Special Feature

doi:10.1038/nindia.2018.56 Published online 30 April 2018

A strong foundation for progress

Supporting and enabling groundbreaking projects from inception to results on the ground.

[Nature India Special Issue: Grand Challenges]

Trevor Mundel

The challenge of improving sanitation demands a pipeline of technological solutions from India’s best minds, along with sustained funding.
© Jonathan Raa/Getty Images
The words science and technology can conjure images of things far from our everyday experience: ISRO’s Mars orbiter or theoretical physics, for instance. But science and technology are both intuitive and immediate, and they are key to addressing the most pressing challenges India faces.

As part of Swachh Bharat, for example, the government of India set a deadline of 2019 for Indians to stop dumping untreated waste into the environment. The government has called for “measurable results” on mal­nutrition by 2022, and it has pledged to eliminate tuberculosis as a serious national health challenge by 2025. That is a lot to do in a short time, which is why India is committed to an innova­tion agenda.

At the Bill & Melinda Gates Foun­dation, we agree that innovation and India’s future are inextricably linked. We believe the world is getting better, and can get better still, in large part because scientific and technological innovation can help solve difficult problems, especially those faced by the poorest. We have been working closely with the government of India for more than a decade as it implements its innovation agenda, and one of our most effective collaborations to date is Grand Challenges India.

The Grand Challenges programme dates back to the very beginning of the Gates Foundation. Bill and Melinda Gates had spent their careers in the software industry, where the best minds came together to unleash an almost-constant stream of innovation that revolutionized the way people lived and worked. They did not see the same focus on innovation in global health and development, and they were convinced that a little attention after years of neglect could unlock big improvements. As a result, they worked with partners to create a pro­gramme that turned the usual grant­making paradigm on its head. Instead of selecting grantees and prescribing their activities, Grand Challenges would explain the end goal — for exam­ple, to discover treatments that don’t lead to drug resistance — and then invite innovators from everywhere to propose ideas for how to achieve it. The hope was to encourage more ideas from more places and push the best ones forward fast.

India had always been a part of our vision for Grand Challenges, both because many of the problems the pro­gramme was designed to solve exist on the subcontinent and because so many world-class innovators come from India as wel. As a result, we decided to host the 2011 Grand Challenges annual meeting in New Delhi. In the run up to that meeting, we forged a strong relationship with the Department of Biotechnology, which was interested in creating a Grand Challenges India to engage more Indian innovators to work on India-specific challenges. In 2012, we signed a memorandum of understanding, the newly formed Biotechnology Industry Research Assistance Council (BIRAC) was given responsibility for the programme, and in 2013 Grand Challenges India issued its first calls for proposals, with funding provided jointly by the government of India and the Gates Foundation.

Many Grand Challenges projects that generated impressive early results are now being scaled up. Together, they offer hope that Prime Minister Narendra Modi’s ambitious targets for improving the quality of life for the poorest in India are within reach.

“The hope was to encourage more ideas from more places, and push the best ones forward."

first.”Consider sanitation. Though open defecation is a problem in rural areas, most people in urban areas use pit latrines or septic tanks. While the waste is contained initially, most of it is eventually dumped, untreated, into the environment. Consequently, one of the first two calls issued by Grand Challenges India was for proposals to “reinvent the toilet”—that is, to create technologies appropriate to the situation on the ground in Indian communities that can prevent the pathogens in human waste from circulating. One of the Reinvent the Toilet grantees, BITS Pilani, is developing what it calls the empow­ered septic tank. Run on photovoltaic power, the system uses electricity to change the pH levels in effluent, killing pathogens and helminth eggs. The team is now pilot testing its technology in a community setting, in preparation for scale-up.

To achieve the results promised on malnutrition, India will need to continue to improve routine immu­nization, since enteric infections can prevent children from absorbing nutrients from food. Improving routine immunization requires improving the supply chain. The old-fashioned paper records were sometimes inaccurate, and even when they weren’t, informa­tion traveled slowly, which meant it could take weeks to address stockouts. One Grand Challenge project sup­ported a start-up company in Bengal­uru called Logistimo, which created a cloud-based mobile supply chain plat­form so that anyone with a smartphone can instantly check stock anywhere in the system. Logistimo is now deployed in five countries and has over 12,000 stores in its network with a stock avail­ability of more than 95 percent.

Fighting tuberculosis is another priority our foundation shares with the government of India, and almost 15 years of Grand Challenges-funded research has produced a better scien­tific understanding of latency, which is helping drug developers accelerate their research. We have also supported programs to promote adherence to the current treatment regimen, includ­ing 99DOTS, an ingeniously simple and inexpensive monitoring system. Each time a patient takes a pill from a specially designed packet, it reveals a number for the patient to call, toll-free. That phone call feeds into a system that dispenses reminders, incentives, and counseling for patients who are having trouble sticking to the regimen.

The impact of each of these inno­vations is significant. But what’s just as significant is that the government of India is supporting a platform that is producing innovations on an ongo­ing basis to overcome a vast array of obstacles standing in India’s way. We are proud to work alongside the nation as it addresses the priorities of today to create the India of tomorrow.

Trevor Mundel is the president of the Bill and Melinda Gates Foundation.