Bill & Melinda Gates foundation

A number of problems plague the development of vaccines against infectious diseases, including insufficient quality and diversity of preclinical candidates, slow progress toward early-stage testing in humans, and the high cost of clinical trials. It typically takes 15 to 20 years to go from target discovery to deployment of a new vaccine.

A low-cost microneedle patch for delivering inactivated polio vaccine is in the testing phase.

We invest in technologies that can identify promising vaccine candidates and refine them before they enter costly and time-consuming clinical trials. We also invest in research to better understand the health factors that affect susceptibility to infectious diseases and vaccine efficacy, such as malnutrition and co-infections. Furthermore, we seek more effective models of collaboration with major vaccine manufacturers to better identify and pursue mutually beneficial opportunities.

Our vaccine discovery efforts focus on developing vaccine technologies and closing knowledge gaps to facilitate the eradication of polio, testing a new strategy for developing a broadly effective HIV/AIDS vaccine, and enabling more rational and accelerated development of TB vaccine candidates.

Antimicrobial drugs have been the cornerstone of infectious disease treatment, but relatively few treatment options are available for the diseases that have the greatest impact in the developing world. Drug-resistant TB and malaria are also growing problems.

We work to speed the identification of the best drug candidates, and, as we do with vaccine discovery, we look for opportunities to collaborate with pharmaceutical companies because of their unique resources and expertise. We also seek to develop new technologies and approaches to slow the evolution and spread of drug resistance, including alternative formulations and drug-delivery technologies.

We support efforts to create a new generation of more effective and less toxic drugs to treat malaria, TB, visceral leishmaniasis (black fever), human African trypanosomiasis (sleeping sickness), onchocerciasis (river blindness), and lymphatic filariasis (elephantiasis), and to control severe diarrhea. To take advantage of major advances in materials science, biology, and chemistry, we invest in developing new contraceptive technologies, including non-hormonal contraceptive drug discovery.

A broad range of scientific studies are needed to identify how maternal, fetal, newborn, and infant health outcomes are affected by factors including nutrition, infection, and exposure to environmental toxins.

An Australian team is developing an inhalable form of the drug oxytocin, which is used to treat postpartum bleeding.

We invest in research to discover the causes of preterm birth, which is a leading cause of infant mortality, and to develop innovative strategies for prevention. We fund projects to discover the causes of growth faltering in utero and during a child’s first two years of life—a window of time in which serious health problems can impair growth and affect long-term health—and to develop new ways to prevent or reverse unhealthy growth marked by stunting and wasting. One such project seeks to develop fetal growth standards through measurements of fetal growth under optimal conditions in sites across the world. We also invest in research to tackle the challenges faced by mothers and newborns from the onset of labor until 48 hours after childbirth—the most dangerous period for both mother and baby. Efforts include a project to develop an inhalable oxytocin powder to treat postpartum hemorrhaging.

Mosquitoes spread many serious diseases, including malaria and dengue fever, to millions of people annually. A primary strategy for fighting these diseases is the use of insecticides to kill disease-transmitting mosquitoes, or vectors. Mosquitoes have grown increasingly resistant to available insecticides, however, and some insecticides are too toxic for widespread use. They also can require people to change their behavior to be effective—to use bed nets, for instance—and they need funding to maintain distribution systems.

Our investments in mosquito vector control include nontraditional biological and genetic approaches as well as new chemical interventions aimed at depleting or incapacitating disease-transmitting mosquito populations. One biological control project for dengue fever begun through our Grand Challenges in Global Health grant program has progressed to field trials in Australia, and approval is being sought for field trials in Brazil, Indonesia, Vietnam, and Thailand.

Diverse vector-control projects funded through our Grand Challenges Explorations grant program—including the use of infrared light as an invisible, easy-to-use bed net—could help achieve the goal of malaria eradication.

One way that we spur breakthrough advances in global health and development is through our Grand Challenges grant programs, which aim to engage creative minds across scientific disciplines and across the world—including those who have not traditionally taken part in global health-related research—to seek innovative solutions to specific global health and development challenges.

A device under development by a U.S. company uses microneedles and vacuum suction to safely and painlessly collect blood samples for medical diagnosis.

The Grand Challenges in Global Health program was launched in 2003 to focus on persistent challenges in improving health in the developing world. It began with the award of 45 grants totaling more than US$450 million to scientists in 33 countries. In 2011, we launched new initiatives under the program aimed at discovering biomarkers of health and disease and new ways to achieve healthy birth, growth, and development.

In 2008, we launched Grand Challenges Explorations to encourage even bolder solutions in specific areas. Anyone with a promising idea can apply using a simple two-page online application; no preliminary data is required. Initial grants are for US$100,000, and successful projects have the opportunity to receive a follow-on grant of up to US$1 million.

To date, nearly 800 Grand Challenges Explorations initial grants have been awarded to scientists in 53 countries. Originally focused on global health topics, the program is also being used in new ways by a growing number of foundation teams. New challenge topics include Aid is Working. Tell the World, which is intended to uncover new ways to find and distribute stories that will inspire people to support development aid, and Labor-saving Innovations for Women Smallholder Farmers.

Governments and NGOs around the world are developing their own Grand Challenges programs and committing significant funds, both independently and in partnership with the foundation. For example, the Canadian government has committed CAD$225 million through the not-for-profit organization Grand Challenges Canada to fund global health ideas that integrate scientific, social, and business innovation; the U.S. Agency for International Development (USAID) has launched a series of Grand Challenges for Development programs, the first being Saving Lives at Birth, which includes Grand Challenges Canada and the foundation as partners; and Grand Challenges Brazil was launched in 2012 as a partnership framework between the government of Brazil and the foundation, with the first joint initiative focused on reducing the burden of preterm birth.

Ethical, social, and cultural considerations are important in all of the foundation’s work. Not only do we strive to be respectful and sensitive to the communities we work with, but we also aim to design our efforts to ensure the greatest chance of acceptance, which is a prerequisite for success.

an international team of biologists is investigating ways to shorten the lifespan of mosquitoes that transmit the dengue virus.

Originally focused on supporting the Grand Challenges in Global Health program, our Ethical, Social, and Cultural (ESC) program now works with program teams across the foundation to anticipate and address cultural barriers to global health and development initiatives. Examples of the ESC program’s recent work include developing community engagement guidelines for TB drug trials, providing guidance for polio-related data sharing, and developing a collaboration model to promote cooperation and trust between public and private groups that work to improve infant and young child nutrition.