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RFPs: Breakthrough Innovations to Reduce the Cost of Severe Malnutrition Treatment

Deadline: 28-Apr-2026

The Gates Foundation is seeking breakthrough innovations that can reduce the total cost of treating Severe Acute Malnutrition (SAM) while maintaining quality, safety, and successful treatment outcomes for children in Sub-Saharan Africa and South Asia. The call supports system-level solutions that can achieve at least a 20% to 30% reduction in cost per child successfully treated, with funding of up to $500,000 (18 months) or $1,500,000 (36 months).

Overview

This funding opportunity is designed to identify high-impact, scalable innovations that make SAM treatment more cost-effective without reducing clinical quality.

The challenge focuses on lowering the overall cost of care, not by changing the ex-factory price of Ready-to-Use Therapeutic Food (RUTF) or replacing it, but by reducing the operational and system costs around treatment delivery.

Program Focus

The call supports innovations that reduce costs linked to:

  • Logistics and distribution

  • Treatment protocols and regimen design

  • Program delivery models

  • Complicated in-patient SAM care

Applicants should propose solutions that lower costs such as:

  • Transport

  • Storage

  • Staffing

  • Supervision

  • Visit frequency

  • Treatment duration

  • Monitoring intensity

  • Other health system overheads

The goal is to treat more children per dollar spent while preserving treatment success.

Why This Challenge Matters

Severe Acute Malnutrition (SAM) remains a major cause of child mortality, yet funding for treatment is often flat or declining.

The Gates Foundation recognizes that the true cost of treatment is much broader than therapeutic food alone. In many settings, large costs come from:

  • Logistics and warehousing

  • Distribution systems

  • Health worker time

  • Supervision

  • Follow-up visits

  • Facility and program overhead

Because of this, the challenge seeks transformative operational and delivery innovations that can create durable savings at scale.

Required Cost Reduction Target

Proposals are expected to show potential for:

  • At least 20% to 30% reduction in the total cost per child successfully treated

This is a high bar, so applications need a strong, evidence-backed case for meaningful cost savings.

Key Focus Areas

1) Logistics and Distribution Optimization

Applicants may propose innovations such as:

  • Redesigned distribution systems

  • Integrated delivery approaches

  • Warehousing improvements

  • Storage optimization

  • Demand forecasting tools

  • Approaches to reduce:

    • Spoilage

    • Leakage

    • Diversion

Proposals must clearly explain which logistics cost components are being reduced and how this lowers total treatment cost.

2) Treatment Protocols and Regimen Design

The challenge also supports innovations in how treatment is structured and delivered, provided they maintain safety and treatment success.

This may include approaches that reduce:

  • Treatment duration

  • Visit schedules

  • Monitoring burden

  • Supervision intensity

3) Program Delivery Models

Relevant ideas may include:

  • Decentralized care

  • Task-shifting to community health workers or volunteers

  • Integrated service delivery

  • Reduced-touchpoint monitoring

  • Better alignment with routine health systems

Applicants must clearly show how the proposed model differs from current practice and why it can reduce cost without compromising outcomes.

4) Complicated In-Patient SAM Care Optimization

Although fewer children need inpatient care, these cases can drive a large share of costs.

Potential innovations may include:

  • Shortening hospital stays

  • Improving clinical pathways

  • Supporting more efficient stabilization

  • Strengthening inpatient-to-outpatient transitions

  • Reducing staffing or monitoring costs without harming outcomes

Evidence and Proposal Requirements

All proposals must include a clear theory of change that links the innovation to measurable cost savings.

Applicants must provide:

  • A transparent cost model

  • Baseline cost decomposition

  • Clear assumptions

  • Identification of key cost drivers

  • Sensitivity analyses

They must also provide proof-of-concept evidence, which may include:

  • Modeling

  • Simulation

  • Pilot data

  • Retrospective analysis

This is a highly technical call, so strong quantitative justification is essential.

Quality and Safety Requirements

Cost savings must not reduce:

  • Clinical quality

  • Patient safety

  • Treatment success

Proposals should therefore include:

  • Safeguards to maintain standards of care

  • Evidence that outcomes will remain strong

  • A credible path to scalability

  • An explanation of why savings would remain durable at scale

  • Where relevant, a pathway toward normative or regulatory acceptance

Funding Available

The challenge offers two funding options.

Option A

  • Up to $500,000

  • Project duration of up to 18 months

Option B

  • Up to $1,500,000

  • Project duration of up to 36 months

In both options, the budget should be proportional to the proposed scope of work.

Who Can Apply?

The call is open to a broad range of organizations with strong technical and implementation capacity.

Eligible Applicants

Applicants may include:

  • Universities

  • Research institutes

  • Nongovernmental organizations with strong technical capacity

  • For-profit entities (subject to global access requirements)

  • Consortia combining scientific, manufacturing, and implementation expertise

Strongly Encouraged

  • Consortia led by or including organizations based in low- and middle-income countries (LMICs)

Not Eligible

  • Individuals

  • Organizations classified as individuals for U.S. tax purposes

How to Apply Strategically

This is a highly competitive and technical opportunity, so strong proposals need both rigorous economics and implementation credibility.

Best Application Approach

  1. Target a major cost driver
    Focus on a cost component large enough to realistically deliver 20–30% savings.

  2. Build a clear cost model
    Show baseline costs, what changes, how much each component shifts, and the total savings.

  3. Protect quality and outcomes
    Explain how clinical success and safety will be maintained.

  4. Use strong proof-of-concept evidence
    Include pilot data, modeling, simulation, or retrospective analysis.

  5. Show scale logic
    Demonstrate why the innovation remains effective and affordable at larger scale.

  6. Choose the right funding option
    Match Option A or Option B to the maturity and complexity of your intervention.

Common Mistakes to Avoid

Avoid these common issues:

  • Focusing only on RUTF price reduction or proposing to replace RUTF

  • Presenting cost savings without a transparent cost model

  • Offering ideas that do not credibly reach 20–30%+ savings

  • Weak evidence for feasibility or proof of concept

  • Ignoring clinical quality and safety safeguards

  • Not showing a credible pathway to scale or normative acceptance

  • Submitting a consortium without clear complementary expertise

FAQs

1) What is the main goal of this Gates Foundation call?

The goal is to support innovations that reduce the total cost of SAM treatment while maintaining quality, safety, and successful outcomes for children in Sub-Saharan Africa and South Asia.

2) What cost reduction is expected?

Applicants should show potential for at least:

  • 20% to 30% or greater reduction in the total cost per child successfully treated

3) Can proposals change the price of RUTF or replace it?

No. The call does not support proposals that:

  • Change the ex-factory price of RUTF

  • Replace RUTF with an alternative product

4) How much funding is available?

Two options are available:

  • Option A: Up to $500,000 for up to 18 months

  • Option B: Up to $1,500,000 for up to 36 months

5) Who can apply?

Eligible applicants include:

  • Universities

  • Research institutes

  • NGOs with strong technical capacity

  • For-profit entities (with global access requirements)

  • Consortia

6) What evidence is required?

Applicants must provide:

  • A clear theory of change

  • A cost model

  • Baseline cost decomposition

  • Sensitivity analyses

  • Proof-of-concept evidence such as modeling, simulation, pilot data, or retrospective analysis

Conclusion

The Gates Foundation SAM innovation challenge is a major opportunity for organizations working in nutrition, health systems, supply chains, and implementation science to develop high-impact, scalable solutions that reduce the total cost of SAM treatment without compromising care quality. With funding of up to $1.5 million, it is best suited for technically strong teams that can show clear cost savings, rigorous evidence, strong safeguards, and a credible path to scale.

For more information, visit Gates Foundation.