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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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Émigrés Remittance for NTD MDA and Iodine Deficiency Elimination

Gilbert Saint JeanUniversity of Notre DameNotre Dame, Indiana, United States
Grand Challenges Explorations
Community-Based Interventions
1 May 2015

Gilbert Saint Jean of the University of Notre Dame in the U.S. will promote the consumption of salt fortified with both iodine, which is essential for child and maternal health, and the drug DEC, which is used to treat the parasitic disease lymphatic filariasis, in Haiti. Haitian emigrants residing in the U.S. frequently purchase food vouchers via money transfer company websites for their families in Haiti. The researchers will partner with food remittance companies to build on this system and offer vouchers for their tested DEC-iodized cooking salt. They will pilot test the approach in Florida by educating a group of emigrants on the health benefits of the salt, and evaluate uptake and the effect on iodine levels and disease incidence in their families back in Haiti.

Zinc Finger Nucleases For in vivo Treatment of HIV Infection

Philip GregorySangamo BioSciences IncRichmond, California, United States
Grand Challenges Explorations
HIV Infection
1 May 2009

People born with a genetic mutation in their CCR5 gene are naturally resistant to HIV infection. Philip Gregory of Sangamo BioSciences, Inc. in the U.S. will use zinc finger nuclease technology to specifically disrupt the CCR5 gene as a new strategy to make people resistant to HIV.

Working Towards the Local Elimination of Multiple Neglected Tropical Diseases

Felix LankesterWashington State UniversityPullman, Washington, United States
Grand Challenges Explorations
Community-Based Interventions
1 May 2015

Felix Lankester of Washington State University in the U.S. will determine whether integrating a mass drug administration campaign targeting soil-transmitted helminth infections with a mass dog rabies vaccination campaign reduces costs and extends treatment coverage for these diseases, which are endemic in Tanzania. Collaborators include: Safari Kinunghi - National Institute of Medical Research, Tanzania, Sarah Cleaveland - University of Glasgow and Deborah Watson Jones - London School of Hygiene and Tropical Medicine. Current mass drug administration efforts mostly target schools, neglecting the young, adult and elderly populations, and often lack community support. They are also difficult to extend to rural communities. However, many people in rural communities own dogs, and are willing to participate in rabies vaccination campaigns. They will perform a randomized cluster controlled trial involving 60 villages receiving either integrated or non-integrated control strategies, and evaluate their effect on disease prevalence and treatment uptake.

Vitamin A to Induce Gut Homing of Immune Cells

David SchwartzHackensack University Medical CenterHackensack, New Jersey, United States
Grand Challenges Explorations
Mucosal Immunity
1 Nov 2009

David Schwartz of Hackensack University Medical Center in the U.S. will test an intradermal injection that increases levels of vitamin A and blocks vitamin D3 metabolism. These important mechanisms can “educate” B cells to home to the gut and to make mucosal antibodies against many viruses, including HIV.

Validation Testing of Novel Multi-Use Intrauterine Device Inserter in Bangladesh

Shuchi KhuranaBioceptive, Inc.New Orleans, Louisiana, United States
Grand Challenges for Development
Saving Lives at Birth
1 Oct 2015

Bioceptive aims to expand access to long-acting reversible contraception (LARC) for the estimated 222 million women around the world with an unmet need for modern family planning resources. The discreet intrauterine device (IUD) is one of the most applicable LARC methods for global use due to its long term of use, high efficacy, and minimal user effort. However, IUD access is frequently limited because the insertion procedure is complicated and only carried out by highly trained physicians. Bioceptive has developed a novel, reusable, sterilizable IUD inserter that makes the procedure simpler and intuitive and allows any healthcare worker to confidently insert an IUD with minimal training, thus using improved technology to overcome existing barriers to service delivery.

Vaccines Against Diarrhea Causing Gram Negative Bacteria

Sangeeta JoshiUniversity of Kansas Center for ResearchLawrence, Kansas, United States
Grand Challenges Explorations
Vaccines
1 Nov 2009

Sangeeta Joshi of the Middaugh laboratory at the University of Kansas in the U.S. will develop a novel polymer vaccine composed of assembled versions of “needle” and “tip” surface proteins used by Shigella and Salmonella pathogens to trigger bacterial invasion in human intestinal cells, and test it for its ability to induce antibody response.

Vaccine to Prevent Latent TB Infection

Gyanu LamichhaneJohns Hopkins UniversityBaltimore, Maryland, United States
Grand Challenges Explorations
Vaccines
1 May 2009

Gyanu Lamichhane of Johns Hopkins University in the U.S. will develop a novel vaccine for TB based on existing BCG vaccines modified to express a gene that is specific to latent TB in order to generate a robust immune response to a latent infection.

Vaccine for HIV Using a Novel Mucosal Vector and Adjuvant

Stephen KentUniversity of MelbourneMelbourne, Victoria, Australia
Grand Challenges Explorations
Vaccines
1 Nov 2009

Stephen Kent and John Stambas of the University of Melbourne in Australia will develop and test an attenuated influenza virus vector with an adjuvant that stimulates natural killer cells. The goal of this approach is to induce robust immunity at mucosal surfaces to HIV, which is important in both prevention and control of infection.

Vaccine Discovery by Mapping Quasi-species Sequence Space

Marco VignuzziInstitut PasteurParis, France
Grand Challenges Explorations
Infectious Diseases
1 May 2009

In organisms that have extreme mutation rates, such as RNA viruses, quasispecies are highly diverse genotypes that may drastically differ from the general population and often become less viable as they continue to mutate. Using new deep sequencing technology, Marco Vignuzzi of the Pasteur Institute in France hopes to identify such RNA viruses that have managed to retain attenuated strains in order to study these genotypes for possible use in the development of viral vaccines.

Using REM Sleep Twitches to Detect and Assess Neurodevelopmental Disorders

Mark BlumbergUniversity of IowaIowa City, Iowa, United States
Grand Challenges Explorations
Brain Function/Gestational Age
1 May 2015

Mark Blumberg from the University of Iowa in the U.S. will develop a method to record and analyze twitching during infant sleep as a non-invasive measure of early brain development. Muscle twitching during REM sleep is known to reflect nervous system function. They hypothesize that it also shapes the developing brain, and could be used to diagnose future neurodevelopmental disorders. They will position miniature accelerometers, which measure physical activity, on the limbs and heads of 16 full-term and 16 preterm infants, and measure the quantity and pattern of muscle twitching biweekly during sleep from age 3-4 months, and then at 6, 9 and 12 months. They will also design analytical tools to interpret the datasets. The goal is a simple, inexpensive, early neurological assessment method that can also be used in low-resource settings.

Using Outdoor Infrastructure for Malaria Eradication

Fredros OkumuIfakara Health InstituteIfakara, Tanzania
Grand Challenges Explorations
Malaria Eradication
1 May 2009

Existing malaria vector control methods (e.g. nets and insecticide sprays) primarily target mosquitoes that enter or attempt to enter human dwellings, yet mosquitoes also obtain significant proportions of essential resources outdoors. Fredros Okumu of Ifakara Health Institute in Tanzania and his co-investigators therefore proposed the use of strategically-located outdoor vector control devices. In this project's Phase I research, the team created new and easy-to-use outdoor methods for luring, trapping and killing mosquitoes, including major African malaria vectors. By combining mosquito lures with mosquito-killing agents, they showed that in addition to trapping, it was consistently possible to contaminate and slowly kill between 74% and 95% of wild malaria vectors visiting the outdoor devices. In Phase II, the team will improve their decoy prototypes and explore practical ways in which the outdoor mosquito control strategy can be implemented by rural and remote communities in malaria endemic areas.

Using Materials Science to Stop HIV Sexual Transmission

Patrick KiserUniversity of UtahSalt Lake City, Utah, United States
Grand Challenges Explorations
HIV Infection
1 May 2009

Patrick Kiser of the University of Utah in the U.S. will design a vaginal gel that blocks HIV by becoming impermeable in response to the pH change induced by the presence of semen, and includes a polymer engineered to bind to HIV surface proteins to halt viral transport to susceptible tissues and HIV target cells. In this project's Phase I research, Kiser and his team engineered a synthetic polymer that has many of the properties of mucus, and demonstrated that the polymers slow or stops the movement of cells in the presence of semen. In Phase II, Kiser will focus on developing a pericoital contraceptive gel that will prevent the movement of spermatozoa into the uterus.

Using Exercise to Improve Pneumococcal Vaccine Efficiency

Kate EdwardsThe University of SydneySydney, New South Wales, Australia
Grand Challenges Explorations
Vaccines
1 Nov 2009

Kate Edwards of University of Sydney in Sydney, Australia will test the theory that brief bouts of exercise consisting of cycling and weight lifting will increase antibody and cell-mediated responses to a pneumococcal vaccination administered immediately after the physical activity.

Using Common Freshwater Protozoa to Produce Malaria Vaccines

William GordonTetragenetics, Inc.Ithaca, New York, United States
Grand Challenges Explorations
Vaccines
1 Nov 2009

William Gordon and collaborators at Tetragenetics, Inc. in the U.S. propose using T. thermophilia, a fresh-water protozoa commonly used in basic research, to produce malaria antigens in a crystalline protein gel. The close evolutionary relationship between T. thermophilia and protozoan malaria parasites may allow the antigens to retain their natural conformation. In this way, multiple vaccine components can be readily harvested as a single, low-cost, high-potency vaccine formulation. This project's Phase I research demonstrated that T. thermophilia can be used to develop anti-malarial transmission blocking vaccines. In Phase II, Marco Cacciuttolo will lead a team of collaborators to further research the production and immune stimulating effects of multi-antigen and adjuvant formulations that could be used in a low-cost, long-lasting malaria vaccine.

Using Bacteria to Contain the Spread of Malaria

Marcelo Jacobs-LorenaJohns Hopkins UniversityBaltimore, Maryland, United States
Grand Challenges Explorations
Malaria Eradication
1 May 2009

Marcelo Jacobs-Lorena, of the Johns Hopkins School of Public Health in the U.S. proposes to modify bacteria that naturally inhabit the mosquito midgut to secrete proteins that interfere with the development of the malaria parasite in the mosquito that is necessary for malaria transmission.

Using Acoustic Analysis of Cough to Diagnosis Pneumonia

Suzanne SmithSTAR Analytical ServicesBedford, Massachusetts, United States
Grand Challenges Explorations
Diagnostics
1 Nov 2009

Suzanne Smith of STAR Analytical Services in the United States will study recorded cough samples with acoustic vocalization-analysis technology to identify sound characteristics that indicate specific symptoms of pneumonia with the aim of rapidly identifying the cause and severity of respiratory illness. It is hoped that such acoustic landmarks would help in the differentiation between viral infections and bacterial illnesses, each of which may require different treatments.

Use Telecom Data to Identify Digitally Excluded and Women Communities

Frederic PivettaReal Impact AnalyticsLuxembourg, Luxembourg
Grand Challenges Explorations
Financial Services Data
1 Nov 2015

Frederic Pivetta of Real Impact Analytics in Luxembourg will develop a platform and applications to leverage data from telecom operators to identify individuals in developing countries, who are often women, without access to digital financial services. They hypothesize that these isolated individuals display unique cell phone behaviors that they can use to identify them. Once identified, they can be directly targeted with appropriate campaigns and products to encourage them to get beneficial financial services such as mobile money accounts. They will refine a predictive model to identify selected user features such as calling volume and social network characteristics from large datasets.

Use of Physiologic Signal Complexity and Correlation Properties to Quantify Brain Development in Infants

Robert HabibAmerican University of BeirutBeirut, Lebanon
Grand Challenges Explorations
Brain Function/Gestational Age
1 May 2015

Robert Habib of the American University of Beirut in Lebanon will determine whether measuring the patterns of heart rate and breathing rate over time in infants reflects the maturity of the autonomous nervous system and thereby the extent of brain development. The autonomous nervous system controls complex physiological rhythms such as the variability of heart rate over time. These rhythms can be measured non-invasively and will be compared between ten full-term and ten preterm infants measured at birth and every six weeks until 56 weeks, and under different stimulating conditions. A low-cost and simple method to collect the physiological data will also be explored.

Understanding Outcomes of Acutely Ill Undernourished Children

Ezekiel MupereCase Western Reserve UniversityCleveland, Ohio, United States
Grand Challenges
All Children Thriving
11 Dec 2015

Umodzi - Men, Women, Boys and Girls in Alliance to Achieve Gender Equality

Thokozani MwenyekondeCAREAtlanta, Georgia, United States
Grand Challenges
Women and Girls
19 Nov 2015

Thokozani Mwenyekonde from CARE in Malawi is implementing the Umodzi project to promote gender equality for women and girls by engaging adolescent girls and boys, along with supportive adult male and female role models, to integrate gender equitable attitudes and behavior in schools as a basis for changing attitudes nationwide. Umodzi, which means "oneness" in the local Chichewa language, will build upon and adapt existing gender equality approaches including integrating efforts into the school curriculum, training teachers who convene teen club meetings, and working with adults who are also engaged in CARE's pro-women agriculture and savings programs in the school catchment areas.

Ultrasound Strain and Time-of-Flight for Diagnosing Pneumonia

Jonathan RubinUniversity of MichiganAnn Arbor, Michigan, United States
Grand Challenges Explorations
Pneumonia
1 Nov 2015

Jonathan Rubin of the University of Michigan in the U.S. will develop a simple, low-cost ultrasound device with cell phone display that can diagnose children with co-existing pneumonia and malnutrition. Over two million children per year die from pneumonia, and many of these deaths are caused by coexisting malnutrition. They will design an ultrasound stethoscope device to automatically measure lung expansion and contraction during breathing to detect ventilation problems caused by pneumonia as well as the levels of subcutaneous fat on the chest wall to detect malnutrition. The device will be tailored for use by a minimally-trained health worker and the results reported on the display by a numeric readout. They will test the adapted ultrasound device in the laboratory, and gather population data to determine the normal distribution of fat thickness in the chest wall for estimating nutritional status.

Transmission-Blocking Vaccine Based on Malaria Gamete Surface Protein

Nirbhay KumarTulane UniversityNew Orleans, Louisiana, United States
Grand Challenges Explorations
Vaccines
1 Nov 2009

Nirbhay Kumar of Johns Hopkins University in the U.S. will use a technique called codon harmonization to fully and correctly express a complex malaria gamete surface protein. The sexual stages of malaria parasites have been shown to be particularly vulnerable to antibody targeting. This approach may be able to block the transmission of malaria in insect vectors.

Transgenic Tomato for Delivery of RNAi Therapeutics

Eric LamRutgers, The State University of NJNewark, New Jersey, United States
Grand Challenges Explorations
Infectious Diseases
1 May 2009

In an effort to develop a low cost and easily transportable therapeutic, Eric Lam of Rutgers, State University of New Jersey in the U.S. will develop transgenic tomatoes that express RNAs that targets several relevant viruses. The team will test whether these antiviral RNAs can accumulate in mammals after their ingestion to suppress viral proliferation.

Toll-Like Receptor 8 Agonists as Novel Neonatal Vaccine Adjuvants

Ofer LevyChildren's Hospital BostonBoston, Massachusetts, United States
Grand Challenges Explorations
Infectious Diseases
1 May 2009

Ofer Levy at Children's Hospital Boston in the U.S. will determine whether synthetic molecules called imidazoquinolines activate newborns' white blood cells, and could be used as candidate vaccine adjuvants to dramatically enhance immunization at birth. In this project's Phase I research, Levy demonstrated that Toll-like Receptor-7 and -8 agonists are superior to agonists of other Toll-like receptors and to alum, an already approved vaccine adjuvant, in activating newborn immune responses in studies in vitro. In Phase II, Levy will conduct in vivo studies to test the ability of these molecules to boost vaccine responses, evaluating both the safety and efficacy of this approach.

Tissue Oxygen Saturation in Malnutrition and Pneumonia

Mark AnserminoUniversity of British ColumbiaVancouver, British Columbia, Canada
Grand Challenges Explorations
Pneumonia
1 Nov 2015

Mark Ansermino of The University of British Columbia in Canada will adapt near-infrared spectroscopy (NIRS) for the simple diagnosis and monitoring of children at increased risk of mortality from pneumonia. Children with moderate to severe malnutrition who develop pneumonia are far more likely to die than more nourished children, but diagnosing pneumonia in these individuals is problematic, likely due in part to muscle wasting that masks the classic symptoms of fast breathing and chest indrawing. NIRS is non-invasive and portable, and can rapidly measure tissue oxygenation levels, which will be reduced by oxidative stress in children with malnutrition. They will collect arm muscle saturation data using NIRS on 200 children under five years old admitted for lung infections at a clinic in Uganda, and use the data to design a prototype device and protocols for identifying at risk children.

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