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Grand Challenges ExplorationsGrand Challenges Explorations

Washington State Technology Summit

April 2008

Steven Buchsbaum

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All lives—no matter where they are lived—have equal value. All lives—no matter where they are lived—have equal value.

Science and technology can save livesScience and technology can save lives

Our focus - reducing inequitiesOur focus - reducing inequities

Where does the inequity lie?

With the 2/3 of the world’s 6 billion people that live in the developing world. The greatest need is among the 1 in 6 that

live on less than $1 per day

Gates Foundation Values & Principles

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Disease BurdenCause widespread illness and death in developing

countries Infectious diseases, maternal and newborn health

conditions, and malnutrition cause nearly half of all deaths in the developing world—many of them preventable

Inequities between Rich and PoorRepresent the greatest inequities between rich and

poor countries 99% of the 7.2 million infant deaths each year occur in

developing countries

99% of pregnancy-related deaths among women are in developing countries

A child born in Africa is up to 20 times more likely to die before her first birthday than a child born in the U.S.

Lack of Attention/ActionReceive inadequate attention and resources Only a small fraction of the billions of dollars spent

annually on health R&D goes toward diseases of the developing world (only 10% is devoted to the diseases that cause 90% of global illness and death)

Of nearly 1,400 drugs approved in the last 25 years by the FDA, only 20 were specifically for diseases that disproportionately affect the developing world

Annual Deaths

Proportion in the Developing World

Acute lower respiratory infections

3.9 million N/A

HIV/AIDS 2.9 million 99%

Vaccine-preventable diseases

>2 million >95%

Diarrheal diseases

1.8 million N/A

TB 1.6 million 99%

Malaria >1 million 99%

Measles 610,000 98%

Maternal conditions

510,000 99%

Hib 400,000-700,000

N/A

Major Causes of Death in the Developing World

Global Health Inequities

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Our Approach

DRIVE RESEARCHDRIVE RESEARCH ACCELERATE ACCESSACCELERATE ACCESS

Basic and clinical research to:» Develop new drugs,

vaccines, and diagnostics Malaria Vaccine Initiative Foundation for Innovative

New Diagnostics – TB

» Improve existing technologies

Grand Challenges projects to create heat-stable, needle-free vaccines

Product introduction» GAVI, GAIN

Large-scale demonstrations» Avahan, MACEPA

Facilitate widespread access » Advocacy» Financing mechanisms» Public health leadership development» Evidence to guide decision-making» Improving delivery and demand

systems

1.1. 2.2.

Ensure that life-saving advances in health are created and shared with those who need them most

Discovery Development Delivery

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DEFINING THE GRAND CHALLENGES IN GLOBAL HEALTH

www.grandchallengesgh.org

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THE 14 GRAND CHALLENGES IN GLOBAL HEALTH SERVE 7 LONG-

TERM GOALS TO IMPROVE HEALTH IN THE DEVELOPING WORLD Improve Childhood VaccinesGrand Challenge #1: Create Effective Single-Dose Vaccines  Grand Challenge #2: Prepare Vaccines that Do Not Require RefrigerationGrand Challenge #3: Develop Needle-Free Vaccine Delivery Systems

Create New VaccinesGrand Challenge #4: Devise Testing Systems for New VaccinesGrand Challenge #5: Design Antigens for Protective ImmunityGrand Challenge #6: Learn About Immunological Responses 

Control Insects that Transmit Agents of DiseaseGrand Challenge #7: Develop Genetic Strategy to Control Insects Grand Challenge #8: Develop Chemical Strategy to Control Insects

Improve Nutrition to Promote Health         Grand Challenge #9: Create a Nutrient-Rich Staple Plant Species

Improve Drug Treatment of Infectious DiseasesGrand Challenge #10: Find Drugs and Delivery Systems to Limit Drug Resistance

Cure Latent and Chronic InfectionGrand Challenge #11: Create Therapies that Can Cure Latent Infection Grand Challenge #12: Create Immunological Methods to Cure Latent Infection

Measure Health Status Accurately and Economically in Developing CountriesGrand Challenge #13: Develop Technologies to Assess Population HealthGrand Challenge #14: Develop Versatile Diagnostic Tools  

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400+ PROPOSALS, 43 (+2) AWARDSGates to fund millions in global health research By Steve Sternberg, USA TODAYOne of the richest lotteries in science got its start two years ago when Microsoft billionaire Bill Gates decided it was time for the world's best scientific minds to tackle the problems that besiege the world's poor. Now, the real work begins.Winners of the Bill & Melinda Gates Foundation's Grand Challenges in Global Health, announced today, will begin research they hope will lead to better vaccines, new ways to control disease-carrying mosquitoes, improved treatment of stubborn infectious diseases, more nutritious food, and pocket-size laboratories for on-the-spot diagnosis of diseases.

Gates to fund millions in global health research By Steve Sternberg, USA TODAYOne of the richest lotteries in science got its start two years ago when Microsoft billionaire Bill Gates decided it was time for the world's best scientific minds to tackle the problems that besiege the world's poor. Now, the real work begins.Winners of the Bill & Melinda Gates Foundation's Grand Challenges in Global Health, announced today, will begin research they hope will lead to better vaccines, new ways to control disease-carrying mosquitoes, improved treatment of stubborn infectious diseases, more nutritious food, and pocket-size laboratories for on-the-spot diagnosis of diseases.

Better Bananas, Nicer Mosquitoes By DONALD G. MCNEIL JR., New York TimesDecember 6, 2005Addressing 275 of the world's most brilliant scientists, Bill Gates cracked a joke: ''I've been applying my imagination to the synergies of this,'' he said. ''We could have sorghum that cures latent tuberculosis. We could have mosquitoes that spread vitamin A. And most important, we could have bananas that never need to be kept cold.'' They laughed. Perhaps that was to be expected when the world's richest man, who had just promised them $450 million, was delivering a punchline. But it was also germane, because they were gathered to celebrate some of the oddest-sounding projects in the history of science. Their deadly serious proposals -- answers to

Better Bananas, Nicer Mosquitoes By DONALD G. MCNEIL JR., New York TimesDecember 6, 2005Addressing 275 of the world's most brilliant scientists, Bill Gates cracked a joke: ''I've been applying my imagination to the synergies of this,'' he said. ''We could have sorghum that cures latent tuberculosis. We could have mosquitoes that spread vitamin A. And most important, we could have bananas that never need to be kept cold.'' They laughed. Perhaps that was to be expected when the world's richest man, who had just promised them $450 million, was delivering a punchline. But it was also germane, because they were gathered to celebrate some of the oddest-sounding projects in the history of science. Their deadly serious proposals -- answers to

Copyright 2005 AllAfrica, Inc.  Africa NewsJune 28, 2005 Tuesday

Mozambique;Gates Foundation Funds Health Research Projects

Agencia de Informacao de Mocambique

The Bill and Melinda Gates Foundation has announced that it is to spend 436 million US dollars on 43 groundbreaking research projects to discover new ways to fight disease in the world's poorest countries.

Copyright 2005 AllAfrica, Inc.  Africa NewsJune 28, 2005 Tuesday

Mozambique;Gates Foundation Funds Health Research Projects

Agencia de Informacao de Mocambique

The Bill and Melinda Gates Foundation has announced that it is to spend 436 million US dollars on 43 groundbreaking research projects to discover new ways to fight disease in the world's poorest countries.

Poverty: Gates funds 43 research projects on infectious diseases

Agence France Presse -- Engl

The Gates Foundation, of Microsoft billionaire Bill Gates, said it has chosen 43 research projects which together will receive 436.6 million dollars to fight infectious diseases in the world's poorest nations.

As part of "The Grand Challenges in Global Health“

Poverty: Gates funds 43 research projects on infectious diseases

Agence France Presse -- Engl

The Gates Foundation, of Microsoft billionaire Bill Gates, said it has chosen 43 research projects which together will receive 436.6 million dollars to fight infectious diseases in the world's poorest nations.

As part of "The Grand Challenges in Global Health“

From malaria to TB, top scientists get £245m to revolutionise world health

Sarah Boseley, health editorTuesday June 28, 2005GuardianSome of the world's most inventive scientists were yesterday awarded grants totalling $450m (£245m) to turn their outside-the-box ideas into practical solutions to the 14 greatest problems besetting human health today. The Bill and Melinda Gates Foundation, whose multibillionaire entrepreneur founder knows something about invention, yesterday revealed the winners of the Grand Challenges in global health, which it launched in 2003 to identify the major obstacles to improving health and find ways to

overcome them.

From malaria to TB, top scientists get £245m to revolutionise world health

Sarah Boseley, health editorTuesday June 28, 2005GuardianSome of the world's most inventive scientists were yesterday awarded grants totalling $450m (£245m) to turn their outside-the-box ideas into practical solutions to the 14 greatest problems besetting human health today. The Bill and Melinda Gates Foundation, whose multibillionaire entrepreneur founder knows something about invention, yesterday revealed the winners of the Grand Challenges in global health, which it launched in 2003 to identify the major obstacles to improving health and find ways to

overcome them.

Grants Given for Freeze-Dried Vaccine, Nutritious TuberculosisBy MARILYN CHASE Staff Reporter of THE WALL STREET JOURNALJune 28, 2005; Page D6A program to conquer health problems of the poor is awarding rich grants for inventions such as hand-held diagnostics, drugs without resistance and needle-free vaccines that hold appeal for affluent countries, too.The awards, announced yesterday, are part of Grand Challenges in Global Health, a$436.6 million bonanza for medical researchers funded by the Bill and Melinda Gates Foundation with contributions from the United Kingdom's Wellcome Trust and the Canadian Institutes of Health Research. The 43 multiyear grants range from about $700,000 to nearly $20 million and average $10 million each.Abraham Sonenshein, professor of molecular biology at Tufts

University

Grants Given for Freeze-Dried Vaccine, Nutritious TuberculosisBy MARILYN CHASE Staff Reporter of THE WALL STREET JOURNALJune 28, 2005; Page D6A program to conquer health problems of the poor is awarding rich grants for inventions such as hand-held diagnostics, drugs without resistance and needle-free vaccines that hold appeal for affluent countries, too.The awards, announced yesterday, are part of Grand Challenges in Global Health, a$436.6 million bonanza for medical researchers funded by the Bill and Melinda Gates Foundation with contributions from the United Kingdom's Wellcome Trust and the Canadian Institutes of Health Research. The 43 multiyear grants range from about $700,000 to nearly $20 million and average $10 million each.Abraham Sonenshein, professor of molecular biology at Tufts

University

Gates' millions to tackle disease BBC NewsBritish scientists have been awarded multi-million pound grants for research into tuberculosis, malaria and HIV by Microsoft billionaire Bill Gates. Mr Gates is donating £240m to 43 projects world-wide designed to tackle some of the world's biggest killers. Among the successful bidders is London's Imperial College, which will receive £11m to fund work on TB. St George's Medical School in London will get £10.7m to develop a HIV vaccine for women. It's shocking how little research is directed toward the diseases of the world's poorest countries Bill Gates Two teams at Oxford University have been awarded grants. One will be given £9m to investigate why some people appear to be more resistant to malaria than others, and a second will be given £5.4m to investigate vaccines for HIV, TB and malaria The Gates Foundation received more than 1,500 bids from scientists after announcing its intention in 2003 to fund research into tackling disease in the world's poorest countries.

Gates' millions to tackle disease BBC NewsBritish scientists have been awarded multi-million pound grants for research into tuberculosis, malaria and HIV by Microsoft billionaire Bill Gates. Mr Gates is donating £240m to 43 projects world-wide designed to tackle some of the world's biggest killers. Among the successful bidders is London's Imperial College, which will receive £11m to fund work on TB. St George's Medical School in London will get £10.7m to develop a HIV vaccine for women. It's shocking how little research is directed toward the diseases of the world's poorest countries Bill Gates Two teams at Oxford University have been awarded grants. One will be given £9m to investigate why some people appear to be more resistant to malaria than others, and a second will be given £5.4m to investigate vaccines for HIV, TB and malaria The Gates Foundation received more than 1,500 bids from scientists after announcing its intention in 2003 to fund research into tackling disease in the world's poorest countries.

43 ways to save the worldJun 29th 2005

The Economist The Gates Foundation’s latest largesse has just been announced. It will pay for some intriguing and original research. But will it translate into healthier people?HALF a billion dollars is not to be sneezed at, even when divided 43 ways. And that, give or take a few million, was the sum at stake when a committee of the medical world’s great and good decided who will take on what have become known as the Grand Challenges in Global Health. Most of the money to meet these challenges—$450m of it—comes from the Bill and Melinda Gates Foundation, the world’s richest charity. The Wellcome Trust, Britain’s richest, has chipped in $27m, and the Canadian government has added $4.5m. The 43 winners were announced on Tuesday June 28th.

43 ways to save the worldJun 29th 2005

The Economist The Gates Foundation’s latest largesse has just been announced. It will pay for some intriguing and original research. But will it translate into healthier people?HALF a billion dollars is not to be sneezed at, even when divided 43 ways. And that, give or take a few million, was the sum at stake when a committee of the medical world’s great and good decided who will take on what have become known as the Grand Challenges in Global Health. Most of the money to meet these challenges—$450m of it—comes from the Bill and Melinda Gates Foundation, the world’s richest charity. The Wellcome Trust, Britain’s richest, has chipped in $27m, and the Canadian government has added $4.5m. The 43 winners were announced on Tuesday June 28th.

June 28, 2005 – New York Times

New Ideas in Global Health Get a $437 Million AssistBy DONALD G. McNEIL Jr. A better banana and a less-toxic cassava, childhood vaccines hidden in spores and drunk with fruit juice, mice that develop AIDS and many other exotic dreams of public health scientists will share $437 million in grant money, the Bill and Melinda Gates Foundation announced yesterday.The 43 projects were the winners of a competition announced by Mr. Gates two years ago …

June 28, 2005 – New York Times

New Ideas in Global Health Get a $437 Million AssistBy DONALD G. McNEIL Jr. A better banana and a less-toxic cassava, childhood vaccines hidden in spores and drunk with fruit juice, mice that develop AIDS and many other exotic dreams of public health scientists will share $437 million in grant money, the Bill and Melinda Gates Foundation announced yesterday.The 43 projects were the winners of a competition announced by Mr. Gates two years ago …

Grand Challenges in Global Health Initiative Selects 43 Groundbreaking Research Projects for More Than $436 Million in FundingCanada NewsWireDate Monday, June 27, 2005

SEATTLE, June 27 /CNW/ -- The Grand Challenges in Global Health initiative, a major effort to achieve scientific breakthroughs against diseases that kill millions of people each year in the world's poorest countries, today offered 43 grants totaling $436.6 million for a broad range of innovative research projects involving scientists in 33 countries. The ultimate goal of the initiative is to create "deliverable technologies" - health tools that are not only effective, but also inexpensive to produce, easy to

distribute, and simple to use in developing countries.

Grand Challenges in Global Health Initiative Selects 43 Groundbreaking Research Projects for More Than $436 Million in FundingCanada NewsWireDate Monday, June 27, 2005

SEATTLE, June 27 /CNW/ -- The Grand Challenges in Global Health initiative, a major effort to achieve scientific breakthroughs against diseases that kill millions of people each year in the world's poorest countries, today offered 43 grants totaling $436.6 million for a broad range of innovative research projects involving scientists in 33 countries. The ultimate goal of the initiative is to create "deliverable technologies" - health tools that are not only effective, but also inexpensive to produce, easy to

distribute, and simple to use in developing countries.

Gates Grants Aim to Change Medicine for World's PoorMon Jun 27, 2005 06:07 PM ET By Maggie Fox, Health and Science Correspondent

WASHINGTON (Reuters) - Projects to develop needle-free vaccines for

children, to render mosquitoes incapable of transmitting disease and to make cassava more nutritious made the cut for $435 million worth of new grants from Gates Foundation. The Grand Challenges awards announced on Monday also include a project to develop a cheap hand-held device that could diagnose a range of illnesses and a plan to fight disease using stem cells as a lifetime vaccine.

Gates Grants Aim to Change Medicine for World's PoorMon Jun 27, 2005 06:07 PM ET By Maggie Fox, Health and Science Correspondent

WASHINGTON (Reuters) - Projects to develop needle-free vaccines for

children, to render mosquitoes incapable of transmitting disease and to make cassava more nutritious made the cut for $435 million worth of new grants from Gates Foundation. The Grand Challenges awards announced on Monday also include a project to develop a cheap hand-held device that could diagnose a range of illnesses and a plan to fight disease using stem cells as a lifetime vaccine.

Grand Challenges in Global Health Initiative Selects 43 Groundbreaking Research Projects for More Than $436 Million in FundingScientists Around the World to Discover New Ways to Fight Disease in Poorest CountriesSEATTLE – The Grand Challenges in Global Health initiative, a major effort to achieve scientific breakthroughs against diseases that kill millions of people each year in the world’s poorest countries, today offered 43 grants totaling $436.6 million for a broad range of innovative research projects involving scientists in 33 countries.

Grand Challenges in Global Health Initiative Selects 43 Groundbreaking Research Projects for More Than $436 Million in FundingScientists Around the World to Discover New Ways to Fight Disease in Poorest CountriesSEATTLE – The Grand Challenges in Global Health initiative, a major effort to achieve scientific breakthroughs against diseases that kill millions of people each year in the world’s poorest countries, today offered 43 grants totaling $436.6 million for a broad range of innovative research projects involving scientists in 33 countries.

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Key Features of GCGH Program Innovative Technical Ideas with a Path to Solution

Collaboration & Data Sharing

Milestone Management

Global Access Strategy (GAS)

Ethical, Social, Cultural Issues

Fostering of a GCGH community to work together to

address common issues

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Key Features of GCGH Program Innovative Technical Ideas with a Path to Solution

Collaboration & Data Sharing

Milestone Management

Global Access Strategy (GAS)

Ethical, Social, Cultural Issues

Fostering of a GCGH community to work together to

address common issues

Build on current GCGH Initiative with:

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THE NEED› To achieve breakthroughs in

global health, we must encourage risk-taking on creative, unorthodox ideas

THE INITIATIVE› US$100 million fast-track grants

initiative of the Gates Foundation

› Will support hundreds of early-stage research projects on creative concepts for new global health solutions

› Initial grants of $100,000; opportunities for future funding

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FAST-TRACK GRANTSNew fast-track grantmaking to make it easy for scientists to apply:

› Short funding proposals• Preliminary data not necessarily required

› Fast proposal review (approximately three months)

› Multiple calls for proposals (every six months)• Each funding round will address a few specific topics or themes

~ 5000New

proposals

~ 80 Phase I$100K, 1 Year

~ 10 Phase II $500K, 2 Years

~ 0 – 4 Phase III$??, ?? Years

Phase I Review Process

Phase II Review Process

Phase III: Shaped & Championed by Staff or Partners

Grand Challenges Explorations Traditional Grants

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Low Burden of Entry› Two page proposals

› No preliminary data required

› Fast proposal review – appx. 3 months from submission to award

Champion, not Consensus Review

Open Path to Larger, Longer Engagement› Phased structure to reward success. Funding will grow as the

project gathers evidence

› Multiple opportunities to apply each year

Key Elements of Grand Challenges | EXPLORATIONS

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Improve Childhood VaccinesGC #1: Create Effective Single-Dose Vaccines  GC #2: Prepare Vaccines that Do Not Require RefrigerationGC #3: Develop Needle-Free Vaccine Delivery Systems

Create New VaccinesGC #4: Devise Testing Systems for New VaccinesGC #5: Design Antigens for Protective ImmunityGC #6: Learn About Immunological Responses 

Control Insects that Transmit Agents of DiseaseGC #7: Develop Genetic Strategy to Control Insects GC #8: Develop Chemical Strategy to Control Insects

Improve Nutrition to Promote Health         GC #9: Create a Nutrient-Rich Staple Plant Species

Improve Drug Treatment of Infectious DiseasesGC #10: Find Drugs and Delivery Systems to Limit Drug Resistance

Cure Latent and Chronic InfectionGC #11: Create Therapies that Can Cure Latent Infection GC #12: Create Immunological Methods to Cure Latent Infection

Measure Health Status Accurately and Economically in Developing CountriesGC #13: Develop Technologies to Assess Population HealthGC #14: Develop Versatile Diagnostic Tools  

Create Drugs and Delivery Systems to Limit Drug Resistance

Create new ways to protect against infectious diseases

Create new ways to prevent or cure HIV infection

Explore the basis for latency in TB

GCE Topics Build on GCGH Goals

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Create new ways to protect against infectious diseases› Untried or unproven approaches to protect against infectious diseases, including

harnessing natural or synthetic immune responses, or eliminating the need for an effective immune response.

Create drugs or delivery systems that limit the emergence of resistance› Innovative ideas for discovering or delivering drugs that are less likely to lose

effectiveness because of resistance developing in the disease-causing agent.

Create new ways to prevent or cure HIV infection› Innovative ideas for HIV prevention or treatment methods that fall outside current

research on vaccines, antiretroviral drugs, and other biomedical and behavior-change strategies.

Explore the basis for latency in TB› Unconventional approaches to understanding latent TB infection, with the goal of

discovering new ways to identify and eliminate latent infection, and break the cycle of TB transmission.

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Round 1› March 3, 2008 Rules and Topics Published

› May 30, 2008 Application period closes

› July 15, 2008 Proposal review completed

› August 1, 2008 Selection completed, due diligence process

› September 2008 Awards announced

Round 2 to begin at the end of 2008

Schedule for Grand Challenges | EXPLORATIONS

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Tips for Grant Seekers

Your proposal must represent an innovative approach responsive to the topic. The foundation has a number of other avenues of funding for the equally important research that is within currently accepted paradigms. Such work will not be funded under Grand Challenges Explorations.

Your proposal will be reviewed by a panel with broad expertise and a track record in identifying innovations – these reviewers may not be deep domain experts in your field. You must describe your idea in clear language without the use of jargon unique to your field.

The work proposed in your Phase I application must have a clear set of key experiments or activities testing your idea providing sufficient evidence to motivate Phase II funding. This does not mean that you must complete the proof-of-concept for your idea in Phase I, but does mean that there must be a clear incremental result supporting the validity of your idea.

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Getting Involved› Spread the word to colleagues

› Sign up at www.gcgh.org/explorations/ for email updates

› Read the Details. Ask Questions. Apply.

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The Vision

"There is no bigger test for humanity than the crisis of global health. Solving it will require the full commitment of our hearts and minds. We need both. Without compassion, we won’t do anything. Without science, we can’t do anything. So far, we have not applied all we have of either."

Bill Gates, World Health Assembly, May 2005

www.gatesfoundation.org