Since its inception, the Bill & Melinda Gates Foundation has bestowed more than $28 billion in grants to organizations working to better the quality of life for people living in the United States and abroad. These exclusive grants are provided to creative thinkers with the most innovative ideas that stand a strong chance of being proven and then translated into use with real world populations to address a variety of global health problems.
While competition for Gates Foundation funding is understandably stiff, two Tufts Medical Center researchers recently received grants to support their efforts in improving the health of underprivileged populations.
A model to understand a childhood killer
Researcher in the Division of Geographic Medicine and Infectious Diseases Honorine Ward, MD was one of 55 projects worldwide to be selected for a Gates Foundation Grand Challenges Explorations Round 12 grant in June, 2014. The grant will provide her research team with $100,000 over 18 months to support their work in developing an in vitro model to better understand the causes of Environmental Enteric Dysfunction (EED). A major problem in tropical areas of the world, EED is a syndrome that affects intestinal absorption and causes stunted growth in young children. While scientists have hypothesized that some combination of environmental, microbial, nutritional and genetic factors are to blame, EED’s origins remain unconfirmed.
“Stunting affects 27 percent of children under five years of age in the resource-limited world and is thought to account for 20-to-30 percent of childhood mortality globally,” said Ward. “Because we don’t yet know what causes EED, we don’t have an effective animal, in vitro or cell culture model to study the disease. The potential to address a worldwide problem by creating this model, determining EED’s source and finding interventions for stunting, is extremely exciting.”
Ward is collaborating with Mary Estes and Sasirekha Ramani at Baylor College of Medicine and Gagandeep Kand and colleagues at the Christian Medical College in Vellore, India to generate the in vitro model of EED. The study will be conducted in India, where the greatest number of stunted children in the world live and EED is highly prevalent. The team will use advanced stem cell technology to derive “enteroids” from the intestinal tissue of EED-infected children who have undergone surgery or biopsies for other reasons. Since the tissue would otherwise be discarded, Ward’s group will obtain informed consent to use the specimens. If the initial research is successful, Ward can apply for a Gates Foundation Phase II grant, for an additional $1 million over two years to continue the project.
An international database for cost-effectiveness in health
Last Fall, Director of the Center for the Evaluation of Value and Risk in Health at the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center Peter Neumann, ScD received a grant of $817,000 over five years from the Gates Foundation to create the first-ever global health database, focused on cost per disability-adjusted life years (DALYs) for health care interventions in lower income countries. Neumann is internationally-recognized for his previous work in building a database of cost effectiveness analyses in health and medicine. The database, the Cost-Effectiveness Analysis (CEA) Registry has become an important resource for researchers and policy makers in determining the value received for money spent on health. However, this database is western-country oriented and its metrics are not always applicable to developing countries.
“You can spend money on health in many different ways,” said Neumann. “The Gates Foundation is interested in improving the health of populations worldwide. To do this effectively and efficiently, we need to
understand the impact of alternative investments and where they can make the biggest impact. With a global health database of cost-effectiveness analyses in place, the international medical community can better quantify the return on different investments in health interventions and understand how much mortality and morbidity are averted for alternative strategies.”
The global database is still in its early stages of development. The first key step of the project was the creation of a data collection form, which was finalized in June. Now, Neumann’s team will take the instrument into the field and begin to collect data, beginning July, 2014; he has subcontracted with a group in Thailand to provide additional information on South East Asian countries.