiladelphia, Pennsylvania, United States
Grand Challenges Canada
Point-of-Care Diagnostics
1 Jan 2012

The objective of this Botswana-based collaboration led by David Goldfarb was to design and evaluate a user-friendly flocked-swab specimen collection system for the identification of enteric infections. This would have immediate impact in much of the world where diarrheal disease remains deadly and for the large part undiagnosed. Using an inexpensive innovation in specimen collection, the team diagnosed previously unrecognized pathogens that had caused the severe diarrhoea of over one-third of children in a group of southern African hospitals. McMaster University researchers designed and tested in Botswana a specially-designed "flocked swab" for collecting samples from children admitted to hospitals with severe diarrhoeal disease. The flocked rectal swab eliminates the wait and biohazard involved in obtaining and transporting a bulk stool (faeces) sample from an infant or child. This efficiency enabled implementation of a randomized clinical trial evaluating same-day diagnosis and treatment for a broad number of pathogens – the first study of its kind anywhere.

A Transmission-Blocking Vaccine Against Dengue Virus Dissemination

Gong ChengTsinghua UniversityBeijing, China
Grand Challenges Explorations
China Tsinghua-GCE
1 Jan 2012

Gong Cheng of Tsinghua University in China will develop a transmission-blocking vaccine against dengue virus that takes advantage of blocking mosquito infection by targeting the transmission from human to mosquito.

Vaccine Design Against HIV-1 Infection: A Novel Reverse Vaccinology Approach

Hua WangTsinghua UniversityBeijing, China
Grand Challenges Explorations
China Tsinghua-GCE
1 Jan 2012

Hua Wang of Tsinghua University in China will use reverse vaccinology, working backwards from host broadly neutralizing antibodies, to design and discover vaccines against HIV infection.

Prevention of Multi-Drug Phenotypic Resistance by Targeting Adaptive Mistranslation

Babak JavidTsinghua UniversityBeijing, China
Grand Challenges Explorations
China Tsinghua-GCE
1 Jan 2012

Babak Javid of Tsinghua University School of Medicine in China will determine whether drugs that increase the accuracy of protein production in Mycobacterium tuberculosis, which causes TB, can boost the effect of existing TB drugs and thereby shorten the current 6 month treatment period. They hypothesized that resistance to TB drugs is caused in part by the ability of the bacterium to change its proteins by making random errors during their synthesis (known as mistranslation). In Phase I, they proved that this was indeed the case, and performed a screen to identify candidate drugs that improved the accuracy of protein production. In Phase II, they will perform a further screen and test whether the identified compounds can reduce therapy duration in two mouse models of TB infection.

Genome-Wide Search for Vaccine Proteins of Streptococcus Pneumonia

Zhengsong WenTsinghua UniversityBeijing, China
Grand Challenges Explorations
China Tsinghua-GCE
1 Jan 2012

Zhengsong Weng of Tsinghua University in China will use reverse vaccinology to seek new antigens for Streptococcus pneumonia to develop new vaccines against bacterial pneumonia.

Novel Frontline Mobile Diagnostics Device for Antenatal Care

Sam SiaColumbia UniversityNew York, New York, United States
Grand Challenges for Development
Saving Lives at Birth
1 Jan 2012

We propose to scale up development and deploy in Rwandan community-level clinics a novel, low-cost, front-line diagnostic testing device that enables simultaneous detection of HIV and syphilis. This device requires just one finger-pricked volume of blood, and performs diagnostic testing that is as accurate as laboratory testing. Integrated into this diagnostic instrument is an GPRS mobile health capability which performs real-time synchronization of data to a central health records database using the cell-phone network or orbiting satellites.

PharmaCheck: Counterfeit and Substandard Drug Detector Device for the Developing World

Muhammad ZamanBoston UniversityBoston, Massachusetts, United States
Grand Challenges for Development
Saving Lives at Birth
1 Jan 2012

The primary objective of this project is to develop a device to screen for substandard anti-malarials and antibiotics, thereby improving adverse maternal and neonatal health outcomes with respect to malaria and sepsis. To date, there is no device to test counterfeit and substandard drugs in the field thoroughly. To this end, we propose PharmaCheck, a user-friendly, cost-effective, contextual and high-throughput device capable of quantitatively measuring active ingredient concentration and drug release profiles to quickly and accurately screen for spurious medicines. Existing methods of counterfeit drug detection are bulky, qualitative, error-prone and do not take time-based measurements of drug release kinetics, and thus do not provide information about whether therapeutic levels of the drug are reached and sustained. PharmaCheck addresses these shortcomings through affordable fluorescence, dissolution testing, which allows for highly specific and quantitative time-course measurements of drug release. PharmaCheck will offer an affordable, effective tool for local health authorities to better safeguard the efficacy of their pharmacopeia and significantly impact maternal and neonatal health outcomes in the developing world.

Performance of an Innovative, Instrument-Free, Low-Cost, Rapid Point-of-Care CD4 Test for Accelerating Initiation of Antiretroviral Interventions for HIV 1-Infected Pregnant Women in Resource-Constrained Settings

Stanley LuchtersBurnet InstituteMelbourne, Victoria, Australia
Grand Challenges for Development
Saving Lives at Birth
1 Jan 2012

A simple and accurate instrument-free, low-cost Point-of-Care CD4 test that is applicable in poor, hard-to-reach settings could sustainably increase uptake of antiretroviral intervention and reduce loss to follow-up associated with centralized laboratory-based testing. Four antenatal care clinics in Kenya and South Africa will enroll 275 HIV-infected pregnant women to prospectively assess the accuracy of the novel, rapid, inexpensive ($1.50) and instrument-free Burnet Point-of-Care CD4 test as performed by nurse-midwives in field settings, compared to a WHO pre-qualified POC CD4 instrument-based (PIMA) and a laboratory-based flow cytometric assay. If proven accurate in field settings, the Burnet Point-of-Care CD4 test could be rapidly scaled-up and markedly enhance care, particularly in rural areas of resource-constrained settings.

Comet: Effective, Compact, and Low-Cost Phototherapy to Treat Newborn Jaundice

Garrett SpiegelD-Rev: Design for the Other Ninety PercentPalo Alto, California, United States
Grand Challenges for Development
Saving Lives at Birth
1 Jan 2012

As part of a suite of jaundice diagnostic and treatment technologies aimed at ending kernicterus, we have developed Comet, an extremely low-cost, high-performance, and compact jaundice treatment device targeted at rural and limited-infrastructure clinics and hospitals in developing countries. Comet integrates low power consumption and high intensity LEDs with a lifespan of 3-5 years to provide phototherapy on par with state-of-the-art devices. However, Comet requires minimal maintenance and is designed to retail at less than $150. In partnership with One Heart World-Wide, we are seeking seed funding to field test Comet in India and Nepal, refine the design for final embodiment, and begin market and delivery development.

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