On 1 May 2003, the Bill and Melinda Gates Foundation (BMGF) widely advertised for requests for application for research projects to investigate 14 grand challenges under the Grand Challenges in Global Health (GCGH) initiative. The grand challenges were described as “a call for a specific scientific or technological innovation that would remove a critical barrier to solving an important health problem in the developing world with a high likelihood of global impact and feasibility”. They were meant to direct investigators to a specific scientific or technical breakthrough that would be expected to overcome one or more bottlenecks in an imagined path towards a solution to one or preferably several health problems.
The GCGH initiative is modelled after the grand challenges formulated more than 100 years ago by mathematician David Hilbert. Hilbert (1862-1943) was a German mathematician recognized as one of the most influential and universal mathematicians on the 19th and early 20th centuries, and his list of unsolved problems has encouraged innovation in mathematics research ever since. Similarly, the GCGH focuses on major global health challenges with the aim of engaging creative minds across scientific disciplines to accelerate research on solutions that could lead to scientific breakthroughs against diseases that kill millions of people each year in the world’s poorest countries.
The GCGH initiative is funded by a US$ 450 million commitment from the BMGF (which included a US$ 200 million commitment from the Foundation for the National Institutes of Health), US$27.1 million from the Wellcome Trust and US$4.5 million from the Canadian Institutes of Health Research (CIHR) support the initiative.
The Grand Challenges program was launched in 2003 and two years later, 43 grants totalling US$436 million were awarded for research projects involving scientists in 33 countries. These projects are currently underway, managed by teams working in partnership across disciplines, sectors and countries. Many feature work from leaders in fields such as chemistry, engineering, statistics, and business, who have never before focused on global health.
According to the Global Health Forum on Health Research, of the billions spent each year on research into life-saving medicines, only 10 percent of medical research today is devoted to the diseases that cause 90 percent of the health burden of the world. Very little investment is focused on discovering and developing new tools to fight the diseases that cause millions of deaths each year in developing countries. The GCGH initiative is an effort to address this imbalance.
The scope of the GCGH is broad, encompassing many strategies for improving health through surveillance, prevention, detection, diagnosis, and treatment of disease. Scientific disciplines underlying these strategies are also likely to be diverse; including immunology, microbiology, genetics, molecular and cellular biology, entomology, agricultural sciences, clinical sciences, epidemiology, population and behavioural sciences, ecology and evolutionary biology.
In a panel discussion, Bill Gates said: “There is great potential for science and technology to solve persistent global health challenges, but far greater resources are needed. This initiative is about discovery and invention. It is about finding specific solutions to the hardest problems. By accelerating research to overcome scientific obstacles in AIDS, malaria, and other diseases, millions of lives could be saved”.
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