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Grand Challenges Exploration (GCE)-India is one of the initiatives under the GCI ambit that has been launched with the aim of identifying health care innovation that will enable the goal of equitable health care in India and beyond. The program intends to provide seed funding to the highly innovative ideas at the pre-proof concept stage in an effort to develop a sustainable mechanism for supporting health and development innovations in the exploratory domain of India. The initiative basically seeks to validate ideas from talented and motivated individuals that lend themselves to be incubated in start-ups with the aim to encourage entrepreneurship. This is designed specifically as a program that supports medtech innovations in early stage research, which is a typically underserved area.
The ultimate goal for the program is a quest for new medical technology devices, drug delivery systems, diagnostics, and technology-enabled service models that can potentially be made available to people from all socio-economic strata. In view of the important public health goals, the call mandates are explicitly drawn from the domain of maternal and child health, wearables, diagnostics and devices, cervical cancer, antimicrobial resistance (AMR), agriculture and nutrition, geriatric care, and water sanitation & Hygiene (WASH).
Since inception five calls have been launched under the GCE-India platform, and a total of 1958 applications have been received under 58 grand challenges that were defined across global health priorities. Total 35 awards have been made so far with the majority of awardees working on areas such as Maternal Child Health, Geriatric Care, Infectious Diseases, AMR followed by Nutrition, Water and Sanitation etc.
The total number of awardees developing medical diagnostics are 13, devices 12, medical technologies 6, Nutrition 3, and Sanitation 1 respectively. GCE-India awardees are located across 14 states in India with the majority of them from Karnataka, New Delhi, and Maharashtra. 22 candidates have their own ventures, 12 are from Academia, and 1 from NGOs. The supported projects are progressing as per their intended timelines. Of supported projects, few are ready to deploy their products.
The GCI team ensures that besides granting funding assistance, the investigators also receive access to technical and regulatory advisors along with a network of market entry/business development professionals to help refine the proposed solutions proposed and take the ideas to the next stage of realization. Besides, leveraging the mentorship, resources, successful projects also have the opportunity to apply for follow-on funds from BIRAC through the BIPP, SBIRI and other GCI programs.
The details of last five rounds of GCE-India call launched and details of grants supported are as follows:
a) Surveillance of antimicrobial resistance among urinary tract infections seen in primary care [OmiX Research and Diagnostics Laboratories Pvt Ltd., Bangalore, Karnataka].The project was focussed on developing a Platform to enable surveillance of Antimicrobial Resistance. The team is working to develop a point of care AMR test and polymer card combined with a phone based surveillance system to detect and track AMR molecular signatures in primary care settings in a cost effective manner. The grant was given for developing proof-of-concept for detection of AMR in urinary tract infections (UTI), establishing and validate a 5-gene AMR signature assay in the proposed AMR test.
b) miRNA as Evaluation Biomarker of Tuberculosis Treatment Response [ The International Centre for Genetic Engineering and Biotechnology (ICGEB), New Delhi, Delhi].The project proposes to identify miRNA patterns and their correlation with the TB treatments response, treatment outcome and possible resistance generation. miRNAs are stable, small RNAs of 18-25 nucleotides that orchester immune response by inhibiting mRNA translation leading to mRNA target degradation. The selected miRNA pattern therefore are valuable evaluation biomarker for predicting response to anti-TB therapy, distinguish fast and slow responders to treatment and thereby offering early information to predict possible drug resistance development or individualised shorter drug regimens.
i) Glucometer used by diabetics for economical HIV viral load testing in resource constrained settings (Wobble Base Bioresearch Private limited, Surat, Gujrat). The project intends to develop a glucometer to detect HIV (Viral) RNA. The proposed assay involves amplification of viral RNA and its detection by the use of glucometer. RNA from lysed viral particles in serum is trapped using specially designed device containing padded silica-coated filter paper, ethanol washed and eluted for reverse transcription which is subsequently amplified using LAMP based method. The amplified cDNA can then be captured onto streptavidin coated magnetic beads coated with specific capture-probe and concentrate HIV targets. This is then hybridized to complementary DNA-invertase enzyme conjugate to make HIV cDNA-DNA-invertase complex. This complex is added to sucrose solution to generate glucose through hydrolysis by invertase enzyme that is detected using glucose meter. The amount of glucose detected is a function of HIV copy number.
ii) Rapid, personalized susceptibility test to accelerate AMR epidemiology study in remote Settings (Center for Cellular and Molecular Platforms, Bengaluru, Karnataka). Current susceptibility tests are not suitable for epidemiological study & transmission of AMR in remote settings of lower/middle income countries on global scale due to the requirement of sample transport, cost of instrument, cost of test and most importantly longer turnaround time. The device called Rapid Personalized Antibiotic Susceptibility Assay (r-PASA) is a DNA based assay with pH sensors on a microfluidics platform. Microfluidic channels have been chosen due to its suitability for rapid bacterial growth. Reaction mechanism involves the accumulation of organic acids as a function of bacterial growth which changes pH of growth medium.
iii) A portable brain scanner with tele monitoring platform for detection and management of neonatal HIE (Arogya Medtech Pvt. Ltd., Kolkata, West Bengal).The project focusses on developing- CEREBROS- a device which is a modular unit that combines electroencephalography (EEG) and near infrared spectroscopy (NIRS) to identify signatures and an IOT component integrated with a telemonitoring platform. This will allow continuous remote monitoring of cerebral hypoxia and seizures and early detection and management of HIE at point-of-care.
iv) High throughput Electrical detection of Malaria Infection in Single RBCs under Low Parasite Density (Raman Research Institute, Bangalore, Karnataka) Awardee proposed to use Resistive Pulse Technique (RPT) for Malaria detection based on the established fact that the Plasmodium Falciparum infected RBC are about 3 to 10 times stiffer than the normal RBC depending on the stage of parasite growth. Therefore, flow velocities of stiffer (infected RBC) and softer (normal RBC) cells can be easily distinguished in a simple fluidic channel using RPT. The difference in these flow velocities would be electrically measured across a spatial constriction to accurately determine the infected stage of individual RBCs.
v) Acousta-A Doppler Stethoscope for fetal Monitoring (Brun Health Private Limited, Hyderabad, Andhra Pradesh).Awardee proposes to develop a Doppler stethoscope-Acousta which acts both as a standard annular Y-shaped stethoscope and as a Doppler stethoscope. The custom-electronics solution comprises a power management module, a demodulation module and signal conditioning system to provide a clean filtered output of the signal. In addition, preliminary work has been done to model vibrational acoustics and its responses for the stethoscope construction proposed.
i) A nutrition specific intervention “nutrient loaded face cream” to tackle iron and vitamin deficiency (Cerelia Nutritech Pvt Ltd, New Delhi, Delhi).The project intends to develop a novel, cost-effective, transdermal multi-micronutrient delivery system as a lotion or a similar, an everyday used item in rural and urban population, thus giving it a unique positioning advantage to enable effective & efficient delivery to the last mile – end user. The final outcome is a platform transdermal technology that enables transdermal delivery of multiple actives.
ii) cTIRF: Miniaturized fluorescent adapter for fluorescent sputum smear microscopy ( Valetude Primus Healthcare Pvt Ltd, New Delhi, Delhi). The study team has developed novel patented (2673/DEL/2015) planar wavelength-based illumination technology called cTIRF (compact Total Internal Reflection Fluorescence); to convert the existing simple bright-field microscope and fluorescent microscope to the total internal reflection fluorescence without any hassle of optical filters, lens installation, and expensive. The module is highly compact (approximately size of a calculator), robust, cost-effective and allows rapid diagnosis of tuberculosis without added infrastructure cost and training.
iii) Affordable, portable easy to use rapid and accurate screening test for pulmonary tuberculosis (AptaBharat Innovation Pvt. Ltd, Faridabad, Haryana).The objective of the project is to develop a novel aptamer based electrochemical sensor for the rapid detection of pulmonary Tuberculosis. The proposed test will overcome the problems (high cost, poor sensitivity, high turnaround time, dependence on sophisticated and expensive instrument) associated with the current diagnostics modalities. The proposed test has high potential to be used as a point-of-care (POC) diagnostics test for pulmonary TB and will guide the clinician to take an appropriate action for tuberculosis management.
iv) cAST-Companion AST (cAST-Companion AST, Jalandhar, Punjab).To develop a rapid diagnostic device to reduce the turnaround time for antimicrobial susceptibility testing reports needed in diagnosing resistant bacterial infections. Antimicrobial resistance is a global healthcare challenge, particularly in India where the current annual patient mortality is considerable due to mis-prescription of empiric antibiotics. A quick diagnostic test revealing the infecting bacteria’s susceptibility to antibiotics will result in appropriate antibiotic prescription by doctors and mitigate the spread of resistant strains. The team proposes to fulfil this unmet meet by developing a device which reduces the turnaround time of susceptibility reports to 2-4 hours, which is a quantum leap from existing assays/devices which take 48-72 hours.
v) LifeBack: Priority Mental Health (Sequoia Insilico Private Ltd, New Delhi, Delhi)The study is aimed at developing tools that will act as Expert Support System for mental health professionals. The approach is to equip mental health care with the power of 5 Ps (Personalized, Precision, Proactive, Patient Centric, Preventive, and Participatory and Predictive). The strong relation between emotional stress and clinical depression has been well established through long research where stress is an important factor leading to depression onset. Likewise, it has also been established that acoustic features of speech and voice are highly correlated and has the capacity to recognise stress conditions in patients. Thus, there is a very strong correlation between acoustic parameters of the speaker and the level of stress and clinical depression among these subjects. Using this combinatorial approach, the team intends to develop a multi-mode channel and assess the onset of stress and depression.
i) A MicroSensor based Instrument to Detect Antibiotic Resistant Staphylococcus aureus(Nanosniff Technologies Pvt Ltd, Mumbai, Maharashtra). The scope of the project is to demonstrate the Proof of Concept that, using Piezoresistive Microcantilever based sensors and High Sensitivity Instrumentation, one can determine if the analyte sample contains antibiotic resistant Staphylococcus aureus. The final outcome is a BioFunctionalized Piezoresistor Microcanitlever 8 UltraSensitive Instrumentation based platform technology that enables detection of S. aureus within 1 to 2 hours. The innovation offers unique benefits like rapid and accurate detection of Antibiotic Resistant S. aureus.
ii) Paper Machines for Affordable Nucleic Acid Sample Preparation (PM-PREP) and Amplification (PM-NAAT) (Indian Institute of Sciences, Bangalore, Karnataka).The present study proposes to develop a low-cost paper based microfluidic device (paper machines) for conducting NAATs (Nucleic Acid Amplification Tests). A novel paper-based integrated device will be developed for conducting DNA extraction and paper based lateral flow assays for detection of nucleic acids. The team is expected to develop two portable battery-operated units that can be operated by minimally trained users for conducting NAATs in low-resource settings for detection of Tuberculosis from sputum by the end of 18 months grant period
iii) Identification and validation of circulating microRNAs as novel biomarkers for neonatal septicaemia ( AIIMS, Bhopal, Madhya Pradesh).he team proposed to integrate systems biology based-network reconstruction approaches with quantitative gene expression experiments for the detection of circulating miRNAs as early biomarkers in different neonatal septicemic conditions. The team aims to adopt three-pronged strategy of identifying the most reliable miRNA biomarkers of neonatal sepsis through bioinformatic modelling, microarray-based comparative gene expression studies, and RT-PCR validation; and thereafter incorporate the identified and validated markers in a robust diagnostic kit capable of diagnosing neonatal sepsis from other simulating clinical conditions.
iv) Fetal Lite - an effective tool to predict birth asphyxia (Sattva MedTech Private Limited, Bangalore, Karnataka).The team has proposed to develop an intelligent, potable easy to use fetal monitoring system based on the principle of non-invasive fetal ECG analysis and a custom consumable for low skill application of the device The final outcome is a CE certified next-generation fetal monitor and a custom low-cost consumable which can be used by low skill staff in low resource settings. The innovation offers unique benefits like a single probe for multiple parameters, no need to locate the fetal heart, automated anomaly detection, auto fetal movement tracking, zero intervention post application, remote monitoring capabilities and ambulatory monitoring for patient comfort. The device can be used by frontline healthcare workers with minimal training. It will lead to early detection of fetal distress and a reduction in intrapartum mortality.
v) PARPCytometry - A Quantitative and Affordable Diagnostic System for Head & Neck Cancer Diagnostics (Cochin Cancer Research Centre, Kochi, Kerala). The team aims to develop a non-invasive, molecular diagnostic tool for oral cancer. This novel diagnostic platform, PARPCytometry, aims to provide a cost-effective solution for diagnosing oral and oropharyngeal cancer. Another key innovation of the technology is that it can overcome the time delay that is typically associated with pathological evaluations. With this platform the team would be able to provide patients with a definitive, diagnostically accurate diagnosis at the point-of-care.
vi) Development of a point of care diagnostic device for detection of early-stage neonatal sepsis (AbGenics, Pune, Maharashtra).The team proposes to develop a highly sensitive Point of Care bacteria detection kit from small amounts of blood samples (< 1 ml) to identify pathogen in blood. This technique will be used primarily to detect early stage sepsis for neonates where extremely low amounts of bacteria (10-100 per ml) have to be detected. For this purpose, they will use a novel format of camelid antibody fragments that have a simple structure, are stable and are specially engineered to have a high specificity, affinity and avidity. Pathogen specific antibodies will be generated and fixed on to a MEMS biosensor that will amplify the signal that can be picked up by electronic instrumentation. This will identify the bacteria instantly so that antibiotic therapy can be started.
vii) Novel alloplastic neo-bladder for bladder replacement in patients with bladder cancer (PI: Dr Bikramjit Basu, Indian Institute of Sciences, Bangalore, Karnataka).The project intends to develop novel alloplastic neo-bladder for bladder replacement in patients with bladder cancer. The team intends to design and develop a non-degradable, non-absorptive, inert and cost-effective synthetic biomaterial, which can replace the use of the intestine as an alternative for urinary diversions, applicable in case of bladder cancer
i) Development of device, and method to provide a risk assessment for early Acute Kidney Injury, Shock(Accord Innovations Private Limited, Bangalore, Karnataka).Acute kidney injury (AKI) is associated with a high risk of death. Majority of the critically ill patients suddenly die due to AKI, Hypovolemic Shock, Septic shock due to unrecognized disorder with no symptoms in early stage. The proposed solution: AKI Care AI device is a novel non-invasive attachment to any traditional urinary Foley catheter, for real-time & accurate measurement to monitor kidney function and provides a risk assessment using machine learning tool for clinicians to detect the onset of AKI, septic AKI, hypovolemic shock to intervene & prevent thousands of avoidable deaths.
ii) Empowering geriatric with urine micro-albumin self-monitoring/PoC device for better health management ( Prantea Solutions Private Limited, Bhuvaneshwar, Odisha). Old age makes geriatric population vulnerable to non-communicable disorders like kidney disorder, cardiovascular disease, stroke, hypertension and diabetes nephropathy. Micro-albumin concentration in urine is a well-established biomarker for early diagnosis and management of these comorbidities. To address this gap, the current proposal aspires to deploy a novel self-monitoring Point-of care (PoC) device to bring independent living with minimum health care support in resource limited settings.
iii) Tattva-Shodh: Point of care, multi-nutrient digital detection kit for new definition of malnutrition (PI: Dr Saughandha Das, Edhaa Innovations Private Limited, Nasik, Maharashtra).Current methods for detection of Malnutrition use physical attributes but not nutrient level. Proposed device relates to technique for rapid quantification of multiple clinically important nutrients in biological fluids for timely interventions. The 3-tiered solution proposes: 1. Colorimetry based estimation of multi-nutrients on single test strip 2. Accurate quantification by a smartphone app 3. Cloud based data collection and analytical reporting for establishing PoC diagnosis.
iv) An effective device to detect and prevent pressure ulcers in bedridden patients (Cureous Labs Private Limited, Pallakad, Kerala).The idea is to prevent Grade I pressure ulcers in bedridden patients. The proposed solution is an overlay which can be retrofitted to any bed and ideally sits below the mattress and above the bed. The solution will be capable of automatically turning / repositioning the patient to different stable sleep positions mimicking the body’s natural motion such that it re-establishes blood flow to compressed tissues. This results in pressure shifting and redistribution, without the aid of caretakers and prevents development of pressure ulcers.
v) Safe Delivery, Health Child (SAVED) (MicroGO LLP, Chennai, Tamil Nadu).The proposed novel solution besides targeting “safe delivery” intends to promote “healthy infant” for a healthy childhood. The cost effective, resource independent, foldable and portable, environmentally sustainable (no disposable single use item, zero waste generation and skill independent) kits are based on FDA approved chlorine dioxide sterilizing and releasing platform. It can be effectively used to sterilize all the essentials required for SAFE DELIVERY (i.e. surgical tools, hand gloves, clothing item, scissor and clips). It can also be used for sterilizing infant gears, disinfecting water and provides convenient hand hygiene.
vi) Bandicoot – The Manhole Cleaning Robot ( Genrobotic Innovations Private Limited, Thiruvananthapuram, Kerala).GenRobotics aims to eradicate the scourge of manual scavenging by changing Manholes to Roboholes, thereby enable the socio-economic transformation of one of the most marginalised sections of society. The world’s first manhole cleaning robot-Bandicoot does all the tasks that are manually done inside the manhole. The robot operations can be controlled and monitored by the control panel placed outside the manhole. It pulls out the solid waste material which is the real reason for blockage, with its specially designed human comparable robotic arm and unblock the sewer line system which helps liquid waste to flow through the sewer line system as usual.
vii) Microfluidic paper based point of care biomarker detection of neonatal sepsis( Institute of Chemical Technology ,Mumbai, Maharashtra).Neutrophil CD64 and procalcitonin present in the peripheral blood are the most promising biomarkers of neonatal early and late onstage sepsis. However, detection of biomarkers from other body fluids, such as urine, appears to be more feasible, considering the non-invasive sample collection and their accessibility from neonates. Additionally, the urinary biomarkers, which includes cytokines such as IL-8, IL-10 and MCP-1, are elevated during early presumed infection. Thus, development of a PoC for an early detection of infection, which will assess biomarkers from urine, will not only be novel but also provide a beneficial solution to this grave health issue in neonates.
viii) Contactless Health Monitor for Elder Care with Real Time Alert System( Turtle Shell Technologies Pvt. Ltd., Bangalore, Karnataka).The study proposes a novel low-cost health monitor with 4 components. The first component is a vibration sensor pad which when placed on the mattress detects heart and respiration signal using ballistocardiograph. The respiration signal obtained is also used for sleep apnea screening and the heart signal is also screened for arrhythmia instances and monitoring cardiac cycles (LVET, ICT, IRT). The second component is a bedside unit for data acquisition, processing & communication (GSM & WiFi) with an alert system. The third component is a bluetooth enabled wireless finger pulse oximeter to measure oxygen saturation. The final component is a wearable 3D axis accelerometer for fall detection. The proposed solution is a novel low-cost easy-to-use health monitor that tracks heart and respiration rate, sleep cycles, cardiac cycles, oxygen saturation and detects fall.
ix) High Throughput Technology to Monitor Environmental Antibiotic Dispersion and Their Impact on AMR (AIIMS, New Delhi, Delhi) .Environmental exposure to antibiotics is correlated well with AMR. The present study proposes the development of high throughput screening (HTS) technique of 125 antibiotics from environmental samples like water (from river, aquifers and food sources like egg and raw meat). A novel in-vitro method will be adopted to correlate AMR with the environmental levels of antibiotics found in Delhi-NCR region and derive safe levels of antibiotics that should be permissible in the environment.
x) AI-based Diagnostic Aid for Wireless Capsule Endoscopy (Indian Institute of Sciences, Bangalore, Karnataka).Wireless Capsule Endoscopy (WCE) has the potential to become the leading screening technique for the entire gastrointestinal (GI) tract. Till date, no Artificial Intelligence (AI) based diagnostic aid has been developed to assist endoscopists in identification and classification of abnormalities post the WCE procedure. The core objective of this proposal is to deliver a first-of-its-kind, multi-platform, AI-powered, fully automated diagnostic web application for real-time detection and classification of multiple abnormalities (angioectasias, aphthae, bleeding, chylous cysts, villous oedema, lymphangiectasia, polypoids, stenosis and ulcers).
xi) Inali Arm – A low cost affordable prosthetic arm (Inali Foundation, Khandwa, Madhya Pradesh).The Inali Arm solves a problem that derails the lives of millions of people across the world. India alone is home to more than 22 million people with disabilities, with children making up nearly 8 million of that number. Due to cost and lack of accessibility, most of these people never get the help they need. The proposal intends to develop indigenous low-cost, affordable arm to for thousands of people who are living without any prosthetic care.
xii) Development of low-cost nutritional products with local bio-resources for maternal nutrition in India (National Innovation Foundation Ahmedabad, Gujrat).he proposal intends to develop 3 region specific, ethnic nutritional products (recipes) for maternal nutrition by blending the best possible combinations of active ingredients from locally available grains, wild plants(edible) and herbs/weeds that will meet the RDA. The products will be developed specific to regions of Western India followed by their nutritional value evaluation in the target population. Thus, the products will be cost effective, easily accessible as well as culturally acceptable to the lower/middle income group of pregnant women.
xiii) Powdered egg: Improving egg consumption in India (Nutrition for Development Foundation, Kolkata, West Bengal).tudies promoting egg consumption among women and children in lower middle-income countries (LMICs) show that growth indicators are significantly improved in children who consume eggs consistently. However, many states in India are chronically egg deficit, unable to fulfil their daily egg demand. The study is exploring the use of powdered-eggs in place of fresh eggs as they are cheaper and have a longer shelf life. Furthermore, the product is convenient to use, easy to transport, store and can be incorporated as an ingredient into Indian recipes and daily diets.
xiv) A novel sol-gel based disposable sensor patch for bilirubin: A jaundice marker (Tatvabodh Technology Private Limited, Gurugram, Haryana).A novel sol-gel patch-based sensor system is proposed for the transdermal detection of bilirubin (BiliPatch). The BiliPatch system is based on the measurement of colour changes due to Fluorescence Resonance Energy Transfer (FRET) between fluorescent dyes entrapped in sol-gel patch with bilirubin (available on the dermal region). The change in the colour will be proportional to the concentration of bilirubin. This novel technique would provide an easy to use patch-based sensor system especially useful for detection and monitoring jaundice in neonates.
xv) Novel methods to Predict & Diagnose Neonatal Sepsis ( Ketaki Solutions Pvt Ltd, Bangalore, Karnataka) Current techniques for Sepsis detection include Sequential Organ Failure Assessment (SOFA), Systemic Inflammatory Response Syndrome (SIRS) and Modified Early Warning Score (MEWS). These scoring techniques do not leverage the inherent information available in-patient history, previous learnings and patterns inherent about sepsis manifestation. The study proposes the use of Machine Learning (using parameters like Blood pressure, heart rate, temperature, respiratory rate, SpO2 and lab data (like glucose, Blood urea nitrogen, blood gas, creatinine, lactate, CRP, CBC) to harness and identify early onset of neonatal sepsis.
xvi) VT Scope – Intubating video stylet (Vinayaka Missions Medical College, Mayiladuthurai , Tamil Nadu) Current techniques for Sepsis detection include Sequential Organ Failure Assessment (SOFA), Systemic Inflammatory Response Syndrome (SIRS) and Modified Early Warning Score (MEWS). These scoring techniques do not leverage the inherent information available in-patient history, previous learnings and patterns inherent about sepsis manifestation. The study proposes the use of Machine Learning (using parameters like Blood pressure, heart rate, temperature, respiratory rate, SpO2 and lab data (like glucose, Blood urea nitrogen, blood gas, creatinine, lactate, CRP, CBC) to harness and identify early onset of neonatal sepsis.