Grand Challenges Initiative Seeks Innovations to Reduce Severe Acute Malnutrition Treatment Costs

Severe acute malnutrition (SAM) remains a leading cause of child mortality worldwide, yet funding for its treatment is stagnant or declining. To address this critical gap, several Grand Challenges initiatives are seeking innovative solutions to dramatically reduce the cost of treating SAM, with a focus on Sub-Saharan Africa and South Asia. These initiatives, funded by the Gates Foundation and supported by organizations like the Children’s Investment Fund Foundation (CIFF) and GiveWell, aim to increase the number of children treated per dollar spent without compromising the efficacy of treatment.

Addressing the High Cost of SAM Treatment

While Ready-to-Use Therapeutic Food (RUTF) is a cornerstone of SAM treatment, it represents only a portion of the total cost. Significant expenses are also incurred through logistics, staffing, supervision, visit frequency, and overall system overhead. These Grand Challenges seek innovations that tackle these systemic costs, aiming for a 20-30% reduction in the total cost per child successfully treated.

Current Grand Challenges and Funding Opportunities

Reducing the Cost of Severe Acute Malnutrition Treatment

A Grand Challenge focused on reducing SAM treatment costs is actively soliciting proposals. Applicants are encouraged to familiarize themselves with supporting documents, including terms and conditions, rules, guidelines, and FAQs provided by the Gates Foundation. More information and application details are available here. A webinar to discuss the Request for Proposals (RFP) will be held on April 2, from 7:00-8:00 AM Pacific Time. Registration is required, and questions can be submitted in advance. The session will be recorded and made available online.

Two funding options are available:

• Option A: Awards of up to $500,000 USD for projects lasting up to 18 months.
• Option B: Awards of up to $1,500,000 USD for projects lasting up to 36 months.

Indirect costs should not exceed 10-15% of the total award, adhering to the Gates Foundation’s policy.

Addressing Physiological Barriers to Micronutrient Absorption

Another Grand Challenge focuses on improving micronutrient absorption from fortified foods. Chronic inflammation, driven by factors like infections and poor sanitation, can hinder the body’s ability to absorb essential nutrients. Details about this challenge can be found here. A webinar will be held on April 2, from 8:30-9:30 AM Pacific Time, to provide an overview of the RFP and answer questions. Like the SAM treatment challenge, a recording will be available for those unable to attend live.

Leveraging Artificial Intelligence for Charitable Giving

A third initiative explores the potential of Artificial Intelligence (AI) to accelerate charitable giving. The Gates Foundation’s Philanthropic Partnerships Team is seeking innovative ways to use AI to connect donors with causes they care about. Further information on this RFP is available here. A webinar was held on March 23, from 7:00-8:00 AM Pacific Time.

Focus Areas for Innovation

The initiatives targeting SAM treatment costs are particularly interested in innovations within the following areas:

• Logistics and Distribution Optimization: Redesigning distribution networks, optimizing inventory, and leveraging digital tools to reduce transport costs and minimize losses.
• Treatment Protocols and Regimen Design: Developing adaptive dosage regimens, reducing RUTF consumption, and simplifying monitoring approaches.
• Program Delivery Models: Implementing community-based care, task-shifting to community health workers, and integrating services with existing health systems.
• Complicated (In-patient) SAM Care Optimization: Reducing the length of stay for inpatient care, optimizing clinical pathways, and improving resource efficiency.

Eligibility and Proposal Requirements

Eligible applicants include universities, research institutes, NGOs, and for-profit entities, with a strong preference for those based in low- and middle-income countries (LMICs). Proposals must demonstrate a clear pathway to a 20-30% cost reduction, include a transparent cost model, and provide proof-of-concept feasibility. Data sharing, environmental considerations, and responsible use of AI (where applicable) are also key requirements.

What Will Not Be Funded

Proposals focusing on clinical trials, scaling existing simplified protocols, routine implementation, or approaches lacking a plausible pathway to significant cost reduction will not be considered.