Grand challenges in humanitarian aid

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Nature
Volume 559 Issue 7713, 12 July 2018
http://www.nature.com/nature/current_issue.html
Comment | 11 July 2018
Grand challenges in humanitarian aid
Fund and study these priorities for natural and social sciences to meet a gaping need, urge Abdallah S. Daar, Trillium Chang, Angela Salomon and Peter A. Singer.

What are Global Alliance for Humanitarian Innovation and Grand Challenges Canada?
The need for innovation in the humanitarian space was recognized at the World Humanitarian Summit in Istanbul10 in May 2016. The largest ever United Nations gathering, this had 9,000 participants from at least 173 countries, including 55 heads of state and governments, hundreds of private-sector representatives, and thousands of people from civil society and non-governmental organizations, including multilateral development banks such as the World Bank.

The summit created the Global Alliance for Humanitarian Innovation with the mission of achieving higher impact and efficiency in humanitarian action11. It complements several initiatives, including Global Humanitarian Lab, Global Partnerships for Humanitarian Impact and Innovation, and the Canadian Humanitarian Assistance Fund. Unfortunately, many of these have insufficient funding to address the magnitude of the problem by creating a healthy pipeline of seed innovations; most do not have the capacity to scale them up.

Grand Challenges Canada (GCC), supported by the Government of Canada, funds technological, social and business innovations in global health. Since its founding in 2010, GCC has supported 1,000 projects in more than 80 countries (see go.nature.com/2jyaozb). The leaders of GCC have a track record of partnering to identify priorities that catalyse the creation of impactful research funding programmes at the global level. These include: the Bill & Melinda Gates Grand Challenges in Global Health programme, based on a 2003 study5; the Global Alliance for Chronic Diseases, based on a 2007 study6; and the Global Mental Health Initiative of the US National Institute for Mental Health and GCC, based on a 2011 study7.
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Top 10 Humanitarian Grand Challenges
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1 STRENGTHEN ECONOMIES (147 cumulative score)
Priority:
Restore functioning markets and the economic stability of affected communities by:
• Scaling up cash-based assistance (rather than in-kind commodities)
• Improving access to financial services
• Increasing autonomous choice over spending
• Expanding social safety-net programmes, such as provision of health care, shelter and transport
• Engaging cross-border refugees, particularly women, who are displaced to countries where they are forbidden to work outside camps*
Research questions:
• How can assistance be maximally scaled in humanitarian crises settings? What are the obstacles to achieving this and how can they be overcome?
• What potential financial services, formal and informal, are available to refugees and affected communities? How can safe and affordable access be improved?
• What are the economic advantages and disadvantages of allowing aid beneficiaries to receive cash and/or control their own spending, rather than receiving aid through material goods or medical supplies?
• What are the most effective ways to distribute cash digitally without compromising user data privacy (for example, via blockchain)?
• What are more affordable/effective ways for diaspora and others to send money to crisis-affected persons?

2 REDUCE INEQUALITY (141)
Priority:
Strengthen resilience in communities at risk of humanitarian crises by:
• Reducing inequality and poverty
• Promoting gender equality
• Improving education*
Research questions:
• How can communities vulnerable to humanitarian crises be identified proactively?
• What are effective ways to raise public awareness about potential disasters in communities not previously affected?
• How can a population be engaged in procuring and storing vital goods such as food, clothing, medical supplies, power generation and rescue equipment? How can these vital goods be most efficiently deployed?
• How do social determinants (such as poverty, gender inequality, low education; and ethnic, tribal and religious or other differences) perpetuate or aggravate humanitarian emergencies?
• How can maternal and child education and health services be more effective, and how can uptake be increased?

3 IMPROVE METRICS (138.5)
Priority:
Measure effectiveness of humanitarian aid by moving away from metrics that measure ‘cost-per-beneficiary’ to those that measure how the needs are met of:
• the most vulnerable
• the most systematically excluded
• the hardest-to-reach communities
Research questions:
• What are the most logical indicators for measuring lives saved and improved in humanitarian crises? This may include existing indicators, such as those in the Paris Declaration on Aid Effectiveness, if appropriate to the context.
• How can technological innovations, such as cloud computing and mobile devices, automate and improve the efficiency of measuring aid effectiveness over time?
• Can ‘big data’ resources such as messaging apps, user-generated maps, GPS, mobile-phone tracking, commercial transactions or electronic medical records be used to identify impacted populations, their needs and gaps in support?
• Do current monitoring and evaluation systems compromise the safety of affected people or place heavy burdens on responders? What are ways to overcome this while still meeting donor needs?

4 ADDRESS FUNDING (128)
Priority:
• Shift from short-term emergency funding toward longer-term humanitarian financing
• Ensure accountable, impactful investments that include incentives or subsidies for host governments to contribute alongside foreign assistance*
Research questions:
• How can states, humanitarian aid agencies, donors and others be effectively engaged in an effort to shift to sustainable funding?
• How effective are impact bonds in financing initiatives in humanitarian settings (recent onset or protracted)? What are other potentially transformative strategies to achieve multi-year funding for protracted crises?
• How can ‘risk insurance’, based on agreed-upon triggers, mitigate humanitarian disasters?

5 PROTECT IDENTITY (121)
Priority:
Provide affected persons with an official private, secure digital identity that reduces the risk of creating stateless persons.
This might:
• Incorporate a universal health card
• Safely and privately store, transport, validate authenticity of, and disseminate personal documents (such as bank cards, land deeds, birth certificates, school diplomas and medical records)*
Research questions:
• How effective have previous efforts been to establish Universal Health Cards, Universal Health Insurance and financial-risk protection for migrants (such as those used in Thailand8)?
• How effective have previous efforts been to issue digital identity cards to hard-to-reach populations (such as India’s Aadhaar9 system)?
• What are the advantages, disadvantages and long-term impacts of providing digital identities by countries of origin or by hosting governments?
• What are the ethical, legal and social issues that may arise in developing and disseminating such digital identities?
• What is the feasibility and impact of using highly secure, efficient technologies to store records in humanitarian settings? What are the potential drawbacks or consequences?

6 EXPEDITE AID (119)
Priority:
Remove all barriers to immediate aid following emergencies or after predetermined ‘triggers’ in slow-onset emergencies, such as restrictions on humanitarian organizations. This prevents the need to wait until public consciousness is raised and pressure applied to donor governments.
Research questions:
• What are the most effective international mechanisms and auspices under which to engage governments to develop partnerships for immediate disaster/emergency relief?
• How feasible and effective are crowdfunding platforms to speed the availability of money in crisis situations?
• How can mechanisms for regional neutral bodies to intervene rapidly in the case of disasters be better coordinated?
• How can the voices of those affected by crises be amplified most effectively?

7 SAVE MORE LIVES (117)
Priority:
Improve access to life-saving assistance for people living in areas that are highly insecure and largely inaccessible to international and national aid organizations.
Research questions:
• What methods promote and ensure compliance (of non-governmental organizations, governments) with international humanitarian law? How can such laws be strengthened?
• How can the private sector improve the delivery of aid and increase the speed, effectiveness and cost-efficiency of delivering or manufacturing commodities (such as by 3D printing) in hard-to-reach places?
• How can crisis-affected people be supported or empowered to create their own local solutions — such as by locally manufacturing and reusing items?
• In what ways can military know-how and capabilities, including transport and logistics, be used ethically in disaster responses? What are potential political obstacles, and how can they be overcome?

8 SUPPORT MENTAL HEALTH (116)
Priority:
Offer emergency psychosocial support at scale.
Research questions:
• How effective are culturally sensitive and locally applicable emergency intervention programmes based on the World Health Organization’s Mental Health Gap Action Programme for mental health and psychosocial support? Where are there gaps and how can they be filled?
• What are the most effective ways for health-care providers to advocate for the incorporation of established ethical principles and more counselling into emergency mental-health intervention programmes?
• What are the population metrics and outcome indicators for mental-health policy and programme surveillance?
• Can artificial intelligence (such as chatbots or apps) deliver mental-health and psychosocial support, in a culturally sensitive and effective manner?

9 DEMOCRATIZE DATA ACCESS (113)
Priority:
Increase (digital) connectivity of affected persons to democratize access to information and opportunities, including market prices, wage information, weather, jobs, banking, insurance and microfinance*.
Research questions:
• What culturally specific and community-based strategies will efficiently and effectively integrate crisis-affected people with worldwide data sources?
• How can mobile-network operators become valuable contributors to preparedness before, and responses after, humanitarian disasters?
• How effective are existing innovative ways to share data in humanitarian settings, such as mesh networks, bluetooth technology, microwave technology and peer-to-peer networks? What other novel strategies exist?

10 BOOST DIRECT COMMUNICATION (110.5)
Priority:
Facilitate direct two-way communications between affected persons and humanitarian agencies, for the sharing of needs, developments, plans and actions.
Research questions:
• What are examples of low-cost satellite or other technologies that can facilitate logistics and cut response time in crisis settings, and how effective are they?
• How can non-governmental organizations, governments and other actors gain feedback from affected persons to improve humanitarian responses? How effective are online surveys, feedback apps and chatbots? What other novel solutions exist?
*Challenge reformatted and/or slightly reworded from the original submission to increase clarity and coherence.