Supporting locally led innovation in global health and development

We are all getting used to dividing history into BCE and CE: Before COVID era and COVID era. Our foundation just hosted the Grand Challenges Annual Meeting for the 17^th time, but only for the second time during the COVID era—which means virtually. The pandemic hasn't just changed our medium, though; it has also changed our message.

The Grand Challenges initiatives have always been about fostering innovation in global health and development. But the way we propose to do that has evolved during the COVID era, as we've seen great successes in science (mRNA vaccines) minimized by great failures in equity (still only 6 percent of Africans fully vaccinated). My team at the foundation, which manages Grand Challenges, has responded by doubling down on our support for local innovation ecosystems—the people and institutions that make up the infrastructure around science—so communities around the world have the resources they need to research, develop, and deliver their own solutions.

My team at the foundation has doubled down on our support for local innovation ecosystems so communities around the world have the resources they need to research, develop, and deliver their own solutions.

COVID isn't the only reason we're evolving. Our team has also been inspired by the movement in global health for diversity, equity, and inclusion (DEI), including the foundation's pledge to work in a way that "is representative of, addresses the needs of, and shares power with the populations and communities we serve in order to achieve our best impact." Our team hopes to help fulfill this pledge. Over the past three years, the proportion of our grant funding going to researchers in low- and middle-income countries has risen from 49% to 97%. The proportion of our grants going to female principal investigators has increased from 40% percent to 47%.

Although the pandemic and the momentum behind DEI has accelerated these changes, they've been in process for almost 20 years. When Grand Challenges was created in 2003, the grants went almost exclusively to researchers in high-income countries. Very quickly, though, we realized that we were leaving out many innovations and innovators, so in 2008 we created Grand Challenges Explorations (GCE) under the slogan "great ideas come from everywhere." We made the grant application much shorter (so you didn't need a grant-writing department to help with the paperwork), and we started reviewing the applications blind. (GCE eventually made grants to principal investigators from 73 countries.) By 2012, we were working with national and regional science institutions to co-launch locally led Grand Challenges initiatives in India, Africa, and elsewhere.

As a result, we began referring to Grand Challenges as a family of initiatives. Today, this family consists of more than a dozen institutions running Grand Challenges programs and more than 3,000 grantees affiliated with thousands of organizations in 117 countries and counting. In other words, although we didn't necessarily use the terminology before, we have been investing in locally led innovation ecosystems for years.

As we move forward with even more intention, our team will continue to do what we've always done, which is to issue requests for proposals (RFPs), but our RFPs will more intentionally support local innovation ecosystems in key geographic areas. At the Grand Challenges Annual Meeting, our CEO Mark Suzman announced the next generation of Grand Challenges: The Global Call to Action, a 10-year program that sponsors cutting-edge science to advance our priorities in global health while providing the long-term resources that teams in low- and middle-income countries need to lead high-impact projects. We’ve committed an initial US$50 million to get the projects up and running, with more to come in the future.

We will also continue to co-fund locally led Grand Challenges initiatives. For example, Grand Challenges Africa’s Drug Discovery program, which recently selected its second cohort of grantees, is funding teams from seven African countries that focus on treatments for high-burden diseases, including malaria, tuberculosis, and neglected tropical diseases. These scientists are working together through the Drug Discovery and Development Centre (H3D), an institute based in South Africa that is building a network of experts on the continent to manage drug-related R&D for years to come.

In addition to funding discrete science projects, we are beginning to invest directly in scientists within those local innovation ecosystems. For example, last year, alongside Grand Challenges Africa and India, we announced fellowships named for Calestous Juma and M.K. Bhan, two groundbreaking scientists and innovators who recently passed away but whose legacies inspire our thinking. The fellowships—each providing five years of support—focus on leadership development for researchers. We just announced the eight women and six men from seven countries in the first cohort of Calestous Juma Science Leadership Fellows.

"Innovation" means all the exciting science we've always supported and always will. It also means finding new ways to implement that exciting science so that it makes the greatest difference to the greatest number of people. That's what we hope to accomplish with our new Global Call to Action, our fellowship programs, and our overall focus on local innovation ecosystems.

Originally published on the Gates Foundation’s Ideas site.