“Fighting Ebola: A Grand Challenge for Development” taught the U.S. Agency for International Development a couple of things.
It became clear that the grand challenge model worked well as a way to rapidly source and deploy innovations, but also that the midst of an outbreak was not the best time to call for those ideas, said Wendy Taylor, director of the Center for Accelerating Innovation and Impact at USAID. With a new grand challenge responding to the Zika outbreak, USAID is putting those lessons to practice, funding innovations with applications beyond Zika, including threats that have yet to be identified.
“We want to make sure we aren’t fighting tomorrow’s outbreaks with yesterday’s tools,” Taylor told Devex.
On the heels of the Ebola outbreak, the Zika virus is causing many responders to shift from reacting to pandemics as they arise to taking more proactive approaches. As health agencies look for new tools to tackle the Zika virus, which has spread to 60 countries according to the World Health Organization, many of them are supporting ideas that can benefit the next pandemic response effort, whatever that may be.
A chemical lure that mimics human scent. Cloud connected ovitraps that provide real-time mosquito surveillance data. Crowdsourced detection of mosquito species using simple flip phones.
These are a few of the 21 nominees USAID announced last week in the first round of the agency’s “Combating Zika and Future Threats” grand challenge.
What unites these innovations is that their designers are not only thinking about Zika, but also about dengue, chikungunya, malaria and other current — and future — mosquito-borne diseases.
When USAID put out a grand challenge call for innovations to tackle the Ebola virus outbreak in 2014, the agency kept a tight focus on immediate solutions. That meant withholding funding to innovations that might take too long to develop, even if they had potential to save lives in the future.
“We were looking at ideas that could be brought to market very quickly but we saw great ideas with longer development timelines that we left on the cutting room floor,” Taylor said.
The Zika challenge, on the other hand, includes both — solutions ready to come to market right away, as well as some designed with the next major health crisis in mind, whatever that might be.
Following on the Ebola grand challenge, USAID was in the process of developing a grand challenge for future health threats when Zika appeared in Brazil. The agency knew it needed to mobilize resources for that response, so Taylor and her team designed a $30 million challenge that called for the best ideas to fight the current outbreak and strengthen the ability of the global community to respond to future health crises.
“Combating Zika and keeping an eye on future threats go hand in hand,” said Bryan Callahan, deputy director of global communications and engagement at the Bill & Melinda Gates Foundation. “While all mosquito species have their own distinct behaviors, you can take learnings from one area of entomology and vector control and apply them to other areas.”
The Gates Foundation is seeing research it has long supported for dengue be repurposed for Zika. Long-term field tests have demonstrated that mosquitoes infected with the Wolbachia bacteria do not transmit arboviruses, the class of virus that includes dengue, Zika and chikungunya, to humans. With support from the Gates Foundation — and now USAID through its Zika grand challenge — the Eliminate Dengue Program at Monash University in Melbourne, Australia, will scale up these efforts in several Latin American communities to test how introducing Wolbachia-infected mosquitoes affects the mosquito and human population.
“Over the last decade or so, there has always been some sort of pathogen that is in the media’s attention as the next global killer, and I think it just reflects how little we know about our broader interactions with microbes in general,” said David Pigott, a professor at the Institute for Health Metrics and Evaluation in Seattle, Washington, who is focused on improving geospatial data on disease. He is trying to predict and map where Zika might appear next, based on the characteristics of places it's already been found. His research shows more than 2.7 billion people live in areas where Zika may spread.
Trying to understand the geography of the pathogens we know about is challenging enough, he said, noting that we need to do more to understand what pathogens may have pandemic potential down the road. One example is PREDICT, a program funded by USAID and based at the University of California Davis. PREDICT works with 35 countries with high biodiversity and population density to explore the human and animal interactions that often yield disease.
“We need to not wait until the next virus jumps from the next animal and the next tree, but we need to get active and get ahead of that curve,” said Larry Brilliant, acting chairman of the board of the Skoll Global Threats Fund.
He appeared at an event in San Francisco last month alongside partners in the Global Virome Project, an initiative that aims to “end the pandemic era” by identifying and characterizing viral threats. When we begin with patient zero, the first human index case, then try to respond, we are already behind, the panelists said.
“Knowledge is powerful,” said Dennis Carroll, director of the global health security and development unit at USAID. “And right now we are pretty stupid about what’s out there waiting for us.”
Health agencies and tech companies have found common ground in the fight.
Premise Data, one of the 21 award nominees for USAID’s Zika grand challenge, is working to deploy its mobile data and analytics platform to gather geotagged data on environmental risk factors for Zika that can be converted into daily heat maps for vector control workers. That could help health workers detect threats earlier, respond in a more targeted way, and allocate resources based on the potential for future outbreaks, instead of relying on less nimble decision making tools.
“At some point, Zika will be contained or controlled,” David Soloff, the founder and CEO of Premise, told Devex. “But there is a set of existing persistent threats — vector-borne diseases — where the same mechanisms for mapping and predicting and responding to the threat will be relevant.”
USAID will announce more nominees for the Zika grand challenge later this month. While many of the first round winners focus on Zika and many of the second round winners are geared toward future threats, the innovators share a common vision: a more proactive than reactive approach to combating disease outbreaks, now and in the future.
“The line between the two is a pretty blurry one,” Taylor said. “A lot of the innovations we have now can work against a range of different types of vector borne diseases that may be coming down the pike.”
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