Next week's Childx conference will feature a keynote address by Peter Singer, MD, chief executive officer of Grand Challenges Canada. The organization, which is supported by the government of Canada, has used venture capital-style funding to support about 700 innovations in global health since it was founded in 2010. I recently spoke with Singer to get a preview of what he plans to say at Childx. (Conference registration is still open and is free to Stanford affiliates.)
One area of focus at Grand Challenges Canada is "saving brains." How does that initiative fit with the theme of this year's Childx conference, with its focus on pregnancy, fetal and newborn health?
It's critically important but also insufficient for children to survive pregnancy and birth. They also need to thrive. One of every three children, or 200 million worldwide, fail to reach their full potential as individuals because their brain development is not well supported, particularly in early childhood. As adults, they end up having lower wages, their countries have lower GDPs, and they have higher rates of criminality and non-communicable diseases including mental health problems.
If you were an evil scientist and were asking, "How could I make sure poor countries stay poor?", you could make sure one in three of their children never reach their full potential, and in fact that's what's happening. By ensuring that children reach their full developmental potential, we are ensuring that the world does as well.
What factors in children's early-life environments may cause them to fail to reach their full brain-development potential?
There are several categories of factors whose absence can mess up brains during development. First, health and nutrition are important -- for instance, if a child is malnourished in first 1,000 days of life, the brain won't fully develop. The second category is early stimulation. Playing and interacting with kids and even providing stimulation in the first days of life, such as skin-to-skin care or Kangaroo Mother Care, has huge effects on brain development, which morphs into a capacity for early learning and succeeding in pre-kindergarten education. The third factor is child protection, which encompasses everything from protecting children from spanking and harsh physical or verbal punishment to keeping them safe from geopolitical conflict and wars.
How is Grand Challenges Canada tackling this problem?
A unique part of the challenge of saving brains is that all the factors that contribute to a child's well-being must come together to be effective. It doesn't matter if you're well-nourished if you're a child soldier in northern Uganda. So we have to look at the problem holistically, and keep in mind that it's the outcome we care about; we're agnostic about the risk factors.
Our total commitment to saving brains has funded over 100 innovations, at a total funding level of about $42 million Canadian. Examples of projects we've assisted include research on the effect of Kangaroo care for low birth weight infants in Columbia on their schooling and wages 20 years later; a project in Tanzania, Bangladesh and Ghana that is testing whether early, rapid malaria treatment with rectal artesunate can reduce cognitive complications of the disease; and a project in Jamaica, Reach Up, that provides family coaching to encourage parents to play and have stimulating interactions with their young children.
All these projects have one goal: to make sure kids not only survive but also thrive.
What can scientists at institutions like Stanford contribute to the goal of saving children's brains?
I think there are a ton of opportunities to better understand how risk factors work together, to dig into the basic mechanisms whereby the damage to kids' brains occurs. When it comes to innovations for global child health, 90-95 percent of the focus is on survival. That's understandable because it's completely immoral for children to be dying of preventable causes, but you also have to ask, once you save those lives, is your obligation finished? Or do you have an obligation to help children reach their full potential?
In a sense, the past focus on survival is hugely counter-intuitive. If you ask parents around the world, "What do you want for your child?", none will say "I want my child to merely survive." They'll say "I want my child to thrive." Their intuition has the same focus as our work on saving brains.
There is a ton of solution- and discovery-oriented work to do in this area. People around Stanford care a lot about human capital and creativity and talent. You could think about this focus on the first 1,000 days of life as the first human-capital-development program. If you get that wrong, the damage may not be completely irreversible, but you're already walking up the down escalator.
Previously: Countdown to Childx: Talking Zika with a Stanford infectious disease expert, Countdown to Childx: Previewing the "epicenter of innovation" for expectant moms and children and Countdown to Childx: Discussing worldwide progress on children's survival
Photo by Save the Children