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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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Engineering Hurdles: Mitigating Bacteriophage-Resistance

Samuel AlcaineUniversity of Massachusetts AmherstAmherst, Massachusetts, United States
Grand Challenges Explorations
Bacteriophage
1 Nov 2015

Samuel Alcaine of the University of Massachusetts Amherst in the U.S. will engineer bacteriophage (viruses that infect bacteria) to produce an antimicrobial compound that helps avoid bacteria such as enteroaggregative Escherichia coli developing resistance to the phage, thereby increasing their value for treating associated childhood diseases. Phage could be valuable for treating intestinal diseases that cause severe morbidity and mortality in developing countries as they can selectively destroy pathogenic bacteria. However, some bacteria rapidly develop resistance to the phage, which renders them useless. By inducing phage-infected bacteria to also release a toxic substance (bacteriocin), this would destroy any potentially resistant neighboring bacteria. They will engineer T7 bacteriophage to express one of two selected bacteriocins and test their ability to circumvent phage resistance in E. coli.

A SIM Overlay Platform to Extend Phone Payments Offline

Ross AndersonUniversity of Cambridge Computer LaboratoryCambridge, United Kingdom
Grand Challenges Explorations
Mobile Money
1 Nov 2015

Ross Anderson at the University of Cambridge in the United Kingdom will develop technology to enable secure offline phone-to-phone and card-to-phone payments between customers and merchants. The ability to use mobile phones to make and receive payments has expanded access to secure financial services in low-resource settings. However, the requirement of a network connection makes it particularly problematic in rural communities. They will develop SIM overlay technology, modern cryptography and audio coupling to securely transfer payments offline also from a SIM format payment card for those without a phone. Merchants can then bank the payments periodically whenever they have a network connection. They will evaluate their prototype for usability and security, and work towards interoperability across countries so that migrant workers can also use it.

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.

Digital Merchant On-Boarding in Uganda

Ronald AzairwePegasus Technologies LimitedKampala, Uganda
Grand Challenges Explorations
Mobile Money
1 Nov 2015

Ronald Azairwe of Pegasus Technologies Ltd. in Uganda will develop an online portal coupled with attractive incentives to recruit merchants and train them to accept mobile money in Uganda. Current methods of recruitment are slow and require multiple in-person visits, which can be difficult in remote areas. The portal will enable merchants to register online and an incentive structure will be developed to reward merchants based on transaction volume. They will test their portal by advertising to merchants in one urban and one rural location where large numbers of employees receive their salary in mobile money, thereby boosting demand for merchants to accept mobile money. They will also provide an online and phone-based helpline.

Lytic Bacteriophages: Stabilizing the Gut Microbiome

Paul BarrowUniversity of NottinghamLoughborough, United Kingdom
Grand Challenges Explorations
Bacteriophage
1 Nov 2015

Paul Barrow of the University of Nottingham in the United Kingdom will identify bacteriophage (viruses that infect bacteria) that can reduce the presence of multiple pathogenic bacteria in the gut to restore healthy bacterial populations (microbiome) and help treat diarrheal diseases. They will characterize phage specificity for three major pathogens that infect both humans and pigs, and select those that are less likely to cause the development of resistance. As pigs are a valuable model for diarrheal diseases in children, they will test the selected phage in their pig enteric model to evaluate their ability to reduce pathogen numbers and restore a healthy gut microbiome.

A Bacteriophage Platform for Programmable Killing of Bacteria

Chase BeiselNorth Carolina State UniversityRaleigh, North Carolina, United States
Grand Challenges Explorations
Bacteriophage
1 Nov 2015

Chase Beisel of North Carolina State University in the U.S. will exploit non-lytic bacteriophage for promoting infant gut health and treating enteric infections in low-resource settings. Generally, lytic phage are being studied for treating diseases, but they suffer from a number of limitations including causing resistance and the release of endotoxins, which can damage healthy cells. They will use the CRISPR-Cas9 defense system to engineer non-lytic P1 phage to specifically target the bacteria Shigella sonnei, which is a leading cause of enteric diseases in children in the developing world. The engineered phage, which can be produced at low cost, will be tested for ability to efficiently infect and kill the targeted bacteria.

Billions of Transactions, Thousands of Photos: Combining Mobile Network Operator Data with Crowd-Sourced Photographs to Measure the Availability and Use of Digital Financial Services

Joshua BlumenstockUniversity of WashingtonSeattle, Washington, United States
Grand Challenges Explorations
Financial Services Data
1 Nov 2015

Joshua Blumenstock of the University of Washington in the U.S. will combine data on mobile phone call details and mobile money use with photographs taken of local infrastructures such as electricity supply, to map access to and use of digital financial services in Ghana. They have access to vast anonymized datasets on phone and mobile money transactions in Ghana, and a technology platform developed by Premise that collects photographs and observations from local citizens to measure economic and social infrastructures. They will develop a method to combine these data and apply standard machine learning in order to measure access to digital financial services across the country.

Disrupting Steroid Signals in Adult Anopheles

Flaminia CatterucciaPresident and Fellows of Harvard CollegeCambridge, Massachusetts, United States
Grand Challenges Explorations
Malaria Transmission
1 Nov 2015

Flaminia Catteruccia of President and Fellows of Harvard College in the U.S. will produce fabrics and nets treated with the dibenzoylhydrazine (DBH) compound methoxyfenozide, which is toxic to malaria-transmitting mosquitoes, to prevent these insects from entering households and spreading disease. The compound is non-toxic to mammals but disrupts steroid signaling pathways in the mosquito, which is a different mechanism than existing insecticides, reducing lifespan and causing sterility. They will combine it with insecticide and evaluate different formulations on geographically diverse mosquito species in the laboratory. The best formulations will then be tested on specific field-collected outdoor mosquito populations from southern Africa.

Affordable and Accurate Malnutrition Diagnostic Device

Pavan DadlaniPhilips ResearchEindhoven, Netherlands
Grand Challenges Explorations
Pneumonia
1 Nov 2015

Pavan Dadlani of Phillips Research in The Netherlands will create a handheld three-dimensional scanner that can automatically analyze body shape and assess malnutrition in young children, which is a strong risk factor for mortality associated with a variety of common diseases. Current physical measurements of children to assess nutritional status are time-consuming, uncomfortable for the child, and difficult to take accurately, particularly in low-resource settings. They will develop and test an algorithm for measuring height, upper arm length, and circumference of the head, belly and upper arm from a three dimensional image, by collecting data from children between 0 and 5 years old. They will also produce a user-friendly design for health workers by conducting a field analysis in low-resource settings.

Merchant Acquiring and Mobile Payments Platform (Mampp) for Shops and Points of Sale

Akinola DixonRoja Payment Solutions Limited (a Qrios Company)Lagos, Nigeria
Grand Challenges Explorations
Mobile Money
1 Nov 2015

Akinola Dixon of Qrios Networks in Nigeria will simplify mobile money payments by building a platform incorporating a unique digital identity for all customer accounts and merchants, and leveraging a stable carrier signaling network using low-cost, automated communication technologies. When a merchant wishes to sell goods, the platform generates a unique payment code for the consumer to authorize on their mobile phone, and the money is transferred. They will research the requirements for their approach, design the required software, and test their platform.

An Artificial Diet for Wolbachia-Infected Ae. aegypti

Heverton DutraCentro de Pesquisas René Rachou - FIOCRUZBelo Horizonte, Minas Gerais, Brazil
Grand Challenges Explorations
Mosquito Control
1 Nov 2015

Heverton Dutra of Centro de Pesquisas René Rachou, FIOCRUZ in Brazil will develop an artificial diet based on protein and fat to sustain mosquitoes infected with the Wolbachia bacteria, which are needed in large numbers to prevent transmission of the dengue virus. These mosquitoes are currently being bred using vertebrate blood, which is difficult to obtain and store, and subject to stringent regulations. They will test variations of cholesterol and amino acids combined with the mixture of bovine serum albumin and phagostimulant that is known to support egg production in non-infected mosquitoes, on egg numbers laid by Wolbachia-infected females. The diet is relatively low cost and comprises widely available ingredients that could be used to support mass-rearing of Wolbachia-infected mosquitoes.

Barcoded Insect Screens to Optimize Articial Diets

Koen DecheringTropIQ Health SciencesNijmegen, Netherlands
Grand Challenges Explorations
Mosquito Control
1 Nov 2015

Koen Dechering of TropIQ in The Netherlands will produce an artificial meal for breeding blood-feeding mosquitoes more easily and effectively in the lab. They will develop a high-throughput screening approach using molecular barcodes carried by endosymbiont bacteria that each tag an individual meal consumed by a live mosquito. The barcodes can then be used to identify those meals that best promote egg laying and longevity from a large pool of test foods. They will rationally design the protein and lipid compositions of the test foods for their screen by using mass spectrometry on blood-fed mosquitoes. Optimized diets identified from the screen will be further validated and analyzed for stability also at tropical ambient temperatures.

Combining Phages with CRISPR for Ecological Vaccination

Kevin EsveltPresident and Fellows of Harvard CollegeCambridge, Massachusetts, United States
Grand Challenges Explorations
Bacteriophage
1 Nov 2015

Kevin Esvelt of President and Fellows of Harvard College in the U.S. will use CRISPR technology to make protective healthy bacteria resistant to phage so they can outcompete pathogenic bacteria that cause childhood diarrhea and stunting. He will develop a method to make the protective Nissle 1917 strain of E. coli resistant to a range of phage, and use it to replace native E. coli strains in the guts of young mice as a model for human infants. This approach will provide long-term protection against pathogenic bacterial infections at low cost.

Disarming Type III Secretion System of Enteric Pathogens

Alessio FasanoMassachusetts General HospitalBoston, Massachusetts, United States
Grand Challenges Explorations
Bacteriophage
1 Nov 2015

Alessio Fasano of Massachusetts General Hospital in the U.S. will isolate bacteriophage (viruses that infect bacteria) that specifically kill pathogenic Escherichia coli and Shigella bacteria, which cause environmental enteropathy and other potentially deadly childhood diseases. They will perform a high-throughput screen using a diverse phage library to isolate phage that specifically target the type-III secretion system expressed by enteric pathogens like E. coli. They will also test an alternative approach by constructing phage to carry so-called CRISPR-Cas9 nucleases that they will engineer to target and cleave bacterial type-III secretion system genes. Results from both approaches will be tested for their capacity to selectively kill enteric pathogens and inhibit infection in a human organoid model, which consists of different cell layers to mimic the structure and function of the human gut.

Finance Application Tool

Ruth FosterTIWA, LLCScottsdale, Arizona, United States
Grand Challenges Explorations
Mobile Money
1 Nov 2015

Ruth Foster of TIWA, LLC in the U.S. will develop a finance application tool using money pictures to enable illiterate users to make accurate transactions. They will design and test a tablet with touch screen and build associated software for consumers that can be used to scan barcodes, or manually add products and prices. The final cost of the purchases will be automatically displayed using images of real money, which the consumer can then use to pay the correct amount.

Development of a Pan-Anti-Anopheles Livestock Vaccine

Brian FoyColorado State UniversityFort Collins, Colorado, United States
Grand Challenges Explorations
Malaria Transmission
1 Nov 2015

Brian Foy of Colorado State University in the U.S. will use antibodies that bind essential proteins in the mosquito Anopheles in order to block malaria transmission. They have already produced antibodies that bind conserved mosquito antigens such as the glutamate-gated chloride channel and used them to supplement blood meals, which was lethal to feeding mosquitoes. They will test whether cattle injected with these antigens produce the corresponding antibodies that are also lethal to the mosquitoes that feed off them.

BIOTOPE - Biomarkers to Diagnose Pneumonia

Joe GallagherUniversity College DublinDublin, Ireland
Grand Challenges Explorations
Pneumonia
1 Nov 2015

Joe Gallagher together with Chris Watson of University College Dublin in Ireland will develop a method to quickly and accurately diagnose bacterial pneumonia in children with acute respiratory infections so that the correct treatments can be given. Physical symptoms of bacterial pneumonia are similar to many other diseases including malaria but they require vastly different treatments. They will use a screening approach to identify protein, metabolite or miRNA biomarkers of bacterial pneumonia in blood and urine samples from 500 children in Malawi clinics with a known diagnosis of pneumonia. The most specific biomarker panel will be combined with a selected panel of symptoms such as heart and breathing rate to generate a highly sensitive clinical prediction model that specifically diagnoses bacterial pneumonia and can be used in low- to middle-income countries.

Phage Therapy in a Weaned Piglet Model of Enteropathy

Jason GillTexas A&M AgriLife ResearchCollege Station, Texas, United States
Grand Challenges Explorations
Bacteriophage
1 Nov 2015

Jason Gill of Texas A&M AgriLife Research in the U.S. will develop an animal model for environmental enteropathy, which is a chronic inflammatory condition of the gut prevalent in children from low-income countries, to test new bacteriophage-based treatments. Bacteriophage (phage) are viruses that infect and can kill bacteria, and can therefore be used to treat bacterial diseases. They will develop a chronic disease model by infecting weaned piglets with low doses of enterotoxigenic Escherichia coli, which is likely involved in environmental enteropathy development in humans. They will also search for a combination of different phage types that can infect and destroy this bacterial strain and effectively cure the disease in their animal model.

Smart Mobile Prepaid Debit Card

Jean-claude Gouesseecash expressBlaineville, Quebec, Canada
Grand Challenges Explorations
Mobile Money
1 Nov 2015

Jean-Claude Gouesse of Ecash Express in Canada will promote the use of mobile money in the Ivory Coast by establishing mobile money payment options for merchants to purchase supplies, and providing a free prepaid debit card for customers to pay for goods. When merchants can use mobile money to buy their own goods, they may also be more willing to receive mobile money payments from their own customers, particularly if they earn commission. They will build a user-friendly interface, and evaluate uptake by issuing 10,000 prepaid cards that can be loaded at participating retail stores, and providing 500 free, low-end Android devices to merchants for accepting payments.

Mobiles4All: New Users, New Insights, Better Data

Margaret McConnellMobiles4AllScottsdale, Arizona, United States
Grand Challenges Explorations
Financial Services Data
1 Nov 2015

Margaret McConnell of Harvard University and Mindy Hernandez of Mobiles4All (M4A) in the U.S. will generate rich datasets related to mobile phone use in Africa by providing mobile phones and incentives for users to share data. These datasets are of value to policymakers to promote the use of mobile money. They are collaborating with mobile network operator Vodacom Mozambique, behavioral scientists at Harvard University and developmental experts. They will run a pilot test, offering at-cost smart phones to 5,000 low-income customers in Mozambique, and evaluate the value of offering rewards in exchange for completing phone-based surveys. These surveys will be far quicker and simpler and cost less than traditional population-based surveys. They will combine the survey data with mobile network data, and package the results into a simple dashboard that can inform about mobile money use and how it might be enhanced.

Thermal Images of the Lung on a Smart Phone to Differentiate Bacterial from Non-bacterial Causes of Pneumonia

Patricia HibberdMassachusetts General HospitalBoston, Massachusetts, United States
Grand Challenges Explorations
Pneumonia
1 Nov 2015

Patricia Hibberd of Massachusetts General Hospital in the U.S. will develop a low-cost thermal imaging system for a smart phone to diagnose bacterial pneumonia in children from developing countries where the standard chest X-ray is often unavailable. They predict that children with pneumonia specifically caused by bacteria will have asymmetric “hot spots” of high temperatures in the lungs caused by localized inflammation. They will perform a proof-of-concept study in children under age 5 with chest infections in a large hospital in Malawi using the FLIR One Thermal Imaging System attached to a smartphone. At least 10 thermal images will be taken, and two short videos to record breathing rate, and the data will be used to develop statistical approaches for the required analytics. They will evaluate performance for diagnosing pneumonia by comparing it to the standard chest X-ray.

Exploring Mobile Money Transaction Data

Paula Hidalgo-SanchisPulse Lab Kampala - UN Global PulseKampala, Uganda
Grand Challenges Explorations
Financial Services Data
1 Nov 2015

Paula Hidalgo-Sanchis and team at Pulse Lab Kampala – UN Global Pulse in Uganda will develop software that can transform raw data on mobile money use in developing countries into user-friendly formats to inform policymakers and researchers to help expand the field. They will collect mobile money and call detail records from two collaborating network providers, while ensuring privacy of users. In parallel, they will collect complementary datasets such as household survey data to enrich the value of the financial services data. They will process the data to evaluate the relationship between mobile money usage and, for example, geographical location or local economic and environmental factors.

The Phageome of Environmental Enteropathy

Lori HoltzWashington University in St. LouisSt. Louis, Missouri, United States
Grand Challenges Explorations
Bacteriophage
1 Nov 2015

Lori Holtz of Washington University in the U.S. will analyze the composition of bacteriophage (viruses that infect bacteria) in the gut of young children to see if it is linked with the chronic inflammatory gut condition, environmental enteropathy, which is highly prevalent in low-income countries and is linked to malnutrition and stunted growth. They will perform metagenomic sequencing on available fecal samples taken over a 6-month period from 489 children under age two from Malawi who were tested for gut dysfunction. They will analyze both RNA and DNA bacteriophage populations as well as the bacterial microbiome and evaluate their association with each other and with the development of environmental enteropathy. Specific bacteriophage associated with the presence or absence of the disease could lead to the development of new treatments.

A Point-of-Care Instrument for Rapid Diagnosis of Pneumonia

Bastiaan HoogendoornCardiff UniversityCardiff, United Kingdom
Grand Challenges Explorations
Pneumonia
1 Nov 2015

Bastiaan Hoogendoorn at Cardiff University in the United Kingdom will develop a simple, inexpensive breath-testing device to measure the type and levels of bacteria in the lungs for rapid diagnosis of pneumonia in children in low-resource settings. Rather than condensing the exhaled breath, which can cause variation, the device directly captures respiratory fluid droplets containing non-volatile pathogen markers. These markers can then be identified using low-cost commercially available bioassay kits. They will analyze biomarker levels in the breath of sick and healthy children, and test and refine the design of their prototype.

Smartphone Image Processing to Assess Childhood Malnutrition

Heba KhamisUniversity of New South WalesSydney, New South Wales, Australia
Grand Challenges Explorations
Pneumonia
1 Nov 2015

Heba Khamis of the University of New South Wales in Australia will use smartphone technology to more accurately measure malnutrition in children from developing countries, which puts them at increased risk of death from diseases such as pneumonia. They will develop an image-processing algorithm for calculating three key growth parameters (height, and arm and head circumference) and thereby assessing nutritional status from a photograph of a child taken by a smartphone. They will recruit twenty children to help refine the algorithm and the protocol for taking the photograph, which will then be validated on an independent set of children.

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