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

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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:

Applicants should propose solutions that lower costs such as:

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:

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:

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:

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:

3) Program Delivery Models

Relevant ideas may include:

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:

Evidence and Proposal Requirements

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

Applicants must provide:

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

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

Quality and Safety Requirements

Cost savings must not reduce:

Proposals should therefore include:

Funding Available

The challenge offers two funding options.

Option A

Option B

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:

Strongly Encouraged

Not Eligible

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:

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:

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

No. The call does not support proposals that:

4) How much funding is available?

Two options are available:

5) Who can apply?

Eligible applicants include:

6) What evidence is required?

Applicants must provide:

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.

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