Stars in Global Health – Portfolio review

Grand Challenges Canada believes that offering innovators breathing room to develop bold ideas that have big impact is a recipe for sustainable and viable solutions in global health. Funded by the Government of Canada, we developed the ‘Stars in Global Health’ program to support these kinds of ideas from the best and brightest talents, both in low- and middle-income countries and in Canada.

The ecosystem we have developed is transparent and effective. Initially, we fund ‘proof of concept’ projects with grants of up to $100,000. If the concept is proven and has the potential to be transformative, the innovations have the opportunity to move to the next phase, called ‘transition to scale’. To date, we have gone through five rounds, our Board is about to approve Round 6 through recommendations from a CIHR Peer Review Committee and we have now published the request for proposals (RFP) for Round 7. Total investments under the Grand Challenges Canada ‘Stars in Global Health’ program exceed $31 million, representing 295 funded projects. After 18 months, Round 1 and Round 2 are now coming to an end. Three innovators have been successful in the Transition to Scale phase.

The main goal of our approach is threefold: stimulate bold ideas in global health from global innovators and entrepreneurs, build and support a robust pipeline of innovations as they transition to scale, and achieve early results.

With a large number of projects ongoing, several completed and a new round being launched this week, it is an interesting exercise to shine the light on the portfolio. What are some of the (early) results and outcomes? Can we see the pipeline of innovations materialize and is it working to transition innovations to scale? 

Looking at the raw numbers offers a first motivating lesson: the overall success rate of applications received is 22%, meaning that 295 of the 1,326 received applications have been approved for funding. Zooming in geographically shows that the funded innovators are based in 31 countries.

Innovators Countries

Innovators come from different backgrounds and work in a variety of contexts. Slightly over half of them (54%) are linked to academic institutions. A smaller number of them work for/with NGOs (14%), for-profit organizations (13%) or research institutes (13%). Hospitals and government account for the remaining 6%.

When determining the impact of projects, we needed a system to identify measurable and perceptible results or outcomes. That`s why we introduced the Results-based Management Accountability Framework (RMAF). The RMAF is a framework that focuses on the expected and achieved results throughout the life of a project. The framework is standard across all the programs. The flowchart revolves around these key questions: What products and services will be developed (outputs)? How many lives will be touched by the innovation (intermediate outcome)? How will the innovation save and improve lives  (ultimate outcome)?

Based on the self-reporting generated data from 28 completed projects, the outcomes look promising.

In 72 cases, the 28 projects had a critical impact in a human life (lives saved). Well over 12,000 lives were improved when, for example, people received treatment. Close to 60,000 people’s lives were touched, meaning they came in contact with an innovative technology, product or service. Outputs came in the form of policies or prototypes developed, patents filed, papers submitted, funds leveraged or team members engaged.

Project Outcomes

Behind the numbers and charts are enthralling stories of real life projects and people.

One project that immediately delivered early results is led by Ri-Hua Xie, using mobile text messaging to reduce maternal and infant deaths in remote rural areas in China. They undertook a cluster-randomized trial in a poor and mountainous region of Hunan province in China. The experimental group received text messages with reminders about and suggestions for pre-natal care. The control group received the usual pre-natal care at their first pre-natal visit. Through this intervention, the rate of still births and the neonatal mortality rate were cut almost in half along with a slight but statistically significant reduction in maternal mortality rate. By comparing the outcomes in the experimental group with the control group, the project team determined that the lives of 32 foetuses, 49 newborns and one mother were saved.

SOIL Haiti is a great example of a social and sustainable enterprise bringing health and sanitation benefits and creating jobs at the same time. SOIL Haiti, in collaboration with Konbit Sante, is providing sanitation in Haiti’s urban slums. The project generates revenue from small monthly toilet user fees, waste treatment fees, and compost sales. It is, by design, an “integrated solution” that simultaneously addresses environmental, public health and livelihood improvement. The broader goal is to create a working social business model that is replicable on a global scale. 2,655 people are currently accessing a SOIL toilet as a result of the initial pilot, and user surveys show a high level of satisfaction and a desire to continue with the paid service. What we are also witnessing is that, in addition to addressing a global health challenge, our Stars in Global Health innovations are also creating jobs. Soil Haiti has created 40 jobs for women to develop their suite of services.  

ColaLife Project

When it comes to innovation, ColaLife has set the tone with a creative and award-winning kit containing 200ml ORS sachets (an African first) and 20mg Zinc tablets and a bar of soap. The small sachets, combined with the fact that the container acts as the measure for the water, is designed to meet the needs of mothers in low resource settings in the household treatment of diarrhoea. In developing countries, 1 in 8 children die before their fifth birthday and the second biggest killer is diarrhoea. The project, called “ColaLife Operational Trial in Zambia” (COTZ) turns the Zambian distribution channel of Coca-Cola into a lifeline for communities. The kits are designed to fit in the space between the necks of the bottles in a crate of Coca-Cola. To date, over 25,000 kits have been sold. In practice very few retailers used the space in the crates. What began as a distribution innovation evolved into a venture where the innovation has been in the creation of a desirable product and its end-to-end value chain.

Moving forward in our pipeline to take innovative ideas to the next level, let’s turn again to the aforementioned 28 completed projects. 17 of them have showed interest in  transition to scale investments. The Investment Committee, overseeing the procedure and evaluation, approved two projects.

This program has also transformed many researchers from being traditional researchers to being innovators. Grantee Nitika Pai of McGill University recently said: “Grand Challenges Canada spurred the innovator Geek in me”. Nitika is working on bringing oral HIV tests to low- and lower-middle-income countries.

Whether we fund promising ideas with proof of concepts grants or help projects evolve with transition to scale, Grand Challenges Canada supports bold ideas with big impact, with the goal of building a strong pipeline of innovations that are in position to transition to scale. The early results in the overall `Stars in Global Health` program portfolio offer a preview of the ultimate outcomes to expect.

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