The Gates Foundation is part of the Grand Challenges partnership network. Visit <a href="https://www.grandchallenges.org" target="_blank">www.grandchallenges.org</a> to view the map of awarded grants across this network and grant opportunities from partners.

Grand Challenges is a family of initiatives fostering innovation to solve key global health and development problems. Each initiative is an experiment in the use of challenges to focus innovation on making an impact. Individual challenges address some of the same problems, but from differing perspectives.

Challenges

Grand Challenges South Africa

Accelerating Innovation in Vaginal Formulations in Support of Women's Health

This RFP is jointly launched by several Grand Challenges funding partners, including Grand Challenges Africa (Science for Africa Foundation), Grand Challenges Brazil (Brazilian Ministry of Health and the National Council on Research), Grand Challenges India (Biotechnology Industry Research Assistance Council), Grand Challenges South Africa (South African Medical Research Council), and the Gates Foundation. Each RFP may differ in its geographic focus, topic areas, and funding levels. Please review the eligibility criteria and specific requirements for each RFP carefully. The individual RFPs are listed separately <a href target="_blank" rel="noopener noreferrer">here</a>. If you qualify for more than one, we encourage you to apply to the RFP that best aligns with your proposed project and geographical location.
Please note: Grand Challenges Brazil will review proposals submitted by Brazilian organizations through the link on this webpage. Proposals selected to receive financial support from the Brazilian Ministry of Health / GC Brazil must be led by researchers linked to non-profit Science, Technology and Innovation Institutions (Instituição Científica, Tecnológica e de Inovação – ICT), registered in Brazil.
Before applying, applicants should familiarize themselves with the supporting documents for this Grand Challenge, including the Rules and Guidelines, Application Instructions, and Frequently Asked Questions.
If you are planning to apply to the Gates Foundation RFP, we will be hosting a dedicated webinar on November 20, from 6:00 to 7:00 AM Pacific Time. This session will provide a comprehensive overview of the RFP details and an opportunity to have your questions answered. To participate in the webinar, please <a href="https://events.teams.microsoft.com/event/2957503f-d95d-47b0-8bfa-b7d28f55266c@296b3838-4bd5-496c-bd4b-f456ea743b74" target="_blank" rel="noopener noreferrer">register</a> and <a href="https://forms.office.com/pages/responsepage.aspx?id=ODhrKdVLbEm9S_RW6nQ7dMKiReMZsCJFmCa42S92Da1UMFBSMVlMQUNLSlRDOVNOMFdNR0dSUUFXNC4u&amp;origin=lprLink&amp;route=shorturl" target="_blank" rel="noopener noreferrer">submit your questions</a> in advance. If you cannot attend live, the webinar will be recorded and available on this challenge page after the session.
<h2>Background</h2>
Local delivery of drugs into the vagina for prevention and treatment of female-specific conditions remains understudied and under-utilized despite clear potential advantages such as discreetness, potent local efficacy, large surface area for drug absorption, high potential for API dosage sparing, potential for fewer systemic side effects, as well as providing autonomy and empowerment of women. Several key drivers may be responsible for this lag, including paucity of mechanistic biological data, particularly from high-burden settings such as low- and middle-income countries (LMICs), to support the development of specific formulations for vaginal use as well as a persistent misconception that vaginally delivered products may not be embraced by women and their sexual partners. Several of our priorities for impactful products for sexual and reproductive health will require vaginal delivery for immediate, on-demand use. We seek to catalyze the development of innovative technologies and approaches that can safely and effectively deliver a wide range of vaginal products. We expect these approaches to have user appeal, including promotion of self-care capability and other beneficial features that women seek, hence the need to couple discovery research with high-quality end-user input.
<h2>The Challenge</h2>
We are soliciting applications that contribute to development of vaginal formulations that promote optimal drug delivery within the vaginal compartment while positively supporting the vaginal milieu, and that also possess beneficial effects, even if unrelated to the API intended effect, that a user might consider desirable, such as enhancement of sexual pleasure. We anticipate identifying product-agnostic features that promote vaginal health and that broadly appeal to women to advance product development and formulations for women's health. We welcome innovations at any stage of development that meet the scope of this call.
Applicants may apply to address one or more of the following objectives of this challenge:
<ol>
<li>Leverage biology for vaginally administered products: In this objective, we seek: 1) innovative formulations and delivery approaches that leverage the biology of the vaginal microenvironment to support development of novel delivery technologies and that have high potential for scalable, low-cost manufacturing options; and 2) novel components that could be incorporated into and improve existing formulations (e.g. films, tablets/inserts) that would promote maintenance of or transition to an optimal vaginal microbiome and/or promote other benefit to the vaginal mucosal epithelium. Specifically, we seek to assess and de-risk novel approaches to vaginal delivery that can leverage and support features of the vaginal milieu including mucus, host cells and microbes for drug delivery and as such we anticipate proposals including evaluation of the impact of these novel approaches or components on changes in the microbiome and vaginal host components (cells/cytokines, mucins, glycans, lectins, etc.).</li>
<li>Define characteristics of an ideal vaginal product: In this objective, we seek to support qualitative studies aimed at identifying and understanding specific features of a vaginally administered product that would most appeal to women such that many women, especially those of reproductive age in LMICs, would seek to use such a product (for example, 'what would you hope to achieve when using this product in your vagina?'). We are particularly interested in defining ancillary benefits (such as odor control, sexual enhancement, etc.) that could be derived from a vaginally delivered product that would likely not be supported by other routes of administration, as well as identifying major hurdles that may prevent a woman from seeking out or preferring a vaginal product. We acknowledge that there may be regional, cultural, demographic or other preference differences, and are seeking to identify desires or barriers that are commonly expressed by women across these demographic differences. Applicants may propose methods to prioritize preferences such that the vaginal product developed can benefit as many women as possible. In sum, we aim to gather insights into preferred and achievable characteristics that would transform vaginal products from 'tolerable' to 'desirable'.</li>
</ol>
Funding Level
Projects with a duration of up to two years and a maximum requested budget of $250,000USD are eligible for funding. Exploratory projects with shorter durations/lower budgets that focus on high-risk, innovative areas are strongly encouraged and will be given priority. Budgets should be commensurate with the scope of work proposed and in line with allowable costs of the targeted funding organization for which the applicant is eligible. Indirect costs should be included in the budget and should not exceed 10-15% of the total award (subject to the <a href="https://docs.gatesfoundation.org/Documents/Indirect_Cost_Policy.pdf" target="_blank" rel="noopener noreferrer">Gates Foundation's indirect cost policy</a>).
Eligibility Criteria
This initiative is open to research institutes, nonprofit organizations, for-profit companies, international organizations, government agencies, and academic institutions. Please note that all applicants will be expected to comply with the Foundation's global access clause. We encourage groups to build upon existing and/or complimentary projects/studies/trials and to collaborate with other institutions. We particularly encourage applications from projects led by women and/or researchers at institutions based in LMICs and/or involving collaboration with women-led or LMIC-based organizations. Only individuals who are applying through a legally recognized corporate entity are eligible.
We are looking for proposals that:
<ul>
<li>Focus on vaginal delivery approaches that do not require retrieval and disposal after use and can be adapted for extended- or slow-release of active ingredients.</li>
<li>Use innovative, rigorous qualitative approaches that improve or deepen our understanding of standard acceptability metrics.</li>
<li>Generate biological or end-user data from low- and middle-income regions and comply with national regulations on data security, data protection and privacy.</li>
<li>Propose rigorous scientific approaches to study a clear research question and whose rationale is clearly supported by peer-reviewed literature.</li>
<li>Demonstrate feasibility with preliminary data in support of the proposed approach; if no preliminary data exists, then the proposal should be limited in scope.</li>
<li>Request the appropriate funds and time to achieve the objectives of the proposed work. Exploratory projects of lower cost but higher risk are strongly encouraged and will be prioritized.</li>
<li>Promote a diverse, inclusive, and supportive research environment, with priority for collaborations involving LMIC-based experts in reproductive health.</li>
</ul>
We will not fund proposals that:
<ul>
<li>Evaluate the impact of currently available vaginally inserted products on the vaginal milieu (e.g. menstrual products, contraceptive devices, over-the-counter probiotics, etc.).</li>
<li>Focus on approaches that would not be feasible or affordable in low- and middle-income countries, including personalized medicine. If these approaches are included, the feasibility of scalable, low-cost development should be explicitly stated.</li>
<li>Focus on the development of therapeutics or interventions for specific conditions, such as treatment for STIs or contraceptive products. While these types of interventions may be used as a test case within the proposal, the work itself should focus on formulations.</li>
<li>Are focused solely on basic exploratory scientific research without a clear translational pathway, including potential end-use scenarios, scalability considerations and regulatory or manufacturing implications.</li>
<li>Center solely on focus groups and interviews. These methods or qualitative approaches are acceptable if embedded within rigorous mixed-methods study designs that generate quantitative, actionable insights beyond anecdotal data or standard acceptability metrics such as affective attitudes.</li>
<li>Do not consider end user preferences or assume end-user preferences. For the purposes of this RFP, end-users can be defined as women of reproductive age in low- and middle-income countries. Proposals may focus on subgroups (e.g., adolescents, post-partum women), but the target group must be explicitly defined and justified.</li>
<li>Primarily depend on traditional acceptability questionnaires or surveys (e.g., “if x hypothetical product existed, how interested would you be in using it?”).</li>
<li>Do not directly address one of the core objectives as outlined above.</li>
<li>Cannot be accomplished within a two-year maximum project duration or within the stipulated budget maximum.</li>
<li>Support researchers or research teams who are affiliated with the tobacco industry, or who receive (or are applying for) funding from the tobacco industry, which includes manufacturers and distributors of e-cigarettes or vaping products.</li>
</ul>

We are soliciting applications that contribute to development of vaginal formulations that promote optimal drug delivery within the vaginal compartment while positively supporting the vaginal milieu, and that also possess beneficial effects, even if unrelated to the API intended effect, that a user might consider desirable, such as enhancement of sexual pleasure.

Accelerating Innovation in Vaginal Formulations in Support of Womens Health

Grand Challenges Brazil

This RFP is jointly launched by several Grand Challenges funding partners, including Grand Challenges Africa (Science for Africa Foundation), Grand Challenges Brazil (Brazilian Ministry of Health and the National Council on Research), Grand Challenges India (Biotechnology Industry Research Assistance Council), Grand Challenges South Africa (South African Medical Research Council), and the Gates Foundation. Each RFP may differ in its geographic focus, topic areas, and funding levels. Please review the eligibility criteria and specific requirements for each RFP carefully. The individual RFPs are listed separately <a href target="_blank" rel="noopener noreferrer">[here]</a>. If you qualify for more than one, we encourage you to apply to the RFP that best aligns with your proposed project and geographical location.
Please note: Grand Challenges Brazil will review proposals submitted by Brazilian organizations through the link on this webpage. Proposals selected to receive financial support from the Brazilian Ministry of Health / GC Brazil must be led by researchers linked to non-profit Science, Technology and Innovation Institutions (Instituição Científica, Tecnológica e de Inovação – ICT), registered in Brazil.
Before applying, applicants should familiarize themselves with the supporting documents for this Grand Challenge, including the Rules and Guidelines, Application Instructions, and Frequently Asked Questions.
If you are planning to apply to the Gates Foundation RFP, we will be hosting a dedicated webinar on November 20, from 6:00 to 7:00 AM Pacific Time. This session will provide a comprehensive overview of the RFP details and an opportunity to have your questions answered. To participate in the webinar, please <a href="https://events.teams.microsoft.com/event/2957503f-d95d-47b0-8bfa-b7d28f55266c@296b3838-4bd5-496c-bd4b-f456ea743b74" target="_blank" rel="noopener noreferrer">register</a> and <a href="https://forms.office.com/pages/responsepage.aspx?id=ODhrKdVLbEm9S_RW6nQ7dMKiReMZsCJFmCa42S92Da1UMFBSMVlMQUNLSlRDOVNOMFdNR0dSUUFXNC4u&amp;origin=lprLink&amp;route=shorturl" target="_blank" rel="noopener noreferrer">submit your questions</a> in advance. If you cannot attend live, the webinar will be recorded and available on this challenge page after the session.
<h2>Background</h2>
Local delivery of drugs into the vagina for prevention and treatment of female-specific conditions remains understudied and under-utilized despite clear potential advantages such as discreetness, potent local efficacy, large surface area for drug absorption, high potential for API dosage sparing, potential for fewer systemic side effects, as well as providing autonomy and empowerment of women. Several key drivers may be responsible for this lag, including paucity of mechanistic biological data, particularly from high-burden settings such as low- and middle-income countries (LMICs), to support the development of specific formulations for vaginal use as well as a persistent misconception that vaginally delivered products may not be embraced by women and their sexual partners. Several of our priorities for impactful products for sexual and reproductive health will require vaginal delivery for immediate, on-demand use. We seek to catalyze the development of innovative technologies and approaches that can safely and effectively deliver a wide range of vaginal products. We expect these approaches to have user appeal, including promotion of self-care capability and other beneficial features that women seek, hence the need to couple discovery research with high-quality end-user input.
<h2>The Challenge</h2>
We are soliciting applications that contribute to development of vaginal formulations that promote optimal drug delivery within the vaginal compartment while positively supporting the vaginal milieu, and that also possess beneficial effects, even if unrelated to the API intended effect, that a user might consider desirable, such as enhancement of sexual pleasure. We anticipate identifying product-agnostic features that promote vaginal health and that broadly appeal to women to advance product development and formulations for women's health. We welcome innovations at any stage of development that meet the scope of this call.
Applicants may apply to address one or more of the following objectives of this challenge:
<ol>
<li>Leverage biology for vaginally administered products: In this objective, we seek: 1) innovative formulations and delivery approaches that leverage the biology of the vaginal microenvironment to support development of novel delivery technologies and that have high potential for scalable, low-cost manufacturing options; and 2) novel components that could be incorporated into and improve existing formulations (e.g. films, tablets/inserts) that would promote maintenance of or transition to an optimal vaginal microbiome and/or promote other benefit to the vaginal mucosal epithelium. Specifically, we seek to assess and de-risk novel approaches to vaginal delivery that can leverage and support features of the vaginal milieu including mucus, host cells and microbes for drug delivery and as such we anticipate proposals including evaluation of the impact of these novel approaches or components on changes in the microbiome and vaginal host components (cells/cytokines, mucins, glycans, lectins, etc.).</li>
<li>Define characteristics of an ideal vaginal product: In this objective, we seek to support qualitative studies aimed at identifying and understanding specific features of a vaginally administered product that would most appeal to women such that many women, especially those of reproductive age in LMICs, would seek to use such a product (for example, 'what would you hope to achieve when using this product in your vagina?'). We are particularly interested in defining ancillary benefits (such as odor control, sexual enhancement, etc.) that could be derived from a vaginally delivered product that would likely not be supported by other routes of administration, as well as identifying major hurdles that may prevent a woman from seeking out or preferring a vaginal product. We acknowledge that there may be regional, cultural, demographic or other preference differences, and are seeking to identify desires or barriers that are commonly expressed by women across these demographic differences. Applicants may propose methods to prioritize preferences such that the vaginal product developed can benefit as many women as possible. In sum, we aim to gather insights into preferred and achievable characteristics that would transform vaginal products from 'tolerable' to 'desirable'.</li>
</ol>
Funding Level
Projects with a duration of up to two years and a maximum requested budget of $250,000USD are eligible for funding. Exploratory projects with shorter durations/lower budgets that focus on high-risk, innovative areas are strongly encouraged and will be given priority. Budgets should be commensurate with the scope of work proposed and in line with allowable costs of the targeted funding organization for which the applicant is eligible. Indirect costs should be included in the budget and should not exceed 10-15% of the total award (subject to the <a href="https://docs.gatesfoundation.org/Documents/Indirect_Cost_Policy.pdf" target="_blank" rel="noopener noreferrer">Gates Foundation's indirect cost policy</a>).
Eligibility Criteria
This initiative is open to research institutes, nonprofit organizations, for-profit companies, international organizations, government agencies, and academic institutions. Please note that all applicants will be expected to comply with the Foundation's global access clause. We encourage groups to build upon existing and/or complimentary projects/studies/trials and to collaborate with other institutions. We particularly encourage applications from projects led by women and/or researchers at institutions based in LMICs and/or involving collaboration with women-led or LMIC-based organizations. Only individuals who are applying through a legally recognized corporate entity are eligible.
We are looking for proposals that:
<ul>
<li>Focus on vaginal delivery approaches that do not require retrieval and disposal after use and can be adapted for extended- or slow-release of active ingredients.</li>
<li>Use innovative, rigorous qualitative approaches that improve or deepen our understanding of standard acceptability metrics.</li>
<li>Generate biological or end-user data from low- and middle-income regions and comply with national regulations on data security, data protection and privacy.</li>
<li>Propose rigorous scientific approaches to study a clear research question and whose rationale is clearly supported by peer-reviewed literature.</li>
<li>Demonstrate feasibility with preliminary data in support of the proposed approach; if no preliminary data exists, then the proposal should be limited in scope.</li>
<li>Request the appropriate funds and time to achieve the objectives of the proposed work. Exploratory projects of lower cost but higher risk are strongly encouraged and will be prioritized.</li>
<li>Promote a diverse, inclusive, and supportive research environment, with priority for collaborations involving LMIC-based experts in reproductive health.</li>
</ul>
We will not fund proposals that:
<ul>
<li>Evaluate the impact of currently available vaginally inserted products on the vaginal milieu (e.g. menstrual products, contraceptive devices, over-the-counter probiotics, etc.).</li>
<li>Focus on approaches that would not be feasible or affordable in low- and middle-income countries, including personalized medicine. If these approaches are included, the feasibility of scalable, low-cost development should be explicitly stated.</li>
<li>Focus on the development of therapeutics or interventions for specific conditions, such as treatment for STIs or contraceptive products. While these types of interventions may be used as a test case within the proposal, the work itself should focus on formulations.</li>
<li>Are focused solely on basic exploratory scientific research without a clear translational pathway, including potential end-use scenarios, scalability considerations and regulatory or manufacturing implications.</li>
<li>Center solely on focus groups and interviews. These methods or qualitative approaches are acceptable if embedded within rigorous mixed-methods study designs that generate quantitative, actionable insights beyond anecdotal data or standard acceptability metrics such as affective attitudes.</li>
<li>Do not consider end user preferences or assume end-user preferences. For the purposes of this RFP, end-users can be defined as women of reproductive age in low- and middle-income countries. Proposals may focus on subgroups (e.g., adolescents, post-partum women), but the target group must be explicitly defined and justified.</li>
<li>Primarily depend on traditional acceptability questionnaires or surveys (e.g., “if x hypothetical product existed, how interested would you be in using it?”).</li>
<li>Do not directly address one of the core objectives as outlined above.</li>
<li>Cannot be accomplished within a two-year maximum project duration or within the stipulated budget maximum.</li>
<li>Support researchers or research teams who are affiliated with the tobacco industry, or who receive (or are applying for) funding from the tobacco industry, which includes manufacturers and distributors of e-cigarettes or vaping products.</li>
</ul>

Grand Challenges Africa

Grand Challenges India

Grand Challenges

Accelerating Development of Innovative, Exceptionally Low-Cost Maternal and Child Nutrient Ingredients and Products

Before applying, applicants should familiarize themselves with the supporting documents for this Grand Challenge, including the terms and conditions of the <a href="https://submit.gatesfoundation.org/res/p/RFPTermsConditions/" target="_blank" rel="noopener noreferrer">Gates Foundation</a>, the <a href="https://gcgh.grandchallenges.org/sites/default/files/files/low-cost_nutritients_cost_rules_and_guidelines.pdf" target="_blank" rel="noopener noreferrer">Rules and Guidelines</a>, <a href="https://gcgh.grandchallenges.org/sites/default/files/files/low_cost_nutrients_application_instructions.pdf" target="_blank" rel="noopener noreferrer">Application Instructions</a>, and <a href="https://gcgh.grandchallenges.org/accelerating-development-innovative-exceptionally-low-cost-maternal-and-child-nutrient-ingredients" target="_blank" rel="noopener noreferrer">Frequently Asked Questions</a>.
If you are planning to apply to this RFP, we will be hosting a dedicated webinar on November 12, from 7:00 to 8:00 AM Pacific Time. This session will provide a comprehensive overview of the RFP details and an opportunity to have your questions answered. To participate in the webinar, please <a href="https://events.teams.microsoft.com/event/e41294d9-be6c-4906-a5db-bd5aedaa5e75@296b3838-4bd5-496c-bd4b-f456ea743b74" target="_blank" title="https://events.teams.microsoft.com/event/73a86f86-39cf-419c-8eff-333f5dc22ca7@296b3838-4bd5-496c-bd4b-f456ea743b74" rel="noopener noreferrer">register</a> and <a href="https://forms.office.com/r/sUWxxATXyT?origin=lprLink" target="_blank" title="https://forms.office.com/pages/responsepage.aspx?id=odhrkdvlbem9s_rw6nq7dnyuf4phutfbmfmat6jkpdduqk5dtlk1tvjqwldktdbpreduntrlqzjrtc4u" rel="noopener noreferrer">submit your questions in advance</a>. If you cannot attend live, the webinar will be recorded and available on this challenge page after the session.
<blockquote>This is a call for transformative innovation. We seek solutions that ensure every mother and child – regardless of where they live – can access the essential nutrients to survive and thrive.
</blockquote>
<h2>Background</h2>
Malnutrition remains one of the most urgent and pervasive threats to maternal, newborn, and child health in low- and middle-income countries (LMICs). It contributes to nearly half of all under-five child deaths and is a significant driver of maternal and child morbidity and mortality. During the first 1,000 days of a child's life (from conception to a child's second birthday), nutritional deficiencies can cause irreversible physical and cognitive impairments, limiting educational attainment, economic productivity, and lifelong health. In LMICs, where poverty, limited health services, and food insecurity intersect, the burden of malnutrition disproportionately affects the most vulnerable populations, exacerbating inequities and hindering progress toward global development goals.
Targeted interventions that improve maternal nutrition before and during pregnancy are essential for breaking this cycle.
Despite decades of evidence demonstrating the importance of adequate intakes and effectiveness of nutrition interventions, many solutions are inaccessible in LMICs due to high costs of nutrients and final products.
The nutrients we are particularly interested in are calcium, choline, and omega-3 long chain polyunsaturated fatty acids (specifically docosahexaenoic acid – DHA).
Calcium supplementation has been recommended by the World Health Organization (WHO) (1.5–2.0 g elemental calcium daily in populations with low dietary intake) since 2011 as a strategy to reduce the risk of preeclampsia in pregnant women. In two recent randomized trials in India and Tanzania, a low-dose regimen (500 mg elemental calcium daily) was found to be noninferior to the high-dose regimen (1,500 mg) in reducing preeclampsia incidence, supporting the possibility of a simpler, lower-dose strategy.
Choline is an essential nutrient that supports fetal brain development, memory function, and placental health, with increasing evidence linking adequate maternal intake to improved child neurocognitive outcomes. The U.S. National Academies of Medicine, the American Academy of Pediatrics, and the European Food Safety Authority (EFSA) all recommend adequate intakes (450–480 mg/day), yet studies consistently show that most pregnant women consume less than recommended, making insufficiency highly prevalent.
DHA supports fetal brain, eye, and nervous system development. A Cochrane meta-analysis found that omega-3 supplementation including DHA in pregnancy reduces the risk of preterm birth (before 37 weeks and before 34 weeks). The WHO and the Food and Agriculture Organization (FAO) recommend ≥200 mg/day of DHA for pregnant and lactating women, while the EFSA advises 100–200 mg/day DHA in addition to regular omega-3 intake. This is consistent with recommendations from professional societies such as the American College of Obstetricians and Gynecologists and the International Society for the Study of Fatty Acids and Lipids. Despite this alignment across authorities, dietary surveys show that most pregnant women worldwide do not meet these targets, particularly in regions with low fish consumption.
The United Nations International Multiple Micronutrient Antenatal Preparation (UNIMMAP) is a standard formulation that provides a base reference for antenatal multiple micronutrient supplementation and is used in this call for proposals.
<h2>The Challenge</h2>
High input costs, complex production processes, and limited manufacturing capacity in LMICs keep the price of essential nutrient ingredients and products prohibitively high. As a result, millions of women and children cannot access proven, lifesaving interventions.
At the same time, there is a clear opportunity: innovations across the entire product lifecycle - raw material sourcing, ingredient formulation, manufacturing methods, and packaging - can dramatically lower costs while maintaining quality. Advances in biotechnology, materials science, food technology, and other industries provide models that could be adapted to nutrition.
We are not seeking incremental improvements. This call is for transformative, bold solutions that can reduce costs by at least 50% compared to current baselines, while maintaining or improving safety, efficacy, and user acceptability. We want to support the development and validation of scalable, sustainable strategies that make high-quality nutrient ingredients and products affordable for LMIC health systems and ensure equitable access for every mother and child.
Based on Latham BioPharm Group research, the commonly available pharmaceutical quality ingredients for the nutrients of interest are calcium carbonate, choline bitartrate, choline chloride, and algal DHA powder. The lowest prices reported are 2.1 USD/kg, 5.8 USD/kg, 1.2 USD/kg, and 52 USD/kg (30% purity) respectively. The target cost for exceptionally low-cost nutrient ingredients should be at least 50% below the lowest price identified.
Focus Areas
Applicants may propose projects under one of the following options:
<div class="responsive-table"><table>
<thead>
<tr>
<th>Option</th>
<th>Scope</th>
<th>Key Requirements</th>
</tr>
</thead>
<tbody>
<tr>
<td>A</td>
<td>Development of exceptionally low-cost nutrient ingredients (calcium, choline, DHA)</td>
<td>
<ul>
<li>≥50% cost reduction compared to current lowest prices (CaCO₃ $2.1/kg, choline chloride $1.2/kg, algal DHA powder $52/kg, etc.)</li>
<li>Must meet pharmacopeial standards and International Council for Harmonisation (ICH) Q7 Good Manufacturing Practice (GMP) requirements</li>
<li>Expected to be stable, allergen-free, culturally inclusive (vegetarian, halal, kosher), and taste neutral</li>
</ul>
</td>
</tr>
<tr>
<td>B</td>
<td>Development of a low-cost prenatal supplement (UNIMMAP MMS + 500 mg/day calcium)</td>
<td>
<ul>
<li>Target cost &lt; US$2 per 180-day regimen</li>
<li>Informed by consumer research (acceptability, usability, palatability)</li>
<li>Demonstrated 3 month real-time and 6-month accelerated stability at ICH Q1 (Zone IVb)</li>
<li>Ideally meet WHO GMP requirements</li>
</ul>
</td>
</tr>
<tr>
<td>C</td>
<td>Development of an advanced prenatal supplement (MMSplus: UNIMMAP MMS + 500 mg/day calcium + 100 mg/day nicotinamide + 450 mg/day choline + 200 mg/day DHA)</td>
<td>
<ul>
<li>Multiple dosage forms or units acceptable (not limited to a single tablet)</li>
<li>Informed by consumer research - Demonstrated 3 month real-time and 6-month accelerated stability at ICH Q1 (Zone IVb)</li>
<li>Ideally meet WHO GMP requirements</li>
</ul>
</td>
</tr>
</tbody>
</table></div>
Funding Level
<div class="responsive-table"><table>
<thead>
<tr>
<th>Option</th>
<th>Scope</th>
<th>Target (summary)</th>
<th>Funding</th>
<th>Duration</th>
</tr>
</thead>
<tbody>
<tr>
<td>A</td>
<td>Exceptionally low-cost nutrient ingredients (Calcium, Choline, DHA)</td>
<td>≥50% cost reduction vs current lowest prices; pharmaceutical quality; stable, allergen-free, culturally inclusive</td>
<td>Up to US$500,000 per ingredient</td>
<td>Up to 18 months</td>
</tr>
<tr>
<td>B</td>
<td>Low-cost prenatal supplement (MMS + 500 mg Calcium)</td>
<td>Less than US$2 per 180-day regimen; consumer informed; 6-month accelerated stability in Zone IVb</td>
<td>Up to US$200,000</td>
<td>Up to 12 months</td>
</tr>
<tr>
<td>C</td>
<td>Advanced prenatal supplement (MMSplus)</td>
<td>Consumer informed; 6-month accelerated stability in Zone IVb</td>
<td>Up to US$400,000</td>
<td>Up to 12 months</td>
</tr>
</tbody>
</table></div>
 Application budgets should be commensurate with the scope of work proposed. Indirect costs should be included in the budget and should not exceed 10-15% of the total award (subject to the <a href="https://docs.gatesfoundation.org/Documents/Indirect_Cost_Policy.pdf" target="_blank" rel="noopener noreferrer">Gates Foundation's indirect cost policy</a>).
Eligibility
This initiative is open globally to nonprofit organizations, for-profit companies, international organizations, government agencies, and academic institutions. We invite innovators from nutrition, biotechnology, food technology, pharmaceuticals, and beyond to apply. Only individuals who are applying through a legally recognized corporate entity are eligible.
What We Are Looking For
Successful proposals will demonstrate bold thinking, technical rigor, and a pathway to scale. Specifically, we are seeking proposals that:
<ul>
<li>Present transformative cost-reduction strategies, not incremental improvements, with a clear pathway to achieve ≥50% cost reduction.</li>
<li>Provide specific steps and/or end-to-end solutions, including credible cost modeling at scale (e.g., 3 million regimens per year).</li>
<li>Demonstrate technical feasibility with the ability to generate meaningful data within 12–18 months.</li>
<li>Clearly outline team capabilities and expertise, with strong preference for collaborations involving LMIC partners.</li>
<li>Include a justified budget, which will be reviewed for alignment with scope and deliverables.</li>
<li>Consider and enable manufacturing in LMICs, ensuring cultural and dietary inclusivity (vegetarian, halal, kosher).</li>
<li>Are informed by consumer research, addressing acceptability, usability, and adherence.</li>
</ul>
We encourage applicants to identify and build collaborations with organizations that bring complementary expertise. Where appropriate, the Foundation may facilitate connections among applicants working on related challenges.
We will not fund proposals that:
<ul>
<li>Rely solely on price negotiation or procurement tactics (e.g., bulk purchasing).</li>
<li>Offer only stepwise, incremental improvements with minimal cost impact.</li>
<li>Focus on delivery models (e.g., distribution, supply chain tools, or market shaping) without product innovation.</li>
<li>Address nutrients or products outside the defined scope.</li>
</ul>

High input costs, complex production processes, and limited manufacturing capacity in LMICs keep the price of essential nutrient ingredients and products prohibitively high. As a result, millions of women and children cannot access proven, lifesaving interventions.
This call is for transformative, bold solutions that can reduce costs by at least 50% compared to current baselines, while maintaining or improving safety, efficacy, and user acceptability. We want to support the development and validation of scalable, sustainable strategies that make high-quality nutrient ingredients and products affordable for LMIC health systems and ensure equitable access for every mother and child.

Accelerating Development of Innovative Exceptionally Low-Cost Maternal and Child Nutrient Ingredients and Products

This RFP is jointly launched by several Grand Challenges funding partners, including Grand Challenges Africa (Science for Africa Foundation), Grand Challenges Brazil (Brazilian Ministry of Health and the National Council on Research), Grand Challenges India (Biotechnology Industry Research Assistance Council), Grand Challenges South Africa (South African Medical Research Council), and the Gates Foundation. Each RFP may differ in its geographic focus, topic areas, and funding levels. Please review the eligibility criteria and specific requirements for each RFP carefully. The individual RFPs are listed separately <a href="https://contentpreview-spoke.grandchallenges.org/challenges/JTdCJTIyc29ydCUyMiUzQSUyMmRlc2NlbmRpbmclMjIlMkMlMjJzb3J0RmllbGQlMjIlM0ElMjJkYXRlJTIyJTJDJTIybnVtYmVyUGVyUGFnZSUyMiUzQTEwJTJDJTIycGFnZU51bWJlciUyMiUzQTAlN0Q=/JTdCJTIyeWVhcnMlMjIlM0ElNUIlMjIyMDI1JTIyJTVEJTJDJTIyY2hhbGxlbmdlcyUyMiUzQSU1QiUyMjM5NCUyMiU1RCUyQyUyMnRlcm1zJTIyJTNBJTVCJTVEJTJDJTIyaW5pdGlhdGl2ZXMlMjIlM0ElNUIlNUQlMkMlMjJsb2NhdGlvbnMlMjIlM0ElNUIlNUQlN0Q=" target="_blank" rel="noopener noreferrer">here</a>. If you qualify for more than one, we encourage you to apply to the RFP that best aligns with your proposed project and geographical location.
Please note: Grand Challenges Brazil will review proposals submitted by Brazilian organizations through the link on this webpage. Proposals selected to receive financial support from the Brazilian Ministry of Health / GC Brazil must be led by researchers linked to non-profit Science, Technology and Innovation Institutions (Instituição Científica, Tecnológica e de Inovação – ICT), registered in Brazil.
Before applying, applicants should familiarize themselves with the supporting documents for this Grand Challenge, including the Rules and Guidelines, Application Instructions, and Frequently Asked Questions.
If you are planning to apply to the Gates Foundation RFP, we will be hosting a dedicated webinar on November 20, from 6:00 to 7:00 AM Pacific Time. This session will provide a comprehensive overview of the RFP details and an opportunity to have your questions answered. To participate in the webinar, please <a href="https://events.teams.microsoft.com/event/2957503f-d95d-47b0-8bfa-b7d28f55266c@296b3838-4bd5-496c-bd4b-f456ea743b74" target="_blank" rel="noopener noreferrer">register</a> and <a href="https://forms.office.com/pages/responsepage.aspx?id=ODhrKdVLbEm9S_RW6nQ7dMKiReMZsCJFmCa42S92Da1UMFBSMVlMQUNLSlRDOVNOMFdNR0dSUUFXNC4u&amp;origin=lprLink&amp;route=shorturl" target="_blank" rel="noopener noreferrer">submit your questions</a> in advance. If you cannot attend live, the webinar will be recorded and available on this challenge page after the session.
<h2>Background</h2>
Local delivery of drugs into the vagina for prevention and treatment of female-specific conditions remains understudied and under-utilized despite clear potential advantages such as discreetness, potent local efficacy, large surface area for drug absorption, high potential for API dosage sparing, potential for fewer systemic side effects, as well as providing autonomy and empowerment of women. Several key drivers may be responsible for this lag, including paucity of mechanistic biological data, particularly from high-burden settings such as low- and middle-income countries (LMICs), to support the development of specific formulations for vaginal use as well as a persistent misconception that vaginally delivered products may not be embraced by women and their sexual partners. Several of our priorities for impactful products for sexual and reproductive health will require vaginal delivery for immediate, on-demand use. We seek to catalyze the development of innovative technologies and approaches that can safely and effectively deliver a wide range of vaginal products. We expect these approaches to have user appeal, including promotion of self-care capability and other beneficial features that women seek, hence the need to couple discovery research with high-quality end-user input.
<h2>The Challenge</h2>
We are soliciting applications that contribute to development of vaginal formulations that promote optimal drug delivery within the vaginal compartment while positively supporting the vaginal milieu, and that also possess beneficial effects, even if unrelated to the API intended effect, that a user might consider desirable, such as enhancement of sexual pleasure. We anticipate identifying product-agnostic features that promote vaginal health and that broadly appeal to women to advance product development and formulations for women's health. We welcome innovations at any stage of development that meet the scope of this call.
Applicants may apply to address one or more of the following objectives of this challenge:
<ol>
<li>Leverage biology for vaginally administered products: In this objective, we seek: 1) innovative formulations and delivery approaches that leverage the biology of the vaginal microenvironment to support development of novel delivery technologies and that have high potential for scalable, low-cost manufacturing options; and 2) novel components that could be incorporated into and improve existing formulations (e.g. films, tablets/inserts) that would promote maintenance of or transition to an optimal vaginal microbiome and/or promote other benefit to the vaginal mucosal epithelium. Specifically, we seek to assess and de-risk novel approaches to vaginal delivery that can leverage and support features of the vaginal milieu including mucus, host cells and microbes for drug delivery and as such we anticipate proposals including evaluation of the impact of these novel approaches or components on changes in the microbiome and vaginal host components (cells/cytokines, mucins, glycans, lectins, etc.).</li>
<li>Define characteristics of an ideal vaginal product: In this objective, we seek to support qualitative studies aimed at identifying and understanding specific features of a vaginally administered product that would most appeal to women such that many women, especially those of reproductive age in LMICs, would seek to use such a product (for example, 'what would you hope to achieve when using this product in your vagina?'). We are particularly interested in defining ancillary benefits (such as odor control, sexual enhancement, etc.) that could be derived from a vaginally delivered product that would likely not be supported by other routes of administration, as well as identifying major hurdles that may prevent a woman from seeking out or preferring a vaginal product. We acknowledge that there may be regional, cultural, demographic or other preference differences, and are seeking to identify desires or barriers that are commonly expressed by women across these demographic differences. Applicants may propose methods to prioritize preferences such that the vaginal product developed can benefit as many women as possible. In sum, we aim to gather insights into preferred and achievable characteristics that would transform vaginal products from 'tolerable' to 'desirable'.</li>
</ol>
Funding Level
Projects with a duration of up to two years and a maximum requested budget of $250,000USD are eligible for funding. Exploratory projects with shorter durations/lower budgets that focus on high-risk, innovative areas are strongly encouraged and will be given priority. Budgets should be commensurate with the scope of work proposed and in line with allowable costs of the targeted funding organization for which the applicant is eligible. Indirect costs should be included in the budget and should not exceed 10-15% of the total award (subject to the <a href="https://docs.gatesfoundation.org/Documents/Indirect_Cost_Policy.pdf" target="_blank" rel="noopener noreferrer">Gates Foundation's indirect cost policy</a>).
Eligibility Criteria
This initiative is open to research institutes, nonprofit organizations, for-profit companies, international organizations, government agencies, and academic institutions. Please note that all applicants will be expected to comply with the Foundation's global access clause. We encourage groups to build upon existing and/or complimentary projects/studies/trials and to collaborate with other institutions. We particularly encourage applications from projects led by women and/or researchers at institutions based in LMICs and/or involving collaboration with women-led or LMIC-based organizations. Only individuals who are applying through a legally recognized corporate entity are eligible.
We are looking for proposals that:
<ul>
<li>Focus on vaginal delivery approaches that do not require retrieval and disposal after use and can be adapted for extended- or slow-release of active ingredients.</li>
<li>Use innovative, rigorous qualitative approaches that improve or deepen our understanding of standard acceptability metrics.</li>
<li>Generate biological or end-user data from low- and middle-income regions and comply with national regulations on data security, data protection and privacy.</li>
<li>Propose rigorous scientific approaches to study a clear research question and whose rationale is clearly supported by peer-reviewed literature.</li>
<li>Demonstrate feasibility with preliminary data in support of the proposed approach; if no preliminary data exists, then the proposal should be limited in scope.</li>
<li>Request the appropriate funds and time to achieve the objectives of the proposed work. Exploratory projects of lower cost but higher risk are strongly encouraged and will be prioritized.</li>
<li>Promote a diverse, inclusive, and supportive research environment, with priority for collaborations involving LMIC-based experts in reproductive health.</li>
</ul>
We will not fund proposals that:
<ul>
<li>Evaluate the impact of currently available vaginally inserted products on the vaginal milieu (e.g. menstrual products, contraceptive devices, over-the-counter probiotics, etc.).</li>
<li>Focus on approaches that would not be feasible or affordable in low- and middle-income countries, including personalized medicine. If these approaches are included, the feasibility of scalable, low-cost development should be explicitly stated.</li>
<li>Focus on the development of therapeutics or interventions for specific conditions, such as treatment for STIs or contraceptive products. While these types of interventions may be used as a test case within the proposal, the work itself should focus on formulations.</li>
<li>Are focused solely on basic exploratory scientific research without a clear translational pathway, including potential end-use scenarios, scalability considerations and regulatory or manufacturing implications.</li>
<li>Center solely on focus groups and interviews. These methods or qualitative approaches are acceptable if embedded within rigorous mixed-methods study designs that generate quantitative, actionable insights beyond anecdotal data or standard acceptability metrics such as affective attitudes.</li>
<li>Do not consider end user preferences or assume end-user preferences. For the purposes of this RFP, end-users can be defined as women of reproductive age in low- and middle-income countries. Proposals may focus on subgroups (e.g., adolescents, post-partum women), but the target group must be explicitly defined and justified.</li>
<li>Primarily depend on traditional acceptability questionnaires or surveys (e.g., “if x hypothetical product existed, how interested would you be in using it?”).</li>
<li>Do not directly address one of the core objectives as outlined above.</li>
<li>Cannot be accomplished within a two-year maximum project duration or within the stipulated budget maximum.</li>
<li>Support researchers or research teams who are affiliated with the tobacco industry, or who receive (or are applying for) funding from the tobacco industry, which includes manufacturers and distributors of e-cigarettes or vaping products.</li>
</ul>

**NOTE: This opportunity was open only to institutions who were invited directly by email.Before applying, applicants should familiarize themselves with the supporting documents for this Grand Challenge, including the <a href="https://gcgh.grandchallenges.org/sites/default/files/files/enteric_and_diarrheal_diseases_data_analysis_rules_and_guidelines.pdf" target="_blank">Rules and Guidelines</a>, <a href="https://gcgh.grandchallenges.org/sites/default/files/files/enteric_and_diarrheal_diseases_data_analysis_application_instructions.pdf" target="_blank">Application Instructions</a>, and <a href="https://gcgh.grandchallenges.org/strengthening-analytic-capacity-enteric-and-diarrheal-diseases-low-and-middle-income-settings" target="_blank">Frequently Asked Questions</a>.<h2>Background</h2>Enteric and diarrheal diseases remain a leading cause of morbidity and mortality in low- and middle-income countries (LMICs), particularly among children under five. Over the past two decades, substantial investments have been made in large-scale epidemiological studies generating rich datasets on enteric pathogens, risk factors, and outcomes across diverse LMIC settings. Despite the volume and potential of this data, much of it remains underutilized, with limited secondary analysis conducted by in-country researchers. Empowering LMIC-based investigators to lead secondary analyses not only enhances the contextual relevance of findings but also strengthens local research capacity and ownership of health solutions. Therefore, there is a significant opportunity to catalyze novel insights into enteric and diarrheal disease etiology, sequelae, interventions, and policy, while promoting equitable research partnerships and advancing global health equity.<h2>The Challenge</h2>This RFP seeks to develop the capacity for leading data analysis related to enteric and diarrheal diseases in low-and-middle income settings.Specifically, the objectives of the challenge will be:<ul><li>Develop novel insights from existing data</li><li>Promote LMIC leadership and independence in global health research</li><li>Strengthen analytical capacity in LMICs</li><li>Inform policy and program decision-making</li><li>Advance open science and data stewardship</li></ul>Funding LevelWe will consider proposals for awards of up to $100,000 USD in direct costs for each project, with a grant term of up to 1 year. Application budgets should be commensurate with the scope of work proposed. Indirect costs will be considered, and should be included in the budget for up to $15,000 USD award (subject to the <a href="https://docs.gatesfoundation.org/Documents/Indirect_Cost_Policy.pdf" target="_blank">Gates Foundation's indirect cost policy</a>).Eligibility CriteriaThis initiative is open to nonprofit organizations, for-profit companies, international organizations, government agencies and academic institutions that 1) are based in a LMIC country<a href="#_ftn1" title="" id="_ftnref1" name="_ftnref1">1</a>; and 2) have received funding from the Gates Foundation as a direct awardee or sub-grantee on enteric and diarrheal disease-related investments. We particularly encourage applications involving projects led by women or from women-led organizations. Applicants should align within their institutions before submitting a proposal as no more than one award will be given to a single institution.We are looking for proposals that:<ul><li>Are led by junior or mid-level researchers that: 1) have experience in the field of enterics and want to lead more analytics work, 2) have analytical skills who want to gain experience in applications in enterics or 3) have experience in both enterics and data analysis and would like to expand their analytic skillset in specific ways.</li><li>Focus on enteric and diarrheal diseases (including but not limited to diarrhea and diarrheal etiologies, typhoid/enteric fever and invasive nontyphoidal Salmonella, Hepatitis E and A)&nbsp;including but not limited to disease epidemiology, genomics, vaccine performance, disease dynamics, treatment effects, diagnostic performance, cost-effectiveness, and/or mathematical models.</li><li>Prioritize policy-relevant analytic questions.</li><li>Demonstrate institutional support and partnerships necessary for growth in analytic skills and successful completion of the objectives.</li><li>Conduct analyses beyond what was funded by the parent study and/or published.</li><li>Result in at least one pre-print manuscript and one policy brief.</li><li>Include support for investigators through a mentor, mentoring team, and/or training plan (e.g., coursework) to develop the analytic skills needed to successfully complete the proposed research. These resources may be provided by the applicant's home institution or a partner institution (located anywhere in the world) supported by a subgrant.</li><li>Contribute to sustainable capacity building for data analysis to be conducted at the home institution in future research projects.</li><li>In case of a multi-site study, particularly those funded by the Gates Foundation, a cross-site analysis can be proposed by an investigator from a single site, and data retrieval mechanisms will be facilitated by the Gates Foundation</li></ul>We will not fund proposals that:<ul><li>Aim to collect or generate new data through this funding.</li><li>Propose descriptive analyses alone.</li><li>Propose analyses that overlap with results already funded and/or published.</li><li>Are not led by an LMIC investigator.</li><li>Do not demonstrate how this award would strengthen local capacity to conduct and lead analysis of future datasets.</li><li>Do not focus on enteric and diarrheal diseases.</li><li>Do not demonstrate a clear commitment to open science and making their findings, processes and/or tools developed accessible and reusable.</li></ul><a href="#_ftnref1" title="" id="_ftn1" name="_ftn1">1</a> See <a href="https://data.worldbank.org/country/XO" target="_blank">World Bank - Low Income Countries for definitions</a>). Subject to the eligibility requirements in the Rules &amp; Guidelines, investigators in low- and middle-income countries are invited (in connection with the organization with which they are affiliated) to apply through the Gates Foundation’s application portal. We reserve the right to determine eligibility for this call based on these characteristics. Grants will go to investigators in low- and middle-income countries, but we encourage partnerships with investigators in other countries regardless of location, especially where the opportunity exists to build on existing collaborations.

Strengthening Analytic Capacity for Enteric and Diarrheal Diseases in Low-and-Middle Income Settings

**NOTE: This opportunity is open only to institutions who have been invited directly by email.
Before applying, applicants should familiarize themselves with the supporting documents for this Grand Challenge, including the <a href="https://gcgh.grandchallenges.org/sites/default/files/files/enteric_and_diarrheal_diseases_data_analysis_rules_and_guidelines.pdf" target="_blank" rel="noopener noreferrer">Rules and Guidelines</a>, <a href="https://gcgh.grandchallenges.org/sites/default/files/files/enteric_and_diarrheal_diseases_data_analysis_application_instructions.pdf" target="_blank" rel="noopener noreferrer">Application Instructions</a>, and <a href="https://gcgh.grandchallenges.org/strengthening-analytic-capacity-enteric-and-diarrheal-diseases-low-and-middle-income-settings" target="_blank" rel="noopener noreferrer">Frequently Asked Questions</a>.
<h2>Background</h2>
Enteric and diarrheal diseases remain a leading cause of morbidity and mortality in low- and middle-income countries (LMICs), particularly among children under five. Over the past two decades, substantial investments have been made in large-scale epidemiological studies generating rich datasets on enteric pathogens, risk factors, and outcomes across diverse LMIC settings. Despite the volume and potential of this data, much of it remains underutilized, with limited secondary analysis conducted by in-country researchers. Empowering LMIC-based investigators to lead secondary analyses not only enhances the contextual relevance of findings but also strengthens local research capacity and ownership of health solutions. Therefore, there is a significant opportunity to catalyze novel insights into enteric and diarrheal disease etiology, sequelae, interventions, and policy, while promoting equitable research partnerships and advancing global health equity.
<h2>The Challenge</h2>
This RFP seeks to develop the capacity for leading data analysis related to enteric and diarrheal diseases in low-and-middle income settings.
Specifically, the objectives of the challenge will be:
<ul>
<li>Develop novel insights from existing data</li>
<li>Promote LMIC leadership and independence in global health research</li>
<li>Strengthen analytical capacity in LMICs</li>
<li>Inform policy and program decision-making</li>
<li>Advance open science and data stewardship</li>
</ul>
Funding Level
We will consider proposals for awards of up to $100,000 USD in direct costs for each project, with a grant term of up to 1 year. Application budgets should be commensurate with the scope of work proposed. Indirect costs will be considered, and should be included in the budget for up to $15,000 USD award (subject to the <a href="https://docs.gatesfoundation.org/Documents/Indirect_Cost_Policy.pdf" target="_blank" rel="noopener noreferrer">Gates Foundation's indirect cost policy</a>).
Eligibility Criteria
This initiative is open to nonprofit organizations, for-profit companies, international organizations, government agencies and academic institutions that 1) are based in a LMIC country<a href="#_ftn1" title id="_ftnref1" name="_ftnref1">1</a>; and 2) have received funding from the Gates Foundation as a direct awardee or sub-grantee on enteric and diarrheal disease-related investments. We particularly encourage applications involving projects led by women or from women-led organizations. Applicants should align within their institutions before submitting a proposal as no more than one award will be given to a single institution.
We are looking for proposals that:
<ul>
<li>Are led by junior or mid-level researchers that: 1) have experience in the field of enterics and want to lead more analytics work, 2) have analytical skills who want to gain experience in applications in enterics or 3) have experience in both enterics and data analysis and would like to expand their analytic skillset in specific ways.</li>
<li>Focus on enteric and diarrheal diseases (including but not limited to diarrhea and diarrheal etiologies, typhoid/enteric fever and invasive nontyphoidal Salmonella, Hepatitis E and A)&nbsp;including but not limited to disease epidemiology, genomics, vaccine performance, disease dynamics, treatment effects, diagnostic performance, cost-effectiveness, and/or mathematical models.</li>
<li>Prioritize policy-relevant analytic questions.</li>
<li>Demonstrate institutional support and partnerships necessary for growth in analytic skills and successful completion of the objectives.</li>
<li>Conduct analyses beyond what was funded by the parent study and/or published.</li>
<li>Result in at least one pre-print manuscript and one policy brief.</li>
<li>Include support for investigators through a mentor, mentoring team, and/or training plan (e.g., coursework) to develop the analytic skills needed to successfully complete the proposed research. These resources may be provided by the applicant's home institution or a partner institution (located anywhere in the world) supported by a subgrant.</li>
<li>Contribute to sustainable capacity building for data analysis to be conducted at the home institution in future research projects.</li>
<li>In case of a multi-site study, particularly those funded by the Gates Foundation, a cross-site analysis can be proposed by an investigator from a single site, and data retrieval mechanisms will be facilitated by the Gates Foundation</li>
</ul>
We will not fund proposals that:
<ul>
<li>Aim to collect or generate new data through this funding.</li>
<li>Propose descriptive analyses alone.</li>
<li>Propose analyses that overlap with results already funded and/or published.</li>
<li>Are not led by an LMIC investigator.</li>
<li>Do not demonstrate how this award would strengthen local capacity to conduct and lead analysis of future datasets.</li>
<li>Do not focus on enteric and diarrheal diseases.</li>
<li>Do not demonstrate a clear commitment to open science and making their findings, processes and/or tools developed accessible and reusable.</li>
</ul>
<a href="#_ftnref1" title id="_ftn1" name="_ftn1">1</a> See <a href="https://data.worldbank.org/country/XO" target="_blank" rel="noopener noreferrer">World Bank - Low Income Countries for definitions</a>). Subject to the eligibility requirements in the Rules &amp; Guidelines, investigators in low- and middle-income countries are invited (in connection with the organization with which they are affiliated) to apply through the Gates Foundation’s application portal. We reserve the right to determine eligibility for this call based on these characteristics. Grants will go to investigators in low- and middle-income countries, but we encourage partnerships with investigators in other countries regardless of location, especially where the opportunity exists to build on existing collaborations.

**NOTE: This opportunity is open only to institutions who have been invited directly by email.

Randomized Controlled Trial on Sexually Transmitted Infections (STIs) and Reproductive Tract Sequelae in Non-Pregnant Women 

The information regarding this Grand Challenges Request for Proposals was last updated on June 6, 2025.
Before applying, applicants should familiarize themselves with the supporting documents for this Grand Challenge, including the <a href="https://gcgh.grandchallenges.org/sites/default/files/files/gcam_2025_cta_rules_and_guidelines.pdf" target="_blank" title="GCAM 2025 CtA - Rules and Guidelines" rel="noopener noreferrer">Rules and Guidelines</a>, <a href="https://gcgh.grandchallenges.org/sites/default/files/files/gcam_2025_cta_application_instructions.pdf" target="_blank" title="GCAM 2025 CtA - Application Instructions" rel="noopener noreferrer">Application Instructions</a>, and&nbsp;<a href="https://gcgh.grandchallenges.org/2025-grand-challenges-annual-meeting-call-action-frequently-asked-questions-faqs" target="_blank" title="GCAM 2025 CtA - Frequently Asked Questions (FAQs)" rel="noopener noreferrer">Frequently Asked Questions</a>.
We are planning a webinar to provide more information and answer your questions on June 17 from 7:00-8:00 AM Pacific Time. To participate, <a href="https://events.teams.microsoft.com/event/96243f4f-c909-4175-9cc6-aa5fa3699391@296b3838-4bd5-496c-bd4b-f456ea743b74" target="_blank" rel="noopener noreferrer">please register</a> and <a href="https://forms.office.com/Pages/ResponsePage.aspx?id=ODhrKdVLbEm9S_RW6nQ7dNyUf4PhutFBmFMAT6JKpddUMzJGQUZFNEZDWExXTTZVM0xYTDQzV0pKUy4u" target="_blank" rel="noopener noreferrer">submit your questions</a> ahead of time.
<h2>Background</h2>
Sexually active young women in low- and middle-income countries (LMICs) experience a high incidence of sexually transmitted infections (STIs), limited access to screening and treatment, and poorly characterized but significant reproductive tract morbidity from untreated infection. Global estimates put the prevalence of gonorrhea and chlamydia among women at 0.8% and 4.0%, respectively, with incidence rates of 1.9 and 3.6 cases per 100 person-years.<a href="#_ftn1" title id="_ftnref1" name="_ftnref1">[1]</a> However, these estimates are limited by sparse data, with few sources providing representative measures of disease frequency, including asymptomatic infections. Studies among young women in LMICs interested in HIV pre-exposure prophylaxis have measured incidence rates per 100 person-years of 12-53 for chlamydia, 6-20 for gonorrhea, and 6-7 for trichomoniasis.<a href="#_ftn2" title id="_ftnref2" name="_ftnref2">[2]</a> Due to the asymptomatic nature of most infections and reliance on syndromic management, most STIs in women go undetected. Untreated STIs have been linked to a range of poor health outcomes, including pelvic inflammatory disease (PID), chronic pelvic pain, infertility, and ectopic pregnancy. However, these estimates of association are imprecise and draw primarily from cross-sectional, case-control, and retrospective cohort studies, mostly conducted in high-income countries. Gaps in available data limit our ability to draw robust inferences on the risk of sequelae following an infection, the timing of pathogenesis, or how factors such as the presence of symptoms or repeat infection may modify these risks.
Better data on the risk of PID and related sequelae are critical to inform prevention and treatment guidelines, motivate funding for product development and provision of services, and shift care-seeking and care-provision behaviors. Research on the prevalence and risk of PID in LMICs has been challenging due to a lack of accurate and scalable diagnostic methods for PID along with funding gaps that limit consistent and comprehensive diagnosis.&nbsp; Although diagnosing subclinical PID remains challenging, targeted research is critical to better understand the risk of developing clinical PID and to evaluate the effectiveness of STI screening and treatment in preventing reproductive tract complications. Strengthening the evidence base in this area will not only advance our understanding of STI-related morbidity but may also stimulate the development and application of improved diagnostic tools to reduce the burden of PID and related outcomes.
<h2>The Challenge</h2>
This Grand Challenge on Randomized Controlled Trial on Sexually Transmitted Infections (STIs) and Reproductive Tract Sequelae in Non-Pregnant Women aims to fill critical gaps in understanding of the risk of PID and related sequelae attributable to STIs and to evaluate the impact of etiologic STI screening and treatment on morbidity. With this Grand Challenge we welcome letters of intent (LOIs) from organizations to conduct a randomized controlled trial (RCT) in sub-Saharan Africa comparing STI screening and standard of care syndromic management. The primary outcome of this study should be PID, with secondary outcomes possibly including chronic pelvic pain, ectopic pregnancy, and infertility. The study should provide insight into the risk of outcomes following infection with gonorrhea, chlamydia, and/or trichomoniasis and the impact and cost-effectiveness of etiologic screening to prevent morbidity.
Funding Level
We will consider applications requesting awards ranging from $8 million to $10 million USD per project, with a grant duration of up to 48 months. Budgets should align with the scale and complexity of the proposed work. Indirect costs are allowable and should be included within the total requested funding. (subject to the <a href="https://docs.gatesfoundation.org/Documents/Indirect_Cost_Policy.pdf" target="_blank" rel="noopener noreferrer">Gates Foundation's indirect cost policy</a>).
Eligibility Criteria
<ul>
<li>This initiative is open to nonprofit organizations, for-profit companies, international organizations, government agencies, and academic institutions.</li>
<li>Study design must be randomized controlled trial or comparable, robust prospective in Sub-Saharan African settings.</li>
<li>We encourage groups to build upon existing and/or complimentary projects/studies/trials and to collaborate with other institutions.</li>
<li>We particularly encourage applications involving projects led by African Primary Investigators (PIs), women, early-career researchers, and practitioners seeking to innovate in women's health measurement, or from women-led organizations and applications from institutions based in LMICs.</li>
</ul>
We are looking for proposals that:
<ul>
<li>Are designed to provide insight into the timing of pathogenesis. This insight could come from comparison of outcomes across arms with varying screening intervals and/or from more frequent collection and storage of samples for subsequent batch testing.</li>
<li>Consider symptom tracking tools (such as symptom diaries) that could be used to track the onset, type, and severity of symptoms. Ideally, based on validated instruments.</li>
<li>Ideally enable stratification of risk by the presence of symptoms, co-infection, and repeat infection.</li>
<li>Ideally provide data to estimate STI incidence and the duration of untreated infection.</li>
<li>Collect detailed sexual behavior data, including the number of current and recent partners, partner type, partnership duration, concurrency, frequency of sex, type of sex, use of condoms, and characteristics and behaviors of partners.</li>
<li>Captures costs of screening, treatment, and management of sequelae.</li>
<li>Engage stakeholders and utilize community advisory boards.</li>
</ul>
We will not fund proposals that:
<ul>
<li>Have trial sites that are not based in sub-Saharan Africa.</li>
<li>Do not include PID as a primary outcome.</li>
<li>Include women who are pregnant at baseline.</li>
<li>Include women with a known diagnosis of infertility at baseline as part of the outcome analysis population.</li>
<li>Restrict the study population based on HIV status without justification.</li>
<li>Propose purely observational, retrospective, or modeling-only design.</li>
<li>Do not address the timing of pathogenesis or provide a strategy for identifying or analyzing the onset of sequelae following STI.</li>
<li>Do not plan for ethical, community, and gender-informed engagement.</li>
<li>Lack consideration of downstream policy relevance, such as linking findings to potential influence on screening, syndromic management, or STI prevention guidelines.</li>
</ul>
<a href="#_ftnref1" title id="_ftn1" name="_ftn1">[1]</a> World Health Organization. (2025). Global and regional STI estimates. The Global Health Observatory. <a href="https://www.who.int/data/gho/data/themes/topics/global-and-regional-sti-estimates">https://www.who.int/data/gho/data/themes/topics/global-and-regional-sti…</a>
<a href="#_ftnref2" title id="_ftn2" name="_ftn2">[2]</a> Kiweewa, et al. (2019). JAIDS, 22(2), e25257. <a href="https://doi.org/10.1002/jia2.25257" target="_blank" rel="noopener noreferrer">https://doi.org/10.1002/jia2.25257</a>; Stewart et al. (2020). AIDS, 34(5), 651–658. <a href="https://doi.org/10.1097/QAD.0000000000002472">https://doi.org/10.1097/QAD.0000000000002472</a>; Delany-Moretlwe (2023). Sex Transm Infect, 99(7), 433–439. <a href="https://doi.org/10.1136/sextrans-2022-055696" target="_blank" rel="noopener noreferrer">https://doi.org/10.1136/sextrans-2022-055696</a>.

This Grand Challenge on Randomized Controlled Trial on Sexually Transmitted Infections (STIs) and Reproductive Tract Sequelae in Non-Pregnant Women aims to fill critical gaps in understanding of the risk of PID and related sequelae attributable to STIs and to evaluate the impact of etiologic STI screening and treatment on morbidity.&nbsp;With this Grand Challenge&nbsp;we welcome letters of intent (LOIs) from organizations to conduct a randomized controlled trial (RCT) in sub-Saharan Africa comparing STI screening and standard of care syndromic management. The primary outcome of this study should be PID, with secondary outcomes possibly including chronic pelvic pain, ectopic pregnancy, and infertility. The study should provide insight into the risk of outcomes following infection with gonorrhea, chlamydia, and/or trichomoniasis and the impact and cost-effectiveness of etiologic screening to prevent morbidity.

2025 Grand Challenges Annual Meeting Call-to-Action

**NOTE: This opportunity is open only to participants who registered for the 2025 Grand Challenges Annual Meeting.
Before applying, applicants should familiarize themselves with the supporting documents for this Grand Challenge, including the <a href="https://gcgh.grandchallenges.org/sites/default/files/files/gcam_2025_cta_rules_and_guidelines.pdf" target="_blank" title="GCAM 2025 CtA - Rules and Guidelines" rel="noopener noreferrer">Rules and Guidelines</a>, <a href="https://gcgh.grandchallenges.org/sites/default/files/files/gcam_2025_cta_application_instructions.pdf" target="_blank" title="GCAM 2025 CtA - Application Instructions" rel="noopener noreferrer">Application Instructions</a>, and <a href="https://gcgh.grandchallenges.org/2025-grand-challenges-annual-meeting-call-action-frequently-asked-questions-faqs" target="_blank" title="GCAM 2025 CtA - Frequently Asked Questions (FAQs)" rel="noopener noreferrer">Frequently Asked Questions</a>.
<h2>The Opportunity</h2>
The Grand Challenges Annual Meeting fosters innovation and international collaboration to address the biggest challenges in global health and development. It has been held in&nbsp;<a href="https://grandchallenges.org/annual-meeting" target="_blank" rel="noopener noreferrer">13 countries</a> over the past 20 years and in a virtual format for three years, including this year's. The 2025 meeting continues the Annual Meeting's goal to support a global community of problem solvers who work together to set an innovation agenda and do the breakthrough science to deliver on it – to go further and faster together.
<h2>The Challenge</h2>
This Call-to-Action provides an opportunity for those registered for the 2025 Grand Challenges Annual Meeting to take action based on ideas they develop and people they engage with during the virtual meeting. For individuals who will not be able to attend the sessions in real time, recordings will be available post-meeting and we encourage all registered participants to watch them and engage with other participants before applying. As noted by past applicants in their submitted proposals, the meeting provides diverse ways to combine expertise and perspectives to speed up the impact of what would otherwise be separate work by individual investigators. The&nbsp;<a href="https://gcgh.grandchallenges.org/grants/JTdCJTIyc29ydCUyMiUzQSUyMmRlc2NlbmRpbmclMjIlMkMlMjJzb3J0RmllbGQlMjIlM0ElMjJkYXRlJTIyJTJDJTIybnVtYmVyUGVyUGFnZSUyMiUzQTEwMCUyQyUyMnBhZ2VOdW1iZXIlMjIlM0EwJTdE/JTdCJTIyeWVhcnMlMjIlM0ElNUIlNUQlMkMlMjJjaGFsbGVuZ2VzJTIyJTNBJTVCJTIyMTI5JTIyJTVEJTJDJTIydGVybXMlMjIlM0ElNUIlNUQlMkMlMjJpbml0aWF0aXZlcyUyMiUzQSU1QiU1RCUyQyUyMmxvY2F0aW9ucyUyMiUzQSU1QiU1RCU3RA==" target="_blank" rel="noopener noreferrer">grants awarded</a> for past Call-to-Action opportunities show this, and we hope that this year's meeting will also provide ways to catalyze collaborative projects that yield a tangible solution to a key problem by the end of the grant.
Funding
Each meeting participant will have one opportunity to apply as the primary applicant, on behalf of their institution, for a USD $100,000 grant or a collaborative USD $200,000 grant, both with an 18-month grant duration. Collaborative awards require the participation of one meeting participant and one or more collaborators from different institutions. While restricted to one application as the primary applicant, meeting participants may participate as collaborators in multiple collaborative applications. Priority will be given to new or newly expanded collaborations, rather than to existing collaborations seeking new funding.
Eligibility Criteria
<ul>
<li>Participants who registered for the 2025 Grand Challenges Annual Meeting are eligible to apply as a Primary Applicant on behalf of an organization with which they are affiliated and will receive further information via email.</li>
<li>Applications are permitted from both non-US and US organizations, including non-profit organizations, for-profit companies, international organizations, government agencies, and academic institutions.</li>
<li>Individuals and organizations classified as individuals for U.S. tax purposes are not eligible to receive an award from the foundation as part of this initiative.</li>
<li>Employees, officers, and directors of the Gates Foundation are not eligible to apply as Primary Applicants nor as collaborators for either type of proposal.</li>
<li>We encourage proposals led by scientists based in low- and middle-income countries and women or women-led institutions.</li>
</ul>
We will give highest priority to proposed projects that:
<ul>
<li>Contribute to a partnership network that empowers those with the local perspective required to direct the right approaches to the right parts of the problems to ensure success. This includes projects led by investigators from low- and middle-income countries and a balanced representation of women principal investigators. Their collective action and directed energy will help solve today's key problems in global health, while building research networks ready to solve tomorrow's.</li>
<li>Are explicitly aligned with the content within the meeting's scientific track sessions. Please note that proposals will be reviewed based on their alignment with one primary track and the specific content presented there (see <a href="https://web.cvent.com/hub/events/def88072-c4c4-4667-ab1a-df1c7d34912d/sessions" target="_blank" rel="noopener noreferrer">meeting agenda</a>), since we seek to provide an opportunity for participants to take action based on an idea that they developed and people they engaged during their virtual participation in a scientific track. Eligible scientific tracks for this Call-to-Action are listed below.</li>
</ul>
Scientific tracks eligible for the Grand Challenges Annual Meeting Call-to-Action
<ul>
<li>Vaccines &amp; Biologics - Innovation &amp; Platforms</li>
<li>Advancing Drug Discovery for Global Health</li>
<li>Strengthening Innovation Ecosystems to Solve Global Health Challenges</li>
<li>Advancing Women's Health Data, Science &amp; Technology</li>
<li>Strengthening the Women's Health R&amp;D Ecosystem</li>
</ul>
We will not consider funding approaches that:
<ul>
<li>Are not explicitly aligned with the specific content within the meeting scientific tracks listed above that are eligible for this request for proposals.</li>
<li>Address the meeting scientific track that is not part of this request for proposals: Strengthening Data Modelling for Global Health &amp; Development in Africa</li>
</ul>

**NOTE: This opportunity is open only to participants who registered for the 2025 Grand Challenges Annual Meeting.

Please note: We anticipate notifying applicants of decisions related to this RFP by the end of June 2025. This timeline is later than originally stated in the Rules and Guidelines document.Before applying, applicants should familiarize themselves with the supporting documents for this Grand Challenge, including the terms and conditions of the <a href="https://submit.gatesfoundation.org/res/p/RFPTermsConditions/" target="_blank">Gates Foundation</a>, the <a href="https://gcgh.grandchallenges.org/sites/default/files/files/heavy_menstrual_bleeding_rules_and_guidelines.pdf" target="_blank">Rules and Guidelines</a>, <a href="https://gcgh.grandchallenges.org/sites/default/files/files/heavy_menstrual_bleeding_application_instructions.pdf" target="_blank">Application Instructions</a>, and <a href="https://gcgh.grandchallenges.org/accelerating-innovations-address-heavy-menstrual-bleeding-women-low-resource-settings-frequently" target="_blank">Frequently Asked Questions</a>.If you are planning to apply to this RFP, we will be hosting a dedicated webinar on February 25, from 7:00 to 8:00 AM Pacific Time. This session will provide a comprehensive overview of the RFP details and an opportunity to have your questions answered. To participate in the webinar, please <a href="https://events.teams.microsoft.com/event/73a86f86-39cf-419c-8eff-333f5dc22ca7@296b3838-4bd5-496c-bd4b-f456ea743b74" target="_blank" title="https://events.teams.microsoft.com/event/73a86f86-39cf-419c-8eff-333f5dc22ca7@296b3838-4bd5-496c-bd4b-f456ea743b74" id="menur1bd">register</a> and <a href="https://forms.office.com/Pages/ResponsePage.aspx?id=ODhrKdVLbEm9S_RW6nQ7dNyUf4PhutFBmFMAT6JKpddUQk5DTlk1TVJQWldKTDBPREdUNTRLQzJRTC4u" target="_blank" title="https://forms.office.com/pages/responsepage.aspx?id=odhrkdvlbem9s_rw6nq7dnyuf4phutfbmfmat6jkpdduqk5dtlk1tvjqwldktdbpreduntrlqzjrtc4u" id="menur1bf">submit your questions in advance</a>. If you cannot attend live, the webinar will be recorded and available on this challenge page after the session.<h2>Background</h2>Heavy menstrual bleeding (HMB) affects millions of women globally. Clinically, HMB is defined as excessive menstrual blood loss that negatively affects a woman's physical, emotional, and social well-being. In research settings, HMB is defined as directly measured blood loss exceeding 80 milliliters per menstrual cycle. Many women seek medical attention based on their perceptions of heavy bleeding and its impact on daily life. Abnormal uterine bleeding, of which HMB is a subset, is caused by various factors. Structural abnormalities include polyps, adenomyosis, fibroids, and malignancy, while non-structural factors include bleeding disorders, ovulatory and endometrial dysfunction, and other factors.Managing HMB presents significant clinical challenges when diagnostic tools are unavailable or inaccessible to distinguish between the diverse possible etiologies. The underlying biological mechanisms, particularly related to endometrial dysfunction-related HMB also remain poorly understood. For an individual woman, the preferred medical and surgical treatment options depend on the specific cause, symptoms, preferences (including factors such as pregnancy intention), and the availability of treatment, including minimally invasive therapies. Currently available medical treatments include hormonal therapies, including contraceptives, such as the hormonal intrauterine device, and non-hormonal options, such as tranexamic acid and non-steroidal anti-inflammatory drugs (NSAIDs). The efficacy of treatment could be improved with an increased understanding of the underlying biological mechanisms and the development of specifically targeted therapies.&nbsp;Research priorities in HMB include understanding the underlying biological mechanisms, particularly related to endometrial dysfunction-related HMB, developing and introducing cost-effective and easy to scale-up diagnostics to identify causes of HMB and guide treatment, and identifying ways to increase acceptability and access to treatments such as the hormonal intrauterine device for women in low-resource settings.<h2>The Challenge</h2>We invite research proposals on HMB based on the clinical definition that focus on:<ol><li>Biological Mechanisms – Advancing understanding of the fundamental biology of HMB to identify targets for innovative diagnostics and treatments.</li><li>Epidemiology and Impact – Assessing disease burden, patterns, and impact on gynecological health and quality of life in women in low-resource settings.</li><li>Measurement and Standardization – Developing and validating improved methods for measuring HMB and establishing standardized research protocols to enable consistent and comparable studies across diverse populations and healthcare systems.</li><li>Innovative Diagnostics – Proposing new technology or piloting the use of existing technology to identify causes of HMB in low resource settings, including the use of artificial intelligence. Technology should be easy to use and affordable.</li><li>Treatment and Access – Evaluating the effectiveness, acceptability, and ways to increase access to treatment including hormonal contraceptives, to inform patient-centered care in low-resource settings.</li></ol>Funding LevelWe will consider proposals for awards of up to&nbsp;150,000 USD for each project, with a grant term of up to 2 years. Application budgets should be commensurate with the scope of work proposed. Indirect costs will be considered and should be included in the budget for a maximum of 15% of the total award (subject to the&nbsp;<a href="https://docs.gatesfoundation.org/Documents/Indirect_Cost_Policy.pdf">Gates Foundation's indirect cost policy</a>).Eligibility CriteriaThis initiative is open to nonprofit organizations, for-profit companies, international organizations, government agencies and academic institutions.&nbsp;We particularly encourage applications involving projects led by women or from women-led organizations and applications from institutions based in low- and middle-income countries.We seek proposals that:<ol><li>Focus on original research and development.</li><li>Focus on the needs of women in Sub-Saharan Africa, India, and Pakistan. While researchers may be based globally, study populations (for original data collection) or intended beneficiaries (for new diagnostics and treatments) must be from these regions.</li><li>Address one or more of the outlined objectives within a single proposal.</li></ol>We will not fund proposals that:<ol><li>Do not focus on HMB – Even if related to gynecological conditions that are associated with HMB, such as infertility or pelvic pain.</li><li>Are not research. Proposals to fund the expansion of routine services, or train clinical service providers, for example, will not be funded.</li></ol>

Accelerating Innovations to Address Heavy Menstrual Bleeding in Women in Low-Resource Settings

Before applying, applicants should familiarize themselves with the supporting documents for this Grand Challenge, including the terms and conditions of the <a href="https://submit.gatesfoundation.org/res/p/RFPTermsConditions/" target="_blank" rel="noopener noreferrer">Gates Foundation</a>, the <a href="https://gcgh.grandchallenges.org/sites/default/files/files/heavy_menstrual_bleeding_rules_and_guidelines.pdf" target="_blank" rel="noopener noreferrer">Rules and Guidelines</a>, <a href="https://gcgh.grandchallenges.org/sites/default/files/files/heavy_menstrual_bleeding_application_instructions.pdf" target="_blank" rel="noopener noreferrer">Application Instructions</a>, and <a href="https://gcgh.grandchallenges.org/accelerating-innovations-address-heavy-menstrual-bleeding-women-low-resource-settings-frequently" target="_blank" rel="noopener noreferrer">Frequently Asked Questions</a>.
If you are planning to apply to this RFP, we will be hosting a dedicated webinar on February 25, from 7:00 to 8:00 AM Pacific Time. This session will provide a comprehensive overview of the RFP details and an opportunity to have your questions answered. To participate in the webinar, please <a href="https://events.teams.microsoft.com/event/73a86f86-39cf-419c-8eff-333f5dc22ca7@296b3838-4bd5-496c-bd4b-f456ea743b74" target="_blank" title="https://events.teams.microsoft.com/event/73a86f86-39cf-419c-8eff-333f5dc22ca7@296b3838-4bd5-496c-bd4b-f456ea743b74" id="menur1bd" rel="noopener noreferrer">register</a> and <a href="https://forms.office.com/Pages/ResponsePage.aspx?id=ODhrKdVLbEm9S_RW6nQ7dNyUf4PhutFBmFMAT6JKpddUQk5DTlk1TVJQWldKTDBPREdUNTRLQzJRTC4u" target="_blank" title="https://forms.office.com/pages/responsepage.aspx?id=odhrkdvlbem9s_rw6nq7dnyuf4phutfbmfmat6jkpdduqk5dtlk1tvjqwldktdbpreduntrlqzjrtc4u" id="menur1bf" rel="noopener noreferrer">submit your questions in advance</a>. If you cannot attend live, the webinar will be recorded and available on this challenge page after the session.
<h2>Background</h2>
Heavy menstrual bleeding (HMB) affects millions of women globally. Clinically, HMB is defined as excessive menstrual blood loss that negatively affects a woman's physical, emotional, and social well-being. In research settings, HMB is defined as directly measured blood loss exceeding 80 milliliters per menstrual cycle. Many women seek medical attention based on their perceptions of heavy bleeding and its impact on daily life. Abnormal uterine bleeding, of which HMB is a subset, is caused by various factors. Structural abnormalities include polyps, adenomyosis, fibroids, and malignancy, while non-structural factors include bleeding disorders, ovulatory and endometrial dysfunction, and other factors.
Managing HMB presents significant clinical challenges when diagnostic tools are unavailable or inaccessible to distinguish between the diverse possible etiologies. The underlying biological mechanisms, particularly related to endometrial dysfunction-related HMB also remain poorly understood. For an individual woman, the preferred medical and surgical treatment options depend on the specific cause, symptoms, preferences (including factors such as pregnancy intention), and the availability of treatment, including minimally invasive therapies. Currently available medical treatments include hormonal therapies, including contraceptives, such as the hormonal intrauterine device, and non-hormonal options, such as tranexamic acid and non-steroidal anti-inflammatory drugs (NSAIDs). The efficacy of treatment could be improved with an increased understanding of the underlying biological mechanisms and the development of specifically targeted therapies.&nbsp;
Research priorities in HMB include understanding the underlying biological mechanisms, particularly related to endometrial dysfunction-related HMB, developing and introducing cost-effective and easy to scale-up diagnostics to identify causes of HMB and guide treatment, and identifying ways to increase acceptability and access to treatments such as the hormonal intrauterine device for women in low-resource settings.
<h2>The Challenge</h2>
We invite research proposals on HMB based on the clinical definition that focus on:
<ol>
<li>Biological Mechanisms – Advancing understanding of the fundamental biology of HMB to identify targets for innovative diagnostics and treatments.</li>
<li>Epidemiology and Impact – Assessing disease burden, patterns, and impact on gynecological health and quality of life in women in low-resource settings.</li>
<li>Measurement and Standardization – Developing and validating improved methods for measuring HMB and establishing standardized research protocols to enable consistent and comparable studies across diverse populations and healthcare systems.</li>
<li>Innovative Diagnostics – Proposing new technology or piloting the use of existing technology to identify causes of HMB in low resource settings, including the use of artificial intelligence. Technology should be easy to use and affordable.</li>
<li>Treatment and Access – Evaluating the effectiveness, acceptability, and ways to increase access to treatment including hormonal contraceptives, to inform patient-centered care in low-resource settings.</li>
</ol>
Funding Level
We will consider proposals for awards of up to&nbsp;150,000 USD for each project, with a grant term of up to 2 years. Application budgets should be commensurate with the scope of work proposed. Indirect costs will be considered and should be included in the budget for a maximum of 15% of the total award (subject to the&nbsp;<a href="https://docs.gatesfoundation.org/Documents/Indirect_Cost_Policy.pdf">Gates Foundation's indirect cost policy</a>).
Eligibility Criteria
This initiative is open to nonprofit organizations, for-profit companies, international organizations, government agencies and academic institutions.&nbsp;We particularly encourage applications involving projects led by women or from women-led organizations and applications from institutions based in low- and middle-income countries.
We seek proposals that:
<ol>
<li>Focus on original research and development.</li>
<li>Focus on the needs of women in Sub-Saharan Africa, India, and Pakistan. While researchers may be based globally, study populations (for original data collection) or intended beneficiaries (for new diagnostics and treatments) must be from these regions.</li>
<li>Address one or more of the outlined objectives within a single proposal.</li>
</ol>
We will not fund proposals that:
<ol>
<li>Do not focus on HMB – Even if related to gynecological conditions that are associated with HMB, such as infertility or pelvic pain.</li>
<li>Are not research. Proposals to fund the expansion of routine services, or train clinical service providers, for example, will not be funded.</li>
</ol>

Heavy menstrual bleeding (HMB) affects millions of women globally. Clinically, HMB is defined as excessive menstrual blood loss that negatively affects a woman's physical, emotional, and social well-being. In research settings, HMB is defined as directly measured blood loss exceeding 80 milliliters per menstrual cycle. Many women seek medical attention based on their perceptions of heavy bleeding and its impact on daily life. Abnormal uterine bleeding, of which HMB is a subset, is caused by various factors. Structural abnormalities include polyps, adenomyosis, fibroids, and malignancy, while non-structural factors include bleeding disorders, ovulatory and endometrial dysfunction, and other factors.