Breaking silos: GCC’s approach to building resilience for human health, amid our climate crisis

Since its inception 12 years ago, Grand Challenges Canada has supported over 1,400 innovations in 96 low- and middle-income countries (LMICs) and/or conflict-affected countries, as well as in Indigenous communities in Canada.

Now, it turns to climate, and to fund innovators in LMICs who are addressing adaptation gaps and building resilience against the effects of climate change on the health and wellbeing of underserved communities.

As part of our series on climate and health, Grand Challenges Canada Associate Director of Global Health Innovation Carolina Kwok discussed how her organization is encouraging communities experiencing these challenges, and those working within those communities, to identify the most important gaps and areas ripe for innovative solutions. “Community-led solutions,” she said, “are inherently more sustainable as they are built upon local needs and demand.”

Tell us about Grand Challenges Canada’s support of “bold ideas with big impact”?

Kwok: GCC believes in supporting innovators who come from communities that directly face the world’s most pressing global health and humanitarian challenges. We believe these inventive, passionate people with the knowledge to build transformative solutions have the potential to change how challenges are addressed, so we are willing to take the risk to test new ideas and invest where others do not. We invest in ideas that not only apply science and technology, but also integrate social and business approaches, to generate transformative impact – bold ideas that may start small, but with the right mix of resources, can have a big impact.

How do you balance the need to fund those ideas with the inherent risk they present?

Kwok: We use rigorous due diligence to assess each potential innovation and during project implementation, we assess a range of additional factors to manage and mitigate risks. We also provide a platform for innovators to develop and test their ideas on how to make the world a more equitable place. From the relatively simple act of linking those who have been excluded from traditional funding approaches to resources, networks, and peers, we are helping to enrich the global marketplace of scalable and sustainable solutions. Then we create pathways to scale that have never existed before, so that proven innovations can have lasting impact.

Climate and health have not been seen in an intersectional manner. How are they related and what problems are created by not looking at both in a holistic way?

Kwok: The intersection between climate and health has been evaluated in a limited manner but a targeted call for proposals to think of new ways to address the impacts of climate change on health has not been explicitly done before. Health is inherently impacted by the environment, and climate change is a major contributing factor. The basic necessities and rights – such as the right to clean air and water, as declared by the UN General Assembly in August 2022, directly impacts health. Not thinking of how climate change impacts health would leave us less prepared to adapt to the changes that are already happening in some parts of the world. Failure to act, learn, and change now will delay the implementation of needed innovations to help us adapt to a rapidly changing environment.

What gaps currently exist in terms of addressing our current climate and health challenges?

Kwok: One of the biggest gaps we see is the lack of funding directed towards adaptation. More specifically, only a small fraction of the already limited adaptation financing is directed towards the health sector in low- and middle-income countries. This shortfall is constraining the ability of governments whose populations contributed the least to climate change to implement adaptation solutions.

How is GCC looking to overcome those gaps in a sustainable manner?

Kwok: With our latest funding call, GCC is seeking to direct funding specifically to innovators in low- and middle-income countries with the goal of addressing adaptation gaps and building resilience against the effects of climate change on the human health and wellbeing of underserved communities. We are keeping the scope of the call quite broad to encourage those working in and with communities experiencing these challenges to tell us where they see the most important gaps and what areas they see as ripe for innovative solutions. We know that community-led solutions are inherently more sustainable as they are built upon local needs and demand.

Why is inclusivity and representation so important to delivering solutions?

Kwok: Globally, there is growing momentum to shift decision-making and power from those who have historically held power, to those who have been marginalized. In our work, this means continuing a journey to shift power from organizations in high-income and relatively conflict-free countries like Canada, to decision makers in low- and middle-income countries and places of conflict. In the context of our Indigenous Innovation Initiative, it means working to shift decision-making from non-Indigenous leaders to Indigenous leaders and communities.

Tell us about the work you do to ensure that this power shift occurs.

Kwok: We are proud that the Grand Challenges Canada model has always focused on supporting innovators closest to the challenges they are working to solve. To date, in our Global Health Innovation and Humanitarian areas of impact, 63% of deals are led by institutions in low- and middle-income countries and/or conflict-affected countries. But we know we can do more.

Over the coming years, we will continue to challenge norms and the way we have ‘always done things.’ Some examples include: working with country governments to define challenges and engage in the selection process of new innovations; trying more trust-based approaches for grant management while still upholding high accountability to meet the needs of our funders; and supporting the Indigenous Innovation Initiative’s strategic vision to be a self-determining platform.

The Stars program provides funding to explore transformative ideas at proof-of-concept stage that use a coordinated application of scientific/technological, social, and business innovation – in order to sustainably bring solutions to scale. Why is this “integrated innovation” model so important?

Kwok: There are powerful synergies with an integrated innovation approach. We believe that innovations that apply elements of these three areas [scientific/technological, social, and business innovation] have a better chance of demonstrating impact, ability to scale, and be sustainable. It does not discount the singular benefits of an innovation but rather, recognizes the strength of innovations that incorporate all three. We conceptualize three types of innovations broadly. The first is scientific/technological innovation, which is based in the psychological, natural, health, or behavioral sciences or in engineering or economics and does not require high-tech solutions. The second is social innovation, which recognizes and/or addresses the broader social, structural and/or political determinants of health, focusing on gender and intersectional inequalities, and addresses local and/or cultural contexts that factor into implementation and scaling. The third is sustainability/business innovation, which maximizes the value, relevance, and unique quality of the solution to create demand and financial sustainability, addressing barriers to affordability and accessibility.

These elements must be revisited and iterated upon as each step of an innovation’s scaling journey unfolds as the teams learn more about what is needed for ongoing scale and sustainability.

GCC has delivered solutions that save or improve lives – but it also touts job creation and policy as one of its achievements. Tell us about the opportunities that are created when innovation is scaled.

Kwok: Over the past 12 years, GCC has created 31,000+ jobs in low- and middle-income countries and through the innovators’ hard work, have influenced 317 policies through government officials, decision-makers, and other local stakeholders. These are the significant, long-lasting opportunities that can be created with patient capital and ongoing innovator support that is provided by GCC. As innovations scale, more jobs can be created as innovators expand their work and impact, and as more evidence of their work builds, more can be used to support transformative policy and guideline changes that can shift how an issue is addressed.

As with many of the world’s biggest challenges, women, girls, and marginalized groups are on the frontlines of the climate crisis. How does GCC prioritize these populations

Kwok: Through our funding calls, we specify that selected innovations are expected to build resilience for the human health and wellbeing of underserved communities. For example, in our ongoing Stars in Global Health program request for proposals, we ask that solutions should consider the fact that older adults, women, young people, Indigenous peoples, people with disabilities, LGBTQI+ individuals, and other traditionally underserved and minority groups are most vulnerable to the health impacts of climate change in many contexts.

We’re pleased to say that since our inception, 42% of projects are led by women and gender diverse individuals. And we want to do more.

Where do you feel we need to do better to help others understand the links between science, innovation, climate, and health?

Kwok: We need to break the siloes that divide these conversations and integrate holistic thinking on climate impacts in all parts of our life. We live in an intrinsically linked ecosystem and that requires a deeper understanding through research on the impact on our health, from the increased spread of infectious diseases due to a warming climate, to premature deaths due to poor air quality. Through a deeper understanding of the linkages, the innovator community can design appropriate solutions to help adapt and mitigate these impacts on all our health, particularly among the most underserved communities. Better communication and collaboration among scientists, innovators, communities, and governments across sectors will help break these siloes and increase creative thinking on developing solutions and strategies to address this complex challenge.