Growth stunting has received increasing attention from the global health community lately, and rightly so. UNICEF estimates that over 60 million children under the age of five are stunted in India alone. Once the child reaches age two, the health consequences of stunting are irreversible.
Stunting is a result of chronic under-nutrition during the critical growth and development periods of a child’s life. It’s defined as children from infancy to around five years old, whose height and weight are two to three standard deviations below the median WHO Child Growth Standards. Stunting doesn’t begin when a child is born; it's associated with the pregnant mother’s nutrition, and what follows is an extremely vicious cycle.
Undernourished moms often lead to undernourished babies. This is exacerbated by lack of clean water, and inadequate sanitation and hygiene practices. Lack of clean water and inadequate sanitation practices lead to contracting enteric diseases. This then leads to chronic bouts of diarrhea and the body’s inability to absorb what little nutrients it's receiving, which then worsens under-nutrition. And the cycle begins all over again.
The Gates Foundation already addresses WASH, maternal and infant health, food security, and enteric diseases in its overall grantmaking. Its latest Grand Challenges have less to do with those issues and everything to do with one of the root causes of stunting—poor gut health.
The challenge that Gates is putting out to the world is to “support all stages of development of bacteriophage-mediated strategies for microbiome engineering in children under two years of age, as a means to reduce the number of cases of environmental enteropathy in low-resource settings.” In other words, it's talking about the use of bacterial viruses to target and infect specific bacteria, eventually leading to their dissolution. Therapeutics to kill specific bacteria? Sounds a little like that problem has been solved with antibiotics. Which is true for the most part, but developing bacteriophage therapeutics has all but stopped since the development of modern antibiotics. Plus, those modern antibiotics aren’t readily available, or affordable, in poor countries.
Initial funding for winning proposals is a $100,000 over 18 months. Should the project show a good deal of promise, Gates ups the ante to $1 million or more.