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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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Acousta - A Doppler for Fetal Monitoring

Balaji TeegalaBRUN Health Pvt. Ltd.Hyderabad, , India
Grand Challenges India
India-GCE
28 Nov 2017

Balaji Teegala from BRUN Health Pvt. Ltd. in India will develop a Doppler stethoscope - Acousta - that acts both as a standard annular Y-shaped stethoscope and as a Doppler stethoscope. The problem in auscultating the fetal heart to identify birth asphyxia among other fetal morbidities is the difficulty, skill, and training needed while using a regular stethoscope. This is mitigated by active sensing systems like the fetal Doppler systems or cardiotocographs. However, these systems are burdensome to carry in addition to a stethoscope. Alternatively, electronic stethoscopes give clarity during auscultation but are predominantly targeted at specialties like cardiology, while still being passive systems in their approach to sensing physiology. Acousta is a combinatorial approach using both these systems.

Glucometer Used by Diabetics for Economical HIV Viral Loading Testing in Resource Limited Settings

Pratap MukhopadhyayaWobble Base Bioresearch Pvt. LtdSurat, , India
Grand Challenges India
India-GCE
27 Nov 2017

Pratap Mukhopadhyaya from Wobble Base Bioresearch Pvt. Ltd. in India will develop a glucometer to detect HIV RNA. The existing major methodologies for viral load quantitation require sophisticated infrastructure and reagents that generate high priced tests (>50 USD per test) that are often not feasible for use in resource limited settings. The new assay involves making an HIV cDNA-DNA-invertase complex, which is added to sucrose solution to generate glucose through hydrolysis by the invertase enzyme that is detected using the glucometer. The amount of glucose detected is a function of HIV copy number.

Improving Childhood Immunizations with Cellular Technology

Sanjay JainJohns Hopkins UniversityBaltimore, Maryland, United States
Grand Challenges Explorations
Immunization Delivery
1 Nov 2017

Sanjay Jain of Johns Hopkins University School of Medicine in the U.S. and colleagues in the U.S. and India will develop a cloud-based platform to record the location, caregiver relationships, and immunization records of infants in developing countries, and provide personalized reminders and incentives via mobile phone to improve the coverage of childhood immunizations. Low immunization coverage has been linked to inaccurate or incomplete records, and the difficulties of encouraging follow-up immunizations and identifying those who miss them. Their platform will store data in a cloud to ensure universal access to records, and use fingerprint identification of the caregiver for accuracy. It will also document each child's care network and location, and use this to send multiple text message reminders, and manage group and combined vaccinations to improve efficiency. They will test their approach in a low-resource rural community by training health workers equipped with mobile tablets, and recruiting around 800 mothers with infants or pregnant women provided with mobile phones.

Neo-PATch: Plasma Analyte Transdermal Wearable Sensor for Newborns

Patricia ConnollyUniversity of StrathclydeGlasgow, United Kingdom
Grand Challenges Explorations
Wearable Sensors
1 Nov 2017

Patricia Connolly of the University of Strathclyde and colleagues in the United Kingdom will develop a low-cost, wearable skin patch that can continuously monitor metabolite levels in newborns without the need for blood sampling, and can alert mothers and health workers to potential problems via mobile phone. Changes in metabolites such as those of hemoglobin and bilirubin are used to assess many aspects of newborn health, but current methods require invasive blood sampling and access to laboratory analysis, which is often unavailable in low-resource settings. To address this, in consultation with users in Sierra Leone, Vietnam and India, they will develop a flat patch incorporating their new technology, which painlessly enhances the flow of analytes through the skin for detection, and a Bluetooth connector that can communicate levels to a smartphone. The prototype patch will be laboratory tested to refine the design.

A Marketplace App for Connected Pathology Services in Africa

Jacob McKnightUniversity of OxfordOxford, United Kingdom
Grand Challenges Explorations
Diagnostics Systems
1 Nov 2017

Jacob McKnight and Mike Wilson of the University of Oxford in the United Kingdom will develop a simple application that contains information about the quality, location, and the nature and cost of services provided by the different pathology laboratories in Kenya so that doctors and patients can choose the one that best suits their needs. They will conduct surveys to collect key information on the pathology laboratories in the Nairobi area, and consult with doctors and medical associations to find out how they use those laboratory services and what needs to be improved. They will build the application using these data and in collaboration with users. Ultimately, the system should also help to improve the overall quality of services.

Confidential Order and Delivery of Contraceptives Using Mobile E-Commerce for Urban and Rural Areas of East Africa

Joanna BichselKashaKigali, Rwanda
Grand Challenges Explorations
Health Supply Chains
1 Nov 2017

Joanna Bichsel of Kasha in Rwanda will adapt their mobile ecommerce platform to enable women in Kenya to confidentially order health products such as contraceptives and sanitary pads by mobile phone. There are many social barriers preventing women in developing countries from accessing products at health clinics. Their platform, Kasha, requires only a mobile phone to order and pay for products that are then delivered to local pick-up points. They have successfully implemented Kasha in Rwanda and will now perform a pilot study in several counties in Kenya. They will customize the platform to the language and existing technology in Kenya, and develop private and public partnerships to tap into existing distribution networks, thereby minimizing costs. Their pilot study will evaluate how well the platform is received by Kenyan women, and how effective it is at delivering products.

Last Mile Healthcare Delivery by Unmanned Aerial Vehicles in Senegal

Daniel PepperVAYU inc.Ypsilanti, Michigan, United States
Grand Challenges Explorations
Health Supply Chains
1 Nov 2017

Daniel Pepper of Vayu in the U.S. will assess the value of using unmanned aerial vehicles integrated with existing healthcare supply chains to transport healthcare products and diagnostic samples in Senegal. Healthcare supply chains are critical for saving lives but are restricted by poor road infrastructure in developing countries. Unmanned aerial vehicles can overcome these restrictions and ensure rapid transport in temperature-controlled conditions. They will engage stakeholders from the Pharmacie National d'Approvisionnement (PNA) to National laboratories, the Expanded Program of Immunization, the National Blood Bank and the Ministry of Health to explore the feasibility of using unmanned aerial vehicles for delivering vaccines, essential medicines, contraceptive products and blood, and also to pick up tuberculosis samples for diagnosis. They will perform a test over a three- to four-month period to evaluate the impact of their approach on delivery and costs, and gather feedback from users.

Introduction of Vaccines Supply Chain Downstream Delivery to Improve Availability of Vaccines at Health Facilities in Lesotho

Bulara MpitiClinton Health Access InitiativeBoston, Massachusetts, United States
Grand Challenges Explorations
Health Supply Chains
1 Nov 2017

Bulara Mpiti of the Clinton Health Access Initiative (CHAI) in the U.S. will use the clinical sample transportation network in Lesotho to increase the efficiency of delivering viable vaccines to local health facilities. Most health facilities in Lesotho experience stock-outs of essential vaccines, which are caused by weak supply chains from the stores at district offices. The health facilities are also visited at least once per week by motorcyclists from delivery agencies to pick-up clinical samples for rapid transport to diagnostic laboratories, which are located in the same district offices as the vaccine stores. They will engage these delivery agencies to also manage the ordering and transport of vaccines in the other direction, from district stores to health facilities. To test their approach, they will perform a pilot in selected districts and train vaccine supply managers, health workers, and sample transporters.

FutureStock Solution

Shahnoza EshonkhojaevaSinostream ABStockholm, Sweden
Grand Challenges Explorations
Health Supply Chains
1 Nov 2017

Shahnoza Eshonkhojaeva of Sinostream AB in Sweden will use machine-learning algorithms to predict the amount of medicines and supplies needed at individual health clinics in low-resource settings, and to inform medical stores for delivery. Their approach involves obtaining daily consumption patterns that are recorded on smart paper stock cards at rural health clinics, which requires no training, internet access, or electricity. These cards will then be scanned at district health service centers, the data digitized, and algorithms used to calculate consumption patterns and waste, and automatically predict future demand. They will build a prototype system and field test it in Uganda to evaluate how well it avoids under- or overstocking products, and the cost-saving and time-saving benefits of having an automated stock management system.

Inventory Visibility Using Radio-Frequency Identification Tags and Near-Field Communication

Mitesh ThakkarArthify IncJohns Creek, Georgia, United States
Grand Challenges Explorations
Health Supply Chains
1 Nov 2017

Mitesh Thakkar and Harsh Shetty of Arthify Inc. in the U.S. will use radio-frequency identification tags (RFID) on vaccine packages that can be detected by near-field communication (NFC) now found on most smartphones to better track vaccines and improve supply chains in developing countries. They will develop an application for health workers to automatically read the tags and store the data in a cloud, which can then be used to take inventories. They will also build a website so that the data can be easily monitored by supply chain managers to analyze performance and predict demand. They will test their platform for accuracy, feasibility, and cost in a network of 20 primary health centers with 100 sub-centers.

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