Grand Challenges: 20 years of backing big ideas to drive innovation

Not that long ago, José Castillo couldn't find anyone to invest in his idea to make vaccines cheaper and more accessible.

Then in 2015, the co-founder of the Belgium-based biotech company Univercells and his team responded to a call for proposals from Grand Challenges, an initiative launched in 2003 by the Bill and Melinda Gates Foundation (BMGF) that uses crowdsourcing to find innovative solutions to major scientific challenges impacting the world's poorest. That year, Grand Challenges was looking for projects to reduce the cost of making vaccines for certain diseases, such as polio and measles-rubella, to US$0.15 cents per dose – a huge drop from their typical cost of between US$1 and US$10 per dose.

Castillo presented his concept for a modular system that would intensify the vaccine-manufacturing process, greatly reducing its footprint and running costs. Shrinking the system would decentralize production and lower the price per dose, bringing vaccine-making capabilities to low- and middle-income countries (LMICs) without the resources to build large manufacturing plants.

The only prototype Castillo had of his potentially revolutionary bioreactor was made out of aluminum and wood. "My investors were excited about it, but also risk averse, so it was really difficult to convince them," he said. "The Grand Challenges panel made the decision to fund our program based on a very nice slide deck, some data, a drawing that I sketched myself, and a vision. In the biotech world, that's a miracle."

Univercells was one of five projects awarded grants that year, with the Grand Challenges network of funders committing US$3 million per year for four years. Once the news got out, the investors started calling, Castillo said. Later, in the wake of the COVID pandemic, Univercells launched Quantoom Biosciences in 2021 to focus on making the production of mRNA vaccines cheaper, simpler, and faster. When the Bill and Melinda Gates Foundation wanted to invest in mRNA technology to help improve access to COVID vaccines for LMICs, they chose Quantoom out of several potential platforms thanks, in part, to Univercells’ experience in modular technology.

"Grand Challenges wants to be a catalyst for innovation – well, for us it was a catalyst on steroids," Castillo said.

Today, there are more than 250 Univercells systems out in the world and the Quantoom tech is being rapidly rolled out. One of each are currently sitting in two manufacturing facilities being built at the leading vaccine development institution Institut Pasteur de Dakar (IPD) in Senegal, where Grand Challenges recently wrapped up its annual meeting marking the initiative's 20th anniversary.

At the meeting, the BMGF announced it was giving Quantoom US$20 million to advance work on its mRNA manufacturing system and giving IPD US$5 million to buy the technology. Another US$5 million will go to the Biovac research institute in South Africa and US$10 million will be distributed next year to other partners yet to be named, for a total investment of US$40 million in efforts to increase the capacity for LMICs to develop their own lifesaving vaccines at scale. 

Alongside the yellow fever vaccine the IPD already makes, it will use the Univercells and Quantoom systems in combination with other technology to ramp up supplies of vaccines for measles-rubella, COVID-19, and other endemic diseases. Eventually, the institute’s new facilities will produce up to 300 million vaccine doses a year, dramatically reducing Africa's dependence on imported vaccines.

"What we care most about as a public health foundation is the epidemics – you want to move fast," said Joe Fitchett, senior adviser at IPD who focuses on medical countermeasures for epidemics. "The more you can improve that intensification and yield, you can have more vaccine available quicker, to get on top of any epidemic and outbreak. That's an important, often overlooked, tool. It's almost not about volume, it's about acceleration. And that is something that's very attractive to us."

This new partnership between Univercells, Quantoom, and the IPD is just one example of how Grand Challenges is helping to fuel new thinking in Africa and transforming the region's role in global health, said the Institut Pasteur de Dakar's CEO, Dr. Amadou Alpha Sall. "People say there is no money for innovation in Africa, but that is not really true – innovation is just not a priority for many African countries," he said. "Governments see Grand Challenges as an opportunity to push innovation and open people's eyes to the benefits of doing something that is bold and very relevant."

Even without the levels of public health funding that richer countries enjoy, Senegal has over the past 20 years become a model in West Africa for how to strengthen health systems and improve health outcomes. Policies and programs to increase vaccine coverage, and improve nutrition, education, and water and sanitation, have driven massive strides in public health. The country's child mortality rate dropped from 117 deaths per 1,000 live births in 2000 to 52 in 2015, for example, and childhood stunting fell from 34% to 17% between 1992 and 2017. Routine vaccination coverage in Senegal is now 90%, compared to just over 70% for the African region as a whole. 

To hold its position as a regional health leader, Senegal needs to maintain the kind of ambitious thinking that Grand Challenges encourages, said Sall. Several "game changing" projects have been given grants through the initiative, he said. They include a sample carrier that allows real-time remote sensing and monitoring of specimens as they are transported from hard-to-reach rural areas back to laboratories, which could help researchers and health workers diagnose outbreaks earlier and slow the spread of epidemics. Proper storage and speedy transportation of samples can be a huge problem in Africa, where about 60% of the population lives in rural areas, many of them without access to paved roads. Another awarded project out of Senegal uses artificial intelligence to analyze epidemiological data, clinical records, and research literature to help health workers and officials predict outbreaks, identify priority areas for interventions, and evaluate the potential impacts of specific policies.

"One of the major strengths in the African region is a creativity that is expressed in all different domains, like art, music, and particularly in science," said Sall. "We want to make sure that all this creativity is not just something that happens once in a while, or only when we need it – we want innovation to be systematic."

To that end, Senegal's government launched its own version of Grand Challenges in 2022, hosted at the IPD with seed funding from the BMGF, Grand Challenges Canada, and investment advisory group ELMA Philanthropies. Now the Senegalese government is one of several African governments belonging to the Grand Challenges family of funders, along with the governments of India, China, Brazil, the United States, and Canada.

In its first challenge call, Grand Challenges Senegal asked for projects focused on pandemic prevention and preparedness. To be eligible, proposals had to be based in Africa with at least one component in Senegal or carried out by African scientists from the diaspora in partnership with an institution in Senegal. It awarded grants of between US$50,000 and US$100,000 each to eight grantees, including one design for a new rapid diagnostic test for yellow fever. With the funding comes at least two years of support with resources, development, and getting products to market.

At the annual meeting in October, Senegal joined six other Grand Challenges partners as they announced this year's call for projects that find locally driven solutions for using AI to improve the health of vulnerable communities.

"Over 20 years of Grand Challenges, there have been real successes that show the world that this is a way to make developing countries really contribute to innovation at the global level," said Sall. "And the fact that this is happening in Africa can change the narrative about Africa, showing that it can contribute to major change around the world, including in health."