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Grand Challenges for Investing in Young Children Globally1
Grand Challenges are a series of initiatives designed to foster innovation in developing solutions to pressing global health problems. Panelists spoke about the focus and intentions of Grand Challenges more broadly, as well as more specific initiatives under the Grand Challenges umbrella in Brazil, involving Grand Challenges Canada and Fundação Maria Cecilia Souto Vidigal (FMCSV). The Grand Challenges presented focused on new investments in research and practice with young children.
Gary L. Darmstadt explained that Grand Challenges were developed in 2003, initially as a call for global health solutions, that has since expanded into a diverse family of initiatives. The initiatives are intended to engage people’s imaginations around finding solutions for the biggest problems in health and development that require multisectoral collaborative solutions. He remarked that the Grand Challenges were developed in a space that encourages the need to take risks and occasionally use failures as lessons for progress. Currently more than 1,000 grants in 50 countries have been funded.
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1 For information about Grand Challenges, please visit http://grandchallenges.org.
2 This section summarizes information from Gary L. Darmstadt, The Bill & Melinda Gates Foundation.
At the Gates Foundation, the role of Grand Challenges is based on the following set of principles3:
- Strategic and well-articulated grand challenges serve to focus research efforts and to engage the world’s best researchers.
- Projects are selected based on public, transparent calls for proposals seeking the best ideas.
- Projects are selected for their scientific excellence as well as for their likelihood to achieve the desired impact; they are milestone driven and actively managed to that end.
- Funders, investigators, and other stakeholders actively collaborate to accelerate progress and ensure advances serving those most in need.
- Projects and investigators make global access commitments to ensure the fruits of their research are available to those most in need.
While the Grand Challenges approach is not suitable for all situations, Darmstadt commented that it could be advantageous under certain circumstances, assuming there is a clear understanding of the scope of the problem. The approach works when there is a need to develop a range of ideas and include new partners and new ways of thinking. In this way, a portfolio of ideas and methods can be built, as well as a platform for convening a community to share their lessons learned. Grand Challenges have shown to be motivating, particularly among young investigators from around the world with new ideas. Darmstadt explained that selection of Grand Challenge awardees is based solely on the quality and feasibility of the idea rather than seniority and experience.
As part of the 10th anniversary of Grand Challenges, Darmstadt stated that a new series of challenges were launched, including a call for putting women and girls at the center of development. This challenge is designed to identify strategies to engage vulnerable women and girls worldwide to improve their health, development, and economic outcomes, and address issues of gender equality.
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3 Presentation by Gary L. Darmstadt, The Bill & Melinda Gates Foundation, November 11, 2014.
Claude Pirmez described that in 2010, The Bill & Melinda Gates Foundation partnered with the Ministry of Health in Brazil to advance the national health policy agenda. There were four components: vaccine development and manufacturing; family health research; discovery research done in partnership with the state research foundations, and joint global initiatives. Grand Challenges Brazil, launched in 2012, focused on seeking strategies to prevent and manage preterm labor to reduce the incidence of preterm births.
A total of 156 projects were submitted, with two selected for full grants and 10 for seed grants. They were cofunded by the National Council for Scientific and Technological Development (CNPq) and the Ministry of Health’s Department of Science and Technology (DECIT), totaling $8 million reais. The projects, originating from 12 different institutions in Brazil, addressed issues of preterm birth, from investigating the causes of preterm birth to the development of such solutions as clinical trials for treatment of preterm birth and the management of maternal health. A further set of studies are examining social and environmental factors.
The second Grand Challenges initiative for Brazil, explained Pirmez, is called All Children Thriving, and also includes India and South Africa. This initiative moves beyond reducing preterm birth by expanding the efforts to promote health further into the lifespan. All Children Thriving programs includes three components: diet and nutrition during pregnancy through age 5; maternal, newborn, and child health, including a number of interventions such as immunization, postnatal growth, and management of childhood illness; and social and environmental factors, such as water, sanitation, and violence and child abuse.
SAVING BRAINS GRAND CHALLENGE5
Dominique McMahon explained that Grand Challenges Canada focuses on integrated innovation, specifically social, financial, science, and technological innovation. The aim is to catalyze ideas to have impact at scale. There are four programs, three of which are targeted for global health issues—Saving Lives at Birth, Global Mental Health, and Saving Brains.
McMahon stated that 200 million children, or about one-third of the world’s children, are not reaching their full developmental poten-
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4 This section summarizes information presented by Claude Pirmez, Instituto Oswaldo Cruz.
5 This section summarizes information presented by Dominique McMahon, Grand Challenges Canada, and Eduardo Marino, Fundação Maria Cecilia Souto Vidigal.
tial (Grantham-McGregor et al., 2007). The Saving Brains Challenge is designed to foster the development of “sustainable products, services, implementation models, and delivery models that can . . . protect, promote, and nurture early brain development and child development in the first 1,000 days . . . that can have a lasting impact at scale on the formation of human capital and that can be applicable in low-resource settings.” She asserted that the child is at the center of the Saving Brains Challenge. Moreover, because children in poverty face multiple adversities, solutions should combine approaches that promote health, nutrition, social protection, and nurturing environments.
Thus far, McMahon noted that Grand Challenges Canada has provided 33.7 million Canadian dollars for the Saving Brains Challenge. The first phase of this challenge looked at the persistent impact of interventions that took place in early life, with follow-up from 4 to 18 years later to see the long-term effects of those interventions. The current phase is focused on implementation of new ideas as proofs of concept, with exploration of how to transition to scale. McMahon noted that the success of the Saving Brains challenge rests on a comprehensive partnership at global, regional, and local levels, including both implementation partners and donors. In closing, McMahon remarked that the Saving Brains partnership, first announced in October 2014, includes Grand Challenges Canada, The Bill & Melinda Gates Foundation, Norlien Foundation, Bernard van Leer Foundation, and FMCSV.
Eduardo Marino further discussed the experience of FMCSV with early childhood development programs. FMCSV first began working to support early childhood development in 2008, as described by Marino. One year later, they partnered with the state research agency to create a fund supporting early childhood development with the objective of improving services and public policies from pregnancy to the first 1,000 days of life. With this fund, FMCSV has supported 26 projects. A recent evaluation showed substantial impact for interventions; however, there is still a long path toward affecting public policy.
FMCSV joined with Grand Challenges Canada in 2014, and three projects in Brazil were funded through this partnership, Marino explained. The vision of FMCSV, he remarked, is to create a Brazilian Saving Brains platform to establish stronger policy-friendly proofs of concept, with strong evaluation methodology and scalability.
Grantham-McGregor, S., Y. B. Cheung, S. Cueto, P. Glewwe, L. Richter, and B. Strupp. 2007. Developmental potential in the first 5 years for children in developing countries. Lancet 369(9555):60-70.
