The Grand Challenges in Global Health initiative, a major effort to achieve scientific breakthroughs against diseases that kill millions of people each year in the world's poorest countries, recently offered 43 grants totaling $436.6 million for a broad range of innovative research projects involving scientists in 33 countries. The ultimate goal of the initiative is to create "deliverable technologies" — health tools that are not only effective, but also inexpensive to produce, easy to distribute and simple to use in developing countries.

The initiative is supported by a $450 million commitment from the Bill & Melinda Gates Foundation, as well as two new funding commitments: $27.1 million from the Wellcome Trust, and $4.5 million from the Canadian Institutes of Health Research. The initiative is managed by global health experts at the Foundation for the National Institutes of Health, the Gates Foundation, the Wellcome Trust and CIHR. Additional proposed Grand Challenges projects are under review and may be awarded grants later this year.

The Grand Challenges initiative was launched by the Gates Foundation in 2003, in partnership with NIH, with a $200 million grant to the FNIH to help apply innovation in science and technology to the greatest health problems of the developing world. The 14 Grand Challenges were identified from among more than 1,000 suggestions from scientists and health experts around the world.

"The Grand Challenges projects are very ambitious, and the researchers are taking important risks that others have shied away from," said NIH director Dr. Elias Zerhouni, who is a member of the Grand Challenges scientific board. "Many of these research projects will succeed, leading to breakthroughs with the potential to transform health in the world's poorest countries."

He said, "When we started this project, the Gates Foundation had only committed $200 million. It is telling that the funding was increased.because of the quality of the grand challenges, in the sense that each one of them is a long-term problem that would be of defining importance for the field of global health."

Zerhouni said NIH currently spends about $600 million a year on global health activities, "about half of which is related to TB and malaria.Our global health portfolio outside of HIV/AIDS has almost tripled in the past 5 years." He said NIH invests in 85 countries currently, and views the Grand Challenges funding as complementary to what NIH is already doing abroad.

Zerhouni noted that "the researchers involved in these projects really come from backgrounds that would not have been attracted to this field, were it not for this funding source."

For a full description of the projects that were funded, visit www.grandchallengesgh.org.