Opinion Leader: Community-owned innovation meets community-based challenges

By Karlee Silver and Jocelyn Mackie

Karlee Silver and Jocelyn Mackie are co-CEOs of Toronto-based Grand Challenges Canada, which is funded by the federal government and other partners.

The Péligre Dam is just one example in a long history of innovations failing to improve lives.

In 1956, a modern hydroelectric dam was built in Haiti as part of a poverty-reduction program led by the precursor to the World Bank. The Péligre Dam flooded some of the country’s best agricultural land and displaced thousands of families. Haitian farmers lost their livelihoods and homes and, to this day, relocated families suffer from disproportionately high rates of tuberculosis and HIV infection.

Too often, decision-making, funding, and influence lie outside of the communities being affected. This top-down approach to implementing programs has repeatedly been shown to be wasteful, ineffective, and even harmful to the communities they are supposed to serve.

We now know how important it is that decisions are made by those closest to the challenges that need to be solved.

When local communities participate in identifying and solving their own problems, there is a sense of real ownership. They are more likely to be invested in sustaining and scaling up any innovation project they have helped create, along with the knowledge and relationships to develop lasting solutions.

Funded by the Government of Canada through Global Affairs Canada and by other partners, Grand Challenges Canada (GCC) has focused on shifting power to the communities where innovations are being implemented in the Global South and conflict-affected regions.

For the Indigenous Innovation Initiative, which is incubated at GCC, this means hosting a platform for First Nation, Inuit and Métis innovators to identify and solve the challenges their own communities face.

We are proud that the Grand Challenges Canada model has always focused on supporting innovators closest to the challenges they are working to solve.

For example, GCC’s Transition to Scale program has provided $220 million in funding for 253 innovations in 61 low- and middle-income countries. Of the projects funded through the program, 69 percent have been led by organizations from low- and middle-income countries, with 43 percent of the portfolio led by people who identify as women or non-binary.

So far, the resulting innovations have saved more than 55,000 lives and improved 11.5 million lives, with the potential to save 1.78 million lives and improve 64 million lives by 2030. In addition, more than 14,000 jobs have been created or livelihoods strengthened in low-resource countries.

Addressing challenges within a local context

As just one example, two female entrepreneur physicians from Pakistan, Dr. Iffat Zafar and Dr. Sara Saeed Khurram, have created a telemedicine platform that is helping solve two of their country’s biggest problems.

One is that Pakistan’s vulnerable population, which includes refugees, lack access to affordable, quality health care. Secondly, there is a dearth of doctors in Pakistan, in part because 60 percent of female physicians give up their practice due to cultural norms and pressure to start a family.

So Zafar and Khurram created Sehat Kahani, an affordable telemedicine service that allows female Pakistani physicians to work remotely from the comfort of their home. This solution would not be apparent to those from outside this context.

To date, the digital healthcare platform has mobilized a network of 5,000 healthcare providers and supported 19,000 clients. GCC’s investment of $1 million through the Humanitarian Grand Challenges program, at both the seed and transition-to-scale stages, is enabling the growth of Sehat Kahani under the leadership of its award-winning founders.

Drawing on lived experience

GCC ensures those who advise us on framing our funding calls, and those who evaluate the applications submitted in response to these calls, include people from the contexts where the solutions need to work. Advisors and reviewers with lived experience are often able to say “Why not?” rather than “No way.” This is critical for an innovation platform that wants to take appropriate risks on the ideas we fund.

We distinctly remember a reviewer, a Syrian refugee to Canada, who changed the minds of an entire selection panel in favour of funding a bold idea to address the challenge of wound care in Syria, dispelling the view that it would not work there.

GCC also seeks to hire more people who come from the places that carry the burden of grand challenges. These talented people bring a wealth of expertise and a breadth of relationships that help keep our work grounded in the complex realities of their countries of origin and communities.

The Indigenous Innovation Initiative (I3) was created in direct response to requests from Indigenous leaders to adapt our funding mechanisms, so that Indigenous innovators and communities could identify and solve their own challenges.

I3 has been shaped by the wisdom of its Indigenous-led team and Indigenous Innovation Council, made up of Indigenous leaders, Elders, and knowledge keepers. To date, it has funded 10 innovation projects by and for First Nation, Inuit and Métis women, Two-Spirit, queer, trans, non-binary and gender-diverse people.

Shifting the power and priorities in innovation  

Despite GCC’s efforts to have those with lived experience make the critical decisions, we have much more to do.

We still face the challenge of being a non-Indigenous organization in a high-income country supporting innovators from Indigenous communities, low- and middle-income countries, and conflict settings.

We continue to work at a distance from where innovations are needed, developed, and implemented. COVID-19 has made this problem even worse, making it harder than ever for those of us who work at a global level to build the relationships and trust required to have impact at a local level.

So we are exploring a number of ways over the next couple of years to shift the power dynamics in innovation even further to match the spirit of this principle: “Nothing for us, without us.”

Instead of setting funding priorities through our Program Advisory Council and Board of Directors (always in consultation with local and global experts), we are testing what happens when we follow the priorities set by local governments.

For example, in partnership with the Government of Senegal and the Bill & Melinda Gates Foundation, Grand Challenges Canada is supporting the newly launched Grand Challenges Senegal. It will fund innovators on priorities most relevant to Senegal and West Africa. This is the newest initiative within the Global Grand Challenges network, which leverages domestic resources to foster innovation to solve global health and development problems.

Similarly, we are funding work led by Insight Health Advisors, a health systems management firm headquartered in Kenya, that will enable two Kenyan county governments to identify the innovation priorities for their health systems, look for ready-to-scale innovations, and incorporate them into their plans and budget.

GCC will also test various trust-based approaches for grant management to gauge their impacts on the level of accountability we can offer our funders.

Finally, we are supporting the Indigenous Innovation Initiative to become a self-determining platform. We do not yet know exactly what this will look like, or by when it will happen, but it will honour Indigenous ways of knowing and being.

Ensuring success

We will know if we are on the right path when innovators and decision-makers, who do not normally have access to funding, are able to contribute to solutions in the global innovation landscape. We will also look to signals of ownership for innovations funded — for example, in procurement and policy changes that make space for new solutions — as a sign we are successful.

In effecting these changes, we expect to unlearn and relearn a lot. We will proceed with humility, fulfilling commitments made to those who trust us to steward their funds responsibly.

GCC was established to address inequities in the world through innovation. But, too often, the way power and funding is distributed in innovation ecosystems reflects and reinforces existing inequalities.

We believe that implementing a shift in power and decision-making is not only the most effective approach for achieving impact in global health, humanitarian assistance, and with Indigenous communities – it is the right thing to do.

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