Marissa Chmiola

On February 20, Jamie Bay Nishi joined GHTC as its new coalition director. Marissa Chmiola, GHTC’s communications officer, sat down with Jamie during her third week on the job to find out more about her background, what inspires her, what challenges and opportunities she sees in advocacy for global health research and development (R&D), and what lies ahead for the coalition. What first got you interested in the field of global health and development, and what inspires you about this line of work? Jamie Bay Nishi. Photo: DevexI grew up as overseas as a “diplobrat,” so I consider an interest in international affairs and global development to be in my DNA. As the child of diplomats, I lived in Saudi Arabia, Egypt, France, and Germany, and had the chance to see firsthand the impact of US engagement in diplomacy and global development.I really fell into health as an area of interest after graduating college. I wanted to work overseas, but most of the opportunities available at the time were contractor positions in Iraq as part of the war effort. Because that wasn’t an interest area of mine, I took a job working at the Advisory Board Company where I helped launch their Technology Insights product, advising hospitals in the United States on their clinical technology purchasing needs. While I found the work interesting, I ultimately recognized that domestic health wasn’t my passion, so I pivoted my career trajectory toward the global development field. I earned a Master’s degree in Conflict Resolution and ultimately took a job at then startup-mode Devex, a membership organization and media platform for the development community (basically a Bloomberg for international development). Over a decade later, I am delighted to have landed at an organization that focuses on both health and development, marrying these two interests! What attracted you to the director role at GHTC, and what excites you most about leading this coalition? I joined GHTC after spending nearly nine years growing Devex’s membership, as well as building unique partnerships. When considering the GHTC director position, I was excited about the possibility of diving deeper into a technical area within the global development field, and exploring how my membership-building and media partnership development skills could be applied in the advocacy space. It’s also exciting to take helm of a coalition that has a decade-long track record of effectively mobilizing support for global health R&D. This gives me a strong foundation to build upon, while at the same time offering me the opportunity to consider new approaches to amplify our advocacy for even greater impact.You’ve been on the job for three weeks now. What are your first impressions?In my first few weeks on the job it has been my priority to meet with each of our coalition members. I have been continually impressed by the incredible and impactful work each organization is doing to advance innovation to save and improve lives around the world. It’s truly inspiring.It’s also clear I’ve come into this role at a pivotal time in American political history. The United States has long lead the world in global health and medical innovation, and now more than ever, there is a need for coalitions like GHTC to engage with policymakers to maintain this support and champion continued US leadership in improving health and well-being worldwide. This is especially the case for protecting investments in global heath R&D—forward-looking investments that can sometimes fly under the radar.Your professional background is in stakeholder engagement, strategic partnerships building, and marketing. How does this experience shape your thinking about advocacy and translate into this new role at GHTC? While I am relatively new to the policy and advocacy field, I feel my previous experience in member engagement and communications will be a useful skill set to bring into the advocacy space. I hope to bring a fresh set of eyes to the advocacy challenges we face today and drive forward innovative approaches to build momentum within the coalition and to achieve impact with policymakers.What do you see as some of the biggest opportunities and challenges right now in advocacy for global health R&D? This year has brought dramatic shifts in the US political landscape, which could alter the US government’s historic leadership role in global health R&D. As a coalition and community, we have a lot of work ahead to support continued US, as well as multilateral leadership, and prioritization of global health R&D, which includes efforts to maintain or increase funding. Maintaining bipartisan political support and buy-in will be our biggest priority—and to do this we will have to make sure that as a coalition we articulate both the need for and promise of new global health innovations, in the United States and around the world. Due to the highly nuanced and technical nature of R&D, this can sometimes be challenging to communicate.On the other hand, I am really looking forward to digging-in to expand and deepen GHTC’s relationships with key policymakers and thought leaders in the United States and multilateral space. To really drive the global health R&D agenda forward, it will be critical to broaden GHTC’s constituency to enlist new supporters, and elevate visibility both for the coalition’s advocacy work and the pivotal role R&D plays in the future of global health.Tell us about your vision for GHTC and what you will be focusing on in your first year as director. I look forward to bringing our members together this spring for GHTC’s first ever member summit, where together we will strategize the future of GHTC. I also look forward to adding to GHTC’s core competencies to complement the incredible efforts and activities of my team. I personally want to look at new ways to augment the visibility of the coalition and its members, engage new stakeholders without diluting the core mission and purpose of GHTC, and strategize new communications efforts that will resonate with policymakers.My team as a whole will also be doubling down on engagement with policymakers in Congress, federal agencies, and multilateral entities to promote continued and expanded engagement in global health R&D.What do you enjoy doing in your spare time? I have a lot of hobbies outside of work including being a Zumba instructor, salsa dancer, stand-up paddle boarder and beer/kombucha homebrewer.

It’s that time of year when Americans join together with family and friends and give thanks for the many things in life for which they are most grateful. In the spirit of the Thanksgiving holiday, GHTC asked our members and staff to share what they are most thankful for in global health. Here’s what they had to say: “I am thankful for all patients who take part in clinical trials so that the world will have more effective regimens to end TB, in all its forms.” Willo Brock, Senior Vice President of External Affairs, TB Alliance “I’m thankful there is increasing global interest in the development and production of vaccines for diseases of poverty, like hookworm, schistosomiasis, and Chagas.” Tara Bracken, Communications Associate, Sabin Vaccine Institute “I am thankful that 2016 was a turning point for women’s HIV prevention research—one that brought us hope for one day soon expanding women’s options with a long-acting vaginal ring. I am also grateful for the amazing partners who believe women’s health and empowerment matter!” Zeda Rosenberg, Founder and CEO, International Partnership for Microbicides “I’m thankful for the new generation of emerging R&D leaders who are both generating new knowledge and achieving global health impact.” Dr. Timothy Mastro, Chief Science Officer, FHI 360 “I’m thankful for sustained US government funding to fight emerging epidemics, like Ebola and Zika, through R&D and scientific advancement.” Lindsay Litwin, Jhpiego Innovations “I’m thankful that elimination of sleeping sickness is now a real possibility thanks to new tests being strategically implemented alongside new vector control technologies and improved treatment regimens.” Dr. Joseph Ndung’u, Head of Neglected Tropical Diseases Programme, FIND “I’m thankful that the six antimalarials MMV and partners have brought forward are saving young lives today!” Andrea Lucard, Executive Vice President of External Relations, Medicines for Malaria Venture “I’m thankful for research that has shown promise for an effective six-month regimen to cure XDR-TB [extensively drug-resistant TB].” Rabita Aziz, Policy Research Coordinator, ISDA Global Health “I’m thankful for the inspirational dedication and continued participation of all HIV vaccine clinical trial volunteers. Without you, the important work of finding a safe and effective HIV vaccine would not be possible.” Dr. Fran Priddy, Chief Medical Officer, International AIDS Vaccine Initiative “I’m thankful for the over 200 members of Congress who have co-sponsored the Reach Act to accelerate efforts to end preventable deaths of mothers and children around the world.” Brandon Ball, Policy and Advocacy Officer, PATH "I'm thankful for low-cost interventions like chlorhexidine gel for umbilical cord care being made more accessible to Sub-Saharan Africa to reduce newborn mortality." Assumpta Nantume, Communications Associate/Global Health Corps Fellow, Global Health Council “I'm thankful a new generation of Middle Eastern scientists are advancing the development, production, and characterization of new vaccines to help endemic countries better respond to the threat of infectious diseases like MERS, schistosomiasis, and leishmaniasis.” Chris Bennett, Senior Program Officer, Sabin Vaccine Institute “I’m thankful for pioneering donors such as UNITAID for funding development of new hepatitis C tests for countries where fewer than 1 percent of people living with hepatitis C have been diagnosed.” Catharina Boehme, Chief Executive Officer, FIND “I’m thankful for scientists and researchers who devote their lives to important global infectious disease work to help people around the world and to protect Americans here at home and the funding the US government provides for such important work.” Karen Goraleski, Executive Director, American Society for Tropical Medicine and Hygiene “I’m thankful for the tremendous progress we’ve made in advancing child and maternal survival and excited for the prospect of saving the lives of more than 6 million mothers and children by 2030 if we work together to advance and scale-up 11 promising innovations.” Heather Ignatius, Multilateral, US, and Europe Policy & Advocacy Team Lead, PATH “I’m thankful for researchers across the globe whose efforts have, with unprecedented speed, deepened our scientific understanding of and advanced new tools to prevent, detect, and treat Zika.” Kat Kelley, Senior Program Assistant, GHTC “I'm thankful so many good dengue vaccine candidates are in development that could help curb the growing global dengue epidemic.” Tara Bracken, Communications Associate, Sabin Vaccine Institute "I'm thankful for increased awareness on global antibiotic resistance and WHO's new evidence-based Infection Prevention and Control Guidelines." Danielle Heiberg, Advocacy Manager, Global Health Council “I'm thankful for the lives of mothers and babies that have been saved, sustained, and supported by midwives across the globe.” Shannon Egan, Jhpiego Innovations “I’m thankful that malaria rapid tests have contributed to better malaria control, which in turn has helped fuel a massive decline in childhood mortality over the past decade—and that partners around the world are working together to find innovative new solutions for identifying non-malarial causes of fever. Diagnosis matters!” Dr. Iveth J. González, Head of Malaria and Acute Febrile Syndrome programme, FIND “I’m thankful for the support of MMV’s committed donors and partners that make our work to develop new antimalarials for vulnerable populations possible.” Andrea Lucard, Executive Vice President of External Relations, Medicines for Malaria Venture “I’m thankful to be a part of the #StartStayAIDSFree initiative which aims to end AIDS in children by 2020.” Catherine Connor, Senior Director of Public Policy and Advocacy, Elizabeth Glaser Pediatric AIDS Foundation “I’m thankful that members of both major US political parties have continued to demonstrate strong, bipartisan support for global health research and development and US efforts to save lives around the world.” Marissa Chmiola, Communications Officer, GHTC

A CDC researcher prepares reagents that would be used in a CDC-developed Zika diagnostic test. Photo: CDC/Sue Partridge, CDC- Ft. CollinsOn Wednesday, 26 current and past presidents of the American Society of Tropical Medicine and Hygiene (ASTMH) sent a letter to the leadership of the US Senate and House of Representatives urging policymakers to pass an emergency spending bill to combat the Zika virus as soon as possible, calling failure to do so “imprudent and reckless.”Six months have now passed since the White House first requested US$1.9 billion in emergency funding for the Zika virus response, yet Republicans and Democrats in Congress have failed to reach a compromise position, and last month Congress adjourned for summer recess without passing a funding bill. As a result, US agencies involved in the response, including the US Centers for Disease Control and Prevention and the National Institutes of Health, have been forced to repurpose funds from the Ebola response and other accounts to continue financing efforts to curtail the spread of the Zika virus. But President Obama and agency leaders have voiced mounting concerns that federal funds to fight Zika are quickly running out and lack of funding could delay vaccine research and development.In the letter to congressional leaders, ASTMH’s current and past-presidents note that, “The science is clear, the call to action is clear and yet, political infighting has carried the day while the outbreak continues….Patchwork and inadequate funding will not do the job—plain and simple.”The letter continues: “Without proper funding, researchers cannot sustain surveillance, planning, mosquito control, or research and development efforts to protect our most vulnerable populations, including women and children.” It ends by urging Congress to “get this job done now.” This collective leadership letter is the first of its kind for the Society, which is the largest international scientific organization of experts dedicated to reducing the worldwide burden of tropical infectious diseases and to improving global health.Click here to read the full letter.

USAID's 2015 Health-Related Research and Development Progress Report. Photo: USAIDLast month the US Agency for International Development (USAID) released its annual Health-Related Research and Development Progress Report detailing the agency’s research and development (R&D) activities to address global health challenges.Breakthroughs Blog is joined by Neal Brandes—team leader for USAID’s Health Research Program (HaRP) in the Bureau for Global Health—to learn more about the report and USAID’s ongoing support for global health R&D. The HaRP team coordinates the cross-bureau effort to produce this publication and has been advocating collaborative and coordinated research and research utilization efforts to accelerate the research-to-use process.Q: GHTC is always excited to dig into this great report each year. Can you highlight for our readers what is new in this year’s report with regard to new programmatic developments at USAID or major scientific developments in USAID-supported biomedical R&D? NB: There are many new developments that we’re excited about in this year’s report. To highlight just a few: The Ebola epidemic this past year emphasized the need for processes to solicit new ideas and rapid solutions based on sound evidence. This year’s report highlights the exciting products of the Fighting Ebola Grand Challenge, as well as the ongoing good works to produce innovations through the Saving Lives at Birth Grand Challenge. On the newborn front, we report on the progress on care of newborns with possibly severe infection or sepsis—one of the leading preventable causes of death. The World Health Organization (WHO) recommends that sick newborns be referred to hospitals for in-patient care, but also recognizes there are significant barriers to families in low- and middle-income settings accessing that essential care. A multicountry and multidonor initiative supported research establishing that newborns unable to access hospital care can be treated by a trained health worker in lower-level health facilities. This treatment is provided on an outpatient basis with a shorter course of antibiotics. The WHO has recently updated its guidance based upon this new evidence, and we are already in the midst of implementation research to test, adapt, and support its effective and safe application in real-world health systems. Finally, there was encouraging progress on research to combat the HIV and AIDS epidemic. Findings from two dapivirine ring trials are highlighted. These are landmark studies because they are the first to test the efficacy of a woman-controlled method of HIV prevention that uses a nongel microbicide.  Q: This year’s report marks the end of USAID’s 2011–2015 Health Research Strategy. Looking back at the last five years of USAID-supported biomedical R&D, what are some of the most exciting and impactful developments or innovations that have resulted? Are there disappointments or areas in which not as much progress was made as the agency had hoped? NB: Research operates across a continuum. Fortunately, in recent years we’ve had the opportunity to witness some of these efforts come to fruition. For example, take the chlorhexidine story. Chlorhexidine was an early effort to invest in a promising idea through a managed research-to-use process. We began with a careful assessment and then a modest series of concurrent proof-of-principle studies; research utilization efforts; and collaborative efforts with governments, universities, nongovernmental organizations, and pharmaceutical companies that demonstrated the potential and established a foundation to save lives. Nepal was both an early adopter and a global champion for the results of this work. Today these efforts have led to global engagement, rigorous introduction, and scale-up planning in 10 countries. We also understand that the nature of research involves uncertainty and planning for failure. Because of the commitment of our partners and the agency’s culture of learning, we are able to see setbacks as opportunities to improve our processes and extract value from our missteps that will improve the next efforts to address complex challenges.Q: The report illustrates how USAID is working with other US agencies across the continuum of R&D to develop new tools to combat tuberculosis (TB) as part of the US government TB strategy. Could you tell us more about how USAID is coordinating with other US agencies to advance development of critically needed tools in other health areas?A lab technician test tuberculosis samples at a lab in Bandung's Public Health Laboratory. Photo: USAID IndonesiaNB: We work with many stakeholders, foremost of which are the host governments. Because we are stewards of the public’s money, we collaborate with US government agencies as well as other donor development agencies such as the United Kingdom Department for International Development and philanthropies on almost every area of our portfolio—whether it’s to keep each other informed to ensure our efforts are aligned and coordinated or coordinating cofunding to advance the R&D agenda with a goal of advancing research investments to save lives. For example, our malaria portfolio consists of many operational research projects that are done through the President’s Malaria Initiative—a joint effort between USAID and the US Centers for Disease Control and Prevention (CDC). The Ebola Grand Challenge efforts were based on a coordinated partnership with USAID, the White House Office of Science and Technology, CDC, and the US Department of Defense. To introduce new tools and measurements in behavior science (like Big Data), we are working with the White House Social and Behavior Science team.Q: Why is it important for USAID to continue to play a strong role in health research, and what’s next for USAID in this area? Should we expect a 2016–2021 strategy, and how might it look similar to or different from the current strategy? NB: We still have many health challenges ahead of us, and our success is dependent on garnering strong evidence to inform decision-making and action. USAID has the advantage as a development agency to provide technical leadership and an on-the-ground presence working in conjunction with our partner countries and other stakeholders to accelerate the application and development of science and innovation.We are actively discussing our new research strategy. Like our previous strategies, it will address the unique needs of each of our technical areas. However, we are also working together to articulate a number of broad principles that define our work—placing emphasis on how our work includes implementation science, innovation, and partnerships.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. Could a US Food and Drug Administration (FDA) approved drug to fight Zika already exist? A new research paper suggests it could be possible. A group of researchers at the University of Texas Medical Branch at Galveston screened 774 FDA-approved drugs to see if they could protect isolated human cells from the virus and found that 24 of the drugs showed some ability to block Zika from infecting certain cell types. Due to the lag time between when a pregnant woman contracts the virus and when the virus passes from mother to fetus, if scientists could find a drug to halt infection, a woman could take it as soon as infection is discovered and prevent the virus from reaching her fetus. Using an existing drug already shown to be safe could help expedite the research and regulatory process to bring it to market. A chemist at the University of Albany has developed at tiny, edible QR bar code he believes could be a solution to fighting the problem of counterfeit drugs. Made of edible materials, the code is smaller than 200 micrometers, or around the size of a dust particle, and can be printed on the surfaces of capsules or embedded in pills. The code, which is able to be read by a cell phone microscope available for about US$10, could contain manufacturing information such as the product number and production date. In low- and middle-income countries, counterfeit drug sales are a major health challenge. Up to 30 percent of drugs on the market are counterfeit. A new study has found that infection with the worm Wucheria bancrofti—which cause lymphatic filariasis—increases risk of HIV infection by two-to threefold. The study followed 1,055 individuals in southwest Tanzania and found that those with the worm infection had a 3.2-fold increased risk of HIV infection in the age group 14 to 25 and a 2.4-fold increased risk in those between 25 to 45 years. The study adds to a growing collection of scientific literature linking infection with neglected tropical diseases with increased HIV infection risk. A new public-private partnershipwill deploy more than $350 million over the next five years to encourage pharmaceutical companies to develop new antibiotics to combat the growing problem of drug resistance. The partnership—Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator (CARB-X)—is a joint initiative of the Boston University School of Law, the Biomedical Advanced Research Authority, the Wellcome Trust, and the Antimicrobial Resistance Centre. With few large pharmaceutical companies in the antibiotic development market today, the program will focus on researchers and smaller biotech firms who may be interested in developing new antibiotics but have little access to funding. The program will provide grants to these developers as well as business and research support through one of four accelerator sites, which will aid these developers with mentoring, business strategy, and other coaching.

A typical pitch for venture capital investment highlights three topics: the problem a technology solves, the size of the market, and the profit potential of the product. But at the pitches I witnessed from innovators last Thursday at the Saving Lives at Birth DevelopmentXChange, this formula was turned on its head. While the discussion focused on problem solving, the questions being asked were not how large the market, but how great the need, and not how much money can be made, but how many lives could be saved.The DevelopmentXChange marked the final stage of competition in the 6th annual Saving Lives at Birth Grand Challenge, a prize program sponsored by the US Agency of International Development, the government of Norway, the Bill & Melinda Gates Foundation, Grand Challenges Canada, the UK Department of International Development, and the Korea International Cooperation Agency to identify and advance transformative, cost-effective solutions to improve maternal and newborn health. The program operates much like a venture capital firm. Innovators apply and pitch their ideas, and the program determines whether to issue them grants to develop, test, and bring their ideas to scale.This year the program received more than 650 applications from 78 countries, with 49 teams chosen as finalists to compete at this year’s DevelopmentXChange and showcase their innovations. At the conclusion of the event, Saving Lives at Birth announced the selection of 12 winning teams in the validation and seed grant categories, who will receive more than $3.4 million in funding to move their projects forward. Award winners in the transition-to-scale category will be announced later this year.  GHTC members featured among finalistsAmong the 48 finalists were five promising innovations from GHTC member organizations, profiled below: Finalization and validation of a postpartum screening tool focused on identifying risk factors for maternal infection as part of routine, predischarge service delivery Jhpiego Despite widespread availability of treatment, postpartum infections account for 11 percent of maternal deaths worldwide. A number of risk factors are strongly associated with postpartum infection, and symptoms usually manifest within 48 hours after birth. In Uganda, women are increasingly giving birth in hospitals; however, they are often discharged early due to overcrowding.To address this challenge, Jhpiego has developed a simple screening tool to assess a woman’s risk of postpartum infection. The tool is a checklist of the key risk factors, composed of eight yes or no questions. The assessment is easy to use, and the results are even easier to interpret. If the tool proves to be predictive of postpartum infection, it could be used by health workers, including nurses and midwives, to make evidence-based decisions on whether a new mother can be safely discharged or whether she should remain in the hospital for an additional 48 hours. At Saving Lives at Birth, Jhpiego was seeking funding to finalize and validate the tool—to determine its predictive value—by rolling it out in two regional referral hospitals in Uganda. If successful, Jhpiego plans to partner with the ministry of health to expand its use across public- and private-sector hospitals.Field validation of a new protein-to-creatinine (PrCr) strip test: An impactful new tool to improve diagnosis of preeclampsia at the front lines of antenatal care in low-resource settingsPATH At least 16 percent of maternal mortality worldwide is attributable to preeclampsia, a dangerous condition that can cause organ failure, seizures, and maternal and newborn death. Screening for preeclampsia—which is characterized by high blood pressure and protein in urine (proteinuria)—ideally occurs as part of the care a woman receives during pregnancy. Throughout the day, the concentration of urine often fluctuates, and so, too, does the concentration of protein in the urine. Consequently, the gold standard for diagnosing proteinuria involves collecting and analyzing urine samples over 24 hours. However, this approach is unrealistic in many low-resource settings, and current diagnosis involves a protein-only dipstick test that catches just 51 to 68 percent of cases.PATH has developed a simple, low-cost protein-to-creatinine strip test to improve the accuracy of preeclampsia screening in low-resource settings and was seeking funding through the Saving Lives at Birth program to evaluate the feasibility and efficacy of the diagnostic test in Ghana. The test is nearly identical to the commonly used protein-only test. However, where the existing tool only tests for protein concentration, the new device also tests for creatinine concentration. By comparing the concentration of both protein and creatinine, a health worker can control for how diluted or concentrated the urine is at the time. PATH has confirmed that the diagnostic strip remains effective when stored for at least four months at 37 to 45°C, and the tool costs just pennies on the dollar. Due to its similarity to the existing protein-only test, rollout of the test should be straightforward, requiring very little additional training.Developing a Rapid Integrated Sepsis Risk Calculator (RISC) to detect and manage severe sepsis in newbornsPATH PATH's Rapid Integrated Sepsis Risk Calculator. Photo: Matthew Robinson/GHTCSepsis kills an estimated 421,000 infants in the first 28 days of life in low- and middle-income countries every year. To address this glaring need, the World Health Organization (WHO) recently published guidelines for diagnosis and treatment of possible serious bacterial infection (PSBI), which will require primary-level health care providers to be versed in sepsis detection and management. Many providers do not currently have the necessary training or tools.The RISC is a smartphone or tablet-based app and off-the-shelf device measuring oxygen saturation levels in the blood that enables even primary-level providers to identify sick infants and either provide the correct treatment or refer them to higher-level care. The app incorporates algorithms that walk the provider step by step through the diagnostic process, increasing provider confidence and greatly improving the accuracy of diagnoses. Because the app will be built using Open Data Kit (ODK) free open-source software and off-the-shelf hardware, it will be highly cost-effective and adaptable. The app also works offline, which is critical in remote primary care facilities. The team was seeking a Saving Lives at Birth seed award to complete the development of the ODK app and conduct a pilot evaluation of RISC’s usability, feasibility, and acceptability in Ghana.Development and evaluation of the RELI Delivery System—an innovative, simplified, low-cost infusion pump for obstetric and newborn emergenciesPATH With a few pumps of a handle, a health worker can power an intravenous fluid infusion pump for an entire work shift, all without the use of electricity or batteries. That’s the idea behind PATH’s RELI Delivery System—an innovative, low-cost infusion pump for obstetric and newborn care. Controlled intravenous delivery of medicines like antibiotics or anesthesia is the gold standard of care for many diseases and conditions, but it’s often not feasible in low-resource settings. Existing infusion pumps cost thousands of dollars to purchase and maintain, require substantial training to operate, and require electricity or batteries. PATH designed the RELI System to overcome many of these barriers to access in low-resource settings. The device, which requires no electricity or batteries, is powered pneumatically, through air pressure. It requires about two minutes of pumping to generate the power needed to operate the device for an entire 12-hour shift. The system also has a simple-to-use interface and can be manufactured inexpensively, with an expected retail price at less than $100 a machine. With the seed grant it won through the program, PATH plans to take the device to the field to solicit user feedback and then refine the design for further field testing.  Outpatient treatment of neonatal sepsis by rectal administration of gentamicinPATH Neonatal sepsis is a leading cause of infant death worldwide. WHO recommends treatment of the condition with intramuscular injection of the commonly used antibiotic gentamicin. But in many low-resource settings, this is easier said than done. Neonatal dosing is extremely sensitive—just a fraction of a difference in dose size can affect effectiveness and safety—so administration requires a highly trained health worker. Additionally, many health providers may not have access to safe injection devices or may be inclined to reuse needles, promoting the spread of the disease.Unfortunately, gentamicin is not effective when delivered orally, so PATH is exploring the feasibility of an alternative method of gentamicin delivery—rectal delivery. As a needle-free method of administration, rectal delivery could improve access to gentamicin by making it safer for the product to be administered by lower-level health workers, increasing dose accuracy, and removing the risks associated with injections. Existing scientific literature suggests rectal delivery could be a biologically viable option for gentamicin. PATH was seeking a grant to conduct further lab studies to assess how different additives or formulations can improve uptake of gentamicin in colon cells and conduct stakeholder interviews to assess feasibility of the concept.The innovation effectGHTC congratulates both our members and the other teams who were selected as finalists and award winners.This year’s prize winners will join the growing community of over 93 innovators supported by the Saving Lives at Birth program. Many of these innovations are beginning to have an impact as they are brought to scale. To date, the program has supported 1.5 million women and newborns and saved nearly 10,000 lives.The Saving Lives at Birth program has made it clear that by putting innovation at the center of global health, we can accelerate the pace of change and transform lives, faster.Kat Kelley, senior program assistant, and Matthew Robinson, MA, policy officer, contributed to this article.