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Challenges faced by multidisplinary new investigators on addressing grand challenges in global health Logie, Carmen; Dimaras, Helen; Fortin, Anny; Ramón-García, Santiago Apr 15, 2014

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DEBATEChallenges faced by multiinvestigators on addressin†Background Research must address problems and develop solu-Logie et al. Globalization and Health 2014, 10:27http://www.globalizationandhealth.com/content/10/1/27formative strategy to overcome barriers to significanthealth issues [2-4].CanadaFull list of author information is available at the end of the article“One bold idea. That’s all it takes. Unorthodoxthinking is essential to overcoming the most persistentchallenges in global health [1]”.tions in order to impact grand challenges in globalhealth. A grand challenge in global health is definedas “a specific critical barrier that if removed wouldhelp to solve an important public health problem. Theintervention(s) it could lead to might be innovativeand, if successfully implemented, will have a high like-lihood of impact and feasibility” [2]. This differs froma description of a global health problem (e.g. HIV,malnutrition) in that it involves an innovative and trans-* Correspondence: helen.dimaras@utoronto.ca†Equal contributors3Department of Ophthalmology & Vision Sciences, University of Toronto,Toronto, ON, Canada4Division of Visual Sciences, Toronto Western Research Institute, Toronto, ON,AbstractBackground: The grand challenges approach aims to spark innovative and transformative strategies to overcomebarriers to significant global health issues. Grand Challenges Canada endorses an ‘Integrated Innovation™’ approachthat focuses on the intersection of scientific/technological, social and business innovation. In this article we explorethemes emerging from a dialogue between the authors, who are multidisciplinary recipients of the ‘Rising Stars inGlobal Health’ award from Grand Challenges Canada, regarding benefits of engaging in integrated innovationresearch, and recommendations for how this approach may develop in the future.Discussion: Our dialogue followed a semi-structured interview format that addressed three topics: 1) reflections onapplying an Integrated Innovation™ approach for global health; 2) thoughts on participation in the Grand Challenges2012 meeting; and 3) authors’ visions of Grand Challenges Canada and the Grand Challenge movement towards 2020.The dialogue was transcribed verbatim and we used thematic analysis techniques to identify, analyze and reportthemes in the data. Benefits of working using the Grand Challenges approach centered on two themes: a) the potentialfor scientific breakthrough and b) building interdisciplinary collaborations and a community of scholars. Challenges andopportunities for Grand Challenges in moving forward included: a) capacity building, particularly regarding IntegratedInnovation™ and scale-up planning; b) interdisciplinary and international mentorship for new investigators; andc) potential for future commercialization.Conclusions: Our discussion highlighted that Integrated Innovation™ offers the opportunity to develop new theories,methods and approaches to global health while simultaneously fostering a collaborative spirit grounded in international,interdisciplinary collaborations. However, the arguable over-emphasis on corporatization poses a major challenge fornew investigators. We propose a more balanced way forward that can harness technology to foster mentorship acrosstime and space to support the development of such skills and ideas among new investigators.Keywords: Public health, Global health, World health, Interdisciplinary studies, Research, International cooperation,Developing countries, Public health professionalin global healthCarmen Logie1,2†, Helen Dimaras3,4,5,10*†, Anny Fortin6,7,11© 2014 Logie et al.; licensee BioMed Central LCommons Attribution License (http://creativecreproduction in any medium, provided the orOpen Accessdisplinary newg grand challengesand Santiago Ramón-García8,9,12†td. This is an Open Access article distributed under the terms of the Creativeommons.org/licenses/by/2.0), which permits unrestricted use, distribution, andiginal work is properly credited.Logie et al. Globalization and Health 2014, 10:27 Page 2 of 8http://www.globalizationandhealth.com/content/10/1/27The grand challenges approach originated in 1900 withthe mathematician David Hilbert, who challenged hiscommunity to solve 23 major problems remaining in theirfield. The Bill & Melinda Gates Foundation (BMGF) re-vived this model and applied it to global health, challen-ging a global panel of experts to first identify grandchallenges in this arena. Twelve grand challenges in 7broad categories of global health were initially identified[4,5]. The BMGF has been instrumental in spurring high-level technological innovation to tackle these grand chal-lenges with its highly competitive grants program. Sincethen, additional grand challenges have been identified toaddress issues in other areas of interest and new organiza-tions have emerged to tackle global health via this ap-proach, including Grand Challenges Canada (GCC). GCC’sfunding approach expands beyond the focus on scientific/technological approaches traditionally supported by BMGF,in that they promote Integrated Innovation™ to tacklegrand challenges in global health. Integrated Innovation™ isthe “the coordinated application of scientific/technological,social and business innovation to develop solutions tocomplex challenges” [6].Engaging multidisciplinary voices in the articulationand tackling of grand challenges is key to addressingethical, social and cultural issues that may arise in globalhealth research [4,5]. There are a wide range of disciplinesengaged in health promotion, including immunology,microbiology, clinical sciences, epidemiology, environmen-tal sciences and population/behavioral sciences. Interdis-ciplinary and international collaboration is transformingthe ‘geography of science’ by engaging multiple competen-cies, theoretical perspectives, and therefore solutions, toaddress health issues from investigators in diverse locales,disciplines, and sectors [5,7].While there is great promise for interdisciplinary andinnovative approaches to address global health grandchallenges, little is known about the experiences of re-searchers engaging in such endeavors. Especially relevantare the views of new investigators, who are integral toaddressing global health challenges [8]. Analyses of social,ethical and cultural issues regarding grand challenges inglobal health highlighted factors to consider in this area ofresearch. These included community and public engage-ment strategies, cultural acceptability of approaches, andeffective collaboration [9].In this article we examine the experiences of four newinvestigators from different disciplines who each re-ceived a GCC ‘Rising Stars in Global Health’ award inRound 1 (2011) or Round 2 (2012). During this period atotal of 34 such grants were awarded (see http://www.grandchallenges.ca/our-innovators/). The authors metwhile attending the Grand Challenges meeting co-organizedby GCC and BMGF in December 2012, and decided to ex-plore the concepts presented in this debate. The groupconstitutes a representative sample of the types of innova-tions that were financed by GCC: projects are linked tohealth care delivery (CL, HD), diagnostics (HD) and novelanti-infective therapies (SRG, AF) (Table 1). Our projectsaddress myriad health issues across global regions: HIV pre-vention in post-earthquake Haiti, cancer pathology inKenya, tuberculosis drug development, and improveddrug-delivery against cutaneous leishmaniasis (Table 1).We found commonality in our commitment tocommunity-based approaches and Integrated Innovation™,and used our heterogeneity as a platform to reflect onour experiences addressing grand challenges in globalhealth. We conducted and digitally recorded a structureddialogue in December 2012 using a semi-structured inter-view guide to explore three topics: 1) our reflections onapplying an Integrated Innovation™ approach in globalhealth research; 2) perceived benefits of our participationin the Grand Challenges 2012 meeting; and 3) our visionfor the future of GCC towards 2020. The dialogue wastranscribed verbatim and thematic analysis techniquesfrom grounded theory were used to identify, analyze andreport themes in the data regarding benefits of the grandchallenges approach and recommendations for GCC mov-ing forward [10]. Critical reflexivity in part guided this dia-logue; this approach has been used by health practitionersand researchers to interrogate knowledge production pro-cesses, and how these processes reproduce or challengepower structures [11,12]. As all of our work aimed to pro-mote health equity among marginalized populations, thiswas a fitting framework.DiscussionOur discussion, as reported in the following paragraphs,highlighted benefits and challenges of involvement inGCC. A recurring theme in our discussion revealed thatwhile Integrated Innovation™ demonstrates a strong po-tential for global health impact, an overemphasis oncommercialization and corporatization may have the op-posite effect. We make recommendations and revisionsto be incorporated into the Grand Challenges Canadaapproach in order to maximize the potential benefit ofaddressing health challenges on a global scale, particu-larly when supporting global health research among newinvestigators (Figure 1).Benefits of working within the grand challengesframeworkBenefits of working under the Grand Challenges approachcentered on two themes: potential for scientific break-through and promotion of interdisciplinary collaborations.Potential for scientific breakthroughThe authors discussed the possibilities provided by thisfunding opportunity that could impact health acrossdsLogie et al. Globalization and Health 2014, 10:27 Page 3 of 8http://www.globalizationandhealth.com/content/10/1/27Table 1 Canadian Rising Stars In Global Health Round 1 anProject title Priority area PlatformRound 1CL Development andevaluation of atablet-based,communityhealthworker deliveredHIV/STI preventioninterventionHIV, Infectious Diseases,Mental Health andNeurodevelopment,Women’s and Children’sHealthMedical/HealthEducation ProgramAF The use of a permanentmake-up (or tattoo)device to target drugdelivery againstcutaneous leishmaniasisInfectious Diseases,LeishmaniasisMedical DevicesSRG New therapeutic drugcombinations forTuberculosis treatmentInfectious Diseases,TuberculosisDrug developmentRound 2HD Saving Lives: CancerPathology in AfricaCancer Diagnosticssectors as well as build theory. This opportunity wasgeared at supporting new investigators embarking oninnovative proof-of-concept studies for scientific break-through. Application of the integrated innovation ap-proach was highlighted as particularly beneficial foreducation and professional development. One partici-pant described the potential for growth afforded by thisfunding: “by awarding this grant, GCC is truly challen-ging us to go beyond our skills and acquire the rightknowledge and (or) collaborators to fit the integratedinnovation model”. Another participant described howthe funding could inform work in other contexts: “iffunded, my project could really be a blueprint for howcommunity-based HIV education is performed in dis-placed and marginalized populations…there are 26million people living in tents around the world thatcould benefit from this project”.Narratives also underscored the potential of lessonslearned to build theory: “not only are we testing out ourindividual approaches to specific problems, but the suc-cess or failure of our projects is really testing out thetheory of integrated innovation. That will be a hugeaddition to global health research”. Another participantreinforced the importance of learning not only from suc-cess but also from failures: “you don’t need to report onlythe successful discoveries; you need to also report theThe authors represent a sample of 3/19 (16%) and 1/15 (7%) Round 1 and Round 2implementation regions.*Indicates proposed implementation region.2 projects represented in the analysisRegion Country URL Awards(#)Sample(%)19Latin Americaand CaribbeanHaiti http://www.grandchallenges.ca/grantee-stars/0016-01/Middle Eastand NorthAfricaIran* http://www.grandchallenges.ca/grantee-stars/0015-01/World-wide South Africa* http://www.grandchallenges.ca/grantee-stars/0031-01/16%15Sub-SaharanAfricaKenya http://www.grandchallenges.ca/grantee-stars/0052-01/7%Summary: 34 12%failures, as you learn more from the failure than fromthe success”. The commitment and persistence to find asolution was articulated: “the recognition that combatingchildhood cancer in the developing world is as importantas in the developed world is central to my vision—I amnot going to give up”.Promotion of interdisciplinary collaborationOne unique benefit of being involved with GCC is theopportunity for interdisciplinary collaboration intrinsicto the Integrated Innovation™ approach: “You have thismixture of social, business and scientific innovators; sotry to put them together, to collaborate and get thingsdone together. This is a very challenging and importantthing to do for the future”. This notion was reinforced byanother participant: “the cool thing about us connectingis that we are out of the silos of our fields of expertise;this is really getting transdisciplinary”. The 2012 GrandChallenge meeting was described as enhancing under-standing of business, social and health issues: “the mixerwith the Gates Foundation gave us exposure to per-spectives beyond just Grand Challenges Canada”. Thegeneral feeling of partnership was described as some-thing worth fostering: “Grand Challenges Canada shouldkeep people in a collaborative spirit; they should focuson this”.funded grants, respectively. Projects range in priority area, platform andLogie et al. Globalization and Health 2014, 10:27 Page 4 of 8http://www.globalizationandhealth.com/content/10/1/27Interdisciplinary collaboration was discussed as po-tentially building partnerships: “you put a face to thepeople; you start talking to them and seeing thingsmore clearly. You get the feeling that they are realpartners”. This has long-term implications for partner-ships to engage in addressing global health issues:“maybe in 2020 Grand Challenges Canada will havebuilt a network of collaborators between Canadian sci-entists and scientists in the developed countries to solvethe problems of the developing world and to facilitatecommunication and collaboration”. The field of Eco-health (the study of how changes in ecosystems affecthuman health), is a prime example of how interdiscip-linary partnerships can address complex problems re-lated to health by harnessing the collaborative power ofmultidisciplinary stakeholders: from farmers and com-munity members to healthcare workers, researchers andgovernment.The importance of developing a community of scholarswas also highlighted:We need a community of scholars and a communityof inquiry; a space where anybody who had been agrand challenges star, or rising star, is part of alarger family, a larger community of innovativeFigure 1 Benefits and recommendations for engagement of new invethinkers. Maybe GCC could have a website or ablog, or a meeting for people who are in the samecity, just so that we can be in touch to keep thatcommunity active. That is what I really liked aboutthis meeting: we just met each other but it alreadyfelt like a community.Building a community of grand challenges recipientswas articulated as a valuable endeavor: “these peoplehave got a lot of potential so keeping them in the loop ormaybe trying to make a Phase 1 community [could bevaluable]”. This community of scholars was described asimportant for both strengthening society as well as fos-tering integrated innovation: “the strength of every soci-ety, of every institution, is their people. So it depends onhow much you care for your people. If you get that poolof people moving forward then you are going to be big, ifyou are not able to integrate that, you are not going toget integrated collaboration”.Challenges and opportunitiesChallenges and opportunities for Grand Challenges Canadato move forward included a focus on capacity building,ongoing mentorship for new investigators, and potentialfor future commercialization.stigators in grand challenges research.Logie et al. Globalization and Health 2014, 10:27 Page 5 of 8http://www.globalizationandhealth.com/content/10/1/27Capacity buildingParticipants discussed the need for support beyond fi-nancial GCC contribution: “the social investment ofGrand Challenges Canada [is important]. It is not justtheir money that we need. For the really impactful inno-vations we need their time and human resources”. Com-mitment to building capacity in new investigators wasperceived as critical to long-term success: “If you areinvesting time and money in people that you know havetalent, try and help them move forward. Don’t just as-sume 1 in 10 will be successful, but actively support themto increase the ratio to, maybe, 5 in 10 successful stories”.Capacity building was suggested regarding application ofthe Integrated Innovation™ approach:I really like the idea of integrating the scientific, socialand business aspects in the development of my idea,but at the same time I find it hard because I am nottrained in all three. I don’t know how often people canmanage the three aspects…We need to integrate morecollaboration in our projects, get training andintegrate capacity-building. To genuinely develop ourideas as integrated innovations, we will need thesupport to do that.Scaling up projects and commercialization was identi-fied as another area for capacity building: “How big thechallenge is for us to try to develop integrated innova-tions given our backgrounds and the type of projects weare working on! Left alone we will have to do miracles toget to the commercialization phase”. The authors feltthat the GCC grantee-oriented sessions at the meeting(e.g. workshops covering the power of story telling, net-working, grant writing, scale-up planning) were benefi-cial. Other suggestions for capacity building specificallyaddress integrated innovation and case studies: “if I had adream vision for Grand Challenges for 2020 it’s actuallyan online course for all the Phase 1 grantees, a lot of infor-mation on social innovation, on technological innovation,on business innovation and successful case studies of howpeople got funding from Phase 1 to Phase 2”. Indeed, theauthors note that GCC is growing in this area, providingresources for grantees and the public on their website(http://www.grandchallenges.ca/resources/).MentorshipGCC ‘Rising Stars in Global Health’ awards were origin-ally designed to attract Canadian scientists within tenyears of completing a PhD or terminal degree (e.g. M.D.)to validate proof-of-concept proposals that addressedany challenge in global health. These new investigatorswere required to have a co-investigator in a low-and-middle-income country (LMIC), also within ten years ofcompleting their degree. In a following Phase II application(also called Transition to Scale), these new investigatorshave the opportunity to apply Integrated Innovation™ totheir validated proof-of-concept and scale-up their ap-proach. Currently, the ‘Rising Stars in Global Health’awards have evolved into ‘Stars in Global Health’ awardsnow open to new investigators from LMICs, and to Can-adian investigators at any level of experience and expertise.This latter change to the eligibility requirements appears toplace new investigators at a disadvantage, as they mustcompete for Phase II funding against some investigatorswith presumably greater laboratory capacity, expertise, net-works and connections, removing what was perceived as agreat opportunity for new investigators to launch their car-eer and develop and test innovative theories and methods.“This could significantly reduce the chance for new investi-gators to benefit from the vital Phase I and II opportunitiesto build research programs”.Mentorship was discussed as key to navigating careerdevelopment, the implementation of Integrated Innovation™and Phase II scale-up funding applications. Multidis-ciplinary approaches to mentorship were recommendedthat included: “trans-disciplinary or multi-disciplinarymentorship, mentorship from people from the GatesFoundation. Like people who got Phase II and then turnedback and mentored Phase I people, or people in PhaseIII can mentor people in Phase II”. Technological ap-proaches and virtual resources were suggested as an ap-proach to international mentorship: “Linking [grantees] tomentors, maybe at the Gates Foundation, maybe in differ-ent countries with previous Phase II winners, or a virtualresource that could guide [new investigators]. In sevenyears, it could be a large enough group to significantly assistfuture generations [of investigators]”.Dialogue also focused on the challenges to providingmentorship across such a wide array of research pro-jects: “Our projects are so individual, and therefore genu-inely difficult [to advise on the transition to Phase II]”.The need to invest time in mentorship, beyond the con-text of a meeting, was also highlighted: “Individual pro-jects are diverse in nature and thus it is difficult tosupport each one individually at a meeting like this”.Potential for future commercializationIntegrated Innovation™ promotes a business approach tohealth projects, in addition to social and scientific com-ponents. In theory this approach allows key stakeholdersto create partnerships and work towards the resolutionof a common problem such a health-related issue. Thisapproach has been successfully implemented in develop-ing countries. However, in the current global neoliberaleconomy, this approach is often challenging to nearlyimpossible when the target population of the innovationdoes not represent a viable market, such as patients suf-fering neglected diseases or marginalized people living inLogie et al. Globalization and Health 2014, 10:27 Page 6 of 8http://www.globalizationandhealth.com/content/10/1/27extreme poverty in low-income countries. Lack of viablemarkets is a major contributor for diseases being under-researched despite huge medical needs. In addition,many funded projects, including the ones of the authors,have limited or no patent protection and a low-to-nullreturn on financial investment. A participant gave a con-crete example: “We will try to set up a women’s coopera-tive on site but it will be very hard…I mean, I have to tryto create a sustainable business with and for people whomake four dollars a month”. In fact, the GCC Phase Ifunding strategy could be correlated with a “survival ofthe fittest” approach where a large number of awards aregiven expecting fewer would progress. Closer interactionand follow up would increase the success ratio. Forthe Phase II application rounds, GCC is committed toprovide 50% matching funding, forcing innovators toestablish alliances and partnerships in view of futurecommercialization. New—as well as more establishedinvestigators—are required to seek private sources forthis 50% matching funding and are not eligible forfederal funding as GCC is partially funded by theCanadian government. Soliciting private funding is anapproach that many researchers in academic settingsare ill-equipped or trained to do; additionally these in-vestigators often have to navigate goals of internaluniversity fundraising initiatives.Thus, without new, innovative funding mechanisms inplace and implicit GCC support to form those alliances,and alternatives to fund projects serving marginalizedpopulations in low-income countries with few viablemarkets, many of the Phase I GCC-funded ideas havevery little chance to reach commercialization despiteachieving proof-of-concept. This impedes contributionsto both scientific knowledge and global health promo-tion. This concept was further highlighted: “This is notjust a question of capacity building. Political authoritiesand GCC officers would need to facilitate this process bycreating new frameworks, for example, new incentives forlarge companies to invest in global health, or by creatingglobal health foundations”. Social returns on investmentsare, however, a tangible outcome for all GCC projects,which may appeal to NGOs or to the so-called “impactinvestors”, if properly addressed.In addition, several GCC Phase I projects tackle proof-of-concept studies at the basic science/molecular level.Based on the history of pharmaceutical/biomedicine in-dustry [13], it is unrealistic to assume that these typesof projects would reach a good position for commer-cialization in the Phase II time-frame. An approach tosupport this type of projects would be to award, in anindividual case-by-case basis and after peer-review,Phase Ib grants with clearly established checkpoints inthe project development. This strategy, which is alreadyimplemented by the BMGF, would help to overcome thelarge time lag between the proof-of-concept and the scal-ing and commercialization stage.Conclusions and recommendationsIn this article we highlight experiences of GCC fundingrecipients in undertaking research following the principleof Integrated Innovation™, and their recommendationsfor future GCC initiatives to maximize its impact in solv-ing grand challenges in global health. In particular wefocus on the benefits and challenges of engaging in Inte-grated Innovation™. This includes the potential to realizethe aims of the grand challenges approach while buildingtheory and strong evidence of its applicability and utilityin addressing global health issues. This approach caninform scientific and technological breakthroughs thataddress health issues across diverse contexts. Fosteringinterdisciplinary, international collaborations and a com-munity of scholars dedicated to a global health IntegratedInnovation™ approach was identified as a major benefit tothe growth and development of new investigators. How-ever, a business focus seriously limits the potential forglobal health innovations to reach the most marginalizedpopulations in low-income countries who may notpresent a viable market. If the Integrated Innovation™ focuson financial returns on investments overshadows socialand health returns this can reproduce the global health re-search inequities that neglect diseases of poverty. Thewidely debated gap in health research, where 10% of globalhealth funding targets diseases that impact 90% of thepopulation, spurred a health equity research agenda[14-16]. Innovation for grand challenges in global healthshould also interrogate how research approaches can chal-lenge health inequities both within and between countries.Specific recommendations for GCC include:Enhanced Support for New Investigators:1. Maintain and support the ‘Rising Stars’ awardprogram, whereby a proportion of Phase I and IIgrants are designated for new investigators. This isan invaluable opportunity to provide new scientistswith a platform to test a novel concept and to nurturefuture generations of global health researchers. Thisapproach is used by other federal funding bodies (e.g.Social Sciences and Humanities Research Council ofCanada) that allocates a proportion of InsightDevelopment Grants to new investigators.2. Integrate a formal mentorship component to theirprograms, linking new and senior global healthresearchers, recognizing that the support of newinvestigators involves more than just financial support.This could take many formats, including meetings indifferent regions, online platforms, webinars, examplesof successful grant applications, etc.3. Build a Grand Challenges community of scholars forincluding a website, blog, or meetings for scientistsat The University of British Columbia. His GCC-funded project focusesHealth Sciences Mall, Vancouver BC V6T 1Z3, Canada.Logie et al. Globalization and Health 2014, 10:27 Page 7 of 8http://www.globalizationandhealth.com/content/10/1/27populations in low-income countries.Building capacity in Integrated Innovation™ and theskills to successfully scale-up the innovations that emerge,in combination with interdisciplinary and internationalmentorship, will support new investigators in further de-veloping innovative approaches to solve grand challengesin global health. GCC could play a pivotal role at promot-ing new political frameworks, incentive measures and col-lective conscious in the business and general communityto foster commercialization of innovations addressing theneeds of developing communities. Conceptualizing returnson investments as social—not only financial—may be keyto promoting global health equity.AbbreviationsGCC: Grand Challenges Canada; BMGF: Bill & Melinda Gates Foundation;LMIC: Low-and-Middle-Income Countries.Competing interestsThe authors declare no competing interests. While all of the authors receivedGrand Challenges Canada funding, the funders played no role in theconceptualization, writing or publication of this paper.Authors’ contributionsConception and design (CL, HD, AF, SRG); Acquisition, analysis, and4. Develop a strong commercialization supportprogram where grant recipients are linked withpotential funders (e.g. NGOs, drug companies,foundations, private investors) either directly or bycreating a widely distributed database of fundedprojects to potential funders. GCC staff memberscould individually work with grantees to assist themto secure matching funding. For some projects,offering an intermediate ‘Phase Ib’ program couldassist investigators in overcoming the large gapbetween the proof-of-concept and the scale-up/commercialization stage.5. Value social returns on investment as equivalent tofinancial returns on investment when working oninnovative health projects with marginalizedlocal, national or internationally.Support Commercialization and Scale-Up:recipients of Phase I/II grants. This could fostercollaborations and networking, development of newintegrated innovations, and could take many forms,Promotion of Global Health Scholarship:interpretation of data (CL, HD, AF, SRG); initial drafting of manuscript (CL);critical revision of manuscript (HD, AF, SRG). All authors read and approvedthe final manuscript.Received: 17 June 2013 Accepted: 27 January 2014Published: 15 April 2014References1. Grand Challenges in Global Health. http://www.grandchallenges.org/Explorations/Pages/Introduction.aspx.2. World Health Organization: Grand Challenges in Genomics for Public Health inDeveloping Countries: Top 10 policy and research priorities to harnessgenomics for the greatest public health problems; 2011. http://www.who.int/rpc/grand_challenges.pdf?ua=1.3. Giles J: Social science lines up its biggest challenges. Nature 2011,470:18–19.4. Varmus H, Klausner R, Zerhouni E, Acharya T, Daar AS, Singer PA: Publichealth. Grand Challenges in Global Health. Science 2003, 302:398–399.5. Singer PA, Taylor AD, Daar AS, Upshur RE, Singh JA, Lavery JV: Grandchallenges in global health: the ethical, social and cultural program. PLoSMed 2007, 4:e265.6. Grand Challenges Canada/Grand Défis Canada: Integrated Innovation; 2010.http://www.grandchallenges.ca/wordpress/wp-content/uploads/integratedinnovation_EN.pdf.7. Adams J: Collaborations: The rise of research networks. Nature 2012,on developing new therapeutic alternatives for the treatment of tuberculosisrepurposing combinations of drugs already approved for other clinicalindications.AcknowledgementsThe authors wish to thank Grand Challenges Canada and The Bill andMelinda Gates Foundation for funding their research and meetingattendance and Dr. Donald Cole for critical review of the manuscript.Author details1Factor-Inwentash Faculty of Social Work, University of Toronto, 246 BloorStreet West, Toronto, ON M5S 1 V6, Canada. 2Women’s College ResearchInstitute, University of Toronto, Toronto, ON, Canada. 3Department ofOphthalmology & Vision Sciences, University of Toronto, Toronto, ON,Canada. 4Division of Visual Sciences, Toronto Western Research Institute,Toronto, ON, Canada. 5Division of Hematology/Oncology, SickKids ResearchInstitute, Toronto, ON, Canada. 6Department of Biochemistry, McGillUniversity, Montreal, Canada. 7Dafra Pharma Research & Development,Turnhout, Belgium. 8Department of Microbiology and Immunology,University of British Columbia, Vancouver, British Columbia, Canada. 9Centrefor Tuberculosis Research, Life Sciences Centre, University of British Columbia,Vancouver, British Columbia, Canada. 10The Hospital for Sick Children, 555University Ave, Room 7260, Toronto, ON M5G 1X8, Canada. 11McGillUniversity, McIntyre Medical Sciences Building, 3655 promenade Sir WilliamOsler, Montréal, Québec H3G 1Y6, Canada. 12Life Sciences Institute, 2350Authors’ informationCL is an Assistant Professor at the Factor-Inwentash Faculty of Social Workat the University of Toronto and an Adjunct Scientist at Women’s CollegeResearch Institute. Her GCC-funded project pilot-tested a community-healthworker delivered psycho-educational HIV/STI prevention project amonginternally displaced women in Leogane, Haiti.HD is an Assistant Professor in the Department of Ophthalmology & VisualSciences at the University of Toronto, Adjunct Scientist at the SickKidsResearch Institute and Affiliate Scientist at the Toronto Western ResearchInstitute. Her GCC-funded project focuses on centralization and digitizationof cancer pathology services in Kenya.AF is an Adjunct Member of the Department of Biochemistry at McGill andthe Director of Research at Dafra Pharma R&D, a pharmaceutical companydedicated to drug development against neglected diseases. Her GCC-fundedproject is a proof-of-concept for using a tattooing instrument as a new system totarget intra-dermal delivery of drug particles to treat a disease called cutaneousleishmaniasis.SRG is a Research Associate in the Department of Microbiology & Immunology490:335–336.8. Walker SH, Ouellette V, Ridde V: How can PhD research contribute to theglobal health research agenda? Can J Public Health 2006, 97:145–148.9. Berndtson K, Daid T, Tracy CS, Bhan A, Cohen ER, Upshur RE, Singh JA,Daar AS, Lavery JV, Singer PA: Grand challenges in global health: ethical,social, and cultural issues based on key informant perspectives. PLoSMed 2007, 4:e268.10. Braun V, Clarke V: Using thematic analysis in psychology. QualitativeResearch in Psychology 2006, 3:77–1010.11. Fook J: Critical Reflectivity in Education and Practice. In TransformingSocial Work Practice: Postmodern Critical Perspectives. Edited by Pease B, FookJ. St. Leonards, Sydney: Alley & Unwin; 1999:195–208.12. Taylor C, White S: Practicing Reflexivity in Health and Welfare: MakingKnowledge. Buckingham: Oxford University Press; 2000.13. DiMasi JA, Hansen RW, Grabowski HG: The price of innovation: newestimates of drug development costs. J Health Econ 2003, 22:151–185.14. Spiegel J, Labonte R, Hatcher-Roberts J, Girard J, Neufeld V on behalf of theCoalition for Global Health Research (Canada): Tackling the “10-90 gap”: aCanadian report. The Lancet 2003, 362(9387):917–918.15. Doyal L: Gender and the 10/90 gap in health research. Bull World HealthOrgan 2004, 82(3):162.16. Kilama WL: The 10/90 gap in sub-Saharan Africa: resolving inequities inhealth research. Acta Trop 2009, 112(Suppl 1):S8–S15.doi:10.1186/1744-8603-10-27Cite this article as: Logie et al.: Challenges faced by multidisplinary newinvestigators on addressing grand challenges in global health.Globalization and Health 2014 10:27.Submit your next manuscript to BioMed Centraland take full advantage of: • Convenient online submission• Thorough peer review• No space constraints or color figure charges• Immediate publication on acceptance• Inclusion in PubMed, CAS, Scopus and Google Scholar• Research which is freely available for redistributionLogie et al. Globalization and Health 2014, 10:27 Page 8 of 8http://www.globalizationandhealth.com/content/10/1/27Submit your manuscript at www.biomedcentral.com/submit


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